Will the government consider comprehensive insurance for doctors?

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Secretary Legal Affairs to head a committee on Comprehensive Insurance Scheme for Advocates: This should have been explored for doctors first

My colleague Ira, an advocate brought to my attention a recent PIB release (dated 8th March, 2019), which stated that the Government has set-up a five-member committee to examine the issues related to framing of a proper, structured scheme for providing of medical insurance cover to the advocates and also suggest modalities for the implementation of such scheme.

The Union Minister for Law set-up the committer under the chairmanship of Secretary Legal Affairs with members including a senior representative from the Department of Financial Services, representative of Department of legal affairs and one representative each from Bar Council of India and State Bar Councils.

The committee shall, within three months, recommend a comprehensive insurance scheme for the welfare of the advocates all over India to address concerns relating to untimely death and medical insurance.

The scheme may include assistance from central and state governments as also involvement of State Bar Councils and in the representatives operating lawyer’s welfare fund.

In 2001, the Central government had enacted the Advocates Welfare Fund Act, 2001 to provide for the Constitution of a Welfare Fund for the benefits of advocates across the country. This act came into force on 14th September, 2001

All practicing lawyers are entitled to membership of the Fund under Section 18 (1) of the Act (as below) at an annual subscription of Rs 50/- to be paid before 31st March. Senior advocates are required to pay an annual subscription of Rs 100/-, as per Section 18 (5)

“18. Membership in Fund

(1) Every advocate practising, before the commencement of this Act, in any court, tribunal or other authority in a State and being a member of a State Bar Association or a State Advocates’ Association in that State, shall apply, within six months of the commencement of this Act, to the Trustee Committee for admission as a member of the Fund, in such form as may be prescribed.

(2) Every person,—

(a) admitted as an advocate on the roll of a State Bar Council, after the commencement of this Act;

(b) practising in any court, tribunal or other authority in a State and being a member of a State Bar Association or a State Advocates’ Association in that State,

shall apply, within six months of his enrolment as an advocate, to the Trustee Committee, for admission as a member of the Fund in such form as may be prescribed.”

Some of the provisions of the Act are as under:

  • The Trustee Committee on an application made to it by a member of the Fund, and after being satisfied about the genuineness of the claim, may allow ex gratia grant from the Fund in case of hospitalisation or major surgical operation or if he is suffering from TB, leprosy, paralysis, cancer, unsoundness of mind or from such other serious disease or disability (Section 19).
  • Every advocate who has been the member of the fund for a period not less than five years shall, shall on the cession of his practice, be paid an amount at the rate specified in Schedule I. If the member dies before receiving such amount payable to him, his nominee or legal heir shall be entitled to receive the amount payable to the deceased member (Section 21).
  • The interest of any member in the Fund, or the right of a member of the Fund or his nominee or legal heir to receive any amount from the Fund, shall not be assigned, alienated, or charged and shall not be liable to attachment under any decree or order of any court, tribunal or other authority. Also, no creditor shall be entitled to proceed against the Fund or the interest therein of any member of the Fund or his nominee or legal heir (Section 22)
  • All income, profits or gains accrued to the Fund shall be exempt from income-tax (Section 23).
  • The Trustee Committee may, for the welfare of the members of the Fund obtain, from the Life Insurance Corporation of India or any other insurer, policies of Group Insurance on the life of the members of the Fund; or provide, in such manner as may be prescribed, for medical and educational facilities for the members of the Fund and their dependants; or provide monies to the members of the Fund for purchase of books; or provide monies to construct or maintain common facilities for the members of the Fund or provide funds for any other purpose which the Trustee Committee may specify; or provide for such other benefits as may be prescribed (Section 24).
  • Senior advocates, or those receiving pension from the Central/State Government are not eligible for ex gratia grant or other benefits under the various provisions of the Act (Section 28).

I personally feel the medical profession too should have been accorded equal priority.

Medical profession is a high-risk profession. Doctors on an average die a decade earlier than non-doctor professionals. They are exposed to various antibiotic resistant infections, contagious and infectious diseases and are at a higher risk of work fatigue, mental problems, heart attacks, paralysis and cancers.

A similar comprehensive insurance for doctors will be an added incentive to stay happy in the profession. Till this is done all doctors may be considered for Central Health Government Scheme (CGHS).

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA

This is good news: PCR teams to be first doctors on spot in Delhi

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PCR vans are usually the first to respond to a road emergency, and now the police control room personnel are set to turn paramedics to manage accident trauma, reported the TOI (Jan.17, 2019). The Delhi PCR vans will now carry cervical collars and fracture braces, among other medical accessories, to provide proper care within the crucial first five minutes of an accident. The van will now also carry ice packs and eye shades to ensure that the victim is in comfort and the pain from the injuries is managed before they are shifted. Additional training will also help the police personnel to judge and deal with the medical condition of the victims.

Doctors from AIIMS and NGOs, who already teach the cops how to provide cardio-pulmonary resuscitations and undertake basic procedures, will instruct them in life-saving measures.

This is good news indeed.

Any delay in treatment in acute emergencies can mean a difference of life and death for the victim. Most acute emergencies will require emergent evaluation and treatment without any delay. The large majority of deaths occurs either at the scene or within the first four hours after the patient reaches a trauma center.

The concept of “golden hour” emphasizes the need for rapid intervention during the first hour of care following major trauma. Prompt medical treatment during the golden hour has the highest likelihood of preventing death.

“Platinum 10 minutes” refers to first ten minutes after trauma and refers to the importance of starting first aid within 10 minutes to reduce the chances of death.

Heart Care Foundation of India (HCFI) is actively engaged in training people from all walks of life, including school children, in the life-saving technique of hands-only CPR (CPR 10).

There is substantial evidence to suggest that CPR is effective in the first 10 minutes of cardiac arrest. After 10 minutes of death, there is practically no chance of recovery unless patient is in hypothermia. So, we created a formula of 10 which is “within 10 minutes of death (earlier the better), at least for the next 10 minutes (longer the better, up to 25 minutes), compress the centre of the chest of the victim with a speed of 10×10 i.e. 100 per minute”.

This way the public can remember the technique of CPR after sudden cardiac death. It is easy to learn and easy to do and one does not need to be a doctor or be certified in this technique to do CPR.

Numerologically also, the CPR equates to number 10. In English alphabets, ‘C’ comes at number ‘3’, ‘P’ comes at number ‘16’ and ‘R’ comes at number ‘18’. If we add the three i.e. C=3, P=16, R=18 (3 + 16 + 18 = 37) and, if we further add the two digits in ‘3 + 7’, the total we get is ‘10’. So, numerologically also, ‘CPR 10’ should be an effective way to remember.

HCFI had also provided training on CPR for 100% PCR vans (over 8000) in Delhi in 2014 along with the Indian Medical Association (IMA) and Delhi Red Cross Society.

The PCR vans should also be equipped with Automated External Defibrillator (AED) machine and personnel should be trained in the use of the AED. Defibrillation within 3 to 5 min of collapse can result in survival rates as high as 50-70%.

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA

Precautions and formula of 80 can help avert heart problems during festive season

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Precautions and formula of 80 can help avert heart problems during festive season

Eating healthy and not stopping physical activity should be the norm

New Delhi, 25th December 2018: According to a new study, Christmas Eve is one of the most dangerous times of the year for the heart. It has indicated that a person’s risk for heart attack reaches its peak around late night a day before Christmas. Christmas Eve is a time to cheer; people tend to consume excessive food, alcohol, and travel long distances, all of which may up the risk of heart attack. Emotional distress with acute experience of anger, anxiety, sadness, grief, and stress, too, increases the risk of a heart attack.

Food of animal origin and saturated foods contain cholesterol. A 1% rise in cholesterol raises the chances of heart attack by 2%. Heart patients should therefore avoid eating cakes during the Christmas and New Year Season. They should distribute fruits and dry fruits instead of cakes.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “In the emergency room, heart attacks can be both over and under diagnosed. About 10% of heart attacks are over diagnosed and an equivalent number can be missed as the ECG can be normal in the first six hours after a heart attack. Most heart attacks occur during winter all over the world including India. Missing heart attacks during this period in the early hours of the morning can lead to spurts in number of cases of sudden cardiac death. Moreover, most senior doctors maybe on vacation during Christmas further worsening the situation for the common man. Every effort should be taken to reduce the number of false positive or false negative diagnosis of heart attack.”

Men and women have about the same adjusted in-hospital death rate for heart attack — but women are more likely to die if hospitalized for a more severe type of heart attack.

Adding further, Dr Aggarwal, Group Editor-in-Chief of IJCP, said, “As doctors, it falls upon us to educate our patients and make them aware of ways to live a healthy lifestyle to reduce the burden of disease in older age. I teach my patients the Formula of 80 to live up to the age of 80 years.

• Keep lower blood pressure, low-density lipoprotein (LDL) ‘bad’ cholesterol, fasting sugar, resting heart rate and abdominal girth all below 80.

• Keep kidney and lung functions >80%.

• Engage in recommended amounts of physical activity (minimum 80 min of moderately strenuous exercise per week). Walk 80 min a day, brisk walk 80 min/week with a speed of at least 80 steps per min.

• Eat less and not >80 gm or mL of caloric food each meal.

• Observe cereal fast 80 days a year.

• Do 80 cycles of parasympathetic breathing (pranayama) a day with a speed of 4/min.

• Do not smoke or be ready to spend Rs 80,000/- for treatment.

• Those who drink but do not want to stop and there is no contraindication, limit alcohol intake to no >80 mL/day for men (50% for women) or 80 gm/week. 10 gm of alcohol is present in 30 mL or 1 oz of 80 proof liquor.

• Do not take >80 mL of soft drink at one go (dilute it to 200 mL by adding soda).

• Take 80 mg of aspirin, if prescribed, for prevention.

• Take 80 mg atorvastatin for prevention, when prescribed.

• Keep noise levels below 80 dB.

• Keep particulate matter PM 2.5 and PM 10 levels below 80 mcg per cubic meter.

• Expose yourself 80 days in a year in sunlight to get vitamin D.

• Achieve 80% of target heart rate when doing heart conditioning exercise.

• Get 80% immunity by taking Flu and pneumonia vaccine.

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