Thursday, May 19, 2022

Editorial

Jaipur Gynaecologist’s Suicide or murder by our sick system ?

PUNJAB NEWS EXPRESS | April 03, 2022 02:27 PM

Dr.AMARDEEP AGGARWAL
CHANDIGARH: In Jaipur a gold medalist gynaecologist allegedly committed suicide by hanging herself, after an FIR was filed against her under section 302 of the IPC (murder) for the alleged death of a pregnant woman who she was treating. A suicide note was recovered from the scene in which the doctor wrote that the patient had died during a normal procedure. The deceased doctor has been identified as Dr Archana Sharma (42).

On Sunday night, a 22-year-old woman was brought to Anand Hospital with labour pain. Despite taking her to the labour room, she was bleeding profusely, and she allegedly died due to excessive bleeding. The woman’s kin gathered at the hospital and alleged medical negligence as the cause of death of the 22-year-old woman. The relatives of the woman protested outside the hospital and an FIR was lodged against Dr Sharma under section 302 of the IPC.

Doctor’s associations are requesting government to take immediate measures to put an end to mobocracy for the doctors- the growing trend of blackmail of doctors by hooligans in the garb of powerful unions, assault on doctors, vandalism in hospitals, booking of doctors under different sections following death of a patient. Governments need to ensure sense of security amongst doctors who routinely deal with serious patients grappling with life.

Brutally assaulting doctors and criticizing the medical profession 364 days in a year and then celebrating Doctors day and calling them second God on a single day and then expecting doctors to continue service to humanity undeterred has become fashion in today’s India. Even during ongoing Covid-19 pandemic where doctors have been working day in and day out as frontline soldiers without expectations of any any posthumous military honours, governments aren’t hesitating in demoralizing the medics of India. While Covid-19 has exposed gaps in public healthcare systems – the gaps that exist even after 75 years of independence, state governments aren’t hesitating in making doctors a scapegoat for poor infrastructure, poor planning of which doctors have not been a vocal part. After beating ‘thali’in honour of doctors on one day, many doctors have been receiving the beating thereafter.

Hollow adjectives such as second God are showered lavishly and lip sympathy is given to the lives of doctors on Doctors day, the plight of individual doctors in our country is not hidden from anybody. While government has not been able to improve its public sector hospitals, government is trying to pin all responsibilities on doctors. Following are few of its examples:

Government as well as society expect us to charge fees at nobility rates , compensation at commercial rates , Patient misplaces records -Private doctors have been asked to maintain them (try getting a record from a government office!), Patient doesn't bring record- private doctors to make it electronic so patient need not bother to bring it, Government ambulance may not be available- doctors responsibility to transfer patients to tertiary hospitals even if the patient has a vehicle, Government hospitals' funds inadequate- so private doctors to treat emergency, trauma free, Government can't reduce the incidence of rapes or acid attacks- so doctors should treat them free, Government can't cope up with deliveries- so doctors to conduct free deliveries on 9th of every month, Government cannot provide health for all-so it brought CEA and thereby tried to fix rates for procedures, Government cannot provide health for all-bring in useless cashless schemes and force doctors to toe the line, Third class traffic management and trauma patient transport system-let patient go to nearest hospital and then the doctor is responsible for transport, Many more such inabilities of the government are covered up by putting the onus on doctors, Patient confidentiality to be respected- doctor’s reputation can be mauled, Doctors to pay for everything on commercial rates - and still expect the nobility to remain, Get medical profession into the consumer court , and still not expect to be paid as business enterprises.

Respective governments have been ignoring public health due to deficiency of doctors in government hospitals. Instead of improving public health sector, governments have been trying every now and then to put the responsibility of public health on shoulders of private doctors. For these reasons exodus of doctors is further deepening the crisis. Illegal capitation fees in private medical colleges, a health-services inequality between urban and rural India and a disconnect between the public-health and medical-education systems. India is short of atleast 5.5 lac doctors and the gap may widen in days to come if government doesn’t give health a priority and serious thinking.

Medical professionals are daily grappling with emergencies in which there is a very thin line between “live” and “dead” status of serious patients. Slightest of error of judgment attracts wrath of relatives, society; adverse propaganda in media and huge compensations from consumer forums/ courts in the name of deficiency of service. Modern day society has an inbuilt hatred and suspicion against doctors that may even manifest as ransacking/arson of pediatrician of Mansa on one day and gunning down of Jind doctor at another day. Advancement of technology has also in a way contributed more negativity against the pious medical profession as most of the prescriptions and case records are tallied with google to detect slightest of deviation from Dr Google’s expert line of treatment. Doctor building up his house after 20 years of hard work is termed as “lootera” building up his house out of public’s money, Doctor owing a car gives gossip- “logo ki jeb kaat kaat kar gaadi mein ghoom raha hai”, Doctor goes abroad even for attending a conference makes people think “zaroor kisi company ne trip sponsor kiya hoga”. Doctors face assault, hospitals are ransacked after death of a patient and rioters have rarely been punished so far. Numerous acts, unending list of legislations, rulings etc added to such vulnerability make medical profession less sought after in India these days. Today, Doctors in India are in a frightened state of mind and usually don’t wish their wards to opt for their career. Entrepreneurship (setting own hospital) amongst doctors has taken a back seat, young doctors are left with three options- move to foreign countries for want of security and better prospects, join government service (if available) and finally joining corporate hospitals in search of better deal. Talking of public health scenario of India, even government hospitals are in a bad state with huge rush of patients, very less specialists and unimaginable number of surgeries/ deliveries/ caeserians with respect to number of gynaecologists/ surgeons/ anaesthetists. Episodes such as Chhatisgarh sterilization deaths where poisonous medicines of government supply killed the patients, but the doctor R K Gupta; labeled as doctor death is still behind bars leave a permanent scar of fear and insecurity on the minds of doctors.

In order to provide state of the art healthcare facilities one has to spend atleast 750 Crores for a 300 bed hospital. After spending this much amount commercialism is bound to creep in and expenses on healthcare are bound to be sky high. On the contrary small setups with modest facilities, are within the reach of most people and provide a blend of good competence with affordability. Obviously if one is going to a hospital with world class facilities, he shall find deficiencies in the relatively affordable small setup. But consumer law and forums in many of their orders expect even small setups to provide same world-class care. Crux of the story here is that medical profession is dogged with innumerable problems; a few of them described here below:

It is a matter of great concern that in spite of the clear guidelines laid down by the SC in Jacob Mathews Case in Aug 2005 that a preliminary enquiry is must before entertaining a private complaint against a doctor alleging negligence , police officers keep on registering cases under section 304 A against doctors and have even arrested them. Following such event there are bound to be headlines painting doctor as a Merchant of death, Doctor Death etc. Even if the doctor is proved innocent in the medical board’s report, the career of the doctor stands finished by the rash act on the part of police as well as such ruthless journalism. The offence under Medicare Services protection Act (in many states) is Cognizable and non-bailable and it has a provision for one year imprisonment and fine of Rs 50, 000- along with penalty of double the purchase price of the medical equipment and property damaged .But the police concerned officers don’t book the culprits under the provisions of this Act in spite of the insistence by the complainant doctor and thus dilute the case. This encourages the miscreants to create trouble at hospitals and nursing homes. Rising cases of assault on doctors and ransacking of the hospitals is testimony to the fact that the desired motive of this Act has not been achieved due to its faulty implementation.

In the name of Biomedical waste disposal medical profession has been given under pollution control boards, in the name of fire safety it has been given under fire department, in the name of safeguarding of ethics it has been given under state medical councils, in the name of checking sex determination/femicide it has been placed under Civil Surgeons, in the name of hazardous profession municipal corporations keep serving notices of license fees etc. No such taboos apply to quacks, tantriks who are free to do what ever they like and even give advertisements for their claims. Rules of the game have to be the same, same have to be the yardsticks.

Doctors are a part of society, none denies the degradation of moral values of society; some medicos are also bound to sweep along the downward waves- but that is the reality in most other professions also. That does not justify genocide of doctors. Many positive steps are needed to be taken by society as well as government to boost the sagging morale of doctors in India; otherwise the day is not far when there will be total exodus of doctors from India! God save the society!

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