In truth, the medical treatment revolves round faith of the patient in his doctor. It is the coming together of two human beings, one who is ill or thinks he is ill, and comes to seek the advice of another, in whom s/he has confidence. White coats of the doctors have a placebo effect of healing. Multiple studies show that patients not only perceive doctors in white coats as more competent but also a man of science and a virtuous person.This confidence works wonders in healing. However, medicine, in the recent past has become a corporate monstrosity. It may have spilled to smaller clinic set ups in the public or private sectors. Alleged or real cheating of the patient has led to increasing number of litigations and physical assaults on doctors. The hype of corrupt practices has shaken the faith of the community in medical profession and doctors are also agitated with dwindling returns on their inputs.
Medical science is not a perfect science. No human being including a doctor is infallible; but why does society, and the courts, find fault for a wrong diagnosis? Diagnosis in medicine is not a mathematical equation as it is made out in the press. Imponderables abound in the diagnostic arena. Even at the best centres in the world, where they pool the wisdom of many people in difficult cases, 12% of the patients’ diagnoses could only be made on the post-mortem table. This is despite the fact that a large number of avoidable investigations are conducted by the doctors
These days, the huge bills of most corporate hospitals work as seeds for litigations to grow. In some cases, the grievances are genuine. Admitting apparently healthy people for all sorts of tests and scans, removing the appendix for every minor pain in the abdomen, abdominal deliveries where normal delivery was feasible, operating on the wrong side or wrong limb, leaving operating instruments inside the patient’s body or administering dangerous wrong medications, the list of consumer complaints is growing. This has resulted backlash on the medical community and consequent frustration and agitation among doctors.
What the agitated doctors demand?
- Capping of compensation allowable on alleged medical negligence cases. It should be a percentage of the bill charged by the hospital/doctor and not phenomenal amounts.
- Amendments in the present act to cap the maximum allowable compensation in any case of medical negligence.
- Mandatory screening of cases of medical negligence, before the case is admitted in the consumer court
- Mandatory provision of seeking expert medical opinion by the court before giving verdict on the technical issues
- Defining/ triaging the complaints into frivolous/ injurious/ grievous etc before submitting to the court of law
- Provision of penalty (to the Doctor/hospital) to be proportionate to the amount of compensation claimed
- The compensation is awarded on the basis of the income of the complainant. But irrespective of the income of the patient, the hospital always same amount for services. Hence the compensation should only be decided on the cost of the treatment.
- Health care Arbitrator: Just like insurance disputes are sent to arbitrators an alternative dispute resolution mechanism can be looked into. The provision will be for providers and patients to submit disputes over alleged malpractice to a third party other than a court. This will help compensate victims faster, more equitably, and with lower transaction costs (As of now the administrative cost of such law suits is approximately 53% of the total compensation claimed)
- Administrative Compensation Systems: It proposes to replace the current tort system with an administrative compensation system. The “health courts” model substitutes a specially trained judge as the finder of fact and arbitrator of law for the current system’s generalist judges and juries
- Judicial audits of the lower courts to assess fairness and judicious application of mind by the lower court
- A comparative analysis of the outcome of judicial verdicts given in past should also be carried out for better understanding of the effectiveness of the compensations awarded till date.
- The legal profession is kept out of the ambit of consumer court. Hence medical services should also be excluded from the consumer court
- Amend PCPNDT Act
- The Act needs urgent modification to allow unambiguous and easy interpretation. The “Rules” need to be simplified and implemented uniformly across the country, and ad hoc changing of rules by each local authority should be strictly prohibited. New rules must be logical and should apply to the entire country only after due discussion with the representative bodies. Time should be given for implementation of the new rules.
- The Act is to be directed only towards Obstetric Ultrasound and not any other applications of ultrasonography.
- The word “Offence” under this act has to be clearly defined. The word Offence should only mean the “actual act of sex determination or female feticide”.
- All other clerical/administrative errors should be classified as non-compliance (and not an offence). Strict penalties can only be imposed for the actual act of sex determination or female feticide and not for other errors. There is a need to redefine “what amounts to sex determination” as mere evidence of clerical error does not amount to sex determination.“Imprisonment” rules should be for the offence (of sex determination or female feticide) & not for non-compliance.
- Inspections should be conducted yearly instead of every 90 days. No NGO can conduct “raids” on doctors’ premises and there should be no impediment to doctors doing their practice during inspections.
- Ultrasonologists should not be restricted to working in only two centers.
- The doctors should have the right to report on those seeking sex determinations and action must be initiated against them.