front cover page · dr. gajendra tomar dr. sona pungaonkar dr. hemant dugad dr. suhas shah dr....
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Vol. 47 | Issue No. 2 | August 2018
TheGRASP
For Private Circulation Only
Official Journal of the Association of Medical Consultants, Mumbai.Published Quarterly in May, August, November, February
MedicalPractice
1Vol. 47 Issue No. 2 August 2018| |
President Dr. Vipin CheckerPresident Elect Dr. Mukesh GuptaImm. Past President Dr. Smita SharmaVice President Dr. Ajit K. DesaiVice President Dr. Deepak BaidHon. Secretary Dr. Sushmita BhatnagarHon. Treasurer Dr. Nilima Vaidya-BhamareJoint Treasurer Dr. Manoj PatelJoint Secretary Dr. Rajendra NagarkattiJoint Secretary Dr. Rajeev AgarwalOffice Secretary Dr. Supriya Arwari
Prog. Committee Chairman Dr. Vivek DwivediEditor - The Grasp Dr. Kritika Doshi
Director Dr. Lalit Kapoor
Office Bearers (2018-2019)
Dr. Ajit K. Desai Dr. Dilip Naik
Dr. Rajendra Chawhan Dr. Sabh Singh Khambay
Dr. Sujata Rao Dr. Kishore Adyanthaya
Dr. Gurudas Kulkarni Dr. Debashish Das
Zonal Directors
Area Representatives
Consultant Benevolent Scheme Dr. Shrikant Badwe
H & A Cell Dr. Suhas Kate
MMC Cell Dr. Bipin Pandit
AMC-NoAH Dr. Niranjan Agarwal
Medicolegal Cell Dr. Sudhir Naik
Social Service Cell Dr. Shivbhagwan N. Agarwal
Media & Communication Cell Dr. Veena Pandit
Affiliate Unit Cell Dr. Kishore Adyanthaya
Chairperson of Cells
EDITORIAL BOARD
BOARD OF TRUSTEES
Editor
Co-Editors
Advisory Board
Managing Trustee
Trustees
Website
Web Editor
Web Co-Editor
Dr. Kritika Doshi
Dr. Mukesh Gupta
Dr. Lalit Kapoor
Dr. Sujata Rao
Dr. Pradeep Baliga
Dr. Suhas Kate
Dr. Umesh Oza
Dr. Achut Nayak
Dr. Suresh Rao
Dr. Shrikant Badwe
Dr. Sabh Singh Khambay
Dr. Niranjan Agarwal
Dr. Ashok Shukla
Dr. Neeraj Bijlani
Dr. Nikhil Datar
www.amcmumbai.com
Disclaimer
Unless otherwise stated, the opinions expressed
by the writers are their personal opinions, The
AMC reserves the right to use material published
in ‘The Grasp’ for its Website or for any other
purpose deemed necessary.
The appearance of advertisement in ‘The Grasp’ is
not guarantee or endorsement of the product or
the claims made by the manufacturer / advertiser.
ASSOCIATION OF MEDICAL CONSULTANTS, MUMBAI4, Ganpati Niwas, Old Police Lines, Opp. Andheri Station,
Andheri (East), Mumbai - 400 069.
Tel.: 2684 4639 / 2683 6019 (10 a.m. to 6 p.m.)
Telefax : 2682 1109
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AMC INDIA Project
Edited by : Dr. Kritika Doshi
Co-ordinated at JASMINE ART PRINTERS PVT. LTD.
Plot No. A-737/3, TTC Industrial Area, Khairane MIDC, Navi Mumbai - 400710. India.
For Association of Medical Consultants, Mumbai. (For Private Circulation Only)
Dr. Aashish Mody Dr. Pradnya Kulkarni
Dr. Abhijit Kale Dr. Prakash Patil
Dr. Alok Modi Dr. Prashant Kerkar
Dr. Anil Parmar Dr. Rahul Rane
Dr. Aparna Govil Dr. Rajednra Tiwari
Dr. Debraj Shome Dr. Reena Wani
Dr. Deepak Vaidya Dr. Ritesh Agarwal
Dr. Dhiren Kalawadia Dr. Sanjay Pattiwar
Dr. Gajendra Tomar Dr. Sona Pungaonkar
Dr. Hemant Dugad Dr. Suhas Shah
Dr. Mandakini Megh Dr. Vidya Shetty
Dr. Narendra Dedhia Dr. Vikram Khanna
Dr. Neeraj Bijlani Dr. Vikrant Desai
Dr. Nikhil Datar Dr. Vivek Sheth
Dr. Pradeep Baliga
2 Vol. 47 Issue No. 2 August 2018| |
Edit Speak - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 03
President’s Precept - Dr. Vipin Checker . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 05
Hon. Secretary’s Report - Dr. Sushmita Bhatnagar . . . . . . . . . . . . . . . . . . . . . . . . 07
DOs AND DON’Ts - Dr. Lalit Kapoor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Website Update - Dr. Ashok Shukla . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
AMC News. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
M@ILBOX. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Achievements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Lack of Monitoring is Medical Negligence - Dr. Suganthi Iyer. . . . . . . . . . . . . . . 22
''Doc in the Dock'' Points to Ponder - Dr. Harish Shetty . . . . . . . . . . . . . . . . . . . . 27
Visual Delight - Dr. Ketki Marthak . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Healthcare Financing & Health Insurance Models - Prof. Sushmita Bhatnagar . . 32
Ayushman Bharat Yojana :
Impact on Medical Professionals - Prof. Sushmita Bhatnagar . . . . . . . . . . . . . . . . 38
Doctor’s Day. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Doctor’s Day PARTICIPANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
From The Press - Dr. Pradeep Baliga . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Dr. Kritika Doshi
Vol. 47 | Issue No. 2 | August 2018
3Vol. 47 Issue No. 2 August 2018| |
Dear Friends, fight-or-flight response. We all experience
some daily stress which is unavoidable."It's not the load that breaks you down, it's
Unfortunately, today, doctors in India facethe way you carry it"..................... Lou Holtz
constant, un-resolving stress - which is a
st July as you all are aware is celebrated problem because it is additive and begins to 1as Doctor's Day. As part of Doctor's Day, impact health, personal behavior and
I was a part of the blood donation drive in relationships. We need to acknowledge the
Thane. There were many doctor colleagues impact such chronic stress is causing on our
who wanted to donate blood but were found daily life. There are many scientific reports
'unfit' and rejected in the screening process. of the health problems associated with stress
Medications for hypertension, Diabetes, like Cardiovascular disease, obesity,
Hypothyroidism, history of Dengue/Malaria diabetes, depression, anxiety, immune
in past 1 year, anemia….these were the system suppression, headaches, back and
common reasons for rejecting the donor. The neck pain, and sleep disturbances. Due to
Blood Bank officer mentioned that they easy access to anxiolytics, antacids,
(blood donation camps) had a better response sedatives and analgesics, many of us use
in the blood donation drive with corporate them without bothering about correcting the
entities and in camps at Railway Stations. underlying cause.
Are we - the "healers" not as "fit" as non- We are readily available for our patients and
medical people? colleagues; but many of us don't have the
same patience or time for our families andShould this worry us? Is there a study on the
ourselves.physical and mental health of doctors in
India? How resilient are our medical students We lose our social support system of family
and junior doctors? and friends in the desire to become
'successful' consultants. Finding a balanceThe 'Stress' of medical practice is growing
between 'adequate' work and relaxation isand it has an impact on our physical and
extremely difficult due to the prevailingmental well being. We know that 'stress' is
system of private practice.the disruption of the body's homeostasis or a
state of disharmony in response to a real or There is no social security or health
perceived threat or challenge and the body insurance for private Practioners. They have
responds to it by autonomic and endocrine to self fund themselves and invest large
EDIT SPEAK
Dr. Kritika Doshi
4 Vol. 47 Issue No. 2 August 2018| |
amounts to begin their practice causing A disturbing forward on WhatsApp on
financial stress. Added to this, the changing "Doctor Suicides" has been written by a
family physician Dr. Pamela Wible. In 5policies in healthcare further add to the
years, she has 757 Doctor Suicides on hermental stress.
registry. I hope we do not see such a trend inDue to the rapid evolution of digital
India among our medical fraternity.technology, various digital tools are
We are fortunate that we Indians are veryavailable at a click on one's smart-phone. Wefamily oriented and social. This year'sare becoming lonely as we go away fromDoctor's Day celebration saw AMCdirect human interactions and prefer 'on-line'members perform and showcase their talentsinteractions. Our young boys and girls havein front of the members. It was wonderful tostruggled for 10-12 years to qualify fromsee the applause every performer receivedvarious medical colleges (often from placesfrom the audience. We need to make aaway from home) and become consultants.conscious effort to come together at all AMCThey spend their youth studying andmeetings and strengthen our bonds oflearning, without having the time to developfriendships with each other in addition to ourdeep friendships or stress busting bonds withprofessional relationships. As consultants,neighbors and family.we understand and comprehend the daily
The long working days as Residents are work issues and work stress faced by us.necessary and we 'adjust' to 'odd hours'. The Who else can offer us better support andresult is that, we are so used to working for comfort in our times of need than our ownlong hours without a break that attending a 3 colleagues!day family wedding with no medical talk
I hope you enjoy this GRASP - dedicated to makes us restless. Switching off the mobileAMC Doctor's Day.phone and being 'unreachable ' is
unthinkable! It may be time for us to invest "Alone we can do so little, together we can domore in our relationships to cope with the so much"................................. Hellen Kellerstress of medical practice. Dr. Harish Shetty
has in his inimitable style urged us to ponder
on some valid points. [email protected]
Like us on :
Media Cell Response :
Twitter : @AMCMUMBAIFB : https://www.facebook.com/amcmumbai
Send your Feedback on
https://timesofindia.indiatimes.com/india/doctors-miffed-with-pm-modis-remarks-on-them-in-london/articleshow/63867664.cms
5Vol. 47 Issue No. 2 August 2018| |
The problem is multifaceted and the solution"efoue keâer yeele" - "Straight from the Heart"is not easy.
Dear Colleagues,There are a lot of things associated withGreetings for the Seasonmedical profession which are not in
n today's society, the Medical Profession our hands: I will enumerate a few asIand Medical Professionals are going following :through a tumultuous phase. We are faced
• Poor Public Healthcare Infrastructure.with policy developments which affect usadversely, with the "noble image" taking a • PoorAllocation of Budget for Health.beating and doctors working under the
• Implementation of Government Policieshanging sword of "CPS" and medical
and Programs related to health and familynegligence. The senior medical practitioners
welfare.will remember the days when we the doctors
• Omnipresent and Ever Pervasivewere considered akin to god and doctorsCorruption in our Society.were given a lot of respect in society.
• Red Tape And Bureaucracy's ReluctantTime has changed and slowly and slowlyAttitude.now we are living in the era where we are no
more God and as per law we are service • Crumbling Infrastructure of Public Healthproviders and our patients are our Delivery System.consumers.
• Overburdened and i l l equippedNow we are living in the era in which the government hospitals and health centres.medical profession which was considered as
• and Many more.a noble profession is now under attack from all quarters of the society. Situation is so Let's see what we can do to improve the
depressing that the people who have inside situation….
knowledge about medical profession, don't Let's do some introspection and find out if werecommend their children to enter in this can help to change the situation for the betterprofession in India. outcome and better results.
Have we ever thought why our profession We are seeing a lot of doctor bashing and wehas lost the sheen and the same profession are attacked by mobs at the slightest pretext which was once considered as the best and sometimes health centres are alsoprofession amongst all profession is now damaged.getting brickbats from the society for all the
I think we should do everything in ourwrong reasons?
PRESIDENT’S PRECEPT
Dr. Vipin Checker
6 Vol. 47 Issue No. 2 August 2018| |
capacity to change the perception about our Our equipment and instruments should be
profession and professionals. calibrated properly on a regular basis andFire and Bio Medical waste disposal shouldTo start with we should emphasise on properbe complied properly.
communication with the patient and weI feel that we should include communicationshould be humble and empathetic while weand empathy in our medical curriculum forare communicating with the patient andour medical students so that the comingpatient's relatives.generations are well versed with the
Communication if done in a proper way can importance of these topics and it will help to
stop so many untoward incidences.r educe v io l ence aga ins t med ica l
We should be good to our patients, professionals in our society.
And we should be transparent in dealings AMC is working overtime in this directionwith our patients. and through our CMEs and Social Media we
it's our constant endeavor to make ourLet's pledge that we will not take any freebiescolleagues aware of the importance of thesefrom pharma companies or will not take anyissues to take corrective steps to change theparties from pharma companies (we all knownegative perception about our profession.it's unethical but it's also open secret that it's
prevalent in our profession). It's an ongoing process and it should continuein future also till we regain our lost glory andLet's pledge that we will not do medicalmake our profession a noble professionjousting.again.
Our prime motive should be our patients'Before I sign out, Team AMC has done awell-being and their safety and care and wetremendous job of connecting & impartingshould have zero tolerance to lacuna in safetymedical education with 21 CME pointsstandards and equipments.(excel sheet on page…….)
Our hospitals should be registered properlyYours Trulyregularly and all required criteria should be
followed properly. [email protected]
AMC's
presented to
Senior PI
Juhu Police
Station
"Medicolegal
Manual
For Police"
7Vol. 47 Issue No. 2 August 2018| |
My DearAMCites, programs in several areas of Mumbai, Thaneand in peripheral areas. AMC schemes,
he Association of Medial Consultants isvision and mission has been widelyTin an extremely dynamic phase and thedisplayed through these connect programs
most appropriate word to describe this phasewhich helped members understand the ideals
isACTION.which AMC symbolizes. 11 Connect
The first quarter of the AMC year 2018-19 programs have been completed with appx.900 members utilizing the educationalshowcased a wide range of activities of theactivities and assimilating 12 MMC creditAssociation, the synopsis of which reacheshours.you all periodically. I am sure you all are as
thrilled as I am with the exposure, outreach 2 Nurses training programs have beenand the kinship what we all are experiencing, conducted in the AMC Zone F - Miraboth within the managing committee and Bhayander & Badalapur successfully withwithin the entire membership base. training imparted to 242 nurses.
AMC has always promoted and is AMC Zonal CME's have been conducted in 3continually committed to Safe and Ethical zones since April 2018 in SEXPLORE inhealthcare delivery systems, pursuing Best Juhu, ADOLESCENSE in Mira Road,Practice Guidelines, educating on Duty of ENHANCING MEDICAL PRACTICE &Care, enlightening the members on Legal PRODUCTIVITY in Chembur. Appx. 400Aspec t s o f Hea l thcare , s eek ing AMC members attended the Zonal CME'sCommunity Enhancement through social and assimilated 6 MMC credit hours.service projects and supporting each and
1st July, the Doctors' day, showcased aevery member in distressing times. Inthoroughly enjoyable entertainmentaddition, being connected with each otherprogram this year wherein the AMC
has been remarkably achieved this year withmembers showcased their talents in other
'On the Field Events', 'Social Mediaspheres such as singing, dancing, musical
Events'. To promote the needs and interests instruments, mimicry, etc. This program was
of the members as well as the medicalheld at Rangmandir at Bandra. The highlight
profession, lot of enterprise occurs and it isof this program was felicitation of Dr. Achut
an obligation to address the 'BackendNayak with Distinguished Services Award
Events' as well as the 'Upcoming Events'.for his meritorious contribution toAMC.
On The Field Events :Not just the Doctors' Day, but the entire week
This year marked the dawn of AMC Connect was celebrated as Doctors' Week by
HON. SECRETARY’S REPORT
Prof. Sushmita Bhatnagar
8 Vol. 47 Issue No. 2 August 2018| |
organizing Blood and organ donation camps tackling any issues related to the medical
at several centers across the city. About 150 professionals, in providing help to our own
bottles of blood were collected and colleagues in the medical field and in puttingapproximately 300 people, including in the best efforts in resolving conflictingmedical professionals visited the camps and situations. The upcoming Ayushman Bharatmany pledged to donate their organs. Yojana has provided an opportunity to AMC
to represent it's members, liase with theSocial Media Events :concerned Governmental bodies in New
Effective operation of social media such as Delhi and meet them personally to discussmobile based apps, Facebook, Twitter, etc. the best situations and options for our ownhave benefitted members in capitalizing and friends. It was indeed an honor to meet thestaying up-to-date on several aspects such as CEO of Ayushman Bharat who greeted usupcoming AMC activities, expression of warmly and gave us his undivided attentiontheir views and ideas, staying informed when to discuss the issues faced by us, thethey were not able to attend meetings/CME's caregivers. Detailed report is published inand also share our achievements within the subsequent pages of this issue.medical community and beyond. The AMC
A survey is being conducted by AMC onFacebook page has 1149 followers and 367'Violence in Healthcare', the link of whichtweets on Twitter thus allowing members toshall be sent to you. I request your co-disburse information far and wide.operation in taking the online survey and
The website ofAMC and the mobile app is in prov id ing AMC with meaningfu lthe phase of being updated with introduction information so that AMC can intervene withof online payment options for CME's as well concerned authorities and take part in theas for membership of AMC and its various rectification process. In this survey, youschemes for the ease of operations and could also report any incidence of violencebenefit of the members. Distress call that you have been able to deal with yourselfapplication, SOS, is also provided to the
without any external support.members in case of emergency situations
Apart from the above, there is a lot of workespecially with violence against thegoing on behind the scenes and this includesregistered member. In case if any of you havethe multiple meetings per week of the officeany situation demanding AMC interventionbearers, program committee, websiteregarding violence, please don't hesitate tocommittee and so on and so forth.press the red SOS button on front page of
AMC Mobile app. Looking at the Sion Upcoming events :hospital episode on 24th of July, it is obvious
AMCON, the Annual conference of AMCthat once the mob is incited, they can harmhas already been announced and will be heldand damage whatever comes in their way.on 18th November at D. Y. Patil Auditorium.Violence in healthcare is on the rise, and it's This is our rapidly approaching star endeavorour responsibility to be well-equipped by allwhich we all look forward to. The AMCmeans to face this growing menace.Premiere League Night Cricket in D.Y.Patil
Backend events :Stadium following the AMCON is
AMC has always been on the forefront in something not be missed.
9Vol. 47 Issue No. 2 August 2018| |
AMC Connect programs and Zonal deal with the lacunae ourselves and thus
programs will continue till the end of this strive towards a peaceful professional life.
year and let's all of us make the best out of it. We can succeed only if we work in greater
unison and follow the path of our MissionMy dear friends, let us all join hands, support
and Commitment. I wish to quote Tonyeach other, rekindle faith in our profession in
Robbins before ending my report and Ithe eyes of the public, media, government,express my gratitude to all of you who arepoliticians and everyone else. Let's comewith theAssociation of Medical Consultants.together to face the most pressing challenges
in the country today, Violence in Healthcare. "The path to success is to take massive,And let us all also work for curtailing the determined actions." - Tony Robbinssituations of violence by advanced
communication skills and thorough patient
counselling. We can do self-assessment and [email protected]
ASSOCIATION OF MEDICAL CONSULTANTS
MEMBERSHIP
Total Membership of the Association : 10932
Members under professional Indemnity Scheme of AMC : 7380
Persons (Members & Family) under H & A Scheme : 5630
Members under CBS Scheme : 1395
GST of 18% payable on the above amount.
10 Vol. 47 Issue No. 2 August 2018| |
n recent years, there has been an Generally speaking, Cosmetic surgery isIexponential rise in the demand for considered to be a high-risk specialty as far
cosmetic surgery in this country. as malpractice litigation is concerned. This is
underscored by the fact that Indian insuranceThere are many obvious reasons for this viz.
Companies have steadfastly refused tothe craving for youth and beauty in Society,
underwrite risks of liability followingno doubt fuelled by images in print andcosmetic surgery. In the Western countries,electronic media, movies and otherthis is not the case and one can get Insurancecommunication channels; the mind-cover against this liability. Ironically, theboggling advances in Medicine andInsurance Companies deny cover to thosetechnology and easy access to these; thewho need it most, just as Banks are eager tosteadily rising disposable incomes of peoplegive loans to those who don't need them.in the wake of economic upturn in theNevertheless, the good news is that AMCcountry and the fact that undergoingfought long and hard on this issue andcosmetic surgery has lost any stigma it mayeventually succeeded in getting it'shave had in the past. In view of this, cosmeticInsurance.surgeons have probably never had it so good.
Interestingly, this overwhelming demand for Company to cover this liability even thoughsurgery has not been dampened by the fact at an added cost. AMC cosmetologists canthat no Insurance Company re-imburses breathe easy since they can now getmedical costs of cosmetic surgery! malpractice indemnity. They can also
consider themselves unique since no otherIn no other medical specialization does the
Insurance Policy in the country affords thisconsumer status of the patient and the service
protection.provider-tag of the doctor get underlined , as
in cosmetic practice.Getting back to the question : Why are
However, cosmetic surgeons, and indeed the cosmetic surgeons more vulnerable to
non-surgical cosmetologists as well, need to medico-legal problems?
recognize that the attendant risks of medico-The following factors may explain this :
legal liability are now an increasingly
a) The quality of results is ultimatelychallenging reality. It is worthwhile pre-
empting these problems by trying to assessed by the patient and hence
understand their genesis. extremely subjective.
DOs AND DON’Ts
MEDICO-LEGAL PITFALLS IN COSMETIC
SURGERY AND COSMETIC DERMATOLOGY
Dr. Lalit Kapoor
11Vol. 47 Issue No. 2 August 2018| |
b) There is more than average risk of a patient selection. I have come across
mismatch between patient's expectations some young practitioners who tend to do
and results obtained. certain procedures often on account of the
acquisition of a new costly machine.c) Patients who seek cosmetic surgery could
have personalities which are less likely to 2) Do not overpromise and under perform.
tolerate imperfection. In fact, let it be the other way around.
d) Possibility of permanent disfigurement 3) Know your limitations and undertake to
adds to the risk of patient wanting to treat patients within the scope of your
claim 'damages'. training and qualifications.
Of course, the possibility of per -operative An issue of the greatest importance is
and post-operative complications would be accurate and diligent record-keeping and
the same as in other branches of surgery cosmetic surgeons cannot afford to be lax in
though there are specific complications such this respect. The pre-operative or pre-
as under or over correction, asymmetry, procedure photographs are important
implant failure, disfigurement, and so on. documents and need to be meticulously
recorded and preserved. However, a warningPerhaps, the key preventive measure lies in
that may be sounded in this regard : Do notpatient-selection. One must understand the
forget to take explicit written consent of themotivation, expectations as well as sub-
patient before taking photographs. A numberconscious desire of the patient before
of our members have landed in malpracticeelective surgery. You must discourageclaims by patients on account of this.wrongly motivated patients especially
patients below 18 years. Do not let a patient Additionally, posting some of thesebully you into an operation or a procedure as photographs on social media may be quiteit is safer to say 'No' before an operation than tempting but must be done with great caution"Sorry, I couldn't give you the result you and circumspection as it can become a verywanted" after the operation. And for those sensitive issue for the patient and a verywhom you decide to operate, build realistic sticky ethico-legal issue for you!!expectations. Beware of the excessively
Unquestionably, the importance ofdemanding patient who brings photographs,
patient's consent for surgery cannot bedrawings and architectural specifications! In
overemphasized. The following pointsrelevant cases, insist on a psychological
must be remembered :assessment of the patient prior to surgery, in
particular, if you detect any clues of a) Consent taken should not of the 'routine'
dysmorphophobia in the patient (Def : an type. As far as possible take 'operation-
obsessive fear that one's body or any part of it specific' consent which details the
procedure as well as the possible risks andis repulsive or may become so).
complications. For example, specificThree other important points :
consent documents should be designed
1) Exclude financial gain as a criterion for for, say Liposuction, Botox treatment,
12 Vol. 47 Issue No. 2 August 2018| |
Laser treatment, hair transplants, Often this amounts to provoking the patient
chemical peels and so on. and many a litigation has its genesis in ill-
advised and provocative statements by theb) Preferably, consent should not be in a
second surgeon. This factor can be easilylanguage the patient does not understand
minimized, if not eliminated, by simplyi.e consent forms should be designed in
resisting the temptation to indulge in one-regional languages as well.
upmanship.c) Caution : Consent of patients below 18
Lastly, the incidence of allegations byyears of age is invalid. The legal guardian
patients of sexual misconduct, orought to be giving consent on behalf of
inappropriate behavior against Cosmeticsuch a patient. Operating upon a minorsurgeons, is more than the average for allmerely with his or her consent can attractother Specialists. Hence special care must bethe penal charge of assault and battery.taken in this regard and male doctors must
d) 'Informed consent' is mandated by law in NEVER examine female patients without thethe USA and not taking it is considered as presence of a female attendant or femalenegligence per se. Indian courts too are relative.taking a similar view as evident from a
Recently, 3 cosmetic surgeons faced medico-few recent judgments. Informed consentlegal problems-two in cases of Liposuctioninvolves making sure the patientand one in a case of mammoplasty. In oneunderstands the nature of his condition,case, of Liposuction, the patient demandedthe alternate treatments and proceduresthat her money be refunded or else she wouldavailable; the nature of the proposedmake a nuisance of herself (hints oftreatment and the chances of success orblackmail).failure of the procedure.
Non-surgical cosmetic practitioners areA vital factor that adds to vulnerability ofequally vulnerable and as much at risk ascosmetic practitioners is the fact that thetheir surgical colleagues. Let me give a fewqualification criteria for cosmetic practiceillustrative (but real) examples.are highly unregulated in this country.
Unqualified or sub-qualified persons can call * A 24 year Spanish female model wasthemselves cosmetic practitioners as there referred to a Dermatologist by a modelingare no strict statutory criteria for the same. agency for acne of the face. She wasAdvertisements in the lay media by all and prescribed Cap Isotretinoin 20 mg andsundry claiming to be doing cosmetic
advised to follow-up after 1 month. Thepractice further compound the problem. On
patient left for Dubai the next day. After 15the other hand, in the USAfor example, in 21
days the dermatologist started receiving aStates only qualified physicians are
series of e mails from the modeling agencypermitted to use lasers in their practice.
asking for answers to the questions of
another doctor in Dubai. Why pregnancy wasAnother important cause of malpractice
not ruled out in this patient? Why she was notlitigation lies within us viz. the proclivity of
many doctors to criticize colleagues, counseled on not getting pregnant? Why
especially the previous treating surgeon. lipid profile was not ordered before starting
13Vol. 47 Issue No. 2 August 2018| |
the medication? Legal action was threatened * Adverse reaction of drugs is an important
if satisfactory answers were not provided. cause of allegations of negligence against
dermatologists. For example, a patientThe member was assisted in replying to thesedeveloped aseptic necrosis of head ofqueries appropriately and the matterfemur following long term use of potentquietened down but not before undergoingsteroids.much anxiety and having learnt a few
lessons.Despite all precautions, we may not be able
* Tattoo removal resulted in burns and skin to avoid medico legal problems---but we
necrosis. Doctor said that it was a very should definitely try to put into place some ofsimple procedure. Allegation : Doc had the measures outlined above, though theseused infrared coagulator device. Should efforts must be sincere and not 'cosmetic'!have used ultra short pulsed NdYag laser.
And, as always, it is better to be safe than* Excessive scarring resulted after removal
sorry!of hemangioma in leg of infant.
* Missed diagnosis of malignant melanoma
leading to spread. [email protected]
MLCON at Nashik on 22nd July, 2018
15Vol. 47 Issue No. 2 August 2018| |
Hi Friends, 3) Login User can login to system.Username will be email ID & PasswordToday we are in a digital era where everyonewill be mobile number. First time loginwould like to access everything from theirwill generate OTP and ask for mobile
smart phone including details about the latestverification. SMS gateway integration
AMC programs (venue, date, topics etc),Only after OTP authentication user can
registration details, online payments etc.successfully login.
To make our members' life easy; we now4) My Account : User can view the
have both : the AMC App as well as ourMembership Status and Payment Made
dynamic website.details. User can view Profile /
We are in the process of a major revamp in registration details. User can ask forboth theApp as well as the website- making it profile change information like name /more informative and user friendly with a RMN / REI / Profile Photo etc.dedicated "Members section".
5) Events Programs : For forthcomingA new features which we have insisted on is AMCON, User can pay delegate fee /Dynamic Content display. registration fee by clicking on events
listed. User can also pay for the eventSalient Features of the Web-site :where Fees will be different for Early
1) Online Registration of a new member : Payment / Regular / Late paying. UserOnline submission of Registration Form will be taken to Pay U / ccAvenue forwith facility to upload document, payment.photocopies of supporting documents.
6) Admin will get facility to ManageThe Admin from office can Approve /AMCON event from admin area and addReject the registration. On Approval, andifferent Fee Early Payment / Regular /email will be sent to the user with a link Late Paying.to pay online.
7) A Postal to view all forthcoming2) Online Payment Gateway integration:
events:Once the payment is successful, the
a) News &Announcement Listing.User (new member) will be activated for
login to the system. Admin can also b) Display Upcoming Events.manually activate and add payment
c) Events - Photo Gallery List Events.received status in case payment is
received offline or any other mode d) Display photo gallery of selected(cheque). events.
WEBSITE UPDATE
Dr. Ashok ShuklaEditor - Website
16 Vol. 47 Issue No. 2 August 2018| |
e) Video Gallery : Video Listing - end (website) we will create customized
calendar where all events will be showedYouTube links.in calendar. From the website backend if
8) Notification : page to displayyou update the records the same will be
notification (sudden announcements,updated in the front end. And the same
condolences, etc).Admin / Staff can senddetails can be viewed on the phone
notification by selecting Users fromCalendar.
admin area. Users will get notification in12) SOS feature on the app is best availableemail and can view notification on
option to members who are in crisiswebsite page login.during attack/violence. This sends an
9) Display Visit / Login Hits Display Visit / sms asking for help to all the members inLogin Hits. the same pincode areas.
10) Newsletter Subscription Newsletter All these features will make the website andsubscription form will be available for App more user-friendly. We hope to go greenuser to subscribe. eventually with all members use online
facility and useAMC website as well as app.11) Admin will get facility to view and
export subscribers to CSV file. In front [email protected]
17Vol. 47 Issue No. 2 August 2018| |
Team AMC 2018 - 2019 has initiated a female sexual disorders a much neglected
member outreach program where we topic. The other topics were "Nar, mada ya
reach out to our members for an Aadha", 'Sex has No Expiry Date' and the
interactive meeting in an attempt to finale 'Pati, PatniAur….Woo….Oooh'!!
understand local issues. This weekly2) 25th May 2018 : Nurses Training;
program is held at different places,Venue :Ambernath
covering a wide range of topics withParticipants : 118, CME points - 0prominent speakers and prominent
members of the Doctor community.
1) 20th May 2018 : "Sexp lo re"
Conference; Venue : IMAhall, Juhu
Participants : 160; CME points -2
The CME included talks on Basic
pharmacology, what symptomatic treatment
to be given in the absence of consultants,
LASA drugs and its importance and
complications; Pre and post operative patient
preparation, care and monitoring; Legal
complications; basics and practical uses of
operative instruments was demonstrated;
fumigation, sterilization, Autoclaving; CPR
for cardiac arrest, cardiac emergency and
method of CPR and action in golden hour
were discussed. In addition, how to predict,
prevent, violence by irate relatives was
especially stressed upon. Actions of staff in
case of mob violence, whom to contact, how
to console relatives were discussed.
An opening talk by fitness Guru Mr. MickeyImportance of consent, documentation,
Mehta on 'Sex and Moksha' mesmerisedconsent, methods of obtaining consent. Dos
everyone but we were 'Mickeymized' by his and don'ts while handling IPD papers and
talk on importance of a healthy life style for legal consequences in Medico legal cases;
good sex life.importance of cordial behavior, sympathetic
The second talk "Women, Let's Talk Sex" attitude and professional behavior was
had a detailed presentation on the nuances of highlighted. Behavior of nurses while
AMC News
speakers on collage....2. Dr. Sanjay Deshpande 3. Dr. Darpan Kaur4. Dr. Udayan Indurkar 5. Mr. Mickey Mehta6. Mr. Ashok Row Kavi 7. Dr. MukundJagannathan 8. Dr. Deepak Jumani
1. Dr. Prakash Kothari
18 Vol. 47 Issue No. 2 August 2018| |
attending OPD patients, well groomed
appearance and hospitality were stressed
upon.
3) 25th May 2018 : Hotel Nakshatra,
Ambernath
Participants : 55; CME points -1
4) 08th June 2018 : Vinayak Hall, Kalyan
Participants : 95; CME points -1
5) 16th June 2018 : Hotel Mayur,
Ulhasnagar
Participants : 89; CME points -1
Included a talk about 'AMC Schemes' withi) Kalyan : Blood Units collected :
description of H&A, NoAH, CBS, Medico210 Photo
legal schemes and policies for the benefit of ii) Dahanu : Blood Units collected :the consultants.
436) 23rd June 2018 : Hotel Regent Garden,
iii)Cooper Hospital : Blood UnitsBhiwandicollected : 50
Participants : 73; CME points -1b) 26th July 2018
7) 24th June 2018 : GCC Club, Mira RoadThane : Blood Units Collected : 26
Participants : 113; CME points -2
P r o g r a m a b o u t " I n t r o d u c t i o n t o
Adolescence'' - the magnitude of problems,
the need for parents and medical fraternity to
be in tune with adolescents, a talk on
"Adolescence: a period of transition",
unraveling the interesting challenges a
medical practitioner faces as a child becomes
an adolescent with details on early and
delayed puberty- sensitising the audience on
pubertal dilemmas, a talk on gynaecological
disorders in adolescence were taken up.
8) Doctor's Day : 01st July 2018;
Balgandharva Rang Mandir
Participants : 418; CME points - 010) 06th July 2018 : LTMMC & LTMG,
9) Doctor's Day Blood Donation Drive : "Chalo Sion Chunabhatti”
a) 1st July 2018 Participants : 70; CME points -1.
19Vol. 47 Issue No. 2 August 2018| |
3-Aug-18 AMC Connect-11Chalo Vikhroli -Bhandup - Mulund
Godrej Memorial Hospital, Vihkroli
1 100
12-Aug-18 AMC Meet-4Tech Conference Nursing Home Issues (Gipsa)
Ashford Chamber - Citylight, Mahim
19-Aug-18 Simulation Workshop (Trauma Care) D.Y. Patil Medical College
18-Nov-18 AMCON Annual ConferenceThe Lalit Hotel,Andheri (E), Mumbai
8-Jul-18 AMC Meet-3Enhancing MedicalPractice & Productivity
Chembur 2 120
20-Jul-18 AMC Connect-10Chalo GhatkoparVidyavihar Powai
Jolly Gymkhana,Ghatkopar
1 85
22-Jul-18 MLCON-2018AMC Mumbai & Amc Nashik
Nashik 2 245
28-Jul-18 TB & MDTBHoliday Inn (Near Sahar Airport)
1 50
8-Jun-18 AMC Connect-6 Chalo Kalyan Vinayak Hall, Kalyan 1 95
16-Jun-18 AMC Connect-7 Chalo Ulhasnagar Hotel Mayur, Ulhasnagar 1 89
23-Jun-18 AMC Connect-8 Chalo BhiwandiHotel Regent Garden, Bhiwandi
1 73
24-Jun-18 AMC Meet-2Adolescense Unravelled a Medico Social Exploration
GCC Club,Mira Road
2 113
1-Jul-18 Doctors' Day Talent Show Balgandharva Rang Mandir 418
1-Jul-18 Doctors' Day Blood Donation Kalyan 210 Unit Collected
1-Jul-18 Doctors' Day Blood Donation Dahanu 43 Unit Collected
2-Jul-18 Doctors' Day Blood Donation Cooper Hospital 50 Unit Collected
6-Jul-18 AMC Connect-9 Chalo Sion ChunabhattiPhysiology Lecture Hall, LTMMC & LTMGHospital, Sion
1 70
8-Jul-18 Doctors' Day Blood Donation Bhayander 55 Unit Collected
10-May-18 AMC Connect-4 Chalo Thane Kalwa IMA Hall, Thane 1 82
20-May-18 AMC Meet-1 Sexplore Conference IMA Hall, Juhu 2 160
25-May-18 Nurses Training Ambernath 118
25-May-18 AMC Connect-5 Chalo Ambernath Badlapur Hotel Nakshatra, Ambernath 1 55
Date Program Venue CME Point Attended
5-Apr-18 AMC Connect-1 Chalo Mira BhayanderWockhardt Hospital,Mira Road
2 150
20-Apr-18 AMC Connect-2Chalo Vasai - Nalasopara - Virar
Hotel Manthan,Nalasopara
1 91
4-May-18 AMC Connect-3Chalo Palghar - Boisar - Dahanu
Hotel Sarovar, Boisar 1 35
6-May-18 Nurses TrainingZaika Orchid Banquet, Bhayandar (W)
AMC Program All Dates
20 Vol. 47 Issue No. 2 August 2018| |
To,
The Editor - GRASP
Dear Sir/Madam,
I am a Physician. A patient's mother placed
a complaint against me, of medical
harassment, while opining and treating her
daughter at the casualty of a hospital.
The patient presented as an obvious case
of Acute Infective Gastroenteritis, but
on examination, I found bowel sounds
were absent. The casualty officer also
checked and found the bowel sounds
absent. I advised a surgical reference and
a USG abdomen with an X-ray Abdomen
Standing. The surgeon took some time
to see her, by which time the USG and
X-ray were already done and reported
normal. He also reported her bowel
sounds as feeble. A little later the bowel
sounds returned, and patient was
advised by the surgeon for only medical
management. However the parents accused
me of an attempt at pushing for surgery,
a n d a l s o o r d e r i n g u n n e c e s s a r y
investigations viz: USG and X-ray
Abdomen. The complaint was directly
launched to a police station, to which
I was summoned.
I was greatly distressed at this incident as
I had done my duty towards the patient -
true to my findings and ordered
investigations and a surgical opinion in
good faith.
After spending two extremely distressing
days in wondering what to do, I turned
to AMC President Dr. Vipin Checker, who
not only responded instantly, heard my
issue out, liasoned with the police and
the lawyers, and advised me on the correct
next steps, which I followed.
The speed, efficiency and the legal
accuracy that was displayed was indeed
very commendable, and has induced a
sense of gratefulness and respect for the
AMC organization.
Thank you,
From,
Dr. Rajesh Jaria
MBBS, MD - Medicine
General Physician
21Vol. 47 Issue No. 2 August 2018| |
1) IP Asset is made in India!
Team AMC 18-19 congratulates the team of Indian clinicians Dr. Debraj Shome, andDr. Rinky Kapoor, who have formulated a blend of bio-mimicking polypeptides (analogous to naturally occurring human protein factors) with amino acids and minerals for hair loss.
They have named this as QR678 : QR= code "Quick Response"; 678 = Morse Code for "there is no answer".
After successful animal trials and cell toxicity studies, they performed a clinical trial and now their QR 678™ hair formulation has been awarded a composition patent (the most difficult form of patent to acquire) by the United States Patent and Trademark Office (USPTO), on 11th July 2017 - USA patent no 9, 700, 504 B2.
AMC Congratulates this Complete "Bench" to "Bed" approach!
ACHIEVEMENTS
2) Anticipating the future!
Team AMC 18-19 congratulates Dr. Dheeraj V. Mulchandani and Dr. M. M. Begani of Abhishek Day Care Institute and Medical Research Centre, which completed 17 years. Theirs is a dedicated Multi speciality Day Care General Surgery Centre. The lack of hospital beds, long waiting lists, increasingly expensive health care system, virtually non-existent medical insurance in India and lack of governmental funding to the private sector of health care, points to day-care surgery being the only answer for common treatable surgical problems in the future.
‘Whether this patient should be sent home’ needs to be changed to: ‘Does this patient even need admission?’
During the period of 17 years, they have performed 6589 surgical procedures - 6051 OPD procedures and 5928 Endoscopic procedures.
That is 18,000 cases of Ambulatory Surgery under local anaesthesia with some form of sedation.
To feature your Achievements in GRASP, Email : [email protected]
22 Vol. 47 Issue No. 2 August 2018| |
hough specialists and supers pecialists allegations were that the doctor did not visitTadvise medications and conduct or monitor the patient regularly after the
procedures, very often, post-operatively and kidney surgery. In addition, the kidney
during administration of medication, close surgery was done with invalid consent as
monitoring is mandatory to prevent/ the alternatives and risks of surgery was not
minimise adverse reactions or watch out for explained. Hence the complaint was filed.
early complications. Lack of adequateHeld : The patient was on Clexane and the
monitoring when indicated would causedosage adjustment is required in patient
damage to the patient and would be medical with kidney damage. Due to excessive
negligence as is illustrated below.administration of Clexane, more than 1 litre
A) I (2017) CPJ 235 (NC) : Singh v/s FH of blood collection occurred in the abdomen.
Repeated aspiration led to infection. As perComplaint : Raminder Singh visited Fortisliterature, Clexane has to be given in theHealthcare for consultation of knee surgerycorrect dose and route with closeand was admitted on the same date (17thmonitoring. Timely detection of mistake inMay) as potassium levels were high. Blooddosing would have prevented internaland radiology investigations were donebleeding in the patient. The Surgeon has to bewhich revealed advanced kidney cancer.vigiliant post operatively to look for signsSurgery was performed (on 23rd May).of bleeding post-operatively. As per MedicalDrain was removed within 3 days and patientRecords, there was abdominal pain andbecame turned serious on 28th May. Thedistension after surgery and considerablehemoglobin dropped. USG was performed indelay in conducting diagnostics. Increasedthe evening of 28th May which revealed 1level of urea and creatinine were ignored by litre of blood collection in the abdomen. Thethe doctor during clexane administration.patient turned critical the next day and re-Relevant investigations regardingexploration was performed on 30th May (the
coagulation was not done during clexanesame could have been immediately after
administration leading to internal bleedingUSG on 28th May). The patient continued to
and subsequent death. Doctor and hospitalhave internal bleeding. The Attending doctor
held negligent for inadequate monitoringproceeded for leave on 6th June and no
Surgeon was available to monitor the patient. of the patient post-operatively leading to
The patient died on 23rd June. The complications.
LACK OF MONITORING IS
MEDICAL NEGLIGENCE
Dr. Suganthi IyerDy. Director - Hinduja Hospital, Mumbai
23Vol. 47 Issue No. 2 August 2018| |
B) III (2016) CPJ 437 (NC) : Patil v/s PD hospital and should have been kept in the
ICU for continuous monitoring. TheComplaint : Mr. Deshmukh was prescribed
hospital "S" did not produce any evidence toGatifloxacin by family doctor and developed
show that the ICU was not fully occupied norrashes and blisters on the skin with itching
that the patient denied ICU admission andand uneasiness. He was admitted to “S"
the patient was treated in the wards withouthospital where he was kept in the Wards for
close monitoring for several days and thusthe same. Doctors said it was Gatifloxacin
sustained ocular damages. She wasallergy and prescribed medicine. However,
diagnosed with as madarosis in both eyes andthe condition deteriorated and she was
trichiasis in right eye. Proper ICU care andunable to swallow food. She was put on
monitoring could have prevented theliquid diet. The patient then got transferred to
ocular damage . Hospital declaredanother hospital in ICU. Ultimately patient
negligent.suffered permanent loss of eye lids, partial
loss of eye sight and permanent loss of tear C) III (2016) CPJ 421(NC) :YHospital Vs
glands. Thus, complaint of wrong treatment Uma Devi & Ors.
and negligence filed.Complaint : Mr. Reddy was admitted to
Held : The patient ultimately developed Yashoda Hospital as he was suffering from
TEN and SJS which is a serious condition jaundice. During ERCP, anaesthesia was
and could be life threatening. Such patients administered and the patient developed
should have been in ICU and not in the sudden cardiac arrest. Hence the procedure
wards. As per medical literature, a disease of ERCP was abandoned. Mr. Reddy was
severity scoring system called SCORTEN brought out of OT in a comatose state. He
(Score of TEN) which is an established finally became brain dead and expired after a
protocol for assessment of severity of illness long struggle two and half years late. A case
in patients with SJS and TEN had not been of medical negligence was filed withmaintained as was the evident that the allegations as to whether ERCP wasmedical record were devoid of the same. performed as per standard guidelines andPatients with SJS and TEN could become whether the dose of anaesthesia was correct.fatal if not monitoring closely. Also the
Held : As per standard of care, thepatient showed signs of increased new
administration and monitoring oflesions. ICUs provide intensive care
propofol administration for such complextreatment and monitoring critically ill and
endoscopic procedures should be theunstable patient. Treatment focuses on
responsibility of a dedicated andeliminating underlying cause and controlling
appropriately trained anaesthetist toand minimizing complications. The initial
ensure that the potential complications ofgoal in managing SJS / TEN is to provide
sedation and anaesthesia are appropriatelyessential life support as both conditions pose
managed.a significant risk. In the instant case, the
patient was diagnosed as SJS/ TEN in "S" The anaesthetist ought to have taken due care
24 Vol. 47 Issue No. 2 August 2018| |
and justification before administration of the diagnosis of pulmonary embolism was
said drug. Carelessness on part of made. Patient was admitted in the Intensive
anesthesiologist landed the patient in a state Care Unit. Inj. Actilyse was prescribed to the
of coma. The medical record establishes patient and was later administered. After the
clear lacuna that there is no recording administration of Actilyse there was steepmaintained between 3.30 to 3.50 pm on the decline in the blood pressure and finally wasdate of the incident. Thus it was evident that transferred to another hospital in septicPropofol was administered without shock on 2ndAugust. Hence a complaint wasmonitoring and caution. Monitoring and filed.recording of patient's vital signs before and
Held : The Court relied upon the literatureduring procedure should be done. Bloodthat when Actilyse is administered there haspressure, oxygen saturation and pulse rateto be close monitoring. Resuscitationshould be monitored and noted. In this case, equipment and medication should be madethere were no records of patient's vitalsavailable. TPA is to be dispensed under theduring ERCP procedure leading to adversesupervision of specialist who would watchinference. In addition, timely intubation wasout for internal and external bleeding. It wasnot done for the patient and hence noalso noted there was no specialist when therecording between 3.30 to 3.50 pm. Cardiac TPA injection being administered. It wasarrest was also not managed properly leadingobserved there was no ventilator availableto coma.during the administration. It was further
Anaesthesiologists are like airoplaneobserved from literature that in addition to
pilots. Essentially 99% of the time they areActilyse, if another medication was being
in "watchful mode." It is the monitoringadministered, there need to be given by
of the patient and the ability of theseparate drip lines. As the side effect include
anaesthesiologist to promptly act withlow blood pressure, breathlessness, allergic
available equipment that makes thereaction, irregular heartbeat, fever and even a
difference between life and death. Thoughcardiac arrest, close monitoring is
the doctors were qualified, they failed inconsidered necessary. The treatment
their duty of care during ERCPrecord filed by the hospital does notprocedure. Forty seven lakhs werea n y w h e r e s t a t e w h e t h e r t h eawarded.aforementioned precautions were taken.
Michael Jackson and Joan Rivers both lost The case sheet is silent about thetheir lives due to anaesthetic agent : Propofol monitoring of the administration of TPA,
except for stating that it was done under theD) II (2017) CPJ 402 (NC) : I Hospital v/s
advice of the doctor.Arora
In addition, the insert on the medicationComplaint : The patient, 61 years, diabetic,
was also taken into consideration whichwent for consultation to Inscol Hospital on
ment ioned Spec ia l warn ings and01st August with fever, breathlessness and
severe pain in left leg. After investigations, precautions :
25Vol. 47 Issue No. 2 August 2018| |
"Actilyse should be used by physician as they carry a heightened risk for
experienced in the use of thrombolytic adverse outcomes and catastrophic harm
treatment and with the facilities to monitor whenever there is an error.that use. As with other thrombolytics, it is
• Close monitoring during sedation /recommended that when Actilyse is
anaesthesia and in the recovery room tilladministered standard resuscitation
shifting out to the wards / ICU.equipment and medication be available in all
circumstances". • Periodic frequent monitoring in ICU /
wards depending upon need of theUnder such circumstances, the court waspatient.of the considered view that Actilyse was
not adminis tered under proper • Closed monitoring during bloodsupervision. Also the medical records was transfusion for transfusion reactions andnot provided to the patient on his request corrective action to be initiated at theby the hospital. Hence negligence was
earliest.slapped on the hospital.
• Establishing clinical guidelines andTake Home Messages :
score sheets for monitoring.
• Close monitoring while administration• Necessary corrective action to be
of High Risk medications as look-alikeinitiated as per manifestation.
drugs , sound-a l ike drugs , low
therapeutic window, control led
substances, psychotherapy medications,
concentrated electrolytes, narcotic and
psychotrophic drugs, chemotherapy, etc. [email protected]
Dr. Kusum Zaveri
Obstetrics/Gynaecology and In-vitro fertilization
Passed Away: 7 June, 2018st
Condolences
27Vol. 47 Issue No. 2 August 2018| |
he President of India recently spoke of is inundated with work. Though heTthe looming mental health epidemic initially felt wronged by the city of his
birth, he is contented with this new town here as we are becoming the 'suicidal capital'
that has thrown up a great opportunity forof the world.him. The 'joy index' is very high among
India is on the threshold of a great tomorrowthose who believe in a 'sincere work
and its young Indians are the architects. Theethic', in 'touch with the times' and
resultant pace of life and rapid sociological'compassionate' towards themselves. The
shifts in the country have its own confusion and self doubts here is less.consequences. The medical profession is no
ii) A female cardiologist dropped in andexception and is facing the onslaughts andasked me whether she should share a partthe adverse effects of globalization. Wearof her 'wallet' with those who support herand tear of the mind and body from running in her practice. I simply said that it is her from one Operation Theatre to the next, fromchoice. Those who solicit patients to buildone OPD to the other is a cause of concern.a robust waiting room in their clinics at
Following are some probable 'narratives' that the earliest lose respect for themselves.the Medical Profession can ponder upon and
So if one's philosophy of work and life islaunch correctives, apply brakes or modifyclear and the concepts gel with their mind,their lifestyles.body and soul the 'peace' experienced is
A) Philosophy of life : The philosophy of better.life is an important variable in defining
B) Micro-breaks & Micro-Pranayama : Ahealth and well-being.long day needs to be invigorated
i) A young doctor recently was looking for periodically. A heavy OPD or an OT can be aattachments in various hospitals and was Doctor's Waterloo if not negotiated well.distraught because he was finding it Those who live in their cars as they trudgedifficult to penetrate the iron walls of through multiple hospitals, having theirthese bastions. He was frustrated. When I meals inside the vehicle are worse off.After aasked him to apply in various cities and long day, there needs to be a small break of 10not only in Mumbai he felt slighted. minutes to cut the cycle of 'pain and therapy'
Reluctantly he shared his resumes around to feel connected with the family after one
and managed to get a good attachment in reaches home. I strongly recommend micro-
a second tier city. Today he is happy as he breaks between surgeries and patients :
''Doc in the Dock''
Points to PonderDr. Harish Shetty, MD
Psychiatrist
mindmoodsandmagic.blogspot.com
28 Vol. 47 Issue No. 2 August 2018| |
i) A call to a colleague, after seeing a few much enthusiasm colored with emotional
patients, sharing one's feelings of the day energy needs to be the same at home.
or indulging in a humorous exchange• Doctors who take either their family or
keeps the hypothalamo-pituitary-axistheir patients for granted slowly slide
intact.down in their health especially
emotionally.ii) Many would benefit with a short bout of
s low breathing or ' sama vri t t i• Many walk like well dressed robots in
Pranayama' [equal inspiration andswanky cars but lose their 'equanimity'
expiration with slow belly breathing].that is so important for us. Those who are
equitable to the 'free ward patients' asiii)Any form of meditation albeit for a short much as the 'general ward' or the 'deluxetime helps. A walk around the hospitalroom' patients remain healthier than theafter five patients can be refreshing.rest.
iv) Those who listen to stories of pain and joy• Emotional equity is also vital. Healing is in their clinics are better off than those
always a two-way process. When thewho only listen to signs and symptoms.doctor smiles and shows compassion to
v) The monotony of being cooped up in a the patient and the patient smiles backchilling air-conditioned OPD can be despite pain or suffering; the doctor getsbroken by a brief sun walk for a few healed himself/herself.moments.
• There are so many examples in my mind vi) A desire for a million attachments is the of relatives coming back after the death of
symptom of an anxious insecure mind. their loved ones and sharing that theyThough super-specialists may have to were fortunate to have great doctors whospread themselves thin and spread their tried their best but failed.dragnet a shade wider than others.
D) Managing Crisis : This is an era whereC) Building Emotional Wealth & the disgruntled patient population has beenEmotional Equity : Emotional wealth is a violently aggressive against doctors. Therapidly depleting reserve in a fast paced angst of a globalized world is being thrownworld. This can happen very early in life if on the easy targets and the medicalproper care is not taken. professionals are vulnerable whipping boys.
It is so important to build horizontalEmotional energy banks need to bepartnerships and support groups among thereplenished as regularly as the banks thatprofessionals irrespective of seniority.
store our monetary savings for the future.Dwelling in a lonely island and living in a
The best methods to fuel the emotionalself created delusion of glory will hurt the
energy bank is to focus on the triad of sleep,doctor. Understanding the compulsions of
diet and exercise.our work and being available around to those
• A spouse of a very famous doctor who have been targeted is so important.complained that her doctor spouse spoke Passing disparaging critical comments on
in mono-syllables with him at home. The fellow professionals is a sure shot method to
words expressed in the clinic with so dig one's own grave. We all can err and the
29Vol. 47 Issue No. 2 August 2018| |
fact that providence can snatch any patient when patients suddenly praised you for
from our safe hands despite of the best efforts what you had done for him/her, and yetneeds to be realized and accepted. Working you do not remember?as teams improves wellness.
In this jet-set age we need to push the 'pauseE) Work life balance : Work life balance is a button' in life to find 'peace' and 'joy'.myth. We have to rush to assist emergencies
• Those who practice meditation of anyat odd hours. Doctors have missed funeralstype have a better emotional quotient.of their loved ones also, during crisis. ThereDance, singing, sports are also forms ofwill be always imbalance but finding balancemeditation.in the midst of imbalances is the key.
• Yog, Vippassana, similar other practices• Recently a doctor shared a dilemma. Heactually increase our Karuna and makeshad planned a holiday with his family andus more effective only if it penetrateshe simultaneously got an urgent call to beevery cell in our body. Many profess thata speaker in an international conference.they do yoga regularly but are very rudeHe could not shift his holiday. I asked himand harsh in their lives. Yog- asanas area simple question whether such dilemmasnot the arrows of Ram that destroys thehave presented to him in the past and hearrows of Ravana. These need to be asaid yes. What did he do then I asked himway of life.and he answered that he would
compromise his holiday and go to give a • Aligning our body clock with the
talk. Well, those who are brutallybiological clock is a key to wellness.
committed to their holidays live betterCalming our autonomic nervous system
lives compared to those who see it as aperiodically and harmonizing our breath
'peace broking activity' with theirwith the orchestra of our body will help
families. The conference will find otherexperience peace and harmony aroundspeakers but your family can not find aothers.substitute father or mother or a husband
or a wife. Such practices need not be ritualistic but
should pervade all aspects of life.In life, the choice is that you can't please or
satisfy everyone. We have to choose whom Medical practice is not a 20/20 cricket matchwe need to displease. and nor is it a marathon.
F) Inner Peace is the key and Joy is a by- It is like a walk on the banks of the Gangesproduct of peace. or the Mississippi……..savouring the flow
& the flood, the sunshine & the moonlight• There is a difference between joy andand also the torrential rains & storms.pleasure. Joy is something one can
neither chase nor avoid. We may bask in the sunshine or get soaked in
the water but the joy of the walk remains• One of my great teachers Dr. NS Vahiabeautiful and so fulfilling. To me if I am bornonce shared with me that the 'Hospital isagain I would still want to be a Doctor as noour temple and patients are our Gods.profession in my mind can ever be asFrom them we learn and from them we
earn.' Remember the days and the joy fulfilling as ours!
30 Vol. 47 Issue No. 2 August 2018| |
VISUAL DELIGHT : Contributed by Dr. Kiran & Dr. Ketki Marthak
I am guide in the forest.I lead you to wherethe best Honey is.My name is Honeyguide.
My beak looksawfully big -
My name is GOSBEAK
My bill is like a parrot's -and so I amBrown Parrotbill
Mrs Gould's Sunbird -My beak can take in
nectar from anyflower_Bhutan Sunbird.
31Vol. 47 Issue No. 2 August 2018| |
Red dots on me is theperfect camouflage ona Rhododendron Tree -Satyr Tragopan
I am OrangeBellied Squirrel
Takin (BurdorcasTaxicolor) - National
Animal of Bhutan
My tail is black.I am extremely shy andwill not show myself.I am black tailed CRAKE
32 Vol. 47 Issue No. 2 August 2018| |
Healthcare Financing : 1. Tax based financing,2. Social insurance financing,
n India, the Minister of Health and Family3. Private health insurance andIWelfare has announced a very ambitious4. Community based health insurance.
and goal-oriented Health Insurance Schemefor the poor population of our country with a Following the lead of many OECDcomplete Government Health Financing. countries, health insurance throughMany states have already signed the MoU government has emerged as a preferred(Memorandum of Understanding) with the method of health financing in many low andUnion Ministry of Health and Family middle-income countries including India.Welfare for implementation of theAyushman The status of health financing in the IndianBharat Yojana - National Health Protection scenario can be graphically represented asScheme / Mission. The various models of follows :Health Financing and Health Insurance arepresented herewith.
WHO (World Health Organisation) definesHealth Financing as the "function of ahealth system concerned with themobilization, accumulation and allocation ofmoney to cover the health needs of thepeople, individually and collectively, in thehealth system."
In 1978, with the introduction of Alma Ata'sdeclaration of 'Health for All', there was a lotof international emphasis on UniversalHealth Coverage and countries andorganizations all over the world have tried toachieve a viable and sustainable system ofuniversalizing health services. Healthfinancing plays a key role in establishingsuch an equitable system of healthcare.
In 2001, Bennett and Gilson had identified 4basic health-financing mechanismsimplemented across the world. Thesemechanisms are not water-tight but areinterrelated as well as interdependent :
HEALTHCARE FINANCING &
HEALTH INSURANCE MODELS
Author : Prof. Sushmita Bhatnagar(MBBS, MS, MCh, MPhil, PGDMLS)
Pediatric Surgeon, Hon. Secretary, AMC
Fig. 1: Sources of Healthcare Financing in India
Fig. 2 : Public & private split in thetotal health expenditure across the world
33Vol. 47 Issue No. 2 August 2018| |
The sources of health financing in India can be graphically depicted as follows :
Indian Models of Health Insurance and cash benefits compensating for the loss of
Financing : earning capacity due to illness, disability or
death. Health provisioning is mainly throughThe distinct models of health insurance andits own hospitals and dispensaries with somefinancing in India from its inception are asadditional empaneled private hospitals.follows :However, India has a large working
1. Employees' State Insurance Scheme population in the unorganized sector. This(ESIS) : 1948 seriously limits the schemes coverage
amongst the neediest worker.This was the first ever-insurance scheme, is
still active since 1948. This scheme was 2. The Central Government Health Schemeapplicable to the lower rung workers in the
(CGHS) : 1954formal sector and their families. Healthcare
This scheme provided health benefitsfinancing was through 3 sources :exclusively to the central government
a. Contributions from the governmentemployees, their families, pensioners,
b. Percentage of employer's share members of Parliament and Supreme Court
judges.c. Percentage of employee's share from
the wages payable to the employee. Healthcare financing was through 2 sources :The least paid workers are exempted
a. Central government fundsfrom employee contribution.
b. Employee contributions.The scheme provides a comprehensive
package at all levels of health care along with They have comprehensive service packages
34 Vol. 47 Issue No. 2 August 2018| |
through their own dispensaries in select catered mainly to the upper and middle-class
cities, some public and private hospitals population.
which are empaneled to provide services. 1999 onwards, a number of similar voluntaryThe scope of this scheme is narrow and health insurance schemes by privateobviously this scheme is not for the general companies were introduced whenpopulation. liberalisation of the economy led to the
insurance sector being thrown open to the3. Community Based Health Insurance
private sector. Simultaneously, developmentSchemes (CBHI)
of private health sector gained momentum;The CBHI are run by NGOs and hospitals for
leading to sprouting of small and largecommunities and have existed in India for
hospitals and private nursing homes. This,many decades. These schemes are
along with the decline of the public healthessentially voluntary and cater to the poor
sector, the household health expenditureshouseholds in the informal sector who are
increased. The expensive private healthunable to afford the high premiums of private
insurance schemes offered thus far werehealth insurance. The disadvantages of these
unaffordable to the poor who continued to besystems are :
impoverished under the burden of healtha. Low premiums mean that the benefit care. There was a dire need to protect the
packages are also lower, poor and hence based on international
experiences in other developing countries,b. There is no cross subsidizing betweenmany community-based as well asthe rich and the poor,government, health insurance schemes were
c. They are not amenable to expansion on introduced across the country.a larger scale. Multiple social
5. Universal Health Insurance Schemeinsurance schemes at both state and(UHIS) : 2003central level including Maharashtra
state for various sections of The Government of India launched the UHISpopulation, railway employees, etc. to reach out to the poorest households. Thegenerated for several years. premiums were heavily subsidized and the
annual cover ranged from INR 15,000 - INR4. Mediclaim : 198630,000 for hospitalisations. Premiums were
The public sector health insurance further lowered in 2004 following poorcompanies launched the first voluntary response from the target BPL population.health insurance scheme called Mediclaim. Despite this, the scheme failed to take off.It covered all those healthy individuals who
6. Governmen t Sponsored Hea l thwere willing to pay premiums based on age,Insurance Schemes : 2003 onwardsforeseeable health risks and corresponding
benefits package for future hospitalisation Several government subsidized insurance
expenses along with tax benefits. schemes in many states across India was a
Policyholders are reimbursed the cost of welcome development though they had
hospitalisation and home care on submission some significant shortcomings. Thus, none
of bills and other documents. This scheme of these schemes served the purpose of
35Vol. 47 Issue No. 2 August 2018| |
universal coverage as each scheme had a funded insurance schemes for the poor
specific target population making them were significantly different from the
limited in scope. existing schemes such as the ESIS and
CGHS.a. Launch of the Yeshaswini Scheme in
Karnataka by the state government for 7. Insurance Schemes in Maharashtra:
the rural co-operative societies 1997-2012
occurred in 2003. The government Several Government schemes wereprovided financial and technical aid to implemented in Maharsthra from time tofarmers, artisans, weavers, fishermen time.Abrief reprt of these is as foolwos :etc. and other workers in the informal
a. 1997 : Jeevandayee Aarogya Yojanasectors. Participation was voluntarywas launched in 1997 for providingand the premiums highly subsidized.financial aid upto INR 1,50,000 to BPLThis was the first ever structuredpatients for surgeries related to heart,scheme with a pre-decided list ofbrain, kidney diseases, and cancer.medical procedures covered, setThis scheme was not truly an insurancepackage of services, fixed packagescheme as there were no premiums orrates and annual package limits. Thisinsurance agencies involved. The statepioneering and very successful schemegovernment allocated funds for thebecame a popular model for severalscheme that were used to directlygovernment health insurance schemesreimburse the designated public andacross the country.private hospitals that performed these
b. Government sponsored health surgeries on a case-by-case basis.insurance schemes like the central Although all grants were fully utilized,government's Rashtriya Swasthya many eligible patients incurred heavyBima Yojana (RSBY 2008) followed OOP expenditure for surgeries,by state level Aarogyasri (2007), diagnostics, travel, etc., because of theKalaignagar (2009), Vajpayee very low awareness about the scheme.Aarogyasri (2010), etc. States that did
b. 2008 : The central scheme RSBY was not have state health insurancealso implemented in Maharashtra as inschemes adopted the central schemeother parts of the country. The schemeRSBY. Target population of BPL andwas available in 32 out of the 35poor households, free of cost ordistricts of the state and only onesubsidized premiums, benefi tdistrict had an empaneled publicpackages for secondary and/or tertiaryhospital. The rest of the empanelledhealthcare, cashless services, healthhospitals were private.provisioning through empaneled
public and private hospitals and c. 2012 : The Jeevandayee Aarogya
i n v o l v e m e n t o f T h i r d P a r t y Yojana was converted into Rajiv
Administrators (TPAs), were some of Gandhi Jeevandayee Aarogya Yojana
the common features across the (RGJAY) and implemented in
schemes. Thus, the new government Maharashtra and the RSBY was
36 Vol. 47 Issue No. 2 August 2018| |
withdrawn across the whole state. 6. Provision of free medicines and food
RSBY covered a wider range of during the treatment.
services including secondary level7. Patients can avail follow-up services up
heath care and primary level liketo 10 days after discharge. In case of
normal deliveries, which is notprocedures where follow-up packages are
included in RGJAY, a tertiaryavailable, these can be availed by the
healthcare oriented scheme.patients later as per the treatment
The State of Maharashtra launched the schedule.
RGJAY on 2 July 2012 in a phased8. Cashless coverage of 121 listed follow-
manner starting with eight districts andup procedures.
after a span of a year; the second phase9. The NIC has outsourced services to threewas launched on 21st November 2013
IRDA certified TPAS (Third Partyin rest of the districts.Administrators) - MD India, Medi assist,
Salient Features of RGJAYare :and Paramount.
1. Total sum insured is INR 1,50,000 per10.There is a separate space for the RGJAY
family per annum on a floater basis. Anaarogyamitras allocated in the form of
exception for renal transplant has beenRGJAY counter/kiosk, which should be
made where the maximum ceiling is INRlocated at the entrance of the hospital or
2,50,000.besides registration counter.
2. Pre-existing health conditions too are11.RGJAY kiosk is equipped with a
covered. If the beneficiary is sufferingcomputer with networking, printer,
from any disease or medical conditionscanner, bar code reader and digital
prior to the scheme inception are alsocamera in order to carry out all the
included in the scheme. Cashlessactivities associated with registration,
coverage of the pre-decided 971preauthorization and claim settlement.
procedures / surgeries is provided across
30 specialties. Also, 131 out of 971 of 12.Free Outpatient Department (OPD)
these procedures can only be carried out consultation for patient seeking RGJAY
in public hospitals. package.
3. Provision for a health card, post The RGJAY has been renamed as Mahatma
enrolment, for the purpose of beneficiary Jyotiba Phule Jan Arogya Yojana (MJPJAY)
identification. from 1stApril 2017.
4. The scheme provides for reasonable pre The upcoming Health scheme of the Modi
and post-hospitalization expenses for one Government is Ayushman Bharat Yojana -
day pr ior and f ive days af te r National Health Protection Scheme (AB-hospitalization. NHPS) which is somewhat similar to the
MJPJAY.5. Provision for one-way transport
allowance. Salient features of AB-NHPS are presented.......
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38 Vol. 47 Issue No. 2 August 2018| |
n order to provide a service to create a in multiple agencies to ensure seamlessIhealthy, capable and content new India, a coordination between the center and states.
new Health Program called Ayushman One of the core principles of this scheme is to
Bharat Yojana or National Health have co-operative federalism and flexibility
Protection Scheme, also known as to states.
Modicare, is going to be launched soon. Dr.Salient features of the NHPS are :
Indu Bhushan has been appointed as the1) Ayushman Bharat - National HealthChief Executive Officer (CEO) for this
Protection Mission will have a definedscheme.benefit cover of Rs. 5 lakh/ family/ year.
It has two goals :2) Benefits of the scheme are portable
1) To create a network of health andacross the country and a beneficiary
wellness infrastructure across the nationcovered under the scheme will be
to deliver comprehensive primaryallowed to take cashless benefits from
healthcare services.any public/private empanelled hospitals
2) To provide insurance cover to at least 40 across the country.
per cent of India's population who are3) Ayushman Bharat - National Health
deprived of secondary and tertiary careProtection Mission will be an
services.ent i t lement-based scheme with
Ayushman Bharat Yojana consists of two entitlement decided on the basis of
major elements : deprivation criteria in the SECC
(Socioeconomic Caste Census)1. National Health Protection Scheme
database.(NHPS) : which will provide cashless
treatment to patients. 4) The beneficiaries can avail benefits in
both public and empanelled private2. Wellness centers : who will be provide
facilities.primary care to the patients.
5) To control costs, the payments forIn fact, the government plans to upgrade the
treatment will be done on package rateexisting Public Health Centers to Wellness
(to be defined by the Government inCenters. According to the latest news, the
advance) basis.welfare scheme might be rolled out on
August 15, 2018. The Government has roped 6) For giving policy directions and
AYUSHMAN BHARAT YOJANA :
IMPACT ON MEDICAL PROFESSIONALS
Prof. Sushmita BhatnagarHon. Secretary [email protected]
39Vol. 47 Issue No. 2 August 2018| |
fostering coordination between Centre implementation process of NHPS and
and States, it is proposed to set up assured us to involve AMC in future
Ayushman Bharat National Health meetings/discussions. The salient features of
Protection Mission Council (AB- this meeting were :
NHPMC) at apex level Chaired by Union1. Association of medical Consultants was
Health and Family Welfare Minister.introduced to Dr. Indu Bhushan, CEO of
7) States would need to have State Health Ayushman Bharat. He patiently listened
Agency (SHA) to implement the to the purpose of our visit, and offered his
scheme. inputs and suggestions,
8) To ensure that the funds reach SHA on 2. Delivery of healthcare services of
time, the transfer of funds from Central Ayushman Bharat scheme (NHPS)
Government through Ayushman Bharat - through Nursing Homes was discussed
National Health Protection Mission to as well as the gate-keeping mechanism to
State Health Agencies may be done allow the nursing homes to be an active
through an escrow account directly. participant in dealing with secondary
patient care upfront and the larger9) In partnership with NITI Aayog, a
hospitals in both public and privaterobus t , modular, sca lab le and
sector taking care of tertiary levels ofinteroperable IT platform will be made
care,operational which will entail a paperless,
cashless transaction. 3. Criteria of empanelment in NHPS
should not be as rigid as NABHWhether we empanel with this scheme or
(National Accreditation Board fornot, the AB-NHPS will have a great impact
Hospitals) criteria,on all the medical professionals (we are the
fundamental key for delivery of healthcare 4. FEQH (Forum for Enhancement of
services)!! Quality in Healthcare) quality control
criteria of AMC are already existent andWhile deliberating on the technicality of
these can be utilized by NHPS afterimplementation process of this scheme for
relevant modifications, as qualifiedour AMC members, certain features
personnel from all sections are requiredunfolded which mandated discussion with
for the delivery of NHPS,the CEO of Ayushman Bharat scheme.
Hence, a meeting with CEO AB-NHPS, 5. Government can fund the existing
Dr. Indu Bhushan was organized on 12th July institutes/centers for up gradation and for
2018 at Nirman Bhavan, New Delhi at 5.15 making them self-sufficient (as required)
pm . AMC was represented by President for dealing with patients registered under
AMC Mumbai Dr. Vipin Checker, and NHPS,
Hon. Secretary AMC Mumbai, Dr. (Prof.)6. The rates for the treatment in different
Sushmita Bhatnagar.categories are not viable, as they do not
We had a fruitful discussion and CEO- even cover the cost of medicines and
NHPS, Dr. Indu Bhushan appreciated and consumables. The rates for NHPS
acknowledged our interest in the registered patients circulated widely
40 Vol. 47 Issue No. 2 August 2018| |
show that these are much less than the violence, increased medico-legal issues
GIPSA (General Insurer's Public Sector and thus chaos and deterioration in the
Association) rates, which themselves are entire organization,about 50% less than the original rates.As
8. AMC represents about 11 ,000per the costing exercise done by AMC
consultants who are the main source ofthrough Hosmac, there is wide variation
healthcare delivery and hence should be in the basic costs even within and on
included in the further meetings andoutskirts of Mumbai, hence there coulddiscussions on the NHPS.be differential costing of treatment,
Dr. Indu Bhushan accepted all the points and7. Medicolegal issues including violencesaid that most of the points are valid. Heagainst doctors arising subsequent toinformed on the current situation inmanagement of patients registered underMaharashtra where other schemes such asthe NHPS needs to be given moreMahatma Jyotiba Phule Jan Arogya Yojanasignificance and should be deliberated(MJPJAY, previously known as Rajivupon. The expectations of populationGandhi Jeevandayee Arogya Yojanaregistered with NHPS are going to beRGJAY) is also in place and that more needshigh on one end, and on the otherto be done within Maharashtra for success ofhealthcare delivery shall be with nominalNHPS. Differential rate structuring iscosts with use of generic drugs, etc. Wepermissible within the State Governmentsanticipate a mismatch between patients'
and its upto the State Governments to takeexpectations and healthcare delivery
systems thus giving way for mob this forward.
41Vol. 47 Issue No. 2 August 2018| |
s per our tradition, this year also AMC Award of Distinguished Services. He wasAheld a celebration for Doctor's Day. felicitated by a memento, shawl and shrifal
This year, team AMC decided to have an as per tradition. Dr. Vipin Checker, Dr. Bipin
AMC Talent Nite - by inviting our own Pandit, Dr. S.S. Khambay and Dr. Ajit Desaimembers to perform. The venue was the did the honours.conveniently located Bal Gandharva Rang
Dr. Achut Nayak gave his acceptance speechMandir in Bandra West. On 1st of July, from
in which he thanked everyone and gave his5:30 pm to 10:30pm, 38 Medical
vision for present and future generationsConsultants gave a grand performance of
fromAMC members.solo songs, duets, Group songs, group dance,
Past President Dr. Ajay Hariyani was invitedperforming on musical instruments, etc andon stage and was felicitated by Presidententhralled the audience.Dr. Vipin Checker with memento and Vice
The Program started by welcoming thePresident Dr. Deepak Baid gave him
guests and Ms. Ridhima anchored thebouquet.
program.Past President Dr. Sangeeta Pikale was
It was highly appreciated by all andinvited on the stage and President Dr. Vipin
applauded by everyone.Checker felicitated her with a memento and
The felicitation program was held where Dr. Rajendra Nagarkatti gave her bouquet.President Dr. Vipin Checker updated the
Past President Dr. Veena Pandit was invitedaudience on the details of the 15 programs of
on the stage and President Dr. Vipin CheckerAMC conducted in 16 weeks (from the time
felicitated her with memento and Dr. Nilimahis team 2018-2019 took over). An
Vaidya Bhamare gave her bouquet.impressive performance indeed! He also
Past President Dr. Smita Sharma was invitedtalked about his future plans and appealed toon the stage and President Dr. Vipin CheckerallAMC members to come forward and workfelicitated with memento and Dr. Ashoktogether to make our society and our country
healthier and happier. Shuckla gave gave her bouquet.
Senior AMC member Dr. Achut Nayak was President Dr. Vipin Checker felicitated
the recipient of this year's Sanjeevani Trust's Dr. Dhiren Kalawadia (Convenor) and
Doctor’s Day
Sanjivani Award recipient Dr. Achyut Nayak
42 Vol. 47 Issue No. 2 August 2018| |
Dr. Hitesh Parikh (Co Convenor) with This program was successful due to the
contribution and hard work of all thememento.participants who came for practice sessions.
Mr. Shabbir Khokar was felicitated with aTeam AMC 2018-19 was ready to guide and
memento by President Dr. Vipin Checker.encourage the participants.
Mr. Nandkumar Kerkar who was master ofThe auditorium was packed and the audience
orchestra was felicitated with a memento byenjoyed the show till the end. The
President Dr. Vipin Checker. enthusiasm of the audience and artists was
visible in every part of the program and it wasAll of the talented AMC artists who
an evening worth spending with colleaguesperformed on the stage were felicitated byenjoying the cultural program.President Dr. Vipin Checker after each
performance by giving them memento and Vote of Thanks was given by Programappreciating their fantastic performances. Committee Chairperson Dr. Vivek Dwivedi
leaving all those present with beautifulThe academic partners of theAMC programsmemories of Doctor's Day 2018.Suburban Diagnostics, Abott Pharma,
Finovate, Ring Tone, Care Soft, SMS and Dr. Vivek Dwivedi
HCG were also present. Program Committee Chairman
Felicitation of Past Presidents
Dr. Smita Sharma 2017-18 Dr. Veena Pandit 2016-17
Dr. Sangeeta Pikale 2015-16 Dr. Ajay Hariani 2012
43Vol. 47 Issue No. 2 August 2018| |
Doctor’s Day PARTICIPANTS
Dr. Anagha Kinare
Dr. Anjum Syed, Dr. Manjusha Shrivastava &Dr. Sumit Shrivastava
Dr. Anand Kumar
Dr. Ashish Sharma
Dr. Atul Wankhede
Dr. Bharat Bhosale
Dr. Bipin Pandit Dr. Dhananjay Chandurkar
Dr. Dilip Bhosale Dr. Geeta Mishra
Dr. Hitesh Parikh
Dr. Ila Shah
44 Vol. 47 Issue No. 2 August 2018| |
Dr. Kishore Nichani
Dr. Kumar Doshi
Dr. Lalita Mayadeo Dr. Manish Sharma
Dr. Milind Surwade Dr. Namrata Joshi
Dr. Nilima Vaidya-Bhamare Dr. Pooja Bandekar
Dr. Prashant Mullerpatan Dr. Pushkar A. Shikarkhane
Dr. Rajesh Valand Dr. Ravi Shah
45Vol. 47 Issue No. 2 August 2018| |
Dr. Rohini Badwe Dr. Roopa Upadhyay
Dr. Salil Bendre Dr. Sangeeta Aranke
Dr. Sanjay Kinare Dr. Shailya Patel
Dr. Shashikant Kamat
Dr. Swati Petkar Dr. Uday Aranke
Dr. Varsha Dandwate Dr. Vikram Badhe
Dr. Sushmita Bhatnagar
47Vol. 47 Issue No. 2 August 2018| |
AMCON - 2018thDate : Sunday 18 November 2018
Conference Venue : The Lalit Hotel, Andheri (E), Mumbai8.00 am to 5.00 pm &
Banquet Venue : Kitty Su, The Lalit Hotel, Andheri (E), Mumbai7.00 pm to 11.00 pm
Modes of Payment
(After Payment Please send UTR Number to )
Paytm : 98674 50066
AMC Office : 98674 50066 / 2683 6019 / 2684 1109Email : [email protected]
Registration Member/Spouse/Guest(accepted only on full payment)
Conference Charges
Banquet Charges (Unlimited food & FML)
Conference + Banquet Charges (Unlimited food & FML)
For Registration Contact :
Upto 30th September Rs. 1000/-Upto 30th October Rs. 1500/-
Upto 7th November Rs. 2000/-After 8th November Rs. 2500/-
Upto 30th September Rs. 2000/-Upto 30th October Rs. 2500/-
Upto 7th November Rs. 3000/-After 8th November Rs. 3500/-
Upto 30th September Rs. 2700/-Upto 30th October Rs. 3600/-
Upto 7th November Rs. 4500/-After 8th November Rs. 5400/-
Cheque in the Name of"Association of Medical Consultants, Mumbai"
[email protected] or 98674 50066
NEFT Details : Central Bank of India Branch, Andheri (E)A/C No : 3154847256 IFSC : CBIN0280595 MICR : 400016003
Cash at AMC office / Managing Committee
48 Vol. 47 Issue No. 2 August 2018| |
FOR IMMEDIATE SALE Prime Location, 25 Bedded, 4000 sqft Carpet, 11 ft ceiling,
running Hospital, 2nd Floor private elevator, 6 private rooms, consultation rooms, ample
water and electric @ Vartak Nagar Naka Thane.
With clear title. [email protected]; 98673 28707; 98214 42341.
RUNNING PATHOLOGY LABORATORY FOR SALE : Business & Premises for
sale : Well established LABORATORY past 28 years, Kandivali (W) for OUTRIGHT
sale. BMC sanctioned ownership space, 612 sq ft carpet; prime location; complete setup
of machines and inventory, infrastructure; Established and reputed business with a
database of clientele.
Serious buyers may Contact : 98198 24224.
For outright SALE, 40 years of well running, maternity and Surgical Nursing Home
near Dadar T. T. with fully equipped O.T. and valid Registration and licenses contact :
Mobile No.: 98200 25460 / 98207 42641 or send on What'sApp.
HOSPITAL FOR LEASE : Ten bed functioning hospital with all facilities situated on
ground floor (Boisar West, very near railway station) for Lease for Orthopaedic/Surgical/
Obst. Gynaec. specialities.
Independent separate entry to hospital. Contact : 98238 72540.
Contact :
CLASSIFIEDS AVAILABLE / REQUIRED
CLASSIFIEDS MATRIMONIAL
Alliance invited for 33 yr female (M.D.) Maratha, 5'4", slim, fair, beautiful, lecturer in
medical college, residing in Mumbai, from a well educated family. Requires a suitable
boy, Mumbai based, preferably a medico. Caste no Bar.
Contact : 98692 21676 / 98214 09967.
Mumbai based doctor parents seeking alliance for their daughter 1991 born perusing
MD. anaesthesia from P.G medico.
Contact : 98336 33335.
Doctor family seeking a suitable alliance for MBBS qualified November 1991 born /
5'3" fair, good looking Tamilian girl currently pursuing PG General Medicine (DNB) final
year. Groom should be postgraduate MD/MS/DNB/MCH/DM settled in Mumbai.
Contact : 98211 27924 / 98212 15564.
49Vol. 47 Issue No. 2 August 2018| |
May 29, 2018 : Capping hospital profits: Delhi puts draft policy in public domain.
Jun 03, 2018 : Indian doctors in UK join call to end visa cap.
May 29, 2018 : Hospital suspended from insurance scheme of state.
Jun 03, 2018 : Govt may bring in new curbs on drug prices.May 31, 2018 : Only senior doctors to give
bad news to patients' kin.
Jun 02, 2018 : Private hospitals oppose 'low' Jun 04, 2018 : Revisit norms for the right Modicare rates.vitamin D levels for Indians.
Jun 04, 2018 : Private cord blood banks play on parents' fears.Jun 02, 2018 : Attempting suicide is no longer
a crime.
New Delhi :
London :
Mumbai :
New Delhi :
Mumbai :
New Delhi :Mumbai :
Mumbai :
Mumbai :
crime in India with the health ministry notifying on May 29 the Mental Healthcare Act 2017 that decriminalises this. The Delhi government put in the
public domain the draft prepared by it on capping of profits by private hospitals for scrutiny and feedback. A leading association of Indian
doctors in the UK has thrown its weight behind a new 'Scrap the Cap' campaign against the "rigid" visa norms that are blocking hundreds of A local hospital found overcharging Indian doctors from helping the country's state 20 poor patients who availed of the state scheme funded National Health Service.has been suspended from the scheme by the
newly appointed CEO.
Among the changes proposed by the government is a move to introduce a new Any bad news about patients price index for pharmaceutical products that admitted to civic-run hospitals will be conveyed will become the benchmark to determine prices to their relatives by a senior medical teacher of all medicines sold in the country -even those instead of resident doctors, who are essentially that are currently outside the drug price control postgraduate students. order.
Some major private hospitals like Traditionally, Indians have shown to Fortis, Apollo, Medanta and Narayana Health
be deficient in vitamin D, prompting doctors to have expressed concern over the government's say that India suffers from a "vitamin D ambitious 'Ayushman Bharat' fixing prices of paradox". some critical procedures, saying the rates are
not viable for them.
Paying huge sums of money to bank your child's cord blood in a private cord blood Attempting suicide is no longer a bank is of limited use and the government ought
FROM THE PRESSDr. Pradeep Baliga
Editor's Note : Media reports relating to Doctors and Healthcare have increased and it is not possible to publish details of all. The author can be contacted if more details are needed.
50 Vol. 47 Issue No. 2 August 2018| |
to be investing more in public cord blood banks. Considering that some donors at
blood banks test positive for HIV but don't
return for counselling and treatment, Mumbai
District AIDS Control has introduced a systemMany women with early stage breast to reach out to them.
cancer who would receive chemotherapy under
current standards do not actually need it,
according to a major international study that is
expected to quickly change medical treatment. There is rise in abortion related
mortalities in India due to poor awareness about
the MTP Act, said a panel of doctors and health
policy experts at a conference organized by The state has upped its ante against Global Health Strategies.
tuberculosis, as the health department has
expanded access to the newest anti-TB drug -
Bedaquiline, to patients across Maharashtra.
MCI has recommended that the
Union Health Ministry prohibit 82 medical
colleges in the country from admitting studentsAround 70% of miscarriages
for the academic session 2018-19.reported in Maharashtra every year are from
rural areas, which has 55% of the state's
population, revealed data available with public
health department. The Bombay high court asked the
state government to furnish details of the action
taken against illegal private nursing homes and Prices of some procedures under
hospitals across Maharashtra.the proposed government-run Ayushman
Bharat National Health Protection Scheme may
go up in some states.
A state government study on
angioplasty patients has questioned certain
cardiological practices in the country, findingFor the first time, Indian Psychiatric
that total stented length greater than 31.5 mmSociety, country's largest body of mental health
was associated with mortality.professionals, announced its official stance on
homosexuality. The society has asked its
members to 'stop considering homosexuality as
an illness'. National Commission has held that
an insurer who renews the policy cannot later
back out by terming the policy to be a fresh one.
India has registered significant
improvement in an area where it has lagged by
reducing maternal mortality deaths from 167 in The Bombay high court has told the2011-13 to 130 (per lakh live births) in 2014-16. state government to employ doctors from other
parts of the country to fill the gap in rural areas
of the state.
Jun 04, 2018 : Many breast cancer patients
don't need chemo.
Jun 08, 2018 : Abortion-related deaths due to
poor knowledge of law.
Jun 04, 2018 : New TB drug now available
across state.
Jun 08, 2018 : MCI blacklists medical
colleges for this session.
Jun 05, 2018 : 70% miscarriages reported
from rural area.
Jun 09, 2018 : List out action taken against
illegal hospitals.
Jun 06, 2018 : Modicare rates may rise.
Jun 09, 2018 : Too many stents can kill you,
warns study.
Jun 06, 2018 : Don't treat homosexuality like
a mental illness.
Jun 11, 2018 : Renewed insurance policy
after a break?
Jun 07, 2018 : Fewer mothers dying in
childbirth across India.
Jun 12, 2018 : Recruit doctors from across
country.
Jun 08, 2018 :AIDS control trust to reach out
to HIV+ donors.
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Jun 12, 2018 : AIIMS postgraduates to be Jun 15, 2018 : Drugresistant bacteria thrive
hired directly. at beaches.
Jun 12, 2018 : Govt wants blood banks to be Jun 15, 2018 : Strong basic healthcare cuts
'centres'. hospital spend.
Jun 13, 2018 : Private medical college
derecognized.
Jun 17, 2018 : Yoga is a science that enhances
health.
Jun 13, 2018 : Health spending pushed 55m
into poverty in a year.
Jun 17, 2018 : Penalty for selling
'unapproved' drugs.
Jun 14, 2018 : MBBS education gets more
elusive.
Jun 18, 2018 : PM exonerates qualified
doctor who was blamed for quack's fault.
Jun 15, 2018 : 48% infertile women have
latent genital tuberculosis.
Jun 19, 2018 : Gaming addiction a mental
illness.
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All post-graduates emerging from The water hitting the shores of
AIIMS will now be absorbed within the Mumbai's most visited beaches contains
institutes across the country as part of the bacteria that is resistant to more than 12 sets of
government's move to fill up huge vacancies of antimicrobial drugs, a study by the National
doctors and faculty positions. Institute of Oceanography has found.
The Centre has proposed to rename Strengthening health subcentres by
'blood banks' as 'blood centres' across the ensur ing adequate medic ines , bas ic
country and streamline the existing rules for infrastructure and trained personnel drastically
blood donation. reduces out-patient visits to private hospitals
and clinics and hence also out-of-pocket
expenses by families, a study by Centre for
Technology and Policy in IIT Madras found.Just two months after it got a free
hand from the state government to decide its fee
structure, Vedantaa Institute of Medical
Sciences has been derecognized by the MCI, Yoga, which recently trended on
which reported "large-scale" infrastructure social media thanks to Prime Minister sharing
deficiencies, including inadequate teaching his exercise regimen, virtually lights up the
staff, at the institute. brain, according to a city pulmonologist's
scientific study on why yoga's practitioners stay
alert and healthy.
About 55 million Indians were
pushed into poverty in a single year because of
having to fund their own healthcare and 38 The Centre is working to plug a
million of them fell below the poverty line due legal loophole that allowed major drug
to spending on medicines alone, a study has manufacturers to sell and market products such
estimated. as emergency contraceptives and anti-obesity
and fertility formulations which have not
undergone clinical trials to establish risk and
efficacy. Sought-after deemed universities in
the state have raised their MBBS fees by up to
80% this year, with the charges of six of them
crossing Rs 20 lakh/year. National Commission has held that
allegations of negligence which are contrary to
the post-mortem report should not be made.
Genital tuberculosis, which is
dormant in uterus, decreases a woman's egg
count leading to infertility, revealed a new study World Health Organisation has
published in medical journal Human listed 'gaming disorder' as a mental illness,
Reproduction. putting it parallel to alcohol and drug abuse,
52 Vol. 47 Issue No. 2 August 2018| |
in the revised International Classification of In a move to regulate quality of
Diseases. high-end medical devices and equipment,health ministry has proposed to expand the listof devices under the purview of drug law.
Medical students at state-run JJHospital in Byculla will - like IITians - soonwear entrepreneurial hats and market medical
BMC hospitals have begun a innovations.clampdown on the nexus between its doctors
and privately-run pathological laboratories,The government is considering afollowing a series of complaints about what is
proposal to make essential medicines morepopularly referred to as 'cut practice' in medicalaffordable by capping prices at the first 'point ofcircles.sale' rather than retail price
The state medical educationUndergoing treatment for infertilitydepartment is having a tough time over mass
is expensive, time-consuming and emotionallyexodus of temporary lecturers from Grantdraining for couples. The fact that it is notMedical College and JJ Hospital over frequentcovered by insurance makes it accessible only to'VIPduties'.the wealthy in India.
The Supreme Court has directed aThe IMAannounced the creation of aJalgaon medical college to pay Rs 20 lakh as
'violence registry' to document every assaultpenalty to each of the 19 meritorious studentsagainst medical personnel or establishments onwho were "illegally" and "wrongly" refusedthe National Doctors' Day.admission by it six years ago.
Considering that housing is the mostIn the absence of laws aboutvexed and the most sought-after issue in
surrogacy in the country, the state governmentMumbai, civic authorities are holding it out as ahas taken a step towards formulating guidelinestantalizing carrot to rope in doctors into itsfor monitoring and regulating surrogacyhealthcare system.centres.
PM reached out to doctors through
"Mann Ki Baat" and said they were an essential
part of society adept not only in treating
ailments but also as friends and lifestyle guides
to people.
A division bench of HC said though
Jun 21, 2018 : Diabetes, high blood pressure
cases double.Jun 29, 2018 : State boosts healthcare with e-
Jun 21, 2018 : Young adults account for 33%cells, training and free ops.
of suicides.
Jun 22, 2018 : KEM dean draws first blood
against doctors' cut practice.
Jun 29, 2018 : Govt mulls cap on drug prices.
Jun 22, 2018 : Fed up, 12 medical lecturersJun 29, 2018 : IVF comes with stiff price tag,quit in a year.no insurance.
Jun 25, 2018 : College ordered to payJul 02, 2018 : Now, registry to keep count ofRs 3.8cr for refusing admission.doctor attacks.
Jul 03, 2018 : Child rights committee takesJun 25, 2018 : Quarters for family housing.steps.
Jun 25, 2018 : PM reaches out to doctors.Jul 04, 2018 : Decide on bringing nurses
under MESMA- HC.
Jul 04, 2018 : BMC to screen diabetic
patients.
Jul 06, 2018 : Marital woes can't be a reason
to end pregnancy.Jun 28, 2018 : More medical devices to come
under purview of drug law.
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women have a constitutional right to their body violence, to medically terminate her 24-weekand reproductive choices, matrimonial discord pregnancy, the SC admitted her case.cannot be the basis to request termination ofpregnancy beyond 20 weeks.
A set of recent guidelines from theMaharashtra's FDA has warned MCI excluding persons with benchmark
citizens against ayurvedic medicines that claim learning disabilities from taking admission into improve vitality, sexual prowess, cure MBBS course under the physical lychronic diseases like diabetes and cancer or treat handicapped quota has dashed hopes of manyblood pressure, psychological issues and heart students across the state.problems.
Use of animals for experiments and Newly formed National Testing research across medical and other courses in
Agency would now conduct the national-level India will soon be stopped.examinations - NET, NEET, JEE Mains - thatwere organised by CBSE.
Clearing the air around its
requirement avail benefits under AyushmanThe MCI and the NBE have Bharat National Health Protection Scheme, the
cracked down on institutions running health ministry said Aadhaar is "desirable" butunrecognised postgraduate medical courses, not mandatory to avail benefits under theincluding those in emergency medicine. insurance scheme.
With a constitution bench of the SC Chemists and pharmacists willset to hear a petition challenging criminalising march to the Food and Drug Administrationhomosexuality, the Indian Psychiatry Society
office in the Bandra Kurla Complex to protestsaid homosexuality was not a psychiatric
the sale of medicines online.disorder.
Out of 1,500 complaints receivedThe death rate due to cardiac
against doctors who are doing practice in areas diseases declined significantly in the US
out of their expertise, action was taken only inbetween 1990 and 2016 even as it continued to
20 cases.rise in India in the same period, withcardiovascular diseases being the leading causeof death.
The state public health department
will establish enrolment centres in around 500
of its hospitals for Aadhaar linked birthNearly three weeks after the Bombay
registrations.HC refused to entertain the plea of a 20-year-oldwoman, who claimed to be a victim of domestic
Jul 12, 2018 : MCI rules bar learning
disabled from MBBS.Jul 07, 2018 : FDAseizes 'magical' medicines.
Jul 12, 2018 : MCI works on animalfreeJul 08, 2018 : NEET, JEE Mains to be held curriculum for courses.twice a year.
Jul 13, 2018 : Govt : Aadhaar 'desirable', not
must for NHPS.Jul 08, 2018 : MCI, NBE crack down on
'illegal' PG courses.
Jul 09, 2018 : Homosexuality no disorder - Jul 13, 2018 : Chemists, pharmacists toIPS. protest.
Jul 13, 2018 : MMC will submit itsJul 10, 2018 : Cardiac deaths dip in US, up in
investigation report next week.India.
Jul 13, 2018 : UID-at-birth at 500 hospitals
soon.
Jul 11, 2018 : SC allows abortion plea of
'domestic violence' victim.
Jul 14, 2018 : Govt to restructure NELM.
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In good news for patients, the
government has decided to restructure the
National List of Essential Medicines with the While alcohol led to a 65% increaseobjective to make it more contemporary, and in in deaths due to liver damage in the US in theline with public health needs. past 17 years, doctors say non-alcoholic liver
disease is emerging as a greater worry in India.
Mobile app by Association of The Ministry of Health & FamilyMedical Consultants is used to raise an alarm Welfare has managed to bring on board IMAduring attack by patients' kin. Doctors can under Ayushman Bharat to facilitateexpect quick support from fellow medicos with empanelment of hospitals with the insurancea mere tap on their phones that will send an alert scheme.message.
High fees in most medical colleges
mean that students who have to take loans to pay
it, cannot hope to service the loans from whatThe Supreme Court denied a 20-they earn as doctors after completing MBBS.yearold woman permission to terminate her 25-
week-old pregnancy, stating that aborting a
healthy foetus that is unlikely to affect the
mother's physical health amounted to murder.Sixteen years after an unsterilized
needle used on an 18-year-old Kandivli youth
for viral fever led to development of "gas
gangrene" and his subsequent death, the stateThe Supreme Court declined to putconsumer commission dismissed an appeal byon hold Centre's new notification that stipulatesone of the two negligent doctors.rotation of images of cancer patients on the
packets of tobacco products while observing
that a large number of persons were suffering
from oral cancer. The National Commission has held
that when the cause of death is clear and foul
play is not suspected, it is not mandatory to get a
post-mortem.The MPCB has served a show-cause
notice to the state-run Central Hospital in
Ulhasnagar for illegally dumping its biomedical The Union health ministry's ban onwaste in the open, posing imminent danger to retail sale of oxytocin has sent gynaecologistshealth and environment. and obstetricians into panic mode.
Wadia Hospital for Children A total of 449 convictions haveconducts two-hour surgery on 22-day-old boy to been secured till March this year from across theremove vaccination needle stuck in the hip; country, for violations under the PCPNDT Act,parents have alleged negligence by a Panvel 1994, according to a report released by the
nursing home. Union health ministry.
Jul 20, 2018 : Non-alcoholic liver disease
emerges as a big worry.
Jul 15, 2018 : Doctors under attack - AMC
App to rush immediate help. Jul 20, 2018 : IMAto help empanelment.
Jul 22, 2018 : Many doctors in debt trap.
Jul 17, 2018 : SC - Aborting healthy foetus
akin to murder
Jul 23, 2018 : Infected needle kills teen,
doctor to pay ?4L.
Jul 17, 2018 : More graphic tobacco pack
warnings soon.
Jul 23, 2018 : Autopsy not must to claim
insurance in accident death.
Jul 19, 2018 : Ulhasnagar hospital flouting
medical waste norms.
Jul 23, 2018 : Ban on retail sale of oxytocin.
Jul 20, 2018 : 2-cm needle removed from Jul 23, 2018 : Haryana tops list of foetus testbaby's hip joint. offenders
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Jul 24, 2018 : Shortage of medicines cripples Jul 27, 2018 : State addition to domicile norm
hospitals. held valid.
Jul 25, 2018 : HIV cases in India came down
by 27%.
Jul 27, 2018 : Drug board backs ban on 343
FDCs.
Jul 25, 2018 : No organ retrieval at
unregistered hospitals.
Jul 28, 2018 : Fake CPS certificates scam.
Jul 26, 2018 : Newborns to get hepatitis B
vaccine for free.
Jul 28, 2018 : Viagra, anaesthetic found in
ayurvedic potency pills.
Jul 27, 2018 : Mumbai hero wins Magsaysay
Award.
Jul 30, 2018 : Prescription sans diagnosis is
culpable negligence.
Jul 27, 2018 : Word 'charitable' must for
charity hospitals.
Jul 31, 2018 : Top hospitals wrongly charge
poor, forced to pay refunds.
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An acute shortage of medicines at In a landmark verdict that sets to reststate-run hospitals - including the big four in the medical admission chaos of recent years, thecity - has plunged the state's health delivery Bombay high court held that the statesystem into an unprecedented crisis. government was empowered to make it
mandatory for aspirants to the 85% state quotaseats in undergraduate medical courses to notonly be domiciled here but also have completed
India has witnessed a major both Class X and XII from the state.reduction in its AIDS burden with new HIVcases dropping by 26.6% and AIDS-relateddeaths declining 56.8% between 2010 and2017, a latest report by the United Nations says. The country's top drug advisory
board has backed the health ministry's decisionto ban 343 fixed dose combinations, some ofwhich were commonly used drugs used in
The state government told the treatment of cold and cough.Bombay high court that organ retrieval cannotbe allowed at hospitals not registered underprovisions of the Transplantation of Human The MMC has barred seven MumbaiOrgans and TissuesAct. doctors from practicing for five years, and
another 50, also from the city, for a year forallegedly submitting fake certificates of PGdiploma and fellowships from the College of
The National Liver Foundation and Physicians and Surgeons.Mumbai Obstetric and GynecologicalAssociation have joined hands in a bid to ensurethat no child born in Mumbai will be leftunprotected due to the lack of a free hepatitis B TheAurangabad division of FDAhasvaccine shot. found sildenafil citrate and a short-acting
anaesthetic drug in two ayurveda medicinesmeant to increase sexual desire and potency thatwere randomly tested for quality recently.
A Borivali psychiatrist, whoserehabilitation foundation rescues mentally-illpersons living on the streets and reunites themwith their families, is among the six A prescription by a doctor without apersonalities who have won this year's diagnosis would amount to culpable negligence,prestigious Ramon MagsaysayAward. the Bombay high court has said while rejecting
the pre-arrest bail plea of two doctors accused ofculpable homicide not amounting to murder forthe death of a woman five days after child-birth.
It is now mandatory for 430charitable hospitals in Maharashtra, 74 of thesein thw city, to mention the word "charitable" or"dharmaday" in their names for easy The state has cracked down on aidentification by poor patients. number of hospitals in Navi Mumbai, including
56 Vol. 47 Issue No. 2 August 2018| |
leading ones such as Terna, Dr. D. Y. Patil and The MMC has suspended the licence
MGM, for wrongly charging poor patients. of a Borivali-based diploma holder in radiology
for promising to treat a mentally disabled boy by
using stem cell therapy and cheating the family
of Rs 3 lakh.
Going by data given to Parliament
by the MCI, there are more than 10.8 lakh
doctors registered. In reality, no one really
knows as is evident from the MCI's own answer
Majority of the complaints - 80 per that 80% availability has to be assumed fromcent, in fact - received from citizens against this total number.doctors are because of a misunderstanding
between the doctors and patients or their
relatives, the MMC revealed.
The State chapter of the IMA has
issued an advisory to doctors to avoid phone
consultations; only in grave emergencies, and
that too when the doctor is aware of the
concerned patient's medical history, should
advice be dispensed over the phone.
Initiating breastfeeding within first
hour of birth is crucial to avert neonatal deaths
as well as to ensure proper growth and
development of a child.Maharashtra may soon get its first
digital autopsy unit, where forensic experts will
use high-definition scans instead of cuttingAs more women seek the high courts' open bodies to find out the cause of death.
permission to get abortions beyond the 20-week
legal deadline, more doctors in the state are
providing legal aid to petitioners.Four national institutes working on
anti-TB medication that will cut down duration
of treatment; the first phase of trials showsOver the past three years, the number 'remarkable' success.
of students not being able to crack MBBS
admissions have increased, revealed the DMER
data. (Sourced from various agencies)
Jul 31, 2018 : TB patients' families can get Rs
500 govt aid in their a/cs.
Aug 01, 2018 : Antibiotics use in animalAug 07, 2018 : How many doctors does Indiaproducts to be curbed.have?
Aug 02, 2018 : UP set to emerge as medical
education capital.
Aug 03, 2018 : Issues between doctors,
patients due to confusion.
Aug 08, 2018 : New MBBS syllabus to focus
on hands-on training.
Aug 09, 2018 : Four more hospitals to keepAug 04, 2018 : No phone consultations.
advanced TB drug.
Aug 10, 2018 : Acute shortage of HIV
medicines.
Aug 11, 2018 : State councils blame MCI for
docs' registry mess.
Aug 13, 2018 : Sion hospital to now perform
autopsies 24x7.Aug 04, 2018 : Breastfeeding within 1st hour
of birth key to survival. Aug 14, 2018 : BMC hospitals may get
surgical robot.
Aug 14, 2018 : Nair Hospital likely to get first
digital autopsy centre in state.
Aug 04, 2018 : Doctors come to legal rescue of
women.
Aug 15, 2018 : IIT's anti-TB 'inhaler' drug
holds out hope of faster recovery.
Mumbai :Aug 06, 2018 : No. of students to crack MBBS
dipped.
Aug 07, 2018 : Cheat radiologist loses licence. [email protected]
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