The Indian Medical Association announces bold steps aimed at restoring faith in doctors and the medical profession

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Proposes certain self-regulatory procedures for doctors and hospitals to adopt

New Delhi, 11 December 2017: The Indian Medical Association (IMA), the largest voluntary organization of Doctors of Modern Scientific Medicine today announced certain self-regulation procedures for hospitals and doctors. This comes in light of the recent incidents involving the lives of a pair of twins, and a 7-year-old girl. The doctor-patient trust in the country, which was already experiencing a downward spiral, has deteriorated further. Doctors, hospitals, the health industry, patients, media, and politicians all are unhappy. Doctors do not have the intent to be the cause for public unrest or loss of public trust. At the same time patients must understand that to err is human and one incident does not mean that there will be more such cases in future as well.

Trust is the foundation of a doctor and patient relationship. The medical profession is undergoing certain changes. While violence against doctors is on the rise and they are being held accountable, at times, for deeds not committed, it is also true that there is some introspection needed on the part of doctors and hospitals, failing which this trust may take a long time to reestablish. Today, the private sector looks after 80% of the patients that too with highest quality. In the absence of state subsidy private sector providing quality care  invariably will come at a cost which is still at fraction of a cost compared to that in advanced countries.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “We represent the collective consciousness of the largest medical association of modern doctors of the country, the IMA. A profession, which has been considered as second to none, & it will remain noble is today, being looked at with suspicion. However, the medical profession is the noblest profession. It is disheartening to see the erosion in trust and we want to make it more transparent. IMA is and will continue to work towards improving doctor-patient relationship. IMA is committed to practicing with humility and pledges to reform the existing system. We will also take the opportunity to say here that the doctor to patient ratio in India is skewed due to which doctors are under a lot of stress. Doctors are also human beings and not healing angels. Once treatment is administered, the recuperation of a patient depends upon physical and organic factors. It is unacceptable and absurd to victimize the medical practitioner if the patient does not respond to treatment.”

All doctors shall practice with compassion and follow IMA ALERT policy (Acknowledge, Listen in detail, Explain, Review and Thank you). The IMA has also announced formation of an IMA Medical Redressal Commission at the state level (in each state) to engage in social, financial, and quality audits of health care (Suo moto or on demand). The commission will have a public man, an IMA office bearer, one former state medical council representative, and two subject experts. The commission shall consider every grievance in a time bound manner. An appeal to the state commission will be heard by the “Head-quarters IMA Medical Redressal Commission” which will have the powers to take suo moto cases also. The headquarters shall also suggest reforms in healthcare on periodic basis.

Adding further, Dr Aggarwal, said, “What happened was most unfortunate. However, not all doctors are wrong, and the public must have faith in them. Such errors happen by accident and not intentionally. Having said this, it is also time for the medical profession to introspect and come out with self-regulation procedures. We are often blamed for prescribing costly drugs. From today onwards, all doctors in the country shall choose affordable drugs. We also appeal to the government to come out with an urgent ordinance for one drug-one company-one price policy. Doctors should actively participate in ensuring that no hospital sells any item priced higher than the MRP. No service charges should be added to procure drugs from outside. MRP shall not be dictated by the purchaser.”

The other points announced by IMA are as follows.

  • IMA recommends that all doctors should prescribe preferably NLEM drugs.
  • All doctors shall promote Janaushidhi Kendras.
  • We appeal to the government to classify all disposables under both NLEM and non-NLEM categories and cap the price of essential ones. Till then all medical establishments should sell the disposables at procurement prize after adding a predefined fixed margin.
  • Hospitals and doctors are often blamed of overcharging and over investigations. Billing should be transparent, and all special investigations should be well informed & explained.
  • Every doctor should ensure that it becomes mandatory on the part of the hospital administrator to give options at the time of admission to choose cost-effective treatment room and treatment (single room, sharing room, and general-ward) and explain the difference in total bill estimates.
  • All doctors should ensure that hospital estimates at the time of admission are near to actual.
  • The treating doctor must explain the chances of death and unexpected complications and resultant financial implication at the time of admission.
  • Once doctors take charge of a patient, the patient should not be neglected. They should look after the patient till discharge.
  • Emergency care is the responsibility of the state government and the government should subsidize the costs of all emergencies in private sector & create a mechanism for reimbursement.
  • Every medical prescription must include counseling on the cost of drugs and investigations.
  • IMA has zero tolerance to doctors indulging in female feticide.
  • IMA has zero tolerance to cuts and commissions. Medical establishment should revisit their referral fee system. Billing paid to doctors should be transparent and reflected in the bill.
  • No hospital can force their consultants to work on targets. Contractual agreements should be in such way in which of both parties that is consultant and the hospital is equally protected. All hospitals should consider not charging service charges from the consultants.
  • Choice of drugs and devices rests with the doctors based on the affordability of the patient and not on the profitability.
  • All hospitals must comply to the commitment towards EWS, BPL, and poor patients without any discrimination.
  • All patient complaints should be addressed in a timely manner through an internal redressal mechanism with a chairman from outside the hospital.
  • All medical establishments must ensure that their business ethics comply with the MCI ETHICS.
  • IMA LAMA policy is being developed as there are no clear guidelines at present.
  • Every dead body needs to be treated with respect and dignity.
  • All charitable hospitals should do their free work as assigned.
  • All needy patients must be routed through the social worker of the establishment and guided and directed to the appropriate place.
  • At least one more equally experienced but unrelated surgeon should be involved in the consent form during elective LSCS.
  • The patient has a right to get medical records within 72 hours of request. Acknowledge their request.
  • The patient has the right to go for a second opinion from an appropriately qualified medical doctor. The primary doctors have should not  get offended.
  • A hospital has no right to stop life-saving investigations or treatment for non-payment of bills if the patient is still admitted in the hospital. The government should make a mechanism for the reimbursement for the above for poor patients.
  • Ensure for us all are equal. BPL, APL, EWS, rich, or poor all should get the same attention and treatment.
  • IMA policy: With no National Guidelines on viability of fetus issue ,it is being looked upon by IMA, FOGSI, IAP and NNF.
  • We are not against any regulations and accountability, but we should all ask for a single window accountability at the state level. The state medical council should be proactive and take timely decisions. We should also ensure a single window registration.
  • We must ensure that our establishment has a transgender policy.
  • All government hospitals should be upgraded and have facilities like those in the private hospitals. All public, private or charitable hospitals should have quality accreditation.
  • No doctors should issue false certificates.

“All the above will & should be implemented with immediate effect”, said Dr Ravi Wankhedkar, National President Elect IMA, in his message.

The above have approval from most stakeholders. A copy of this is being sent to the Health Secretary, Govt of India and Health Minister, Govt of Delhi. Both President and Registrar, Delhi Medical Council, are requested to help in circulating this message to all doctors in Delhi.

We are thankful to the society for raising the issues and will request them to work with the medical fraternity to make IMAs project “Cure in India” a success.

Straight from the Heart: CC Reporting

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We have tried to compile the important meetings held during the year. Following is a list of meetings with government including stakeholders as well as international meetings that IMA participated in. All states branches can attempt to compile a similar list of meetings that your state participated in.Meetings with government/stakeholder’s/

officials

  • Inter-ministerial meetings
  • Monthly meeting of IMA with MoH
  • Shri JP Nadda on 20th January 2017
  • Shri CK Mishra on 3rd March 2017
  • Member of Parliament Doctors meeting on 17th May 2017
  • Addl. Secretary (Health) Shri Sanjeeva Kumar with IMA 19th May 2017
  • Shri Satyender Jain, Health Minster, Delhi Govt.
  • Shri JP Nadda on 6th June 2017
  • Dr Jagdish Prasad on 6th June 2017
  • Shri CK Mishra on 6th June 2017
  • Shri Jitendra Singh on 6th June 2017
  • Shri JP Nadda on 23rd June 2017
  • Dr CP Thakur, Dr Mahesh Sharma, Dr Sanjay Jaiswal and Dr Vikas Mahatme on 24th May 2017
  • FOMA meeting on 6th April 2017 at Hotel Lalit, New Delhi
  • 23rd May meeting with FOMA stakeholders regarding plan organization of Dilli Chalo Movement on 6th June 2017
  • IMA Meeting with WHO Officials on 17th June 2017
  • Meeting with President-Elect Govt. of India on 21st July 2017
  • Meeting with Dr Sanjeeva Kumar, Addl. Secretary, MoHFW on 16th August, 2017
  • Meeting Shri GP Samanta, Under Secy, GOI  to discuss the issues raised by IMA during the meeting with Hon’ble HFM on 19th September 2017 at 3.00 pm under the chairmanship of Addl. Secy. (Health) in Nirman Bhawan, New Delhi
  • Meeting with Shri Sunil Kumar Gupta, Under Secy., GOI, MoHFW, Meeting to discuss the issue raised by IMA on 27thSeptember 2017 , Nirman Bhawan, ND
  • Meeting with Dr Anil Kumar, Addl. DDG (AK) reg. Meeting of sub-committee to finalize the draft notification in respect of medical diagnostic laboratories including signatory authority/Technical head of medical diagnostic laboratory on 1st November, 2017 under the chairmanship of Dr B D Athani, Spl. DGHS Nirman Bhawan, ND
  • Shri GC Dobhal, Deputy Secretary, Petition Committee reg. Meeting of the Parliamentary Committee on petitions, Lok Sabha, w. r. t. Medical Reforms in the country on 20.11.2017 Parliament House Annexe, New Delhi

Other meetings

  • NABH Board Sub-Committee Meeting on 13th January 2017, New Delhi
  • 2nd Meeting of National Core Group on Elimination of Mother to Child Transmission (EMTC) on 6th February 2017
  • Stakeholder Consultation meeting for preparation of Concept Note (2018-20) for Global Fund Grant reg. on 13thFebruary 2017 at New Delhi.
  • NABH Board Sub-Committee Meeting on 17th February 2017, New Delhi
  • 26th Board Meeting of NABH on 24th March, 2017, New Delhi
  • 2nd Meeting of National Medical Wellness Tourism on 28th March 2017 at New Delhi
  • Meeting of Working Group Environment Health on 30th March 2017 at Indira Paryavaran Bhawan, New Delhi
  • Meeting of World Malaria Day on 25th April 2017 at New Delhi
  • Meeting regarding setting up of Facilitation Counters for visitors arriving on e-Medical Visa at International Airport on 25th April 2017 at New Delhi.
  • Meeting Of Governing Body-NBE on 28th April, 2017 New Delhi
  • Meeting of Signal Review Panel Meeting at CDSCO (PvPI) on 16th May 2017
  • Meeting of Expert Group to review self assessment report for patient safety for India & capacity development on patient safety on 30th May 2017 at New Delhi.
  • Meeting of the Expert Committee constituted to draft comprehensive FAQs related to the PC & PNDT Act, 1994 reg. on 30th May 2017 at Nirman Bhawan, New Delhi.
  • National Workshop on “Parivar Niyojan-Sashakt Samaj, Rashtra Ka Vikas on 11th  July 2017 at Vigyan Bhawan, New Delhi
  • Launch of National Strategic Plan (2017-22) by Hon’ble HFM on 12th July 2017 at 5.30 PM at Sovereign Hall, Le Meridien, New Delhi
  • Stakeholders Consultation for MTAB-Reg. on 27th July 2017 at New Delhi
  • National Board of Examination governing council meeting on 7th September, 2017, New Delhi
  • NBQP QCI 12th Nation Quality Conclave on 21-22 September, 2017
  • Inauguration of Pharmacovigilance Programme of India as a WHO collaborating centre on 30th October 2017
  • NABH Board Meeting on 3rd November, 2017
  • NBE Board Meeting on 9th November, New Delhi
  • National Steering Committee PCPNDT Act on 3rd November, 2017

International Meetings

  • Annual Scientific Meeting of Chinese Medical Association held on 14-15 January, 2016 at Nanjing (China)
  • International Summit on Air Pollution – Health Advisories held at New Delhi on March 10, 2017
  • Cyprus to attend and participate in the UNESCO Chair in Bioethics – 12th World Conference on Bioethics, Medical Ethics & Health Law to be held from March 19-24, 2017 at St. Raphael Hotel Resort & Congress Center, Limassoi, Cyprus.
  • 206th World Medical Association (WMA) Council Meeting to be held from April 15th to 22nd April, 2017 at the Avani Victoria Falls Resort in Livingstone, Zambia
  • Annual Meeting of Swedish Medical Association in Stockholm from 29th May to 31st May 2017 at Hotel Scandic Continental Vasagatan 22, Stockholm, Sweden.
  • The Annual Meeting of the American Medical Association on June 10-14, 2017 at Hyatt Regency Hotel, Chicago, Illinois, USA.
  • BMA Annual Representative Meeting on Sunday 25 June- Thursday 29 June 2017 at the Bournemouth International Centre, Exeter Road, Bournemouth BH2 5BH,
  • 32nd CMAAO General Assembly in September 13-15, 2017
  • WMA General Assembly on October 11-14, 2017 at Renaissance Downtown Hotel, Chicago
  • WMA European Region Meeting on End-of-Life Questions on November 16-17, 2017 at Vatican

Straight from the Heart: IMA Online Initiatives

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IMA has taken several online initiatives to make it easy for doctors to either report required information or access information. Mentioned below are the links to these online initiatives. Please save these links and also share them with all members and your doctor friends.

  1. IMA Rare Blood Group Online Blood Bank Directory

http://ima-india.org/Rare

  1. IMA Online TB Notification initiative

ima-india.org/tbnotify

  1. IMA Online Events Reporting initiative

http://www.ima-india.org/ima/left-side-bar.php?scid=228

  1. Proforma for Hypertension Screening

http://module.ima-india.org/

  1. IMA Online Sentinel Events Reporting Initiative

ima-india.org/sentinel

  1. IMA Disease Notification

http://disnotif.ima-india.org/

  1. IMA RISE and SHINE

http://imariseandshine.com/

  1. IMA Blood Donation Initiative

http://www.ima-india.org/ima/left-side-bar.php?scid=289

  1. IMA Flag Salutation

http://www.ima-india.org/ima/left-side-bar.php?scid=14

  1. IMA Prayer

http://www.ima-india.org/ima/left-side-bar.php?scid=14

  1. IMA Digital TV

http://www.ima-india.org/imalive/

  1. IMA Slide Share

http://www.ima-india.org/ima/free-way-page.php?scid=287

  1. I Pledge My Organ

http://module.ima-india.org/ipmo/

  1. IMA Live

http://www.ima-india.org/imalive/

  1. eMedinexus/ART

http://emedinexus.com/artbill/

  1. eMedinexus/Satyagraha

http://emedinexus.com/satyagraha

  1. IMA/ART

http://ima-india.org/artbill

  1. IMA/Satyagraha

http://ima-india.org/satyagraha

19  IMA/Webcast

http://ima-india.org/ima/

  1. IMA Digital TV

http://ima-india.org/digitaltv

  1. BMI Calculator

http://emedinews.in/cal/bmim.html

22 eMedi Calculator SI to Conventional Unit Converter

http://cal.emedinews.org/

  1. SMS Extractor

http://sms.emedinews.in/mobileext.aspx

  1. eMail Extractor

http://sms.emedinews.in/emailext.aspx

25 eIMANews

http://www.ima-india.org/ima/left-side-bar.php?scid=113

26 eJIMA

http://www.ima-india.org/eJIMA/

27 IMA Diabetes Survey

http://module.ima-india.org/Survey/Default.aspx

27 IMA Radio

http://module.ima-india.org/imaradio/

28 DilliChalo

http://module.ima-india.org/dillichalo/

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