ATTENTION- FORMER CHIEF JUSTICE, SUPREME COURT OF INDIA

To,

Justice R S Lodha,

Supreme Court committee,

Overseeing working of Medical Council of India,

Delhi.

Subject-  Requesting your intervention in matter of ‘cut- practice’ in medicine

Respected Sir,

I read in the newspaper that a committee under your able chairmanship has been set up to study and monitor the working of Medical Council of India, with particular reference to corrupt practices. I am writing this letter with the hope that something may be done about  ‘cut- practice’ in the medical profession.

‘Cut practice’ is the system of earning commission for referring patients to a particular doctor or medical organisation. It undermines medical care and harms the patient. Hence, it must be stopped as soon as possible. Cut- practice is labelled ‘unethical’ but the MCI or Maharashtra Medical Council have no set procedures to investigate or punish violations. It is not ‘illegal’ as there is no law against it.

 In 2013 Dr Bawaskar filed a complaint in the Maharashtra Medical Council about one such instance. Though the fact of giving cuts in this case was proved and admitted to by the defendent, no action can be taken on basis of a technicality- that the cut was issued not by an individual doctor but by a medical organisation. In effect, it seems that cut-practice is unethical for individuals but a legitimate business practice for groups of individuals. This can only be termed as a travesty. The case is now stuck at this point at the Mumbai High Court. Meanwhile, the Medical Council of India has passed a circular stating expressly that its mandate is only to act against individual registered doctors and not against organised group of doctors, further bolstering the above case. (I can provide you the details, if you wish. Meanwhile, you may see them on my blog mentordoc@blogspot.com)

 These developments are dangerous for the public. It endangers the ability to choose medical treatment that is competent and affordable. The most important intervention would be to bring medical organisations, associations and commercial healthcare entities under regulation by making registration under medical councils mandatory. Medical ethics and laws should be the same for individuals and groups.

I, therefore request you to study this matter deeply. With your knowledge, experience and authority you may be able to suggest a suitable remedy to stem this rot. Sir, an effective action will bring succour to all Indians. I exhort you to please do something in this matter.

I also request you to kindly acknowledge this letter, at least through email.

With much anticipation

Sincerely,

Dr Vani Kulhalli

(I HAVE POSTED ON BLOG BECAUSE EVEN AFTER 3 mts of SEARCHING I WAS UNABLE TO GET THE POSTAL OR MAIL ADDRESS. I JUST HOPE THIS WORKS.)

TIME MANAGEMENT IN PRACTICE

http://bmjopen.bmj.com/content/4/5/e004679.full

This is a continuation of my previous piece about time management in medical practice.

There is a lot of anger among the public over waiting in the doctor’s clinic. As  patient is in discomfort and pain, there is an expectation of relief at the earliest. When this expectation is not met- anger is likely. Some doctors do not care to organise their practice leading to time mismanagement and delays. The worst offenders are doctors who call all patients at the same time, so that they can arrive after a sizeable number assembles and then proceed to rush through the que. This is wilful waste of the patient’s time which is completely unforgiveable. Some doctors have given up on time management thinking it is a hopeless attempt and just announce their working hours. Any patient arriving within that time is seen on a first come first served basis. So essentially there is no appointment given. In all these scenarios the doctor has designed a schedule which is heavily weighted in the doctor’s favour and in favour of a patient who is disorganised consumer. Yes, some patients do feel reassured taking treatment from a busy doctor who makes them wait for hours- these patients are welcome to wait.

Working by appointments is by far the best way to work. It is good for the doctor as well as for the patient. It is the doctor’s responsibility to implement a system that ensures time management. The most important intervention to reserve the first two slots of the day to patients who are known to be punctual. Work must BEGIN ON TIME.  Second important intervention is to turn back and reschedule appointments of patients who come late. Patients should be accommodated for reasonable delay which may be upto 15 mins. Beyond that appointment stands cancelled. Thirdly, after every 4-5 appointments, an empty slot should be kept to accommodate delays and extended sessions. On certain days, when time- consuming interventions like therapy are to be done , patients come prepared to wait because I inform them in advance- so that is okay by them. I keep my side of the deal by not charging patients if I make them wait excessively, irrespective of who is at fault. Majority of patients appreciate the doctor’s punctuality. There are some patients who cannot understand all the fuss- but well the doctor has to take responsibility for clinic management not the patient.

After doing this for 15 years, I have a beautiful practice which allows me to start my day as planned and end it on time.