Thousands of doctors under the umbrella of the Indian Medical Association will go on an indefinite strike from November 13, the same day the winter session of the Karnataka Assembly begins.
Over 25,000 doctors are planning to go on a “Belagavi Chalo” hunger strike. Their demand - to drop the new amendment to the Karnataka Private Medical Establishments Act. The strike called by the Karnataka chapter of the IMA will affect all private outpatient medical facilities in Karnataka.
Among the provisions that the IMA has objected to are the provisions to imprison doctors for alleged mistreatment, to cap prices for various kinds of services and to form a new patient grievance redressal forum at the district level.
The IMA has already communicated these objections to the Karnataka Chief Minister and the Health Minister. Association members have also threatened to quit the profession since they believe the proposed amendments are draconian.
However, speaking to TNM, Dr Sylvia Karpagam, a Public Health Researcher in Karnataka, says that the debate between the doctors and the government on the issue of the amendment has neglected the rights of thousands of patients, and even doctors who support the amendment.
“The doctors who are protesting are not telling the whole story. If you look at the larger picture, many doctors in huge private hospitals are under pressure to perform unnecessary tests because the hospitals demand it. In the meantime, it is the patients who are suffering. Unnecessary procedures and surgeries are on the rise,” Dr Sylvia alleges.
She further claims that there are a lot of unethical practices going on currently, from unnecessarily placing patients in the ICU, putting them on a ventilator for no rational reason, recommending irrational tests, to conducting unnecessary procedures, including surgeries.
“The bill provides a safety net to patients. I have a friend, a neurologist, who has been given a target to perform a certain number of surgeries in a month. I have analysed a lot of hysterectomy reports. Before a patient is referred for hysterectomy, scans have to be conducted and also certain tests. Only in extreme cases, hysterectomy is advised. In most cases, the scans were normal. The diagnosis was poor hygiene and such patients were referred for hysterectomy. This is not right. Any ethical doctor would object to these kinds of unethical practices,” Dr Sylvia argues.
Noting that regulatory bodies have failed "completely", Dr Sylvia alleges that it has become common for doctors to protect other doctors. According to Dr Sylvia, a recent study about insurance schemes showed that most of the reimbursements are going to Bengaluru-based hospitals. Hospitals in North Karnataka districts have reportedly not got any reimbursements. The KPMEA offers a mechanism to regulate private hospitals and ensure that patients are not duped.
"The act is a platform for doctors to practise their profession in an ethical manner. Health is not a field where you come in to make huge amount of profits. With ethical practice, a lot of people can have a dignified lifestyle. How much are you going to fleece your patients? Don’t do it at the cost of people who are placing their trust in you. Those who are looking to make money should not take up medicine,” Dr Sylvia states.
Dr Vasu HV from Bengaluru, who is also a social activist, says that he supports the KPMEA. “The public has lost faith in the medical community. The general opinion is that doctors are negligent and only want to make money. Being a doctor myself, I don’t think the doctors are wrong all the time. Not every patient can be saved all the time. Despite this fact, there is still no trust for the medical community. If the relatives of patients feel that they can approach a body which will address their grievance, then they will not take law into their hands and end up assaulting doctors,” Dr Vasu says.
Some doctors are of the opinion that the current grievance redressal mechanism is inadequate. Currently, the Consumer Protection Forum and local police are the only forum aggrieved patients can approach.
“In very few cases, people can file a police complaint. Police usually go by what the autopsy report says or what the district health officer says. Consumer Forum relies on expert evidence only. I do not deny that expert evidence is required. It very much is because a person who does not have medical knowledge cannot decide these thing. Doctors usually don’t go against fellow doctors and right now there is no fair platform,” he said.
The proposed amendments are not only about medical negligence but also fee fixation. Dr Vasu says that a lot of doctors working in private hospitals also feel that the rates are way too high.
“These big private hospitals also set targets for their doctors. Doctors are expected to bring in a certain amount of business every year. This is putting pressure on doctors as well. How can professionals in health sector be so business minded? Doctors consider themselves as individuals above everyone else and feel superior to other people. They don’t care to explain to the patients properly as to what has happened to them. It is a noble profession. They have to be ethical as well. They should not become business minded. This has to stop. Speaking on behalf of the doctors, I welcome the KPMEA Act,” Dr Vasan adds.
Why the protesting doctors are calling the bill draconian?
“By the time we finish our graduate and post graduate course, we are 30 years old. People in other professions would have become financially stable by the time we begin work. Do we not have the right to live a dignified life? The grievance redressal cell will give the government officials reasons to become even more corrupt. They will end up taking bribes and ruling against those who haven’t paid them. Doctors are in danger of getting convicted even if they are innocent,” claims Dr Chandrika Muralidhar, President of the Bengaluru Society of Obstetrics and Gynaecologists.
Alleging that the state government’s decision to table the bill was only an election gimmick, Dr Chandrika said that the bill is curbing the doctors’ rights. “This is hurting so many medical professionals across Karnataka. The number of doctors is less compared to number of patients. The election is just a few months away and they are doing this only to get votes. We will quit our profession if the government does not drop the proposed amendment,” she added.
Speaking to TNM, Dr Ravindra, President-elect of the Indian Medical Association (IMA) said, “If the government does not listen to us, we will quit our profession by November 10.”