Straight from the heart: IMA Road Map

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The main objective of IMA is to provide affordable available accessible and accountable quality and safe health care to the public through its members in a stress free environment. IMA works hand in hand with the central and state governments to achieve its objectives via profession and community friendly policies. One of the objectives of IMA is to concentrate on primary preventive and primordial care. In this regard IMA has launched many campaigns like Sun to Lo Dekh to lo Koi Dekh to Nahi Raha Koi Sun to Nahi Raha Baar Baar Pucho Puchna Mat Bhulo Woh to Theek Hai par Mara Kyon Woh to Theek Hai par Heart Attack Hua Kyon Katwayega to Nahi among others. IMA is also incorporating social determinants of health in providing medical care. IMA Project Jiska Koi Nahi Uska IMA provides avenues to patients from every segment of the society in getting cost effective treatment within their reach and within the same environment where he she is residing. IMA has helped achieve millennium development goals and now is committed to achieve sustainable development goals. IMA Road Map IMA believes in patient centric medicine where the treatment plan is adjusted to the needs of the patient on case to case basis. IMA is fighting with government for one price one drug one company policy so that cost of 80 of medicine can be reduced. Today 80 cost of health care is on medicines and investigations. IMA policy is to prescribe NLEM drugs and when writing non NLEM drugs to take consent from the patient. IMA members are implementing all national health programs. But for the same government should hire every general practitioner on retainership basis. IMA wants 100 PG seats so that every doctor who does MBBS is ensured a PG Seat and those seats where Indian doctors opt out can be allotted to foreigners. Most of the new PG seats should be in Family Medicine. IMA is for providing all emergent services to people which is the mandate of state government who is not able to provide it. Hence this should be reimbursed by state governments. IMA is not against accountability but is against the people taking law in their hands. IMA wants single window accountability for the same. IMA also want Single Window Registration for any health care facility. IMA also wants Single Registration for doctors so that they can practice in any state in the country. Medical profession is not a business and all doctors provide reasonable subsidy to their patients for which they are entitled to non commercial rates for water electric property and and other amenities. IMA respects Ayush doctors and the government should let them excel in their own field and not diversify into the modern system of medicine. IMA believes in the concept of equity equality and justice. To this end IMA wants uniform age of retirement uniform pay scale uniform infrastructure uniform hours of duty etc. IMA is for bringing preventable deaths to zero. Preventable deaths should be unacceptable. To achieve this IMA recommends auditing every preventable death to find what went wrong so that another such death can be prevented by timely action. IMA wants professional autonomy and for the doctors to be able to decide their drug investigation and line of management based on patient centric medicine. IMA is for competence based training and not theoretical based training. IMA is against repeated multiple theoretical exams for doctors to test their updated knowledge status. IMA wants all doctors to use petrol cars car pool grow grass in muddy areas plant trees and promote walking as their contributions in efforts to reduce air pollution. All IMA CMEs should be noise free with noise levels between 45 50 dB. The average life span of doctors is 10 13 years shorter than non doctors. IMA recommends all doctors to have their annual check up done and get 100 vaccinated. The cost of intensive care is beyond reach of a common man. It s the state government mandate to provide free emergency care. If they cannot ICU establishment costs should be subsidized by the government. All IMA CMEs should have a slide each on pharmacovigilance bioethics and AMR. IMA policy is to spend time on informing patient about the cost of treatment. The cost variation should not be more than 10 . IMA policy is to promote GTN in TB GeneXpert test trace every contact and notify TB . Even the dead have a right to dignity. All dead bodies whether in the dissection hall or in the hospital settings must be respected To build credibility all doctors should explain the reason if they are referring a patient to a specific lab imaging center pharmacy or a hospital.

“Woh to theek hai, par mara kyon”? Preventable deaths should be unacceptable

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Most deaths are preventable as most deaths are caused by preventable factors. People with diseases such as heart attack, cancer, stroke, pneumonia, chronic respiratory diseases, vector-borne diseases, diarrhea, tuberculosis should live and not die unless there is a complicating factor.

India ranks first among countries with the highest number of child deaths in the world. In 2015, out of the total 5.9 million child deaths globally, 1.2 million i.e. 20% of the world’s share, occurred in India. A significant majority of these deaths are due to preventable causes such as diarrhea, pneumonia, malnutrition etc.

Whenever a person dies of preventable illnesses, questions should arise as a routine “Why did he die”? Was the death preventable?

All deaths should be self-audited to look for preventable causes. If no cause is found, then virtual autopsy can be done. Virtopsy or virtual autopsy is an alternative to traditional autopsy, conducted with scanning and imaging technology. IMA is for establishing virtual autopsies at clinical level for non-medicolegal cases (whole body CT, whole body MRI, postmortem angio, molecular autopsy).

In every death, IMA members should give an option for virtual biopsy with or without mini FNAC/ tissue biopsy. And informed refusal must be noted.

“Woh to theek hai, par mara kyon” is one of the major IMA campaigns this year to audit every preventable death with the objective of preventing these avoidable illnesses and mortalities through strategic planning, awareness campaigns and mutual collaboration with concerned authorities. If we are able to find a cause of death, then we must act on preventing a second such death in the family; look for preventable complications in the future.

Nobody should die a preventable death in this time and age.

Dr KK Aggarwal
National President IMA

Donating blood reduces chances of heart attack

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One should donate blood at least once in a year. Donating blood regularly has been shown in many reports to reduce chances of future heart attacks. Blood donation is also one of the best charities that one can do as it can save multiple lives through various components taken out of a single blood transfusion.

All those who are going for elective surgery should donate their blood well in advance and the same should be used at the time of surgery.

In the current medical tourism scenario, many patients who are Jehovah’s Witnesses refuse blood transfusion on religious grounds. They do not accept transfusion of whole blood or any of the four major components (blood cells, platelets, plasma and white cells). They are prepared to die rather than receive the blood. They also do not accept transfusion of stored blood including their own due to the belief that blood should not be taken out of the body and stored for any length of time. In such cases, every effort should be made to reduce blood loss, conserve blood and give drugs that can enhance hemoglobin formation.

A new concept called Bloodless Medicine has now become a reality where treatment, surgery and even emergency surgery can be done without using any blood.

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