front cover page · dr. gajendra tomar dr. sona pungaonkar dr. hemant dugad dr. suhas shah dr....

Vol. 47 | Issue No. 2 | August 2018

TheGRASP

For Private Circulation Only

Official Journal of the Association of Medical Consultants, Mumbai.Published Quarterly in May, August, November, February

MedicalPractice

1Vol. 47 Issue No. 2 August 2018| |

President Dr. Vipin CheckerPresident Elect Dr. Mukesh GuptaImm. Past President Dr. Smita SharmaVice President Dr. Ajit K. DesaiVice President Dr. Deepak BaidHon. Secretary Dr. Sushmita BhatnagarHon. Treasurer Dr. Nilima Vaidya-BhamareJoint Treasurer Dr. Manoj PatelJoint Secretary Dr. Rajendra NagarkattiJoint Secretary Dr. Rajeev AgarwalOffice Secretary Dr. Supriya Arwari

Prog. Committee Chairman Dr. Vivek DwivediEditor - The Grasp Dr. Kritika Doshi

Director Dr. Lalit Kapoor

Office Bearers (2018-2019)

Dr. Ajit K. Desai Dr. Dilip Naik

Dr. Rajendra Chawhan Dr. Sabh Singh Khambay

Dr. Sujata Rao Dr. Kishore Adyanthaya

Dr. Gurudas Kulkarni Dr. Debashish Das

Zonal Directors

Area Representatives

Consultant Benevolent Scheme Dr. Shrikant Badwe

H & A Cell Dr. Suhas Kate

MMC Cell Dr. Bipin Pandit

AMC-NoAH Dr. Niranjan Agarwal

Medicolegal Cell Dr. Sudhir Naik

Social Service Cell Dr. Shivbhagwan N. Agarwal

Media & Communication Cell Dr. Veena Pandit

Affiliate Unit Cell Dr. Kishore Adyanthaya

Chairperson of Cells

EDITORIAL BOARD

BOARD OF TRUSTEES

Editor

Co-Editors

Advisory Board

Managing Trustee

Trustees

Website

Web Editor

Web Co-Editor

Dr. Kritika Doshi

Dr. Mukesh Gupta

Dr. Lalit Kapoor

Dr. Sujata Rao

Dr. Pradeep Baliga

Dr. Suhas Kate

Dr. Umesh Oza

Dr. Achut Nayak

Dr. Suresh Rao

Dr. Shrikant Badwe

Dr. Sabh Singh Khambay

Dr. Niranjan Agarwal

Dr. Ashok Shukla

Dr. Neeraj Bijlani

Dr. Nikhil Datar

www.amcmumbai.com

Disclaimer

Unless otherwise stated, the opinions expressed

by the writers are their personal opinions, The

AMC reserves the right to use material published

in ‘The Grasp’ for its Website or for any other

purpose deemed necessary.

The appearance of advertisement in ‘The Grasp’ is

not guarantee or endorsement of the product or

the claims made by the manufacturer / advertiser.

ASSOCIATION OF MEDICAL CONSULTANTS, MUMBAI4, Ganpati Niwas, Old Police Lines, Opp. Andheri Station,

Andheri (East), Mumbai - 400 069.

Tel.: 2684 4639 / 2683 6019 (10 a.m. to 6 p.m.)

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AMC INDIA Project

Edited by : Dr. Kritika Doshi

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Plot No. A-737/3, TTC Industrial Area, Khairane MIDC, Navi Mumbai - 400710. India.

For Association of Medical Consultants, Mumbai. (For Private Circulation Only)

Dr. Aashish Mody Dr. Pradnya Kulkarni

Dr. Abhijit Kale Dr. Prakash Patil

Dr. Alok Modi Dr. Prashant Kerkar

Dr. Anil Parmar Dr. Rahul Rane

Dr. Aparna Govil Dr. Rajednra Tiwari

Dr. Debraj Shome Dr. Reena Wani

Dr. Deepak Vaidya Dr. Ritesh Agarwal

Dr. Dhiren Kalawadia Dr. Sanjay Pattiwar

Dr. Gajendra Tomar Dr. Sona Pungaonkar

Dr. Hemant Dugad Dr. Suhas Shah

Dr. Mandakini Megh Dr. Vidya Shetty

Dr. Narendra Dedhia Dr. Vikram Khanna

Dr. Neeraj Bijlani Dr. Vikrant Desai

Dr. Nikhil Datar Dr. Vivek Sheth

Dr. Pradeep Baliga

2 Vol. 47 Issue No. 2 August 2018| |

Edit Speak - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 03

President’s Precept - Dr. Vipin Checker . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 05

Hon. Secretary’s Report - Dr. Sushmita Bhatnagar . . . . . . . . . . . . . . . . . . . . . . . . 07

DOs AND DON’Ts - Dr. Lalit Kapoor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Website Update - Dr. Ashok Shukla . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

AMC News. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

M@ILBOX. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Achievements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Lack of Monitoring is Medical Negligence - Dr. Suganthi Iyer. . . . . . . . . . . . . . . 22

''Doc in the Dock'' Points to Ponder - Dr. Harish Shetty . . . . . . . . . . . . . . . . . . . . 27

Visual Delight - Dr. Ketki Marthak . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

Healthcare Financing & Health Insurance Models - Prof. Sushmita Bhatnagar . . 32

Ayushman Bharat Yojana :

Impact on Medical Professionals - Prof. Sushmita Bhatnagar . . . . . . . . . . . . . . . . 38

Doctor’s Day. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

Doctor’s Day PARTICIPANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

From The Press - Dr. Pradeep Baliga . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Dr. Kritika Doshi

Vol. 47 | Issue No. 2 | August 2018


Dear Friends, fight-or-flight response. We all experience

some daily stress which is unavoidable."It's not the load that breaks you down, it's

Unfortunately, today, doctors in India facethe way you carry it"..................... Lou Holtz

constant, un-resolving stress - which is a

st July as you all are aware is celebrated problem because it is additive and begins to 1as Doctor's Day. As part of Doctor's Day, impact health, personal behavior and

I was a part of the blood donation drive in relationships. We need to acknowledge the

Thane. There were many doctor colleagues impact such chronic stress is causing on our

who wanted to donate blood but were found daily life. There are many scientific reports

'unfit' and rejected in the screening process. of the health problems associated with stress

Medications for hypertension, Diabetes, like Cardiovascular disease, obesity,

Hypothyroidism, history of Dengue/Malaria diabetes, depression, anxiety, immune

in past 1 year, anemia….these were the system suppression, headaches, back and

common reasons for rejecting the donor. The neck pain, and sleep disturbances. Due to

Blood Bank officer mentioned that they easy access to anxiolytics, antacids,

(blood donation camps) had a better response sedatives and analgesics, many of us use

in the blood donation drive with corporate them without bothering about correcting the

entities and in camps at Railway Stations. underlying cause.

Are we - the "healers" not as "fit" as non- We are readily available for our patients and

medical people? colleagues; but many of us don't have the

same patience or time for our families andShould this worry us? Is there a study on the

ourselves.physical and mental health of doctors in

India? How resilient are our medical students We lose our social support system of family

and junior doctors? and friends in the desire to become

'successful' consultants. Finding a balanceThe 'Stress' of medical practice is growing

between 'adequate' work and relaxation isand it has an impact on our physical and

extremely difficult due to the prevailingmental well being. We know that 'stress' is

system of private practice.the disruption of the body's homeostasis or a

state of disharmony in response to a real or There is no social security or health

perceived threat or challenge and the body insurance for private Practioners. They have

responds to it by autonomic and endocrine to self fund themselves and invest large

EDIT SPEAK

Dr. Kritika Doshi


amounts to begin their practice causing A disturbing forward on WhatsApp on

financial stress. Added to this, the changing "Doctor Suicides" has been written by a

family physician Dr. Pamela Wible. In 5policies in healthcare further add to the

years, she has 757 Doctor Suicides on hermental stress.

registry. I hope we do not see such a trend inDue to the rapid evolution of digital

India among our medical fraternity.technology, various digital tools are

We are fortunate that we Indians are veryavailable at a click on one's smart-phone. Wefamily oriented and social. This year'sare becoming lonely as we go away fromDoctor's Day celebration saw AMCdirect human interactions and prefer 'on-line'members perform and showcase their talentsinteractions. Our young boys and girls havein front of the members. It was wonderful tostruggled for 10-12 years to qualify fromsee the applause every performer receivedvarious medical colleges (often from placesfrom the audience. We need to make aaway from home) and become consultants.conscious effort to come together at all AMCThey spend their youth studying andmeetings and strengthen our bonds oflearning, without having the time to developfriendships with each other in addition to ourdeep friendships or stress busting bonds withprofessional relationships. As consultants,neighbors and family.we understand and comprehend the daily

The long working days as Residents are work issues and work stress faced by us.necessary and we 'adjust' to 'odd hours'. The Who else can offer us better support andresult is that, we are so used to working for comfort in our times of need than our ownlong hours without a break that attending a 3 colleagues!day family wedding with no medical talk

I hope you enjoy this GRASP - dedicated to makes us restless. Switching off the mobileAMC Doctor's Day.phone and being 'unreachable ' is

unthinkable! It may be time for us to invest "Alone we can do so little, together we can domore in our relationships to cope with the so much"................................. Hellen Kellerstress of medical practice. Dr. Harish Shetty

has in his inimitable style urged us to ponder

on some valid points. [email protected]

Like us on :

[email protected]

Media Cell Response :

Twitter : @AMCMUMBAIFB : https://www.facebook.com/amcmumbai

Send your Feedback on

https://timesofindia.indiatimes.com/india/doctors-miffed-with-pm-modis-remarks-on-them-in-london/articleshow/63867664.cms


The problem is multifaceted and the solution"efoue keâer yeele" - "Straight from the Heart"is not easy.

Dear Colleagues,There are a lot of things associated withGreetings for the Seasonmedical profession which are not in

n today's society, the Medical Profession our hands: I will enumerate a few asIand Medical Professionals are going following :through a tumultuous phase. We are faced

• Poor Public Healthcare Infrastructure.with policy developments which affect usadversely, with the "noble image" taking a • PoorAllocation of Budget for Health.beating and doctors working under the

• Implementation of Government Policieshanging sword of "CPS" and medical

and Programs related to health and familynegligence. The senior medical practitioners

welfare.will remember the days when we the doctors

• Omnipresent and Ever Pervasivewere considered akin to god and doctorsCorruption in our Society.were given a lot of respect in society.

• Red Tape And Bureaucracy's ReluctantTime has changed and slowly and slowlyAttitude.now we are living in the era where we are no

more God and as per law we are service • Crumbling Infrastructure of Public Healthproviders and our patients are our Delivery System.consumers.

• Overburdened and i l l equippedNow we are living in the era in which the government hospitals and health centres.medical profession which was considered as

• and Many more.a noble profession is now under attack from all quarters of the society. Situation is so Let's see what we can do to improve the

depressing that the people who have inside situation….

knowledge about medical profession, don't Let's do some introspection and find out if werecommend their children to enter in this can help to change the situation for the betterprofession in India. outcome and better results.

Have we ever thought why our profession We are seeing a lot of doctor bashing and wehas lost the sheen and the same profession are attacked by mobs at the slightest pretext which was once considered as the best and sometimes health centres are alsoprofession amongst all profession is now damaged.getting brickbats from the society for all the

I think we should do everything in ourwrong reasons?

PRESIDENT’S PRECEPT

Dr. Vipin Checker


capacity to change the perception about our Our equipment and instruments should be

profession and professionals. calibrated properly on a regular basis andFire and Bio Medical waste disposal shouldTo start with we should emphasise on properbe complied properly.

communication with the patient and weI feel that we should include communicationshould be humble and empathetic while weand empathy in our medical curriculum forare communicating with the patient andour medical students so that the comingpatient's relatives.generations are well versed with the

Communication if done in a proper way can importance of these topics and it will help to

stop so many untoward incidences.r educe v io l ence aga ins t med ica l

We should be good to our patients, professionals in our society.

And we should be transparent in dealings AMC is working overtime in this directionwith our patients. and through our CMEs and Social Media we

it's our constant endeavor to make ourLet's pledge that we will not take any freebiescolleagues aware of the importance of thesefrom pharma companies or will not take anyissues to take corrective steps to change theparties from pharma companies (we all knownegative perception about our profession.it's unethical but it's also open secret that it's

prevalent in our profession). It's an ongoing process and it should continuein future also till we regain our lost glory andLet's pledge that we will not do medicalmake our profession a noble professionjousting.again.

Our prime motive should be our patients'Before I sign out, Team AMC has done awell-being and their safety and care and wetremendous job of connecting & impartingshould have zero tolerance to lacuna in safetymedical education with 21 CME pointsstandards and equipments.(excel sheet on page…….)

Our hospitals should be registered properlyYours Trulyregularly and all required criteria should be

followed properly. [email protected]

AMC's

presented to

Senior PI

Juhu Police

Station

"Medicolegal

Manual

For Police"


My DearAMCites, programs in several areas of Mumbai, Thaneand in peripheral areas. AMC schemes,

he Association of Medial Consultants isvision and mission has been widelyTin an extremely dynamic phase and thedisplayed through these connect programs

most appropriate word to describe this phasewhich helped members understand the ideals

isACTION.which AMC symbolizes. 11 Connect

The first quarter of the AMC year 2018-19 programs have been completed with appx.900 members utilizing the educationalshowcased a wide range of activities of theactivities and assimilating 12 MMC creditAssociation, the synopsis of which reacheshours.you all periodically. I am sure you all are as

thrilled as I am with the exposure, outreach 2 Nurses training programs have beenand the kinship what we all are experiencing, conducted in the AMC Zone F - Miraboth within the managing committee and Bhayander & Badalapur successfully withwithin the entire membership base. training imparted to 242 nurses.

AMC has always promoted and is AMC Zonal CME's have been conducted in 3continually committed to Safe and Ethical zones since April 2018 in SEXPLORE inhealthcare delivery systems, pursuing Best Juhu, ADOLESCENSE in Mira Road,Practice Guidelines, educating on Duty of ENHANCING MEDICAL PRACTICE &Care, enlightening the members on Legal PRODUCTIVITY in Chembur. Appx. 400Aspec t s o f Hea l thcare , s eek ing AMC members attended the Zonal CME'sCommunity Enhancement through social and assimilated 6 MMC credit hours.service projects and supporting each and

1st July, the Doctors' day, showcased aevery member in distressing times. Inthoroughly enjoyable entertainmentaddition, being connected with each otherprogram this year wherein the AMC

has been remarkably achieved this year withmembers showcased their talents in other

'On the Field Events', 'Social Mediaspheres such as singing, dancing, musical

Events'. To promote the needs and interests instruments, mimicry, etc. This program was

of the members as well as the medicalheld at Rangmandir at Bandra. The highlight

profession, lot of enterprise occurs and it isof this program was felicitation of Dr. Achut

an obligation to address the 'BackendNayak with Distinguished Services Award

Events' as well as the 'Upcoming Events'.for his meritorious contribution toAMC.

On The Field Events :Not just the Doctors' Day, but the entire week

This year marked the dawn of AMC Connect was celebrated as Doctors' Week by

HON. SECRETARY’S REPORT

Prof. Sushmita Bhatnagar


organizing Blood and organ donation camps tackling any issues related to the medical

at several centers across the city. About 150 professionals, in providing help to our own

bottles of blood were collected and colleagues in the medical field and in puttingapproximately 300 people, including in the best efforts in resolving conflictingmedical professionals visited the camps and situations. The upcoming Ayushman Bharatmany pledged to donate their organs. Yojana has provided an opportunity to AMC

to represent it's members, liase with theSocial Media Events :concerned Governmental bodies in New

Effective operation of social media such as Delhi and meet them personally to discussmobile based apps, Facebook, Twitter, etc. the best situations and options for our ownhave benefitted members in capitalizing and friends. It was indeed an honor to meet thestaying up-to-date on several aspects such as CEO of Ayushman Bharat who greeted usupcoming AMC activities, expression of warmly and gave us his undivided attentiontheir views and ideas, staying informed when to discuss the issues faced by us, thethey were not able to attend meetings/CME's caregivers. Detailed report is published inand also share our achievements within the subsequent pages of this issue.medical community and beyond. The AMC

A survey is being conducted by AMC onFacebook page has 1149 followers and 367'Violence in Healthcare', the link of whichtweets on Twitter thus allowing members toshall be sent to you. I request your co-disburse information far and wide.operation in taking the online survey and

The website ofAMC and the mobile app is in prov id ing AMC with meaningfu lthe phase of being updated with introduction information so that AMC can intervene withof online payment options for CME's as well concerned authorities and take part in theas for membership of AMC and its various rectification process. In this survey, youschemes for the ease of operations and could also report any incidence of violencebenefit of the members. Distress call that you have been able to deal with yourselfapplication, SOS, is also provided to the

without any external support.members in case of emergency situations

Apart from the above, there is a lot of workespecially with violence against thegoing on behind the scenes and this includesregistered member. In case if any of you havethe multiple meetings per week of the officeany situation demanding AMC interventionbearers, program committee, websiteregarding violence, please don't hesitate tocommittee and so on and so forth.press the red SOS button on front page of

AMC Mobile app. Looking at the Sion Upcoming events :hospital episode on 24th of July, it is obvious

AMCON, the Annual conference of AMCthat once the mob is incited, they can harmhas already been announced and will be heldand damage whatever comes in their way.on 18th November at D. Y. Patil Auditorium.Violence in healthcare is on the rise, and it's This is our rapidly approaching star endeavorour responsibility to be well-equipped by allwhich we all look forward to. The AMCmeans to face this growing menace.Premiere League Night Cricket in D.Y.Patil

Backend events :Stadium following the AMCON is

AMC has always been on the forefront in something not be missed.


AMC Connect programs and Zonal deal with the lacunae ourselves and thus

programs will continue till the end of this strive towards a peaceful professional life.

year and let's all of us make the best out of it. We can succeed only if we work in greater

unison and follow the path of our MissionMy dear friends, let us all join hands, support

and Commitment. I wish to quote Tonyeach other, rekindle faith in our profession in

Robbins before ending my report and Ithe eyes of the public, media, government,express my gratitude to all of you who arepoliticians and everyone else. Let's comewith theAssociation of Medical Consultants.together to face the most pressing challenges

in the country today, Violence in Healthcare. "The path to success is to take massive,And let us all also work for curtailing the determined actions." - Tony Robbinssituations of violence by advanced

communication skills and thorough patient

counselling. We can do self-assessment and [email protected]

ASSOCIATION OF MEDICAL CONSULTANTS

MEMBERSHIP

Total Membership of the Association : 10932

Members under professional Indemnity Scheme of AMC : 7380

Persons (Members & Family) under H & A Scheme : 5630

Members under CBS Scheme : 1395

GST of 18% payable on the above amount.


n recent years, there has been an Generally speaking, Cosmetic surgery isIexponential rise in the demand for considered to be a high-risk specialty as far

cosmetic surgery in this country. as malpractice litigation is concerned. This is

underscored by the fact that Indian insuranceThere are many obvious reasons for this viz.

Companies have steadfastly refused tothe craving for youth and beauty in Society,

underwrite risks of liability followingno doubt fuelled by images in print andcosmetic surgery. In the Western countries,electronic media, movies and otherthis is not the case and one can get Insurancecommunication channels; the mind-cover against this liability. Ironically, theboggling advances in Medicine andInsurance Companies deny cover to thosetechnology and easy access to these; thewho need it most, just as Banks are eager tosteadily rising disposable incomes of peoplegive loans to those who don't need them.in the wake of economic upturn in theNevertheless, the good news is that AMCcountry and the fact that undergoingfought long and hard on this issue andcosmetic surgery has lost any stigma it mayeventually succeeded in getting it'shave had in the past. In view of this, cosmeticInsurance.surgeons have probably never had it so good.

Interestingly, this overwhelming demand for Company to cover this liability even thoughsurgery has not been dampened by the fact at an added cost. AMC cosmetologists canthat no Insurance Company re-imburses breathe easy since they can now getmedical costs of cosmetic surgery! malpractice indemnity. They can also

consider themselves unique since no otherIn no other medical specialization does the

Insurance Policy in the country affords thisconsumer status of the patient and the service

protection.provider-tag of the doctor get underlined , as

in cosmetic practice.Getting back to the question : Why are

However, cosmetic surgeons, and indeed the cosmetic surgeons more vulnerable to

non-surgical cosmetologists as well, need to medico-legal problems?

recognize that the attendant risks of medico-The following factors may explain this :

legal liability are now an increasingly

a) The quality of results is ultimatelychallenging reality. It is worthwhile pre-

empting these problems by trying to assessed by the patient and hence

understand their genesis. extremely subjective.

DOs AND DON’Ts

MEDICO-LEGAL PITFALLS IN COSMETIC

SURGERY AND COSMETIC DERMATOLOGY

Dr. Lalit Kapoor


b) There is more than average risk of a patient selection. I have come across

mismatch between patient's expectations some young practitioners who tend to do

and results obtained. certain procedures often on account of the

acquisition of a new costly machine.c) Patients who seek cosmetic surgery could

have personalities which are less likely to 2) Do not overpromise and under perform.

tolerate imperfection. In fact, let it be the other way around.

d) Possibility of permanent disfigurement 3) Know your limitations and undertake to

adds to the risk of patient wanting to treat patients within the scope of your

claim 'damages'. training and qualifications.

Of course, the possibility of per -operative An issue of the greatest importance is

and post-operative complications would be accurate and diligent record-keeping and

the same as in other branches of surgery cosmetic surgeons cannot afford to be lax in

though there are specific complications such this respect. The pre-operative or pre-

as under or over correction, asymmetry, procedure photographs are important

implant failure, disfigurement, and so on. documents and need to be meticulously

recorded and preserved. However, a warningPerhaps, the key preventive measure lies in

that may be sounded in this regard : Do notpatient-selection. One must understand the

forget to take explicit written consent of themotivation, expectations as well as sub-

patient before taking photographs. A numberconscious desire of the patient before

of our members have landed in malpracticeelective surgery. You must discourageclaims by patients on account of this.wrongly motivated patients especially

patients below 18 years. Do not let a patient Additionally, posting some of thesebully you into an operation or a procedure as photographs on social media may be quiteit is safer to say 'No' before an operation than tempting but must be done with great caution"Sorry, I couldn't give you the result you and circumspection as it can become a verywanted" after the operation. And for those sensitive issue for the patient and a verywhom you decide to operate, build realistic sticky ethico-legal issue for you!!expectations. Beware of the excessively

Unquestionably, the importance ofdemanding patient who brings photographs,

patient's consent for surgery cannot bedrawings and architectural specifications! In

overemphasized. The following pointsrelevant cases, insist on a psychological

must be remembered :assessment of the patient prior to surgery, in

particular, if you detect any clues of a) Consent taken should not of the 'routine'

dysmorphophobia in the patient (Def : an type. As far as possible take 'operation-

obsessive fear that one's body or any part of it specific' consent which details the

procedure as well as the possible risks andis repulsive or may become so).

complications. For example, specificThree other important points :

consent documents should be designed

1) Exclude financial gain as a criterion for for, say Liposuction, Botox treatment,


Laser treatment, hair transplants, Often this amounts to provoking the patient

chemical peels and so on. and many a litigation has its genesis in ill-

advised and provocative statements by theb) Preferably, consent should not be in a

second surgeon. This factor can be easilylanguage the patient does not understand

minimized, if not eliminated, by simplyi.e consent forms should be designed in

resisting the temptation to indulge in one-regional languages as well.

upmanship.c) Caution : Consent of patients below 18

Lastly, the incidence of allegations byyears of age is invalid. The legal guardian

patients of sexual misconduct, orought to be giving consent on behalf of

inappropriate behavior against Cosmeticsuch a patient. Operating upon a minorsurgeons, is more than the average for allmerely with his or her consent can attractother Specialists. Hence special care must bethe penal charge of assault and battery.taken in this regard and male doctors must

d) 'Informed consent' is mandated by law in NEVER examine female patients without thethe USA and not taking it is considered as presence of a female attendant or femalenegligence per se. Indian courts too are relative.taking a similar view as evident from a

Recently, 3 cosmetic surgeons faced medico-few recent judgments. Informed consentlegal problems-two in cases of Liposuctioninvolves making sure the patientand one in a case of mammoplasty. In oneunderstands the nature of his condition,case, of Liposuction, the patient demandedthe alternate treatments and proceduresthat her money be refunded or else she wouldavailable; the nature of the proposedmake a nuisance of herself (hints oftreatment and the chances of success orblackmail).failure of the procedure.

Non-surgical cosmetic practitioners areA vital factor that adds to vulnerability ofequally vulnerable and as much at risk ascosmetic practitioners is the fact that thetheir surgical colleagues. Let me give a fewqualification criteria for cosmetic practiceillustrative (but real) examples.are highly unregulated in this country.

Unqualified or sub-qualified persons can call * A 24 year Spanish female model wasthemselves cosmetic practitioners as there referred to a Dermatologist by a modelingare no strict statutory criteria for the same. agency for acne of the face. She wasAdvertisements in the lay media by all and prescribed Cap Isotretinoin 20 mg andsundry claiming to be doing cosmetic

advised to follow-up after 1 month. Thepractice further compound the problem. On

patient left for Dubai the next day. After 15the other hand, in the USAfor example, in 21

days the dermatologist started receiving aStates only qualified physicians are

series of e mails from the modeling agencypermitted to use lasers in their practice.

asking for answers to the questions of

another doctor in Dubai. Why pregnancy wasAnother important cause of malpractice

not ruled out in this patient? Why she was notlitigation lies within us viz. the proclivity of

many doctors to criticize colleagues, counseled on not getting pregnant? Why

especially the previous treating surgeon. lipid profile was not ordered before starting


the medication? Legal action was threatened * Adverse reaction of drugs is an important

if satisfactory answers were not provided. cause of allegations of negligence against

dermatologists. For example, a patientThe member was assisted in replying to thesedeveloped aseptic necrosis of head ofqueries appropriately and the matterfemur following long term use of potentquietened down but not before undergoingsteroids.much anxiety and having learnt a few

lessons.Despite all precautions, we may not be able

* Tattoo removal resulted in burns and skin to avoid medico legal problems---but we

necrosis. Doctor said that it was a very should definitely try to put into place some ofsimple procedure. Allegation : Doc had the measures outlined above, though theseused infrared coagulator device. Should efforts must be sincere and not 'cosmetic'!have used ultra short pulsed NdYag laser.

And, as always, it is better to be safe than* Excessive scarring resulted after removal

sorry!of hemangioma in leg of infant.

* Missed diagnosis of malignant melanoma

leading to spread. [email protected]

MLCON at Nashik on 22nd July, 2018


Hi Friends, 3) Login User can login to system.Username will be email ID & PasswordToday we are in a digital era where everyonewill be mobile number. First time loginwould like to access everything from theirwill generate OTP and ask for mobile

smart phone including details about the latestverification. SMS gateway integration

AMC programs (venue, date, topics etc),Only after OTP authentication user can

registration details, online payments etc.successfully login.

To make our members' life easy; we now4) My Account : User can view the

have both : the AMC App as well as ourMembership Status and Payment Made

dynamic website.details. User can view Profile /

We are in the process of a major revamp in registration details. User can ask forboth theApp as well as the website- making it profile change information like name /more informative and user friendly with a RMN / REI / Profile Photo etc.dedicated "Members section".

5) Events Programs : For forthcomingA new features which we have insisted on is AMCON, User can pay delegate fee /Dynamic Content display. registration fee by clicking on events

listed. User can also pay for the eventSalient Features of the Web-site :where Fees will be different for Early

1) Online Registration of a new member : Payment / Regular / Late paying. UserOnline submission of Registration Form will be taken to Pay U / ccAvenue forwith facility to upload document, payment.photocopies of supporting documents.

6) Admin will get facility to ManageThe Admin from office can Approve /AMCON event from admin area and addReject the registration. On Approval, andifferent Fee Early Payment / Regular /email will be sent to the user with a link Late Paying.to pay online.

7) A Postal to view all forthcoming2) Online Payment Gateway integration:

events:Once the payment is successful, the

a) News &Announcement Listing.User (new member) will be activated for

login to the system. Admin can also b) Display Upcoming Events.manually activate and add payment

c) Events - Photo Gallery List Events.received status in case payment is

received offline or any other mode d) Display photo gallery of selected(cheque). events.

WEBSITE UPDATE

Dr. Ashok ShuklaEditor - Website


e) Video Gallery : Video Listing - end (website) we will create customized

calendar where all events will be showedYouTube links.in calendar. From the website backend if

8) Notification : page to displayyou update the records the same will be

notification (sudden announcements,updated in the front end. And the same

condolences, etc).Admin / Staff can senddetails can be viewed on the phone

notification by selecting Users fromCalendar.

admin area. Users will get notification in12) SOS feature on the app is best availableemail and can view notification on

option to members who are in crisiswebsite page login.during attack/violence. This sends an

9) Display Visit / Login Hits Display Visit / sms asking for help to all the members inLogin Hits. the same pincode areas.

10) Newsletter Subscription Newsletter All these features will make the website andsubscription form will be available for App more user-friendly. We hope to go greenuser to subscribe. eventually with all members use online

facility and useAMC website as well as app.11) Admin will get facility to view and

export subscribers to CSV file. In front [email protected]


Team AMC 2018 - 2019 has initiated a female sexual disorders a much neglected

member outreach program where we topic. The other topics were "Nar, mada ya

reach out to our members for an Aadha", 'Sex has No Expiry Date' and the

interactive meeting in an attempt to finale 'Pati, PatniAur….Woo….Oooh'!!

understand local issues. This weekly2) 25th May 2018 : Nurses Training;

program is held at different places,Venue :Ambernath

covering a wide range of topics withParticipants : 118, CME points - 0prominent speakers and prominent

members of the Doctor community.

1) 20th May 2018 : "Sexp lo re"

Conference; Venue : IMAhall, Juhu

Participants : 160; CME points -2

The CME included talks on Basic

pharmacology, what symptomatic treatment

to be given in the absence of consultants,

LASA drugs and its importance and

complications; Pre and post operative patient

preparation, care and monitoring; Legal

complications; basics and practical uses of

operative instruments was demonstrated;

fumigation, sterilization, Autoclaving; CPR

for cardiac arrest, cardiac emergency and

method of CPR and action in golden hour

were discussed. In addition, how to predict,

prevent, violence by irate relatives was

especially stressed upon. Actions of staff in

case of mob violence, whom to contact, how

to console relatives were discussed.

An opening talk by fitness Guru Mr. MickeyImportance of consent, documentation,

Mehta on 'Sex and Moksha' mesmerisedconsent, methods of obtaining consent. Dos

everyone but we were 'Mickeymized' by his and don'ts while handling IPD papers and

talk on importance of a healthy life style for legal consequences in Medico legal cases;

good sex life.importance of cordial behavior, sympathetic

The second talk "Women, Let's Talk Sex" attitude and professional behavior was

had a detailed presentation on the nuances of highlighted. Behavior of nurses while

AMC News

speakers on collage....2. Dr. Sanjay Deshpande 3. Dr. Darpan Kaur4. Dr. Udayan Indurkar 5. Mr. Mickey Mehta6. Mr. Ashok Row Kavi 7. Dr. MukundJagannathan 8. Dr. Deepak Jumani

1. Dr. Prakash Kothari


attending OPD patients, well groomed

appearance and hospitality were stressed

upon.

3) 25th May 2018 : Hotel Nakshatra,

Ambernath


4) 08th June 2018 : Vinayak Hall, Kalyan


5) 16th June 2018 : Hotel Mayur,

Ulhasnagar


Included a talk about 'AMC Schemes' withi) Kalyan : Blood Units collected :

description of H&A, NoAH, CBS, Medico210 Photo

legal schemes and policies for the benefit of ii) Dahanu : Blood Units collected :the consultants.

436) 23rd June 2018 : Hotel Regent Garden,

iii)Cooper Hospital : Blood UnitsBhiwandicollected : 50

Participants : 73; CME points -1b) 26th July 2018

7) 24th June 2018 : GCC Club, Mira RoadThane : Blood Units Collected : 26


P r o g r a m a b o u t " I n t r o d u c t i o n t o

Adolescence'' - the magnitude of problems,

the need for parents and medical fraternity to

be in tune with adolescents, a talk on

"Adolescence: a period of transition",

unraveling the interesting challenges a

medical practitioner faces as a child becomes

an adolescent with details on early and

delayed puberty- sensitising the audience on

pubertal dilemmas, a talk on gynaecological

disorders in adolescence were taken up.

8) Doctor's Day : 01st July 2018;

Balgandharva Rang Mandir

Participants : 418; CME points - 010) 06th July 2018 : LTMMC & LTMG,

9) Doctor's Day Blood Donation Drive : "Chalo Sion Chunabhatti”

a) 1st July 2018 Participants : 70; CME points -1.


3-Aug-18 AMC Connect-11Chalo Vikhroli -Bhandup - Mulund

Godrej Memorial Hospital, Vihkroli

1 100

12-Aug-18 AMC Meet-4Tech Conference Nursing Home Issues (Gipsa)

Ashford Chamber - Citylight, Mahim

19-Aug-18 Simulation Workshop (Trauma Care) D.Y. Patil Medical College

18-Nov-18 AMCON Annual ConferenceThe Lalit Hotel,Andheri (E), Mumbai

8-Jul-18 AMC Meet-3Enhancing MedicalPractice & Productivity

Chembur 2 120

20-Jul-18 AMC Connect-10Chalo GhatkoparVidyavihar Powai

Jolly Gymkhana,Ghatkopar

1 85

22-Jul-18 MLCON-2018AMC Mumbai & Amc Nashik

Nashik 2 245

28-Jul-18 TB & MDTBHoliday Inn (Near Sahar Airport)

1 50

8-Jun-18 AMC Connect-6 Chalo Kalyan Vinayak Hall, Kalyan 1 95

16-Jun-18 AMC Connect-7 Chalo Ulhasnagar Hotel Mayur, Ulhasnagar 1 89

23-Jun-18 AMC Connect-8 Chalo BhiwandiHotel Regent Garden, Bhiwandi

1 73

24-Jun-18 AMC Meet-2Adolescense Unravelled a Medico Social Exploration

GCC Club,Mira Road

2 113

1-Jul-18 Doctors' Day Talent Show Balgandharva Rang Mandir 418

1-Jul-18 Doctors' Day Blood Donation Kalyan 210 Unit Collected

1-Jul-18 Doctors' Day Blood Donation Dahanu 43 Unit Collected

2-Jul-18 Doctors' Day Blood Donation Cooper Hospital 50 Unit Collected

6-Jul-18 AMC Connect-9 Chalo Sion ChunabhattiPhysiology Lecture Hall, LTMMC & LTMGHospital, Sion

1 70

8-Jul-18 Doctors' Day Blood Donation Bhayander 55 Unit Collected

10-May-18 AMC Connect-4 Chalo Thane Kalwa IMA Hall, Thane 1 82

20-May-18 AMC Meet-1 Sexplore Conference IMA Hall, Juhu 2 160

25-May-18 Nurses Training Ambernath 118

25-May-18 AMC Connect-5 Chalo Ambernath Badlapur Hotel Nakshatra, Ambernath 1 55

Date Program Venue CME Point Attended

5-Apr-18 AMC Connect-1 Chalo Mira BhayanderWockhardt Hospital,Mira Road

2 150

20-Apr-18 AMC Connect-2Chalo Vasai - Nalasopara - Virar

Hotel Manthan,Nalasopara

1 91

4-May-18 AMC Connect-3Chalo Palghar - Boisar - Dahanu

Hotel Sarovar, Boisar 1 35

6-May-18 Nurses TrainingZaika Orchid Banquet, Bhayandar (W)

AMC Program All Dates


To,

The Editor - GRASP

Dear Sir/Madam,

I am a Physician. A patient's mother placed

a complaint against me, of medical

harassment, while opining and treating her

daughter at the casualty of a hospital.

The patient presented as an obvious case

of Acute Infective Gastroenteritis, but

on examination, I found bowel sounds

were absent. The casualty officer also

checked and found the bowel sounds

absent. I advised a surgical reference and

a USG abdomen with an X-ray Abdomen

Standing. The surgeon took some time

to see her, by which time the USG and

X-ray were already done and reported

normal. He also reported her bowel

sounds as feeble. A little later the bowel

sounds returned, and patient was

advised by the surgeon for only medical

management. However the parents accused

me of an attempt at pushing for surgery,

a n d a l s o o r d e r i n g u n n e c e s s a r y

investigations viz: USG and X-ray

Abdomen. The complaint was directly

launched to a police station, to which

I was summoned.

I was greatly distressed at this incident as

I had done my duty towards the patient -

true to my findings and ordered

investigations and a surgical opinion in

good faith.

After spending two extremely distressing

days in wondering what to do, I turned

to AMC President Dr. Vipin Checker, who

not only responded instantly, heard my

issue out, liasoned with the police and

the lawyers, and advised me on the correct

next steps, which I followed.

The speed, efficiency and the legal

accuracy that was displayed was indeed

very commendable, and has induced a

sense of gratefulness and respect for the

AMC organization.

Thank you,

From,

Dr. Rajesh Jaria

MBBS, MD - Medicine

General Physician


1) IP Asset is made in India!

Team AMC 18-19 congratulates the team of Indian clinicians Dr. Debraj Shome, andDr. Rinky Kapoor, who have formulated a blend of bio-mimicking polypeptides (analogous to naturally occurring human protein factors) with amino acids and minerals for hair loss.

They have named this as QR678 : QR= code "Quick Response"; 678 = Morse Code for "there is no answer".

After successful animal trials and cell toxicity studies, they performed a clinical trial and now their QR 678™ hair formulation has been awarded a composition patent (the most difficult form of patent to acquire) by the United States Patent and Trademark Office (USPTO), on 11th July 2017 - USA patent no 9, 700, 504 B2.

AMC Congratulates this Complete "Bench" to "Bed" approach!

ACHIEVEMENTS

2) Anticipating the future!

Team AMC 18-19 congratulates Dr. Dheeraj V. Mulchandani and Dr. M. M. Begani of Abhishek Day Care Institute and Medical Research Centre, which completed 17 years. Theirs is a dedicated Multi speciality Day Care General Surgery Centre. The lack of hospital beds, long waiting lists, increasingly expensive health care system, virtually non-existent medical insurance in India and lack of governmental funding to the private sector of health care, points to day-care surgery being the only answer for common treatable surgical problems in the future.

‘Whether this patient should be sent home’ needs to be changed to: ‘Does this patient even need admission?’

During the period of 17 years, they have performed 6589 surgical procedures - 6051 OPD procedures and 5928 Endoscopic procedures.

That is 18,000 cases of Ambulatory Surgery under local anaesthesia with some form of sedation.

To feature your Achievements in GRASP, Email : [email protected]


hough specialists and supers pecialists allegations were that the doctor did not visitTadvise medications and conduct or monitor the patient regularly after the

procedures, very often, post-operatively and kidney surgery. In addition, the kidney

during administration of medication, close surgery was done with invalid consent as

monitoring is mandatory to prevent/ the alternatives and risks of surgery was not

minimise adverse reactions or watch out for explained. Hence the complaint was filed.

early complications. Lack of adequateHeld : The patient was on Clexane and the

monitoring when indicated would causedosage adjustment is required in patient

damage to the patient and would be medical with kidney damage. Due to excessive

negligence as is illustrated below.administration of Clexane, more than 1 litre

A) I (2017) CPJ 235 (NC) : Singh v/s FH of blood collection occurred in the abdomen.

Repeated aspiration led to infection. As perComplaint : Raminder Singh visited Fortisliterature, Clexane has to be given in theHealthcare for consultation of knee surgerycorrect dose and route with closeand was admitted on the same date (17thmonitoring. Timely detection of mistake inMay) as potassium levels were high. Blooddosing would have prevented internaland radiology investigations were donebleeding in the patient. The Surgeon has to bewhich revealed advanced kidney cancer.vigiliant post operatively to look for signsSurgery was performed (on 23rd May).of bleeding post-operatively. As per MedicalDrain was removed within 3 days and patientRecords, there was abdominal pain andbecame turned serious on 28th May. Thedistension after surgery and considerablehemoglobin dropped. USG was performed indelay in conducting diagnostics. Increasedthe evening of 28th May which revealed 1level of urea and creatinine were ignored by litre of blood collection in the abdomen. Thethe doctor during clexane administration.patient turned critical the next day and re-Relevant investigations regardingexploration was performed on 30th May (the

coagulation was not done during clexanesame could have been immediately after

administration leading to internal bleedingUSG on 28th May). The patient continued to

and subsequent death. Doctor and hospitalhave internal bleeding. The Attending doctor

held negligent for inadequate monitoringproceeded for leave on 6th June and no

Surgeon was available to monitor the patient. of the patient post-operatively leading to

The patient died on 23rd June. The complications.

LACK OF MONITORING IS

MEDICAL NEGLIGENCE

Dr. Suganthi IyerDy. Director - Hinduja Hospital, Mumbai


B) III (2016) CPJ 437 (NC) : Patil v/s PD hospital and should have been kept in the

ICU for continuous monitoring. TheComplaint : Mr. Deshmukh was prescribed

hospital "S" did not produce any evidence toGatifloxacin by family doctor and developed

show that the ICU was not fully occupied norrashes and blisters on the skin with itching

that the patient denied ICU admission andand uneasiness. He was admitted to “S"

the patient was treated in the wards withouthospital where he was kept in the Wards for

close monitoring for several days and thusthe same. Doctors said it was Gatifloxacin

sustained ocular damages. She wasallergy and prescribed medicine. However,

diagnosed with as madarosis in both eyes andthe condition deteriorated and she was

trichiasis in right eye. Proper ICU care andunable to swallow food. She was put on

monitoring could have prevented theliquid diet. The patient then got transferred to

ocular damage . Hospital declaredanother hospital in ICU. Ultimately patient

negligent.suffered permanent loss of eye lids, partial

loss of eye sight and permanent loss of tear C) III (2016) CPJ 421(NC) :YHospital Vs

glands. Thus, complaint of wrong treatment Uma Devi & Ors.

and negligence filed.Complaint : Mr. Reddy was admitted to

Held : The patient ultimately developed Yashoda Hospital as he was suffering from

TEN and SJS which is a serious condition jaundice. During ERCP, anaesthesia was

and could be life threatening. Such patients administered and the patient developed

should have been in ICU and not in the sudden cardiac arrest. Hence the procedure

wards. As per medical literature, a disease of ERCP was abandoned. Mr. Reddy was

severity scoring system called SCORTEN brought out of OT in a comatose state. He

(Score of TEN) which is an established finally became brain dead and expired after a

protocol for assessment of severity of illness long struggle two and half years late. A case

in patients with SJS and TEN had not been of medical negligence was filed withmaintained as was the evident that the allegations as to whether ERCP wasmedical record were devoid of the same. performed as per standard guidelines andPatients with SJS and TEN could become whether the dose of anaesthesia was correct.fatal if not monitoring closely. Also the

Held : As per standard of care, thepatient showed signs of increased new

administration and monitoring oflesions. ICUs provide intensive care

propofol administration for such complextreatment and monitoring critically ill and

endoscopic procedures should be theunstable patient. Treatment focuses on

responsibility of a dedicated andeliminating underlying cause and controlling

appropriately trained anaesthetist toand minimizing complications. The initial

ensure that the potential complications ofgoal in managing SJS / TEN is to provide

sedation and anaesthesia are appropriatelyessential life support as both conditions pose

managed.a significant risk. In the instant case, the

patient was diagnosed as SJS/ TEN in "S" The anaesthetist ought to have taken due care


and justification before administration of the diagnosis of pulmonary embolism was

said drug. Carelessness on part of made. Patient was admitted in the Intensive

anesthesiologist landed the patient in a state Care Unit. Inj. Actilyse was prescribed to the

of coma. The medical record establishes patient and was later administered. After the

clear lacuna that there is no recording administration of Actilyse there was steepmaintained between 3.30 to 3.50 pm on the decline in the blood pressure and finally wasdate of the incident. Thus it was evident that transferred to another hospital in septicPropofol was administered without shock on 2ndAugust. Hence a complaint wasmonitoring and caution. Monitoring and filed.recording of patient's vital signs before and

Held : The Court relied upon the literatureduring procedure should be done. Bloodthat when Actilyse is administered there haspressure, oxygen saturation and pulse rateto be close monitoring. Resuscitationshould be monitored and noted. In this case, equipment and medication should be madethere were no records of patient's vitalsavailable. TPA is to be dispensed under theduring ERCP procedure leading to adversesupervision of specialist who would watchinference. In addition, timely intubation wasout for internal and external bleeding. It wasnot done for the patient and hence noalso noted there was no specialist when therecording between 3.30 to 3.50 pm. Cardiac TPA injection being administered. It wasarrest was also not managed properly leadingobserved there was no ventilator availableto coma.during the administration. It was further

Anaesthesiologists are like airoplaneobserved from literature that in addition to

pilots. Essentially 99% of the time they areActilyse, if another medication was being

in "watchful mode." It is the monitoringadministered, there need to be given by

of the patient and the ability of theseparate drip lines. As the side effect include

anaesthesiologist to promptly act withlow blood pressure, breathlessness, allergic

available equipment that makes thereaction, irregular heartbeat, fever and even a

difference between life and death. Thoughcardiac arrest, close monitoring is

the doctors were qualified, they failed inconsidered necessary. The treatment

their duty of care during ERCPrecord filed by the hospital does notprocedure. Forty seven lakhs werea n y w h e r e s t a t e w h e t h e r t h eawarded.aforementioned precautions were taken.

Michael Jackson and Joan Rivers both lost The case sheet is silent about thetheir lives due to anaesthetic agent : Propofol monitoring of the administration of TPA,

except for stating that it was done under theD) II (2017) CPJ 402 (NC) : I Hospital v/s

advice of the doctor.Arora

In addition, the insert on the medicationComplaint : The patient, 61 years, diabetic,

was also taken into consideration whichwent for consultation to Inscol Hospital on

ment ioned Spec ia l warn ings and01st August with fever, breathlessness and

severe pain in left leg. After investigations, precautions :


"Actilyse should be used by physician as they carry a heightened risk for

experienced in the use of thrombolytic adverse outcomes and catastrophic harm

treatment and with the facilities to monitor whenever there is an error.that use. As with other thrombolytics, it is

• Close monitoring during sedation /recommended that when Actilyse is

anaesthesia and in the recovery room tilladministered standard resuscitation

shifting out to the wards / ICU.equipment and medication be available in all

circumstances". • Periodic frequent monitoring in ICU /

wards depending upon need of theUnder such circumstances, the court waspatient.of the considered view that Actilyse was

not adminis tered under proper • Closed monitoring during bloodsupervision. Also the medical records was transfusion for transfusion reactions andnot provided to the patient on his request corrective action to be initiated at theby the hospital. Hence negligence was

earliest.slapped on the hospital.

• Establishing clinical guidelines andTake Home Messages :

score sheets for monitoring.

• Close monitoring while administration• Necessary corrective action to be

of High Risk medications as look-alikeinitiated as per manifestation.

drugs , sound-a l ike drugs , low

therapeutic window, control led

substances, psychotherapy medications,

concentrated electrolytes, narcotic and

psychotrophic drugs, chemotherapy, etc. [email protected]

Dr. Kusum Zaveri

Obstetrics/Gynaecology and In-vitro fertilization

Passed Away: 7 June, 2018st

Condolences


he President of India recently spoke of is inundated with work. Though heTthe looming mental health epidemic initially felt wronged by the city of his

birth, he is contented with this new town here as we are becoming the 'suicidal capital'

that has thrown up a great opportunity forof the world.him. The 'joy index' is very high among

India is on the threshold of a great tomorrowthose who believe in a 'sincere work

and its young Indians are the architects. Theethic', in 'touch with the times' and

resultant pace of life and rapid sociological'compassionate' towards themselves. The

shifts in the country have its own confusion and self doubts here is less.consequences. The medical profession is no

ii) A female cardiologist dropped in andexception and is facing the onslaughts andasked me whether she should share a partthe adverse effects of globalization. Wearof her 'wallet' with those who support herand tear of the mind and body from running in her practice. I simply said that it is her from one Operation Theatre to the next, fromchoice. Those who solicit patients to buildone OPD to the other is a cause of concern.a robust waiting room in their clinics at

Following are some probable 'narratives' that the earliest lose respect for themselves.the Medical Profession can ponder upon and

So if one's philosophy of work and life islaunch correctives, apply brakes or modifyclear and the concepts gel with their mind,their lifestyles.body and soul the 'peace' experienced is

A) Philosophy of life : The philosophy of better.life is an important variable in defining

B) Micro-breaks & Micro-Pranayama : Ahealth and well-being.long day needs to be invigorated

i) A young doctor recently was looking for periodically. A heavy OPD or an OT can be aattachments in various hospitals and was Doctor's Waterloo if not negotiated well.distraught because he was finding it Those who live in their cars as they trudgedifficult to penetrate the iron walls of through multiple hospitals, having theirthese bastions. He was frustrated. When I meals inside the vehicle are worse off.After aasked him to apply in various cities and long day, there needs to be a small break of 10not only in Mumbai he felt slighted. minutes to cut the cycle of 'pain and therapy'

Reluctantly he shared his resumes around to feel connected with the family after one

and managed to get a good attachment in reaches home. I strongly recommend micro-

a second tier city. Today he is happy as he breaks between surgeries and patients :

''Doc in the Dock''

Points to PonderDr. Harish Shetty, MD

Psychiatrist

mindmoodsandmagic.blogspot.com


i) A call to a colleague, after seeing a few much enthusiasm colored with emotional

patients, sharing one's feelings of the day energy needs to be the same at home.

or indulging in a humorous exchange• Doctors who take either their family or

keeps the hypothalamo-pituitary-axistheir patients for granted slowly slide

intact.down in their health especially

emotionally.ii) Many would benefit with a short bout of

s low breathing or ' sama vri t t i• Many walk like well dressed robots in

Pranayama' [equal inspiration andswanky cars but lose their 'equanimity'

expiration with slow belly breathing].that is so important for us. Those who are

equitable to the 'free ward patients' asiii)Any form of meditation albeit for a short much as the 'general ward' or the 'deluxetime helps. A walk around the hospitalroom' patients remain healthier than theafter five patients can be refreshing.rest.

iv) Those who listen to stories of pain and joy• Emotional equity is also vital. Healing is in their clinics are better off than those

always a two-way process. When thewho only listen to signs and symptoms.doctor smiles and shows compassion to

v) The monotony of being cooped up in a the patient and the patient smiles backchilling air-conditioned OPD can be despite pain or suffering; the doctor getsbroken by a brief sun walk for a few healed himself/herself.moments.

• There are so many examples in my mind vi) A desire for a million attachments is the of relatives coming back after the death of

symptom of an anxious insecure mind. their loved ones and sharing that theyThough super-specialists may have to were fortunate to have great doctors whospread themselves thin and spread their tried their best but failed.dragnet a shade wider than others.

D) Managing Crisis : This is an era whereC) Building Emotional Wealth & the disgruntled patient population has beenEmotional Equity : Emotional wealth is a violently aggressive against doctors. Therapidly depleting reserve in a fast paced angst of a globalized world is being thrownworld. This can happen very early in life if on the easy targets and the medicalproper care is not taken. professionals are vulnerable whipping boys.

It is so important to build horizontalEmotional energy banks need to bepartnerships and support groups among thereplenished as regularly as the banks thatprofessionals irrespective of seniority.

store our monetary savings for the future.Dwelling in a lonely island and living in a

The best methods to fuel the emotionalself created delusion of glory will hurt the

energy bank is to focus on the triad of sleep,doctor. Understanding the compulsions of

diet and exercise.our work and being available around to those

• A spouse of a very famous doctor who have been targeted is so important.complained that her doctor spouse spoke Passing disparaging critical comments on

in mono-syllables with him at home. The fellow professionals is a sure shot method to

words expressed in the clinic with so dig one's own grave. We all can err and the


fact that providence can snatch any patient when patients suddenly praised you for

from our safe hands despite of the best efforts what you had done for him/her, and yetneeds to be realized and accepted. Working you do not remember?as teams improves wellness.

In this jet-set age we need to push the 'pauseE) Work life balance : Work life balance is a button' in life to find 'peace' and 'joy'.myth. We have to rush to assist emergencies

• Those who practice meditation of anyat odd hours. Doctors have missed funeralstype have a better emotional quotient.of their loved ones also, during crisis. ThereDance, singing, sports are also forms ofwill be always imbalance but finding balancemeditation.in the midst of imbalances is the key.

• Yog, Vippassana, similar other practices• Recently a doctor shared a dilemma. Heactually increase our Karuna and makeshad planned a holiday with his family andus more effective only if it penetrateshe simultaneously got an urgent call to beevery cell in our body. Many profess thata speaker in an international conference.they do yoga regularly but are very rudeHe could not shift his holiday. I asked himand harsh in their lives. Yog- asanas area simple question whether such dilemmasnot the arrows of Ram that destroys thehave presented to him in the past and hearrows of Ravana. These need to be asaid yes. What did he do then I asked himway of life.and he answered that he would

compromise his holiday and go to give a • Aligning our body clock with the

talk. Well, those who are brutallybiological clock is a key to wellness.

committed to their holidays live betterCalming our autonomic nervous system

lives compared to those who see it as aperiodically and harmonizing our breath

'peace broking activity' with theirwith the orchestra of our body will help

families. The conference will find otherexperience peace and harmony aroundspeakers but your family can not find aothers.substitute father or mother or a husband

or a wife. Such practices need not be ritualistic but

should pervade all aspects of life.In life, the choice is that you can't please or

satisfy everyone. We have to choose whom Medical practice is not a 20/20 cricket matchwe need to displease. and nor is it a marathon.

F) Inner Peace is the key and Joy is a by- It is like a walk on the banks of the Gangesproduct of peace. or the Mississippi……..savouring the flow

& the flood, the sunshine & the moonlight• There is a difference between joy andand also the torrential rains & storms.pleasure. Joy is something one can

neither chase nor avoid. We may bask in the sunshine or get soaked in

the water but the joy of the walk remains• One of my great teachers Dr. NS Vahiabeautiful and so fulfilling. To me if I am bornonce shared with me that the 'Hospital isagain I would still want to be a Doctor as noour temple and patients are our Gods.profession in my mind can ever be asFrom them we learn and from them we

earn.' Remember the days and the joy fulfilling as ours!


VISUAL DELIGHT : Contributed by Dr. Kiran & Dr. Ketki Marthak

I am guide in the forest.I lead you to wherethe best Honey is.My name is Honeyguide.

My beak looksawfully big -

My name is GOSBEAK

My bill is like a parrot's -and so I amBrown Parrotbill

Mrs Gould's Sunbird -My beak can take in

nectar from anyflower_Bhutan Sunbird.


Red dots on me is theperfect camouflage ona Rhododendron Tree -Satyr Tragopan

I am OrangeBellied Squirrel

Takin (BurdorcasTaxicolor) - National

Animal of Bhutan

My tail is black.I am extremely shy andwill not show myself.I am black tailed CRAKE


Healthcare Financing : 1. Tax based financing,2. Social insurance financing,

n India, the Minister of Health and Family3. Private health insurance andIWelfare has announced a very ambitious4. Community based health insurance.

and goal-oriented Health Insurance Schemefor the poor population of our country with a Following the lead of many OECDcomplete Government Health Financing. countries, health insurance throughMany states have already signed the MoU government has emerged as a preferred(Memorandum of Understanding) with the method of health financing in many low andUnion Ministry of Health and Family middle-income countries including India.Welfare for implementation of theAyushman The status of health financing in the IndianBharat Yojana - National Health Protection scenario can be graphically represented asScheme / Mission. The various models of follows :Health Financing and Health Insurance arepresented herewith.

WHO (World Health Organisation) definesHealth Financing as the "function of ahealth system concerned with themobilization, accumulation and allocation ofmoney to cover the health needs of thepeople, individually and collectively, in thehealth system."

In 1978, with the introduction of Alma Ata'sdeclaration of 'Health for All', there was a lotof international emphasis on UniversalHealth Coverage and countries andorganizations all over the world have tried toachieve a viable and sustainable system ofuniversalizing health services. Healthfinancing plays a key role in establishingsuch an equitable system of healthcare.

In 2001, Bennett and Gilson had identified 4basic health-financing mechanismsimplemented across the world. Thesemechanisms are not water-tight but areinterrelated as well as interdependent :

HEALTHCARE FINANCING &

HEALTH INSURANCE MODELS

Author : Prof. Sushmita Bhatnagar(MBBS, MS, MCh, MPhil, PGDMLS)

Pediatric Surgeon, Hon. Secretary, AMC

Fig. 1: Sources of Healthcare Financing in India

Fig. 2 : Public & private split in thetotal health expenditure across the world


The sources of health financing in India can be graphically depicted as follows :

Indian Models of Health Insurance and cash benefits compensating for the loss of

Financing : earning capacity due to illness, disability or

death. Health provisioning is mainly throughThe distinct models of health insurance andits own hospitals and dispensaries with somefinancing in India from its inception are asadditional empaneled private hospitals.follows :However, India has a large working

1. Employees' State Insurance Scheme population in the unorganized sector. This(ESIS) : 1948 seriously limits the schemes coverage

amongst the neediest worker.This was the first ever-insurance scheme, is

still active since 1948. This scheme was 2. The Central Government Health Schemeapplicable to the lower rung workers in the

(CGHS) : 1954formal sector and their families. Healthcare

This scheme provided health benefitsfinancing was through 3 sources :exclusively to the central government

a. Contributions from the governmentemployees, their families, pensioners,

b. Percentage of employer's share members of Parliament and Supreme Court

judges.c. Percentage of employee's share from

the wages payable to the employee. Healthcare financing was through 2 sources :The least paid workers are exempted

a. Central government fundsfrom employee contribution.

b. Employee contributions.The scheme provides a comprehensive

package at all levels of health care along with They have comprehensive service packages


through their own dispensaries in select catered mainly to the upper and middle-class

cities, some public and private hospitals population.

which are empaneled to provide services. 1999 onwards, a number of similar voluntaryThe scope of this scheme is narrow and health insurance schemes by privateobviously this scheme is not for the general companies were introduced whenpopulation. liberalisation of the economy led to the

insurance sector being thrown open to the3. Community Based Health Insurance

private sector. Simultaneously, developmentSchemes (CBHI)

of private health sector gained momentum;The CBHI are run by NGOs and hospitals for

leading to sprouting of small and largecommunities and have existed in India for

hospitals and private nursing homes. This,many decades. These schemes are

along with the decline of the public healthessentially voluntary and cater to the poor

sector, the household health expenditureshouseholds in the informal sector who are

increased. The expensive private healthunable to afford the high premiums of private

insurance schemes offered thus far werehealth insurance. The disadvantages of these

unaffordable to the poor who continued to besystems are :

impoverished under the burden of healtha. Low premiums mean that the benefit care. There was a dire need to protect the

packages are also lower, poor and hence based on international

experiences in other developing countries,b. There is no cross subsidizing betweenmany community-based as well asthe rich and the poor,government, health insurance schemes were

c. They are not amenable to expansion on introduced across the country.a larger scale. Multiple social

5. Universal Health Insurance Schemeinsurance schemes at both state and(UHIS) : 2003central level including Maharashtra

state for various sections of The Government of India launched the UHISpopulation, railway employees, etc. to reach out to the poorest households. Thegenerated for several years. premiums were heavily subsidized and the

annual cover ranged from INR 15,000 - INR4. Mediclaim : 198630,000 for hospitalisations. Premiums were

The public sector health insurance further lowered in 2004 following poorcompanies launched the first voluntary response from the target BPL population.health insurance scheme called Mediclaim. Despite this, the scheme failed to take off.It covered all those healthy individuals who

6. Governmen t Sponsored Hea l thwere willing to pay premiums based on age,Insurance Schemes : 2003 onwardsforeseeable health risks and corresponding

benefits package for future hospitalisation Several government subsidized insurance

expenses along with tax benefits. schemes in many states across India was a

Policyholders are reimbursed the cost of welcome development though they had

hospitalisation and home care on submission some significant shortcomings. Thus, none

of bills and other documents. This scheme of these schemes served the purpose of


universal coverage as each scheme had a funded insurance schemes for the poor

specific target population making them were significantly different from the

limited in scope. existing schemes such as the ESIS and

CGHS.a. Launch of the Yeshaswini Scheme in

Karnataka by the state government for 7. Insurance Schemes in Maharashtra:

the rural co-operative societies 1997-2012

occurred in 2003. The government Several Government schemes wereprovided financial and technical aid to implemented in Maharsthra from time tofarmers, artisans, weavers, fishermen time.Abrief reprt of these is as foolwos :etc. and other workers in the informal

a. 1997 : Jeevandayee Aarogya Yojanasectors. Participation was voluntarywas launched in 1997 for providingand the premiums highly subsidized.financial aid upto INR 1,50,000 to BPLThis was the first ever structuredpatients for surgeries related to heart,scheme with a pre-decided list ofbrain, kidney diseases, and cancer.medical procedures covered, setThis scheme was not truly an insurancepackage of services, fixed packagescheme as there were no premiums orrates and annual package limits. Thisinsurance agencies involved. The statepioneering and very successful schemegovernment allocated funds for thebecame a popular model for severalscheme that were used to directlygovernment health insurance schemesreimburse the designated public andacross the country.private hospitals that performed these

b. Government sponsored health surgeries on a case-by-case basis.insurance schemes like the central Although all grants were fully utilized,government's Rashtriya Swasthya many eligible patients incurred heavyBima Yojana (RSBY 2008) followed OOP expenditure for surgeries,by state level Aarogyasri (2007), diagnostics, travel, etc., because of theKalaignagar (2009), Vajpayee very low awareness about the scheme.Aarogyasri (2010), etc. States that did

b. 2008 : The central scheme RSBY was not have state health insurancealso implemented in Maharashtra as inschemes adopted the central schemeother parts of the country. The schemeRSBY. Target population of BPL andwas available in 32 out of the 35poor households, free of cost ordistricts of the state and only onesubsidized premiums, benefi tdistrict had an empaneled publicpackages for secondary and/or tertiaryhospital. The rest of the empanelledhealthcare, cashless services, healthhospitals were private.provisioning through empaneled

public and private hospitals and c. 2012 : The Jeevandayee Aarogya

i n v o l v e m e n t o f T h i r d P a r t y Yojana was converted into Rajiv

Administrators (TPAs), were some of Gandhi Jeevandayee Aarogya Yojana

the common features across the (RGJAY) and implemented in

schemes. Thus, the new government Maharashtra and the RSBY was


withdrawn across the whole state. 6. Provision of free medicines and food

RSBY covered a wider range of during the treatment.

services including secondary level7. Patients can avail follow-up services up

heath care and primary level liketo 10 days after discharge. In case of

normal deliveries, which is notprocedures where follow-up packages are

included in RGJAY, a tertiaryavailable, these can be availed by the

healthcare oriented scheme.patients later as per the treatment

The State of Maharashtra launched the schedule.

RGJAY on 2 July 2012 in a phased8. Cashless coverage of 121 listed follow-

manner starting with eight districts andup procedures.

after a span of a year; the second phase9. The NIC has outsourced services to threewas launched on 21st November 2013

IRDA certified TPAS (Third Partyin rest of the districts.Administrators) - MD India, Medi assist,

Salient Features of RGJAYare :and Paramount.

1. Total sum insured is INR 1,50,000 per10.There is a separate space for the RGJAY

family per annum on a floater basis. Anaarogyamitras allocated in the form of

exception for renal transplant has beenRGJAY counter/kiosk, which should be

made where the maximum ceiling is INRlocated at the entrance of the hospital or

2,50,000.besides registration counter.

2. Pre-existing health conditions too are11.RGJAY kiosk is equipped with a

covered. If the beneficiary is sufferingcomputer with networking, printer,

from any disease or medical conditionscanner, bar code reader and digital

prior to the scheme inception are alsocamera in order to carry out all the

included in the scheme. Cashlessactivities associated with registration,

coverage of the pre-decided 971preauthorization and claim settlement.

procedures / surgeries is provided across

30 specialties. Also, 131 out of 971 of 12.Free Outpatient Department (OPD)

these procedures can only be carried out consultation for patient seeking RGJAY

in public hospitals. package.

3. Provision for a health card, post The RGJAY has been renamed as Mahatma

enrolment, for the purpose of beneficiary Jyotiba Phule Jan Arogya Yojana (MJPJAY)

identification. from 1stApril 2017.

4. The scheme provides for reasonable pre The upcoming Health scheme of the Modi

and post-hospitalization expenses for one Government is Ayushman Bharat Yojana -

day pr ior and f ive days af te r National Health Protection Scheme (AB-hospitalization. NHPS) which is somewhat similar to the

MJPJAY.5. Provision for one-way transport

allowance. Salient features of AB-NHPS are presented.......

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n order to provide a service to create a in multiple agencies to ensure seamlessIhealthy, capable and content new India, a coordination between the center and states.

new Health Program called Ayushman One of the core principles of this scheme is to

Bharat Yojana or National Health have co-operative federalism and flexibility

Protection Scheme, also known as to states.

Modicare, is going to be launched soon. Dr.Salient features of the NHPS are :

Indu Bhushan has been appointed as the1) Ayushman Bharat - National HealthChief Executive Officer (CEO) for this

Protection Mission will have a definedscheme.benefit cover of Rs. 5 lakh/ family/ year.

It has two goals :2) Benefits of the scheme are portable

1) To create a network of health andacross the country and a beneficiary

wellness infrastructure across the nationcovered under the scheme will be

to deliver comprehensive primaryallowed to take cashless benefits from

healthcare services.any public/private empanelled hospitals

2) To provide insurance cover to at least 40 across the country.

per cent of India's population who are3) Ayushman Bharat - National Health

deprived of secondary and tertiary careProtection Mission will be an

services.ent i t lement-based scheme with

Ayushman Bharat Yojana consists of two entitlement decided on the basis of

major elements : deprivation criteria in the SECC

(Socioeconomic Caste Census)1. National Health Protection Scheme

database.(NHPS) : which will provide cashless

treatment to patients. 4) The beneficiaries can avail benefits in

both public and empanelled private2. Wellness centers : who will be provide

facilities.primary care to the patients.

5) To control costs, the payments forIn fact, the government plans to upgrade the

treatment will be done on package rateexisting Public Health Centers to Wellness

(to be defined by the Government inCenters. According to the latest news, the

advance) basis.welfare scheme might be rolled out on

August 15, 2018. The Government has roped 6) For giving policy directions and

AYUSHMAN BHARAT YOJANA :

IMPACT ON MEDICAL PROFESSIONALS

Prof. Sushmita BhatnagarHon. Secretary [email protected]


fostering coordination between Centre implementation process of NHPS and

and States, it is proposed to set up assured us to involve AMC in future

Ayushman Bharat National Health meetings/discussions. The salient features of

Protection Mission Council (AB- this meeting were :

NHPMC) at apex level Chaired by Union1. Association of medical Consultants was

Health and Family Welfare Minister.introduced to Dr. Indu Bhushan, CEO of

7) States would need to have State Health Ayushman Bharat. He patiently listened

Agency (SHA) to implement the to the purpose of our visit, and offered his

scheme. inputs and suggestions,

8) To ensure that the funds reach SHA on 2. Delivery of healthcare services of

time, the transfer of funds from Central Ayushman Bharat scheme (NHPS)

Government through Ayushman Bharat - through Nursing Homes was discussed

National Health Protection Mission to as well as the gate-keeping mechanism to

State Health Agencies may be done allow the nursing homes to be an active

through an escrow account directly. participant in dealing with secondary

patient care upfront and the larger9) In partnership with NITI Aayog, a

hospitals in both public and privaterobus t , modular, sca lab le and

sector taking care of tertiary levels ofinteroperable IT platform will be made

care,operational which will entail a paperless,

cashless transaction. 3. Criteria of empanelment in NHPS

should not be as rigid as NABHWhether we empanel with this scheme or

(National Accreditation Board fornot, the AB-NHPS will have a great impact

Hospitals) criteria,on all the medical professionals (we are the

fundamental key for delivery of healthcare 4. FEQH (Forum for Enhancement of

services)!! Quality in Healthcare) quality control

criteria of AMC are already existent andWhile deliberating on the technicality of

these can be utilized by NHPS afterimplementation process of this scheme for

relevant modifications, as qualifiedour AMC members, certain features

personnel from all sections are requiredunfolded which mandated discussion with

for the delivery of NHPS,the CEO of Ayushman Bharat scheme.

Hence, a meeting with CEO AB-NHPS, 5. Government can fund the existing

Dr. Indu Bhushan was organized on 12th July institutes/centers for up gradation and for

2018 at Nirman Bhavan, New Delhi at 5.15 making them self-sufficient (as required)

pm . AMC was represented by President for dealing with patients registered under

AMC Mumbai Dr. Vipin Checker, and NHPS,

Hon. Secretary AMC Mumbai, Dr. (Prof.)6. The rates for the treatment in different

Sushmita Bhatnagar.categories are not viable, as they do not

We had a fruitful discussion and CEO- even cover the cost of medicines and

NHPS, Dr. Indu Bhushan appreciated and consumables. The rates for NHPS

acknowledged our interest in the registered patients circulated widely


show that these are much less than the violence, increased medico-legal issues

GIPSA (General Insurer's Public Sector and thus chaos and deterioration in the

Association) rates, which themselves are entire organization,about 50% less than the original rates.As

8. AMC represents about 11 ,000per the costing exercise done by AMC

consultants who are the main source ofthrough Hosmac, there is wide variation

healthcare delivery and hence should be in the basic costs even within and on

included in the further meetings andoutskirts of Mumbai, hence there coulddiscussions on the NHPS.be differential costing of treatment,

Dr. Indu Bhushan accepted all the points and7. Medicolegal issues including violencesaid that most of the points are valid. Heagainst doctors arising subsequent toinformed on the current situation inmanagement of patients registered underMaharashtra where other schemes such asthe NHPS needs to be given moreMahatma Jyotiba Phule Jan Arogya Yojanasignificance and should be deliberated(MJPJAY, previously known as Rajivupon. The expectations of populationGandhi Jeevandayee Arogya Yojanaregistered with NHPS are going to beRGJAY) is also in place and that more needshigh on one end, and on the otherto be done within Maharashtra for success ofhealthcare delivery shall be with nominalNHPS. Differential rate structuring iscosts with use of generic drugs, etc. Wepermissible within the State Governmentsanticipate a mismatch between patients'

and its upto the State Governments to takeexpectations and healthcare delivery

systems thus giving way for mob this forward.


s per our tradition, this year also AMC Award of Distinguished Services. He wasAheld a celebration for Doctor's Day. felicitated by a memento, shawl and shrifal

This year, team AMC decided to have an as per tradition. Dr. Vipin Checker, Dr. Bipin

AMC Talent Nite - by inviting our own Pandit, Dr. S.S. Khambay and Dr. Ajit Desaimembers to perform. The venue was the did the honours.conveniently located Bal Gandharva Rang

Dr. Achut Nayak gave his acceptance speechMandir in Bandra West. On 1st of July, from

in which he thanked everyone and gave his5:30 pm to 10:30pm, 38 Medical

vision for present and future generationsConsultants gave a grand performance of

fromAMC members.solo songs, duets, Group songs, group dance,

Past President Dr. Ajay Hariyani was invitedperforming on musical instruments, etc andon stage and was felicitated by Presidententhralled the audience.Dr. Vipin Checker with memento and Vice

The Program started by welcoming thePresident Dr. Deepak Baid gave him

guests and Ms. Ridhima anchored thebouquet.

program.Past President Dr. Sangeeta Pikale was

It was highly appreciated by all andinvited on the stage and President Dr. Vipin

applauded by everyone.Checker felicitated her with a memento and

The felicitation program was held where Dr. Rajendra Nagarkatti gave her bouquet.President Dr. Vipin Checker updated the

Past President Dr. Veena Pandit was invitedaudience on the details of the 15 programs of

on the stage and President Dr. Vipin CheckerAMC conducted in 16 weeks (from the time

felicitated her with memento and Dr. Nilimahis team 2018-2019 took over). An

Vaidya Bhamare gave her bouquet.impressive performance indeed! He also

Past President Dr. Smita Sharma was invitedtalked about his future plans and appealed toon the stage and President Dr. Vipin CheckerallAMC members to come forward and workfelicitated with memento and Dr. Ashoktogether to make our society and our country

healthier and happier. Shuckla gave gave her bouquet.

Senior AMC member Dr. Achut Nayak was President Dr. Vipin Checker felicitated

the recipient of this year's Sanjeevani Trust's Dr. Dhiren Kalawadia (Convenor) and

Doctor’s Day

Sanjivani Award recipient Dr. Achyut Nayak


Dr. Hitesh Parikh (Co Convenor) with This program was successful due to the

contribution and hard work of all thememento.participants who came for practice sessions.

Mr. Shabbir Khokar was felicitated with aTeam AMC 2018-19 was ready to guide and

memento by President Dr. Vipin Checker.encourage the participants.

Mr. Nandkumar Kerkar who was master ofThe auditorium was packed and the audience

orchestra was felicitated with a memento byenjoyed the show till the end. The

President Dr. Vipin Checker. enthusiasm of the audience and artists was

visible in every part of the program and it wasAll of the talented AMC artists who

an evening worth spending with colleaguesperformed on the stage were felicitated byenjoying the cultural program.President Dr. Vipin Checker after each

performance by giving them memento and Vote of Thanks was given by Programappreciating their fantastic performances. Committee Chairperson Dr. Vivek Dwivedi

leaving all those present with beautifulThe academic partners of theAMC programsmemories of Doctor's Day 2018.Suburban Diagnostics, Abott Pharma,

Finovate, Ring Tone, Care Soft, SMS and Dr. Vivek Dwivedi

HCG were also present. Program Committee Chairman

Felicitation of Past Presidents

Dr. Smita Sharma 2017-18 Dr. Veena Pandit 2016-17

Dr. Sangeeta Pikale 2015-16 Dr. Ajay Hariani 2012


Doctor’s Day PARTICIPANTS

Dr. Anagha Kinare

Dr. Anjum Syed, Dr. Manjusha Shrivastava &Dr. Sumit Shrivastava

Dr. Anand Kumar

Dr. Ashish Sharma

Dr. Atul Wankhede

Dr. Bharat Bhosale

Dr. Bipin Pandit Dr. Dhananjay Chandurkar

Dr. Dilip Bhosale Dr. Geeta Mishra

Dr. Hitesh Parikh

Dr. Ila Shah


Dr. Kishore Nichani

Dr. Kumar Doshi

Dr. Lalita Mayadeo Dr. Manish Sharma

Dr. Milind Surwade Dr. Namrata Joshi

Dr. Nilima Vaidya-Bhamare Dr. Pooja Bandekar

Dr. Prashant Mullerpatan Dr. Pushkar A. Shikarkhane

Dr. Rajesh Valand Dr. Ravi Shah


Dr. Rohini Badwe Dr. Roopa Upadhyay

Dr. Salil Bendre Dr. Sangeeta Aranke

Dr. Sanjay Kinare Dr. Shailya Patel

Dr. Shashikant Kamat

Dr. Swati Petkar Dr. Uday Aranke

Dr. Varsha Dandwate Dr. Vikram Badhe

Dr. Sushmita Bhatnagar


AMCON - 2018thDate : Sunday 18 November 2018

Conference Venue : The Lalit Hotel, Andheri (E), Mumbai8.00 am to 5.00 pm &

Banquet Venue : Kitty Su, The Lalit Hotel, Andheri (E), Mumbai7.00 pm to 11.00 pm

Modes of Payment

(After Payment Please send UTR Number to )

Paytm : 98674 50066

AMC Office : 98674 50066 / 2683 6019 / 2684 1109Email : [email protected]

Registration Member/Spouse/Guest(accepted only on full payment)

Conference Charges

Banquet Charges (Unlimited food & FML)

Conference + Banquet Charges (Unlimited food & FML)

For Registration Contact :

Upto 30th September Rs. 1000/-Upto 30th October Rs. 1500/-

Upto 7th November Rs. 2000/-After 8th November Rs. 2500/-





Cheque in the Name of"Association of Medical Consultants, Mumbai"

[email protected] or 98674 50066

NEFT Details : Central Bank of India Branch, Andheri (E)A/C No : 3154847256 IFSC : CBIN0280595 MICR : 400016003

Cash at AMC office / Managing Committee


FOR IMMEDIATE SALE Prime Location, 25 Bedded, 4000 sqft Carpet, 11 ft ceiling,

running Hospital, 2nd Floor private elevator, 6 private rooms, consultation rooms, ample

water and electric @ Vartak Nagar Naka Thane.

With clear title. [email protected]; 98673 28707; 98214 42341.

RUNNING PATHOLOGY LABORATORY FOR SALE : Business & Premises for

sale : Well established LABORATORY past 28 years, Kandivali (W) for OUTRIGHT

sale. BMC sanctioned ownership space, 612 sq ft carpet; prime location; complete setup

of machines and inventory, infrastructure; Established and reputed business with a

database of clientele.

Serious buyers may Contact : 98198 24224.

For outright SALE, 40 years of well running, maternity and Surgical Nursing Home

near Dadar T. T. with fully equipped O.T. and valid Registration and licenses contact :

Mobile No.: 98200 25460 / 98207 42641 or send on What'sApp.

HOSPITAL FOR LEASE : Ten bed functioning hospital with all facilities situated on

ground floor (Boisar West, very near railway station) for Lease for Orthopaedic/Surgical/

Obst. Gynaec. specialities.

Independent separate entry to hospital. Contact : 98238 72540.

Contact :

CLASSIFIEDS AVAILABLE / REQUIRED

CLASSIFIEDS MATRIMONIAL

Alliance invited for 33 yr female (M.D.) Maratha, 5'4", slim, fair, beautiful, lecturer in

medical college, residing in Mumbai, from a well educated family. Requires a suitable

boy, Mumbai based, preferably a medico. Caste no Bar.

Contact : 98692 21676 / 98214 09967.

Mumbai based doctor parents seeking alliance for their daughter 1991 born perusing

MD. anaesthesia from P.G medico.

Contact : 98336 33335.

Doctor family seeking a suitable alliance for MBBS qualified November 1991 born /

5'3" fair, good looking Tamilian girl currently pursuing PG General Medicine (DNB) final

year. Groom should be postgraduate MD/MS/DNB/MCH/DM settled in Mumbai.

Contact : 98211 27924 / 98212 15564.


May 29, 2018 : Capping hospital profits: Delhi puts draft policy in public domain.

Jun 03, 2018 : Indian doctors in UK join call to end visa cap.

May 29, 2018 : Hospital suspended from insurance scheme of state.

Jun 03, 2018 : Govt may bring in new curbs on drug prices.May 31, 2018 : Only senior doctors to give

bad news to patients' kin.

Jun 02, 2018 : Private hospitals oppose 'low' Jun 04, 2018 : Revisit norms for the right Modicare rates.vitamin D levels for Indians.

Jun 04, 2018 : Private cord blood banks play on parents' fears.Jun 02, 2018 : Attempting suicide is no longer

a crime.

New Delhi :

London :

Mumbai :

New Delhi :

Mumbai :

New Delhi :Mumbai :

Mumbai :

Mumbai :

crime in India with the health ministry notifying on May 29 the Mental Healthcare Act 2017 that decriminalises this. The Delhi government put in the

public domain the draft prepared by it on capping of profits by private hospitals for scrutiny and feedback. A leading association of Indian

doctors in the UK has thrown its weight behind a new 'Scrap the Cap' campaign against the "rigid" visa norms that are blocking hundreds of A local hospital found overcharging Indian doctors from helping the country's state 20 poor patients who availed of the state scheme funded National Health Service.has been suspended from the scheme by the

newly appointed CEO.

Among the changes proposed by the government is a move to introduce a new Any bad news about patients price index for pharmaceutical products that admitted to civic-run hospitals will be conveyed will become the benchmark to determine prices to their relatives by a senior medical teacher of all medicines sold in the country -even those instead of resident doctors, who are essentially that are currently outside the drug price control postgraduate students. order.

Some major private hospitals like Traditionally, Indians have shown to Fortis, Apollo, Medanta and Narayana Health

be deficient in vitamin D, prompting doctors to have expressed concern over the government's say that India suffers from a "vitamin D ambitious 'Ayushman Bharat' fixing prices of paradox". some critical procedures, saying the rates are

not viable for them.

Paying huge sums of money to bank your child's cord blood in a private cord blood Attempting suicide is no longer a bank is of limited use and the government ought

FROM THE PRESSDr. Pradeep Baliga

Editor's Note : Media reports relating to Doctors and Healthcare have increased and it is not possible to publish details of all. The author can be contacted if more details are needed.


to be investing more in public cord blood banks. Considering that some donors at

blood banks test positive for HIV but don't

return for counselling and treatment, Mumbai

District AIDS Control has introduced a systemMany women with early stage breast to reach out to them.

cancer who would receive chemotherapy under

current standards do not actually need it,

according to a major international study that is

expected to quickly change medical treatment. There is rise in abortion related

mortalities in India due to poor awareness about

the MTP Act, said a panel of doctors and health

policy experts at a conference organized by The state has upped its ante against Global Health Strategies.

tuberculosis, as the health department has

expanded access to the newest anti-TB drug -

Bedaquiline, to patients across Maharashtra.

MCI has recommended that the

Union Health Ministry prohibit 82 medical

colleges in the country from admitting studentsAround 70% of miscarriages

for the academic session 2018-19.reported in Maharashtra every year are from

rural areas, which has 55% of the state's

population, revealed data available with public

health department. The Bombay high court asked the

state government to furnish details of the action

taken against illegal private nursing homes and Prices of some procedures under

hospitals across Maharashtra.the proposed government-run Ayushman

Bharat National Health Protection Scheme may

go up in some states.

A state government study on

angioplasty patients has questioned certain

cardiological practices in the country, findingFor the first time, Indian Psychiatric

that total stented length greater than 31.5 mmSociety, country's largest body of mental health

was associated with mortality.professionals, announced its official stance on

homosexuality. The society has asked its

members to 'stop considering homosexuality as

an illness'. National Commission has held that

an insurer who renews the policy cannot later

back out by terming the policy to be a fresh one.

India has registered significant

improvement in an area where it has lagged by

reducing maternal mortality deaths from 167 in The Bombay high court has told the2011-13 to 130 (per lakh live births) in 2014-16. state government to employ doctors from other

parts of the country to fill the gap in rural areas

of the state.

Jun 04, 2018 : Many breast cancer patients

don't need chemo.

Jun 08, 2018 : Abortion-related deaths due to

poor knowledge of law.

Jun 04, 2018 : New TB drug now available

across state.

Jun 08, 2018 : MCI blacklists medical

colleges for this session.

Jun 05, 2018 : 70% miscarriages reported

from rural area.

Jun 09, 2018 : List out action taken against

illegal hospitals.

Jun 06, 2018 : Modicare rates may rise.

Jun 09, 2018 : Too many stents can kill you,

warns study.

Jun 06, 2018 : Don't treat homosexuality like

a mental illness.

Jun 11, 2018 : Renewed insurance policy

after a break?

Jun 07, 2018 : Fewer mothers dying in

childbirth across India.

Jun 12, 2018 : Recruit doctors from across

country.

Jun 08, 2018 :AIDS control trust to reach out

to HIV+ donors.

Mumbai :

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Jun 12, 2018 : AIIMS postgraduates to be Jun 15, 2018 : Drugresistant bacteria thrive

hired directly. at beaches.

Jun 12, 2018 : Govt wants blood banks to be Jun 15, 2018 : Strong basic healthcare cuts

'centres'. hospital spend.

Jun 13, 2018 : Private medical college

derecognized.

Jun 17, 2018 : Yoga is a science that enhances

health.

Jun 13, 2018 : Health spending pushed 55m

into poverty in a year.

Jun 17, 2018 : Penalty for selling

'unapproved' drugs.

Jun 14, 2018 : MBBS education gets more

elusive.

Jun 18, 2018 : PM exonerates qualified

doctor who was blamed for quack's fault.

Jun 15, 2018 : 48% infertile women have

latent genital tuberculosis.

Jun 19, 2018 : Gaming addiction a mental

illness.

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All post-graduates emerging from The water hitting the shores of

AIIMS will now be absorbed within the Mumbai's most visited beaches contains

institutes across the country as part of the bacteria that is resistant to more than 12 sets of

government's move to fill up huge vacancies of antimicrobial drugs, a study by the National

doctors and faculty positions. Institute of Oceanography has found.

The Centre has proposed to rename Strengthening health subcentres by

'blood banks' as 'blood centres' across the ensur ing adequate medic ines , bas ic

country and streamline the existing rules for infrastructure and trained personnel drastically

blood donation. reduces out-patient visits to private hospitals

and clinics and hence also out-of-pocket

expenses by families, a study by Centre for

Technology and Policy in IIT Madras found.Just two months after it got a free

hand from the state government to decide its fee

structure, Vedantaa Institute of Medical

Sciences has been derecognized by the MCI, Yoga, which recently trended on

which reported "large-scale" infrastructure social media thanks to Prime Minister sharing

deficiencies, including inadequate teaching his exercise regimen, virtually lights up the

staff, at the institute. brain, according to a city pulmonologist's

scientific study on why yoga's practitioners stay

alert and healthy.

About 55 million Indians were

pushed into poverty in a single year because of

having to fund their own healthcare and 38 The Centre is working to plug a

million of them fell below the poverty line due legal loophole that allowed major drug

to spending on medicines alone, a study has manufacturers to sell and market products such

estimated. as emergency contraceptives and anti-obesity

and fertility formulations which have not

undergone clinical trials to establish risk and

efficacy. Sought-after deemed universities in

the state have raised their MBBS fees by up to

80% this year, with the charges of six of them

crossing Rs 20 lakh/year. National Commission has held that

allegations of negligence which are contrary to

the post-mortem report should not be made.

Genital tuberculosis, which is

dormant in uterus, decreases a woman's egg

count leading to infertility, revealed a new study World Health Organisation has

published in medical journal Human listed 'gaming disorder' as a mental illness,

Reproduction. putting it parallel to alcohol and drug abuse,


in the revised International Classification of In a move to regulate quality of

Diseases. high-end medical devices and equipment,health ministry has proposed to expand the listof devices under the purview of drug law.

Medical students at state-run JJHospital in Byculla will - like IITians - soonwear entrepreneurial hats and market medical

BMC hospitals have begun a innovations.clampdown on the nexus between its doctors

and privately-run pathological laboratories,The government is considering afollowing a series of complaints about what is

proposal to make essential medicines morepopularly referred to as 'cut practice' in medicalaffordable by capping prices at the first 'point ofcircles.sale' rather than retail price

The state medical educationUndergoing treatment for infertilitydepartment is having a tough time over mass

is expensive, time-consuming and emotionallyexodus of temporary lecturers from Grantdraining for couples. The fact that it is notMedical College and JJ Hospital over frequentcovered by insurance makes it accessible only to'VIPduties'.the wealthy in India.

The Supreme Court has directed aThe IMAannounced the creation of aJalgaon medical college to pay Rs 20 lakh as

'violence registry' to document every assaultpenalty to each of the 19 meritorious studentsagainst medical personnel or establishments onwho were "illegally" and "wrongly" refusedthe National Doctors' Day.admission by it six years ago.

Considering that housing is the mostIn the absence of laws aboutvexed and the most sought-after issue in

surrogacy in the country, the state governmentMumbai, civic authorities are holding it out as ahas taken a step towards formulating guidelinestantalizing carrot to rope in doctors into itsfor monitoring and regulating surrogacyhealthcare system.centres.

PM reached out to doctors through

"Mann Ki Baat" and said they were an essential

part of society adept not only in treating

ailments but also as friends and lifestyle guides

to people.

A division bench of HC said though

Jun 21, 2018 : Diabetes, high blood pressure

cases double.Jun 29, 2018 : State boosts healthcare with e-

Jun 21, 2018 : Young adults account for 33%cells, training and free ops.

of suicides.

Jun 22, 2018 : KEM dean draws first blood

against doctors' cut practice.

Jun 29, 2018 : Govt mulls cap on drug prices.

Jun 22, 2018 : Fed up, 12 medical lecturersJun 29, 2018 : IVF comes with stiff price tag,quit in a year.no insurance.

Jun 25, 2018 : College ordered to payJul 02, 2018 : Now, registry to keep count ofRs 3.8cr for refusing admission.doctor attacks.

Jul 03, 2018 : Child rights committee takesJun 25, 2018 : Quarters for family housing.steps.

Jun 25, 2018 : PM reaches out to doctors.Jul 04, 2018 : Decide on bringing nurses

under MESMA- HC.

Jul 04, 2018 : BMC to screen diabetic

patients.

Jul 06, 2018 : Marital woes can't be a reason

to end pregnancy.Jun 28, 2018 : More medical devices to come

under purview of drug law.

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women have a constitutional right to their body violence, to medically terminate her 24-weekand reproductive choices, matrimonial discord pregnancy, the SC admitted her case.cannot be the basis to request termination ofpregnancy beyond 20 weeks.

A set of recent guidelines from theMaharashtra's FDA has warned MCI excluding persons with benchmark

citizens against ayurvedic medicines that claim learning disabilities from taking admission into improve vitality, sexual prowess, cure MBBS course under the physical lychronic diseases like diabetes and cancer or treat handicapped quota has dashed hopes of manyblood pressure, psychological issues and heart students across the state.problems.

Use of animals for experiments and Newly formed National Testing research across medical and other courses in

Agency would now conduct the national-level India will soon be stopped.examinations - NET, NEET, JEE Mains - thatwere organised by CBSE.

Clearing the air around its

requirement avail benefits under AyushmanThe MCI and the NBE have Bharat National Health Protection Scheme, the

cracked down on institutions running health ministry said Aadhaar is "desirable" butunrecognised postgraduate medical courses, not mandatory to avail benefits under theincluding those in emergency medicine. insurance scheme.

With a constitution bench of the SC Chemists and pharmacists willset to hear a petition challenging criminalising march to the Food and Drug Administrationhomosexuality, the Indian Psychiatry Society

office in the Bandra Kurla Complex to protestsaid homosexuality was not a psychiatric

the sale of medicines online.disorder.

Out of 1,500 complaints receivedThe death rate due to cardiac

against doctors who are doing practice in areas diseases declined significantly in the US

out of their expertise, action was taken only inbetween 1990 and 2016 even as it continued to

20 cases.rise in India in the same period, withcardiovascular diseases being the leading causeof death.

The state public health department

will establish enrolment centres in around 500

of its hospitals for Aadhaar linked birthNearly three weeks after the Bombay

registrations.HC refused to entertain the plea of a 20-year-oldwoman, who claimed to be a victim of domestic

Jul 12, 2018 : MCI rules bar learning

disabled from MBBS.Jul 07, 2018 : FDAseizes 'magical' medicines.

Jul 12, 2018 : MCI works on animalfreeJul 08, 2018 : NEET, JEE Mains to be held curriculum for courses.twice a year.

Jul 13, 2018 : Govt : Aadhaar 'desirable', not

must for NHPS.Jul 08, 2018 : MCI, NBE crack down on

'illegal' PG courses.

Jul 09, 2018 : Homosexuality no disorder - Jul 13, 2018 : Chemists, pharmacists toIPS. protest.

Jul 13, 2018 : MMC will submit itsJul 10, 2018 : Cardiac deaths dip in US, up in

investigation report next week.India.

Jul 13, 2018 : UID-at-birth at 500 hospitals

soon.

Jul 11, 2018 : SC allows abortion plea of

'domestic violence' victim.

Jul 14, 2018 : Govt to restructure NELM.

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In good news for patients, the

government has decided to restructure the

National List of Essential Medicines with the While alcohol led to a 65% increaseobjective to make it more contemporary, and in in deaths due to liver damage in the US in theline with public health needs. past 17 years, doctors say non-alcoholic liver

disease is emerging as a greater worry in India.

Mobile app by Association of The Ministry of Health & FamilyMedical Consultants is used to raise an alarm Welfare has managed to bring on board IMAduring attack by patients' kin. Doctors can under Ayushman Bharat to facilitateexpect quick support from fellow medicos with empanelment of hospitals with the insurancea mere tap on their phones that will send an alert scheme.message.

High fees in most medical colleges

mean that students who have to take loans to pay

it, cannot hope to service the loans from whatThe Supreme Court denied a 20-they earn as doctors after completing MBBS.yearold woman permission to terminate her 25-

week-old pregnancy, stating that aborting a

healthy foetus that is unlikely to affect the

mother's physical health amounted to murder.Sixteen years after an unsterilized

needle used on an 18-year-old Kandivli youth

for viral fever led to development of "gas

gangrene" and his subsequent death, the stateThe Supreme Court declined to putconsumer commission dismissed an appeal byon hold Centre's new notification that stipulatesone of the two negligent doctors.rotation of images of cancer patients on the

packets of tobacco products while observing

that a large number of persons were suffering

from oral cancer. The National Commission has held

that when the cause of death is clear and foul

play is not suspected, it is not mandatory to get a

post-mortem.The MPCB has served a show-cause

notice to the state-run Central Hospital in

Ulhasnagar for illegally dumping its biomedical The Union health ministry's ban onwaste in the open, posing imminent danger to retail sale of oxytocin has sent gynaecologistshealth and environment. and obstetricians into panic mode.

Wadia Hospital for Children A total of 449 convictions haveconducts two-hour surgery on 22-day-old boy to been secured till March this year from across theremove vaccination needle stuck in the hip; country, for violations under the PCPNDT Act,parents have alleged negligence by a Panvel 1994, according to a report released by the

nursing home. Union health ministry.

Jul 20, 2018 : Non-alcoholic liver disease

emerges as a big worry.

Jul 15, 2018 : Doctors under attack - AMC

App to rush immediate help. Jul 20, 2018 : IMAto help empanelment.

Jul 22, 2018 : Many doctors in debt trap.

Jul 17, 2018 : SC - Aborting healthy foetus

akin to murder

Jul 23, 2018 : Infected needle kills teen,

doctor to pay ?4L.

Jul 17, 2018 : More graphic tobacco pack

warnings soon.

Jul 23, 2018 : Autopsy not must to claim

insurance in accident death.

Jul 19, 2018 : Ulhasnagar hospital flouting

medical waste norms.

Jul 23, 2018 : Ban on retail sale of oxytocin.

Jul 20, 2018 : 2-cm needle removed from Jul 23, 2018 : Haryana tops list of foetus testbaby's hip joint. offenders


Jul 24, 2018 : Shortage of medicines cripples Jul 27, 2018 : State addition to domicile norm

hospitals. held valid.

Jul 25, 2018 : HIV cases in India came down

by 27%.

Jul 27, 2018 : Drug board backs ban on 343

FDCs.

Jul 25, 2018 : No organ retrieval at

unregistered hospitals.

Jul 28, 2018 : Fake CPS certificates scam.

Jul 26, 2018 : Newborns to get hepatitis B

vaccine for free.

Jul 28, 2018 : Viagra, anaesthetic found in

ayurvedic potency pills.

Jul 27, 2018 : Mumbai hero wins Magsaysay

Award.

Jul 30, 2018 : Prescription sans diagnosis is

culpable negligence.

Jul 27, 2018 : Word 'charitable' must for

charity hospitals.

Jul 31, 2018 : Top hospitals wrongly charge

poor, forced to pay refunds.

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An acute shortage of medicines at In a landmark verdict that sets to reststate-run hospitals - including the big four in the medical admission chaos of recent years, thecity - has plunged the state's health delivery Bombay high court held that the statesystem into an unprecedented crisis. government was empowered to make it

mandatory for aspirants to the 85% state quotaseats in undergraduate medical courses to notonly be domiciled here but also have completed

India has witnessed a major both Class X and XII from the state.reduction in its AIDS burden with new HIVcases dropping by 26.6% and AIDS-relateddeaths declining 56.8% between 2010 and2017, a latest report by the United Nations says. The country's top drug advisory

board has backed the health ministry's decisionto ban 343 fixed dose combinations, some ofwhich were commonly used drugs used in

The state government told the treatment of cold and cough.Bombay high court that organ retrieval cannotbe allowed at hospitals not registered underprovisions of the Transplantation of Human The MMC has barred seven MumbaiOrgans and TissuesAct. doctors from practicing for five years, and

another 50, also from the city, for a year forallegedly submitting fake certificates of PGdiploma and fellowships from the College of

The National Liver Foundation and Physicians and Surgeons.Mumbai Obstetric and GynecologicalAssociation have joined hands in a bid to ensurethat no child born in Mumbai will be leftunprotected due to the lack of a free hepatitis B TheAurangabad division of FDAhasvaccine shot. found sildenafil citrate and a short-acting

anaesthetic drug in two ayurveda medicinesmeant to increase sexual desire and potency thatwere randomly tested for quality recently.

A Borivali psychiatrist, whoserehabilitation foundation rescues mentally-illpersons living on the streets and reunites themwith their families, is among the six A prescription by a doctor without apersonalities who have won this year's diagnosis would amount to culpable negligence,prestigious Ramon MagsaysayAward. the Bombay high court has said while rejecting

the pre-arrest bail plea of two doctors accused ofculpable homicide not amounting to murder forthe death of a woman five days after child-birth.

It is now mandatory for 430charitable hospitals in Maharashtra, 74 of thesein thw city, to mention the word "charitable" or"dharmaday" in their names for easy The state has cracked down on aidentification by poor patients. number of hospitals in Navi Mumbai, including


leading ones such as Terna, Dr. D. Y. Patil and The MMC has suspended the licence

MGM, for wrongly charging poor patients. of a Borivali-based diploma holder in radiology

for promising to treat a mentally disabled boy by

using stem cell therapy and cheating the family

of Rs 3 lakh.

Going by data given to Parliament

by the MCI, there are more than 10.8 lakh

doctors registered. In reality, no one really

knows as is evident from the MCI's own answer

Majority of the complaints - 80 per that 80% availability has to be assumed fromcent, in fact - received from citizens against this total number.doctors are because of a misunderstanding

between the doctors and patients or their

relatives, the MMC revealed.

The State chapter of the IMA has

issued an advisory to doctors to avoid phone

consultations; only in grave emergencies, and

that too when the doctor is aware of the

concerned patient's medical history, should

advice be dispensed over the phone.

Initiating breastfeeding within first

hour of birth is crucial to avert neonatal deaths

as well as to ensure proper growth and

development of a child.Maharashtra may soon get its first

digital autopsy unit, where forensic experts will

use high-definition scans instead of cuttingAs more women seek the high courts' open bodies to find out the cause of death.

permission to get abortions beyond the 20-week

legal deadline, more doctors in the state are

providing legal aid to petitioners.Four national institutes working on

anti-TB medication that will cut down duration

of treatment; the first phase of trials showsOver the past three years, the number 'remarkable' success.

of students not being able to crack MBBS

admissions have increased, revealed the DMER

data. (Sourced from various agencies)

Jul 31, 2018 : TB patients' families can get Rs

500 govt aid in their a/cs.

Aug 01, 2018 : Antibiotics use in animalAug 07, 2018 : How many doctors does Indiaproducts to be curbed.have?

Aug 02, 2018 : UP set to emerge as medical

education capital.

Aug 03, 2018 : Issues between doctors,

patients due to confusion.

Aug 08, 2018 : New MBBS syllabus to focus

on hands-on training.

Aug 09, 2018 : Four more hospitals to keepAug 04, 2018 : No phone consultations.

advanced TB drug.

Aug 10, 2018 : Acute shortage of HIV

medicines.

Aug 11, 2018 : State councils blame MCI for

docs' registry mess.

Aug 13, 2018 : Sion hospital to now perform

autopsies 24x7.Aug 04, 2018 : Breastfeeding within 1st hour

of birth key to survival. Aug 14, 2018 : BMC hospitals may get

surgical robot.

Aug 14, 2018 : Nair Hospital likely to get first

digital autopsy centre in state.

Aug 04, 2018 : Doctors come to legal rescue of

women.

Aug 15, 2018 : IIT's anti-TB 'inhaler' drug

holds out hope of faster recovery.

Mumbai :Aug 06, 2018 : No. of students to crack MBBS

dipped.

Aug 07, 2018 : Cheat radiologist loses licence. [email protected]

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