शुक्रवार, 12 जून 2020

Whether Drs should earn?

It's totally ethical. Running a clinic, hospital is commercial per law, bijli pani property all charges are to be paid per commercial rates, then salaries of employees is there. In any Govt or Pvt hospital there're half to one dozen employees (प्रत्यक्ष + अप्रत्यक्ष) attending to a patient per day from sweeper to HoD. Then there're costs of sterlisation, airconditioning, laundry, medical gases, electricity back up, transport... endless list plus exigencies. That's why I always recommend people to NOT go to Pvt hospital if they cannot afford or doubt their charges. 
Simple OT gown comes for ₹1000-1500. What to talk of a PPE kit costing ₹350!  No quality check, most are not DGCI or Indian Pharmacopoeia approved. PPE kit must be impermeable to the tiniest of pathogen and it must be certified with criminal liability. Nothing's there in India right now. 

Some say 80% of Drs are unethical.  Because 80% population have negative ethics, Drs or any other professional are a cross section of this society only. 
It's a truth. Casting baseless  aspersions on the most noble profession is a reflection of one's thought process. 

Dr is NOT Bhagavan. 

Consumer Protection Act, Medical Establishment Act, Commercial Establishment Act and many other laws and judicial orders plus executive decisions explicitly say that medicine is NOT philanthropy but a fully commercial activity. Drs only protested it, everybody else sided with the system in this. Now after making medicine a market the Drs are conveniently blamed for the mess created by unethical people. If anybody in any business is criminally liable for astronomical monetary compensation and possible jail without expert opinion for every professional work it's natural he/she would safeguard oneself with money. Especially when medicine is legally considered commercial activity. 
Those who see Pvt Drs as villains must  consult Govt Hospitals only I always recommend. 

There was one old relative in a small town near a state capital who suddenly suffered AMI while in the capital, we were called up at midnight about suggestions, we told her to take her father right away to KGMU or SGPGI  whichever was close by after hiring an ambulance, she said OK, after a while she called again what to do, we said take him to Govt hospital urgent it's already late, she called us after a while and told us she admitted her father in a Pvt hospital as Govt Hospitals not good, we said a medical college is the best place for treatment and expenses are negligible but in Pvt everything with every visit will be billed so after he stabilises you take him to Govt hospital but she didn't pay heed to it and continued while complaining to us everyday that it's costly, we said we warned you to which she said she loves her father and did the best, we said then you must accept your own decision, in the end she was complaining that her lakhs were spent, mean the while we called up every treating Dr in that Hospital everyday to monitor his health and the Drs exempted professional fees for many visits, still she was unhappy saying the Drs loot the patients after her father was saved from death. 

Because the actual cost is always far more than what Govt empanelment schemes compensate to the hospitals. People want state of the art treatment done by most qualified Drs and the State of Art imported machines with branded drugs plus full personal care from latrine to medicine as well as 2 🌟 to 7 🌟 facilities  but want to not pay at all for their lives saved by all of the above, especially the Drs. All such thankless, selfish, ungrateful, rapacious, opportunistic unethical people are actually राक्षस।Most hospitals have not even received for years the dues amounting to even crores per hospital  under empanelment schemes from the authorities. 

Many a times it's being clearly pointed out that the dispensation has made medicine a business, not the Drs, in fact Drs always opposed the legal commercialisation of medicine. Can't blame Drs for the legal commercialisation of medicine by the system itself run by neta, babu, karporet, every one who matters in power. 
Insurance industry in medicine is the SINGLE BIGGEST PROBLEM making healthcare commercialised exponentially. It's the insurance industry which in cahoots with big corporate hospitals and pharma companies run the businesses in the name of healthcare and coerce the small fishes ie individual Pvt Drs to comply else be phased out of competition. Insurance companies have now entered Govt healthcare after gobbling up the corporate/Pvt health sectors. For these megacorps any patient or Dr is a client who help generate flow of money, Drs are not even experts of service providers but mere business generating units which must be ruthlessly replaced or eliminated if not profitable. In any karporet haaspeetal a medical bill has hardly 5-10% as Dr's fee, still the Drs get the blame and not the profiteering non medico owners of carpowrates doing all this in collusion with Pharma, Insurance,  hospitality & many other  industries. Laws for which are all made by Netas Babus. Govt hospitals are unable to get licences and permits for various departments and equipments despite multiple applications through proper channel but tycoons & carpowrates running the medical institutes get all such licences & permits in a jiffy. It's not a mystery who grants these . But blame the Drs!  


Then a patient avoids Govt hospital for lack of facilities and goes to 7 🌟 medicities and then cribs he has been billed in lakhs! What did he expect? Sheraton at the rate of nukkad kee kachori with dharmshala?? Ok, don't come to Govt hospital for all perceived reasons because line long, OPD not everyday, cannot meet favourite Dr.. so go to the neighbourhood friendly Dr to obviate all the above-mentioned troubles and after getting all the requirements met instantly crib about being charged ₹200 extra. Price of life is ₹200 or ₹2000000? It's way more, priceless! Yet, people who waste money on every harmful/useless  thing from samose chaat to pizza burger to cigarettes to alcohol to movies to toxic make up to  weekend parties to running  vehicles and shower repeatedly worthless people with all their monies for these poisons to destroy their health  yet cry hoarse for petty ₹ when their lives are saved by Drs. Life of a human being cannot be weighed even in crores of Rupees. 

For those unsatisfied with Pvt/carpowrate hospitals are welcome in Govt hospitals where the best talents in medicine work against all odds and there's no concern of paying any fee, forget cribbing about ₹200 or ₹2000000 for a precious life saved. 

 माननीय सर्वोच्च न्यायालय के आदेशानुसार किसी भी रोग की जाँच के लिये सभी आवश्यक प्रमाण होने ही चाहिये अन्यथा चिकित्सा को दोषपूर्ण अथवा आपराधिक माना जायेगा और चिकित्सक तथा चिकित्सालय को भारी दण्ड(हत्या की धाराओं के अंतर्गत) दिया जायेगा जिसमें करोड़ों रुपयों की क्षतिपूर्ति से लेकर सश्रम आजीवन कारावास तक दिया जाता है। ऐसे तुच्छ बतगोले साझा करने से पहले कुछ जानकारी भी प्राप्त करें। चिकित्सक की नैदानिक क्षमता अथवा अनुभव और ज्ञान को माननीय न्यायालय में प्रमाण नहीं माना जाता। प्रमाण होता है जाँचें। डॉ के समर्पण/भावना/परिश्रम/कौशल को चिकित्सा नहीं माना जाता है माननीय न्यायालय में क्योंकि वह व्यक्तिपरक है वस्तुनिष्ठ एवं सुसंगत नहीं है, अपितु सुविधाओं और विभिन्न कलपुर्जे/अवयवों के प्रयोग को ही चिकित्सा बताया गया है वैधानिक रूप से। 
The controversial Dr Kunal Saha case 👇
This particular disease happens one in millions, the three Drs who treated were the best and most experienced and did their best to treat the lady, unfortunately she succumbed to the condition in spite of the very best treatment given in the country. Her USA based husband, a Dr himself, registered police case in Kolkata, the three Drs served jail, their medical licences were cancelled, after years of litigation the honourable supreme court decided that the treating Drs were at fault because of 'wrong diagnosis' and must pay astronomical ₹5 Crs+ with interest as compensation to the 'victim'. 

हम सभी कहते ही हैं कि जीवन अमूल्य है, करोड़ों अरबों-खरबों रुपए से भी कहीं अधिक। माननीय सर्वोच्च न्यायालय ने भी करोड़ों में ही बताया। 
अब पैसे नहीं लगने देने हैं प्राणरक्षा के लिये तो सरकारी चिकित्सालयों में आइये। सरकारें, न्यायालय, प्रशासन ही तो वैधानिक रूप से निजी/कारपोरेट चिकित्सालयों को चलवा रहे हैं तो‌ वहाँ प्राणरक्षा हेतु २००, २०००, २००००, २०००००० ₹ लगाना तो हमारी पुरातन मान्यताओं अथवा  माननीय सर्वोच्च न्यायालय के मानदण्डों का दशमांश भी नहीं है।🙏 

यह जो सीजीएचएस, ईसीएचएस आदि सरकारी व्यवस्थाये हैं वह‌ तो स्वयं ही सरकारी कर्मचारियों, सैनिकों, अधिकारियों, न्यायधीशों, नेताओं, पत्रकारों के निजी/कारपोरेट चिकित्सालयों में अद्यतन प्रचलित खर्चे पर चिकित्सा कराने पर ही चल रहे हैं। तो जो यह व्यवस्था सुनिश्चित कर रहे हैं कि सात सितारा निजी चिकित्सालय हों उन्हें दोष न देकर भुक्तभोगी चिकित्सकों को दोष देना तो नितांत खोखलापन है। 

एक चिकित्सालय चलाने के प्रत्यक्ष तथा अप्रत्यक्ष व्यय, बिजली पानी, संसाधन तथा कर्मचारियों के वेतन भत्ते आदि की चर्चा तो तो पता चले कि वह आकाश से नहीं बरसते। तनिक भी संदेह मन में ना रखें, सरकारी सार्वजनिक चिकित्सालयों में ही आयें, आपका सदैव स्वागत है। और अपने लाखों करोड़ों रुपये निजी/कारपोरेट को व्यर्थ सौंपकर नष्ट होने देने तथा निजी / कारपोरेट को धनवान होने से बचायें। 

Whether private/corporate hospitals should be there at all? 👇 

No one condones negligence, every Dr is intolerant to it. Split second decisions in extraordinary circumstances by daring Drs are retrospectively scrutinised by non medico legal system for years and decades आराम से only to declare the Drs guilty for negligence. While judgement in murder, mass murder or child gangrape cases in‌ honourable courts takes not split second but decades and generations and mostly the accused roam free ultimately like Manu Sharma, Shushil Kr, Afroz. Cruel paradox that a filmy fellow's footpath run over case judgement has been reversed by the honourable HC then re-reversed by the most honourable SC ie total three verdicts in same case in three different courts in decades but split second decisions by Drs are negligence. So Drs are villains. 
Of course the cost of healthcare will rise if Drs have to be ready for indemnity in crores in any random case as the law of vicarious liability too has been discontinued with.
see 

The unfortunate patient suffered Toxic Epidermal Necrolysis which has 50% case fatality rate. The court case in Kolkata ran for 14 years during which one of the four "accused" Drs died. 
Now the compensation in this Kolkata case claimed was 77 Crores primarily and further 20 Crs were claimed ie total 97 crores. The plea said that the compensation should be calculated on the day of judgement as the amount of money the victim would have earned in USA plus the interest plus the compensatory amount. 
BTW Indian court 7 years ago awarded ₹ 11.41 Crs as the compensation taking into account the victims income in dollars plus interest. 

So in the current scenario Drs must ask for fees as the system decides because daktari is humanitarian selfless service but when punishment is to be given in a grave case where every other patient is known to succumb to the disease still punishment is to be given: the Drs must be jailed too and the compensation should be per the earning capacity of the patient, preferably in $,€,£ at current rates. 

Medicine is the most investment intensive and the least profitable business. Unfortunately it's considered business only by the system. Every licencing, charge, rate, levy, tax, cess is at or above market rate. Upon that medico-legal liabilities are abound and minimum at crores per case. You must be aware that echs, cghs, pmjay compensation to hospital are mostly half or lesser than even the costs incurred by the hospital/doctor per case. That's why I recommend better to use Govt hospital, if one can pull strings even better. 

Altruism and charity were good only till MBBS was the final degree, every doctor had job/earning surplus, there was no consumer act, medico-legal liabilities were not applied: ie till late 80s.. scenario didn't change overnight though.. but those who've joined MBBS in 80s are subjected to later MD SR DM MCh phalana dhimkana making studentship/trainee period over 15 years ie no income and still no job/earning surety plus every other case being a consumer act medico-legal liability. So doctors MUST NOT do charity.

 See here 👉

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