Practice of modern scientific medicine is being made more and more difficult by increase in arbitrary laws and interference of judiciary in purely medical professional decisions. This has simultaneously been quixotically supplemented by allowing all kinds of quacks the right to practice modern medicine. The standards and the rules imposed on the qualified practitioners of modern medicine are all waived off and outright illegality promoted while legitimizing crosspathy.
What to talk of writing generic medicines legibly, 85% of the doctors , 9.5 lac MBBS and about 30 lac non MBBS practitioners of modern medicine do not give prescription but do dispensing of open medicines. At least when I prescribe a trade name my patient after purchase knows what is the components of the medicine. All the medicines which are dispensed remain clouded in mystery even after the patient has received them. If a Ayurvedacharya had to write the generic components of the Ayurvedic medicine on his prescription it would require extraordinary intelligence, calligraphic skills and patience with rims of paper.
So effectively all the ruckus being created about legibility of prescription and generic drugs is only for the 15 % of doctors who are prescription writing and are mainly specialists in various fields of modern medicine. The analytical result of the discussion is “It is legal to dispense medicine but illegal to prescribe medicine” Or to put it in another way, it is very easy to detect an illegality in any prescription.
That India resents its practitioners of modern medicine is evident. There is a political compulsion of every Government to create a Bogey of someone who can be blamed for its failures. In times of Indra Gandhi it used to be “Foreign Hand” . Everything wrong happening in the country used to be blamed on foreign hand. Our current Government has found a more convenient “Villian” the cardiologist who puts stents, the modern medicine practitioners who prescribes medicines and they are lampooned at election rallies to gather votes. People are after all sensible and they are no longer swayed by partisan politics of blaming the other political party or caste. But when a national leader dramatizes putting a stent as a crime in an election speech the issue is emotive and all sections of society across party lines and caste divides respond to it. After all out of pocket medical expenses have ruined many a families.
What needs to be asked is why , sir, are your subjects needing to spend on health from their pockets. Is it not their Government’s responsibility to provide them health care facilities which will look after them in their hour of need. But then that would require money to be spent by the Government. That this dramatization has fanned the incidents of violence happening against hospitals is of course a moot point.
But are we not also at fault. We sell ourselves short. Since we are available for a pittance we are considered expendable and replaceable. If some consultants leave the country or stop practice due to such issues it is not considered a loss. Why can our leaders in medicine and those at the top of their fields not set the trend and value their worth. If a consultation with a Senior advocate can cost Rs 50000 why our Padam Sri Doctors provide their consultations for Rs 700-1200. Because we are available cheaply and at all odd hours we are considered cheap. I have still failed to instill a sense of discipline regarding appointments in my patients. The crux of the matter is that either turn into dispensing doctors where your medicines will remain cloaked in mystery, your aura will grow with the amount of steroids you secretly dispense or if you wish to prescribe and practice ethical medicine then charge more.
Once a patient is given appointment after 3 months to see a specialist even with payment of a consultation fee of 20000 , automatically the value and worth of a doctor will percolate into the society. The same NRIs who wait patiently for their turn to see the cardiologist in UK for more than 4 months will in India demand the services in a tone as if the angiography should have been done the moment they stepped off the plane onto their mother country. This can only be changed by the leaders in their fields and only then the culture of valuing our services will trickle down.
My point is simple. If I am supposed to counsel my patient before every procedure or even while writing prescriptions which would now be lengthy, take consent for every thing I may need to do or which may happen inadvertently, do everything in a way that courts and authorities cannot find fault with it, equip myself to comply with standards set by armchair experts, then I need to be paid more.
I am reminded of an article I had written earlier titled “My Hero” available at https://www.facebook.com/medicoslegalactiongroup/posts/567153570061731 . This needs to be read again.
There is of course another way. Resign from your registration in State Medical Council. Change your name to something else , change your place of work and start afresh like a quack. No rules will then apply, Government will support you, and courts will be lenient on you in case of mishap.
Dr Neeraj Nagpal
Convenor,Medicos Legal Action Group, Managing Director MLAG Indemnity,
Ex President IMA Chandigarh
Director Hope Gastrointestinal Diagnostic Clinic,
1184, Sector 21 B Chandigarh
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