11 Monday
December 2017
Why are Gurgaon Doctors protesting?

In UK,17% of the nations budget is financial spend on healthcare. Poor countries like Sri Lanka and Bangladesh spend 6-8% on healthcare. Indian government spends 1.3% of budget on its people’s health.

The government hospitals, PHCs etc cater to 20% of the population, another 10% is given by Corporate hospitals. A whopping 70% of healthcare in India is provided by private clinics, hospitals and small nursing homes which are going to bear the brunt of this Central Clinical Establishment Act which the Haryana government is going to implement.

The CEA is 170 point document .The salient points of the Act are as follows.

– any serious patient comes to any clinic, the doctor has to STABILISE the patient. That means if a patient having Heart attack or stroke or woman in labour reaches my ENT clinic i have to do ECG/ delivery or transfer the patient in my OWN AMBULANCE with a Doctor in attendance and take to nearest referral centre ; at my own cost if the patient can’t pay!

– Any surgery or delivery can only be done if the centre has a 4 bedded fully equipped ICU.

-ICU should have one nurse per 2 beds, and all nurses should be registered. So a 4 bed ICU will need 8 nurses round the clock and we will have to bear the charges because the government will fix ICU charges, all procedure charges and cap the profit a medical organisation can make.

– if the doctor in whose name the registration is done dies, the registration is summarily cancelled. A fresh registration needs to be done , till then the hospital is unrecognised.

– any one can make even an anonymous complaint against any clinic/hospital/ doctor and the regulatory board can take suo moto notice and start proceedings for any allegation be it over charging, under treating, over investigating , excess waiting time etc

– if found guilty penalty is 1lakh, 2lakh, 5 lakh and even jail.

– the regulatory committee will consist of DC,Policeman, lawyer and one Doctor! And they will decide whether any medical irregularities have been done.

-there are also issues of 25 certificates for starting a nursing home including a NOC from the entire city, that means for 1 month after you decide to start a nursing home, posters will be put up and anyone in the city can come and raise objections as to why you should not open the nursing home.

This law if passed will make medical practise in a clinic / small nursing home impossible, will raise healthcare costs in corporate hospitals as well, and the capping on treatment charges will ensure that the private healthcare also becomes as bad as current government healthcare.

The public will suffer rising prices, and doctors will simply have to shut shop. The Haryana government provides just 20% of healthcare to its people, it is now ensuring that the balance 80% provided by private sector is also crippled and brought at par with the government sector. I assume that must be their intention as the general public sure won’t benefit from this ridiculous piece of legislation.

We urge the sane people of this country to stand with Doctors today, as the cost of your healthcare will be personally affected. Ask the government to stop meddling in private healthcare, tell them to raise the medical budget, stop siphoning off funds from public healthcare schemes and provide quality healthcare to the people who vote them into power.

If you keep quiet today , an entire generation of doctors will be wiped out, the neighbourhood clinic, the small affordable nursing home, and you will be paying through your nose for treatment in corporate hospitals. We will learn to earn a living by alternate means, but who will treat you when you are sick?

Please stand with your Doctors today.

Dr.Sarika Verma
ENT surgeon & Allergy Specialist

10 Sunday
December 2017
Why do Indians hate their doctors.

There has been media furore over the patients involved in two corporate hospitals in the last weeks, the health ministers statements and government action, public cheer over the actions and Doctor’s anguish in various forums. I’m trying to decipher essentially this public angst towards their healers.

In the public domain there is so much discussion about doctors taking cuts and kickbacks, corporate hospitals setting targets of revenue generation for doctors, unnecessary investigations, procedures and surgeries and pharma company sponsored freebies for doctors.

In the Doctors forums there are innumerable tales of being threatened by patients,serious violence and bodily harm, fear of assault and families unwilling to pay bills after a patients death. A rising trust deficit during treatment.

Every non Doctor I meet , has their own personal tale of how they were ripped off by a doctor or hospital and how anyone in their family would have never died had it not been for the greedy doctor/ hospital.

My mother in law died after a small bronchoscopy procedure , and I saw the doctors and nurses tried to save her day and night. We lost her , but I thanked the 3 doctors who tried to save her life. All 3 of them attended her funeral. The bill of almost 4 lakhs was covered by insurance.

I’m beginning to wonder had we paid the 4 lakhs out of our savings and had I not been a doctor, understanding the medical complications and being explained in detail every day, would I have been as understanding? Would I feel the same magnanimity and appreciation for our attending physicians? And that I think is the crux of the public-doctor hate story today.

Less than 10% people in India are covered by health insurance . So 90% people have the option to visit a government hospital which except in cities like Delhi and Chandigarh do not offer comprehensive tertiary health care, have non functioning CT and MRI machines, do not have enough ventilators, intensive care units, neonatal ICU etc. They are also overcrowded, not air conditioned, fairly unsanitary and very poor conditions of patients.

The public , whoever can afford to, and many who take loans just to save their loved ones, pay their hard earned savings. This is the crux of the anger. When the money invested saves the patient, its a story about how much the doctor /hospital made out of their misery. And if the patient dies, it’s a full on diatribe on how the hospital killed a dear one and want to make money over the dead body.

If like the National Health Service (UK) we were all covered by a government sponsored comprehensive health care program, we would also wait patiently to be seen in the ER for 14 hours before we were attended to. We wouldn’t raise our voices or our hands on the health workers because they have a zero tolerance for such behaviour.

Alternatively, a system like the USA where people pay huge amounts of money annually as insurance premium and then are treated at private hospitals cashlessly. They crib and complain about the high insurance costs,but they know they are paying for their healthcare and never dare to raise hands on doctors or think of breaking a clinic or nursing home. Because that simply lands them in jail.

In India, except Delhi, no other state has government hospitals working as tertiary care centres. In Tamil Nadu , the government has a comprehensive insurance policy. Every citizen is eligible for treatment at private hospitals cashlessly while the government pays for their treatment. In the rest of the country, people sell lands and Jewelry for transplants, deliveries, cancer treatment and when the patient dies , they hate their doctors.

Beatings, assault, destroying property and frivolous FIRs are the order of the day, and doctors now genuinely believe their profession is injurious to their health.

Maybe there could be a central government initiative to make universal healthcare insurance a priority. Once quality healthcare is provided to patients and they don’t have to pay for it, they will stop questioning every investigation, and start believing that the doctors are doing their best to save their patients too.

In the end it’s all about the money. Not morals, humanity or doctors becoming businessmen.

Dr Sarika Verma
ENT Surgeon & Allergy Specialist