winter cover.indd 2 01-12-12 4:36:32 pmeditorial board editor dr. gupta mukesh co-editors dr. baliga...

Vol. 41 │ Issue No. 3 │ November 2012Offi cial Journal of the Association of Medical Consultants, Mumbai Published Quarterly in May, August, November, February

For Private Circulation Only

BIRLA MATUSHRI SABHAGAR,19 NEW MARINE LINES,

MUMBAI - 400020

A MATUSHRI SABAMCONAMCON

SUN 13 JAN 2013

Winter Cover.indd 1Winter Cover.indd 1 01-12-12 4:36:29 PM01-12-12 4:36:29 PM

EDITORIAL BOARD

EDITORDr. Gupta Mukesh

CO-EDITORSDr. Baliga Pradeep

Dr. Rao NitinDr. Sushmita Bhatnagar

Dr. Baid Deepak

ADVISORY BOARDDr. Kapoor Lalit M.

Dr. Rao P. N. Dr. Oza Umesh

BOARD OF TRUSTEESMANAGING TRUSTEE

Dr. Shah Bipin V.

TRUSTEESDr. Badwe ShrikantDr. Kate Suhas

Dr. Nayak Achyut

Dr. Oza UmeshDr. Pandit BipinDr. Rao Suresh S.

WEBSITEwww.amcmumbai.com

WEB EDITORS

Dr. Checker Vipin

WEB CO-EDITORS

Dr. Arshad G. Moh’d.Dr. Rao Sujata

Dr. Dani Saurabh

DISCLAIMERUnless 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, MUMBAIASSOCIATION 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.)

Telefax : 2682 1109

e-mail: [email protected]

MANAGING COMMITTEE (2012 - 2013)

President Dr. Adyanthaya Kishore Imm. Past President Dr. Ajay HarianiImm. Past President Dr. Niranjan AgrawalVice President Dr. Naik SudhirVice President Dr. Sabh KhambayPresident Elect Dr. Rao Sujata Hon. Secretary Dr. Pandit VeenaHon.Treasurer Dr. Pikale SangeetaHon. Jt. Treasurer Dr. Baliga Pradeep Hon. Jt. Secretary Dr. Chawhan Rajendra Hon. Jt. Secretary Dr. Sharma SmitaProg. Committee Chairperson Dr. Parikh HiteshOffi ce Secretary Dr. Vazzifdar Khurshed

Editor- The Grasp Dr. Gupta Mukesh

ZONAL DIRECTORS

Dr. Agarwal Shivbhagwan N. Dr. Badwe ShrikantDr. Dave Rajesh Dr. Desai Ajit K.Dr. Kulkarni Gurudas B. Dr. Naik Dilip S.Dr. Oza Umesh Dr. Shah Bipin V.

COMMITTEE MEMBERS

Dr. Badwe Rohini Dr. Pradhan Sunay Dr. Bahekar Pramod Dr. Rao NitinDr. Baid Deepak Dr. Shah JayeshDr. Bhatnagar Sushmita Dr. Shah SuhasDr. Bhatt Hitesh Dr. Shetty RathnakaraDr. Checker Vipin Dr. Shukla Ashokkumar Dr. Dani Saurabh Dr. Sundaram Natarajan Dr. Khambay Sabh Dr. Suradkar ShekharDr. Lokras Girish Dr. Vaidya DeepakDr. Patel Manoj Dr. Vora AgamDr. Pattiwar Sanjay Dr. Worlikar Umesh

CHAIRPERSON OF CELLS

Consultants Benevolent Scheme Dr. Shah Bipin V.H & A Cell Dr. Rao Suresh S. MMC Cell Dr. Pandit BipinInfrastructure Cell Dr. Naik SudhirMedico Legal Cell Dr. Datar NikhilSocial Service Cell Dr. Agarwal Shivbhagwan N. Public Relations Cell Dr. Pikale SangeetaAffi liate Unit Cell Dr. Agarwal NiranjanDirector AMC India Dr. Kapoor Lalit M.

Edited by : Dr. GUPTA MUKESHCo-ordinated at MAGNA GRAPHICS, 101 C-D Govt. Indl. Estate,

Kandivli (West), Mumbai – 400 067

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

Vol. 41 Issue No. 3 November 2012 1

AMC_GRASP_Nov-2012_#637.indd 1AMC_GRASP_Nov-2012_#637.indd 1 03-12-12 10:10:48 AM03-12-12 10:10:48 AM

ASSOCIATION OF MEDICAL CONSULTANTSASSOCIATION OF MEDICAL CONSULTANTSM E M B E R S H I PM E M B E R S H I P

Total Membership of the Association : 7441Members under Professional Indemnity Scheme of AMC : 4633Persons (Members & Family) under H & A Scheme : 4234Members under CBS Scheme : 1116

AMCONANNUAL DAY CELEBRATIONSUNDAY 13 JANUARY 2013

BIRLA MATUSHRI SABHAGAR, 19 NEW MARINE LINES, MUMBAI - 400020

Registration Rs. 600/- for Member & SpouseRs. 900/- for Guests and Spot Registration

Edit Speak - Dr. Mukesh Gupta .............................................................................................. 03

President Precept - Dr. Kishore Adyanthaya .......................................................................... 05

Secretary’s Report - Dr. Veena Pandit ................................................................................... 07

Do’s and Dont’s - Dr. Lalit Kapoor ......................................................................................... 09

Beware-Pharma Freebees/Sponsorships - Prof. Gopinath Shenoy ........................................... 13

Positive Thinking - Mrs. Pushpa Eswar ................................................................................... 17

Russia and Baltic Tour - Dr. Smita Sharma ............................................................................. 18

From the Press - Dr. Pradeep Baliga ....................................................................................... 21

New H & A Policy 2012-2013 ................................................................................................ 25

AMC - Mangalore Branch - Photos ........................................................................................ 28

AMC MEET - 2012 .................................................................................................................. 30

Mumbai Diary - Dr. Sujata Rao .............................................................................................. 35

Vol. 41 Issue No. 3 November 2012

CONTENT


Dear Friends,

Working in an organization refl ects our learning in life .Various facets of life come alive in the routine functioning of the associations. Many activities and events in an association are done to obtain larger good in the long term which many fail to foresee and fi nd waste of efforts. Some such activities may actually turn futile but a few are landmark events in the history of the organization. Most such activities do not lead to results and benefi ts to the individuals working at the inception but like a selfl ess gardener they toil to plant the mango tree whose fruits they never survive to enjoy.

But the managing committee who are chosen to shepherd the organization will fail in their duties if they do not at least try to create a vision and work positively towards its achievement. The team carries along some enthusiastic minds who form the core think-tank who have to keep sounding ideas and refi ning them. Most ideas occur and get formulated in piecemeal in different minds and ultimately take the fi nal form

after lots of debate and discussions. Some passionate individuals get demotivated by the alternate point of view or by the shallow credit hungry individuals who perceivably try to hijack the accolades on potential achievement of the success. But this cannot stop the organization and its true believers to deter from toiling for larger good of the members.

AMC has had its fair share of several amazing projects, activities and ongoing services which are results of the brilliance of a conglomerate of ever trying minds of past and present committees. There may have been great ideas and projects which failed to pick steam but lessons thus learnt always help to consolidate further modalities and methodology of working. Lessons are learnt by all those who are involved in the process as the journey towards the destination is equally enjoyable to an inquisitive mind. Many a times in our impatience to achieve more we fail to appreciate the present. It’s true that unless we dream we cannot try to achieve but in our endeavor to quickly

Dr. Mukesh Gupta


EDIT SPEAKEDIT SPEAK


reach the destination we fail to notice the lessons learnt in the path.

This reminds me of an interesting thought that “The PRESENT is actually the best gift we give ourselves by avoidance of past worries and future anxieties”.

The true strength of an organization like AMC comes from the perseverance of its core team for working towards a positive idea against all odds and the strength of the numbers in support. There is always a need for more and more minds to help convert ideas into reality. Also there is tremendous requirement for members to provide seeds

for newer ideas. Higher the felt need for the positive mind to achieve the destination more is the probability of the idea to succeed.

Please don’t stop sending your ideas and opinions. Do not hesitate

to send reminders if your team strays into another focus of activities.Remember a small spark can start a forest fi re but also a small thought in your mind can start an unbelievable success story for our brethren.

KEEP THINKING AND SHARING IDEAS………DON’T LET THEM DISSIPATE WITHOUT TRIAL.

E-mail: [email protected]

Nurses Training Programme on 11th November 2012Dear Seniors and Colleagues,

I had att ended the Nurses Training Program arranged byt Dr. S N Agarwals at Bhyander Mira Road. This is the 4th program he has conducted. I would like you all to know that the programs are a pleasure to att end. They are well conducted with a warm and friendly ambience and great hospitality Dr. Agarwal has got such a wide variety of speakers each one of them able to bring a new dimension.

I would request you all to also drop in if there is a program next ti me and to please deliver a talk. I can assure you of a very interested and capti ve audience. The hall is always fi lled to full capacity (about 70)

I would like to acknowledge this great eff ort on the part of Dr. S N Agarwal and thank him for the same

Dr. Smita Sharma, Jt. Secretary, AMC



President’sPresident’sPreceptPrecept

Dr. Kishore AdyanthayaPresident, Association of Medical Consultants, Mumbai

Wishing all our members A Very Happy Diwali and A Prosperous New Year!

This year the mantra at AMC has been growth: Grow or perish.

There is success in unity; we have recently seen the result in National Commission for Human Resources in Health. The Parliamentary Standing Committee on Health rejected the NCHRH Bill, and urged the health ministry to withdraw the bill and introduce a fresh one after addressing all opposing points raised by various stakeholders, including state governments. But, the Clinical Establishment Act will haunt us. We have to fi ght this evil, united.

Chemists just gave a notice for three day-strike - the state government bent on its knees and met them, accepting all their major demands, paving the way for them to call off the strike.

As we are extending our horizon beyond Maharashtra, we are watched keenly by our colleagues from other cities. If our house is not in order, I don’t think we can achieve much. Mangalore centre has more than 150 members. They have started providing medico-legal help to their members; after liaison with the commissioner of police, settled many local issues. Next is the fi rst responder’s class for police personnel at the insistence of the commissioner.

Bangalore affi liate unit has birth pangs. They had a successful patient safety

workshop which was well attended. We are getting calls from various cities to attend. Next in line is Sufi pilgrimage city of Ajmer in Rajasthan followed by Hubli and Aurangabad. I request members to provide us with contacts in other cities.

There seems to be a systematic condemnation towards the demise of small medical establishments. Last year it was the Change of User, this year we have Fire Safety Norms. We have just about completed one and we are running around for the other. We have done the merry go round of Health ministry, chief secretary and urban development secretary; now we are to see the law ministry. The fi re safety norm which the BMC wants us to follow is too elaborate for a small nursing home. During our last meeting with the additional municipal commissioner along with personnel from health, building and fi re department, we were told to submit application to fi re offi cer along with fl oor plan in triplicate; the fi re department after inspection would inform the short comings and we were to rectify the short comings, if any. The requirements will depend on the nursing homes and there is no standard code. The fi re chief of each municipality has his own interpretation.

I really dread to think what is in store for us next year- Separate drainage? Qualifi ed nurses??



With new problems creeping up at regular intervals and to effectively deal with them, Infrastructure cell has been revamped as NoAH (Network of AMC Hospitals) - with the avowed objective of creating a cohesive group of small health-care providers. The focus will be on nursing home issues exclusively, and therefore, providing solutions more effectively. By this, we hope that unity of nursing homes under this banner will give us better negotiating powers with the authorities, medical equipment companies, TPAs etc. It would of course function just like any other Cell of AMC. We are at the stage of advanced negotiation

with a major banking institution to get excellent deals for our members. It will be a single window for all our needs - may it be loans for clinic, housing, children’s education, marriage etc. There will be provision of a single telephone number for all our queries.

AMCON is round the corner; the committee is trying hard to arrange for a rich lineup of excellent speakers. Kindly block the date – Sunday, 13th January, 2013. So wishing you all, A very Happy Diwali and A Prosperous New Year and hope to see in large numbers at the AMCON.


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SECRETARY’S REPORTSECRETARY’S REPORTDr. Veena Pandit

The Grasp is here for you to read while you relax after a hectic Diwali! Wish

you all a very Happy New Year! Do follow our on-going activities:

Fire NOC:

We at AMC have met several offi cials at various levels and achieved only limited success.

The draft of the new fi re safety guidelines which are easy to follow, has now been sent to the Legal Department for opinion, and we await its return.

In the mean time, at AMC we are in the process of identifying agents who can help our members to draft plans of the Nursing Home, and fulfi ll all criteria and forms required to apply for Fire NOC and see it through to getting the NOC and then of course the Nursing Home registration.

As soon as we are sure of the credentials of such agents, we will get back to you.

There is very hectic work going on at AMC on several interlinked fronts.

AMC has always helped all the members whenever the member was in need, be it a nursing home issue like Change of User or Separate access / government regulations & restrictions / medico-legal / attack on doctors / grievances against medical equipment companies so on and so forth.

Since our members include Nursing Home owners and non-nursing home owner consultants, and since the problems encountered by Nursing Homes are on the increase, we need more teeth for the cell that manages the work related to these problems.

This has now brought about a revamping of the Infra Structure Cell into a new Avatar“Network of Association of Medical Consultant’s Hospitals”. (NOAH)

This cell will not only help fi nd solutions to all the problems of the nursing homes, but will offer value added services too.

The proposed structure of NOAH is in your emails. The special General Body to discuss the concept and constitution of NOAH was very interactive and the formation of NOAH was passed. Now the nitty gritties are being worked out and all those eagerly waiting to join can do so.

As you know, some private insurance companies have shown their desire to tie up with AMC as a body and enroll the Nursing Homes of all our members.

Signing MOU with Bajaj Alliance:

At the last Special GBM we had specifi ed that Bajaj Alliance is keen to sign a MOU with our members. We have drawn up a special MOU for you, a MOU that will be



the envy of all who do not have it. There is a slight delay as we have to make this appropriate.

This MOU will for the basis of our MOUs with all medical insurance companies that approach us. Many of the insurance companies are waiting with bated breath for our agreement with Bajaj Alliance following the buzz of AMC-NOAH being formed.

Hope to have more news soon.

Appointing facilitator for all TPA work of our members:

As you will recall, the last Special GBM about TPA had given the Managing Committee the go ahead for arranging an MOU with the private players in the Insurance sector.

The work involved in asking for AL, getting it and following up with the TPA till the bill is settled is a lot. We want our consultants to be able to concentrate on their medical practice. So to facilitate your dealings

with the TPAs, we have started negotiations with a facilitator who will also help you to enroll with various TPAs.Do await further developmentsOur new branches at Mangalore and Bangalore are functioning well and they too are awaiting news of all our above mentioned activities.Soon we will have Aurangabad, Ajmer, Goa in our fold. Parliamentary Standing Committee rejected the NCHRH Bill. It is heartening to see that the bill has been shot down due to the splendid show of solidarity by all medical associations.We now await the December season of good cheer and soon it will be time for the AMCON. It will be held on 13 Jan 2013, so please mark your calendars. As usual we have fantastic speakers lined up for you. Hope to see you in large numbers.See you all at the AMCON!


Public Relation CellThis year the Public Relation Cell under the Chairman Dr. Sangeeta Pikale has had 2 press conferences 1st with help of outsourced event management company for Blood Donation drive and Organ Donation awareness in month of July where AMC got extensive cover in print and Media.

2nd press conference on awareness on the harmful effects of noise pollution was held on 12th September in Press club conducted by AMC alone had also got print media cover in more than 8 newspapers and got covered on TV IBN lokmat . This was well received by press and further to this the press in all subsequent work on noise pollution came to AMC for quips and assistance.

Dr. Sangeeta PikaleChairman-Public Relation Cell



DODOss' AND DON’T' AND DON’Tss DEALING WITH ‘ACCIDENTAL’COMPLICATIONSDr. Lalit Kapoor

An obstetrician was conducting a full term normal delivery in a patient who

was a ‘primi’. The labour was progressing as per normal staging.However, the sequence of events which unfolded later was unimaginable. I would even call it bizarre. It is worth recounting the episode as it has some lessons for us and raises a number of vital issues.

During the course of the labour, the Obstetrician instructed a nurse to disconnect an IV drip which was going on. As per common practice, the nurse detached the IV tubing from the IV cannula and anchored it to a needle, stuck in the plastic IV bottle, which had been inserted to function as an air vent. I believe this practice is quite prevalent.

As the uterine contractions intensifi ed, the patient started making vigorous limb movements. As a result, the adjoining IV stand became unstable and, in the process, the needle stuck in the IV bottle got detached. As fate would have it, the needle came cruising down and, with the precision of a marksman, penetrated the eye of the patient and that too, in the exact centre of the eye. It pierced the cornea over the pupillary area and entered the lens. Soon after, the patient reported total loss of vision in that eye. Since labour was in progress, as an immediate measure,

some eye drops were instilled in the eye. After a little while, a healthy baby boy was delivered. However, the happiness of the patient and relatives was short-lived, since the patient continued to say she could not see from the injured eye. An ophthalmologist who saw the patient diagnosed traumatic cataract and indicated she would need surgery.Incidentally, all this was witnessed by the sister-in-law of the patient who had been allowed by the Obstetrician to be present at the delivery. The doctor told me later that this was her normal practice and she always allowed a relative to be present, if they desired.

Allegations fl ew fast and thick. The relative who was present in the labour room insisted that the needle fl ew out because a nurse knocked the IV stand and the nurses claimed that the patient’s hand movement knocked down the IV set. Nevertheless, the fact was that the patient became blind in one eye following this strange and unfortunate accident.

“Gangrene of dorsum of foot in a child following extravasation of IV fl uids”



The relatives were understandably agitated and threatened legal action–including a criminal case. It also appeared that they might resort to physical violence against the hospital.What were the various options available to this doctor and what would you have done had you landed in a similar situation?The possible options available were:(a) Insist that it was no fault of yours and

that it was solely due to the vigorous movements of the patient that the needle was knocked down as a result of which the accident happened. The hospital could not be held liable.

(b) Explain that the whole thing was unfortunate and should be considered as an act of God.

(c) Apologise (or don’t apologise) but assure that the management of the injury (including the costs) would be undertaken by the hospital.

(d) Refuse to pay any compensation other than cost of treatment or agree to pay additional compensation and negotiate the amount.

(e) Ask them to fi le a case and get compensation through the court.

(f) In case of physical threats, inform the Police.

In practice, it is not easy to take the right decision. It has to be a tailor-made decision, depending on the several variables in the patient profi le including socio-economic and education levels of the patient as also on the quality of the doctor-patient relationship. A combination of the above-mentioned options may have to be employed.Which option did the above Obstetrician use?

Several stormy meetings took place between the relatives and the doctor. Various demands for compensation were made and fi nally it was agreed that the doctor would arrange the patient’s surgery at her own cost until fi nal recovery of the patient.

Accordingly, a senior Ophthalmologist operated the patient after which the patient recovered fully. The Ophthalmologist was kind enough to reduce his charges. The patient and her relatives had no further grievances or demands and there was a closure to the entire unfortunate accident. Incidentally, the socio-economic status of the patient was low middle class.

Before discussing the broader issues, two points that can be quickly mentioned are: (1) whether piercing a needle from the unsterile surface of the IV bottle to be used as an air vent is necessary and the correct procedure and will it stand theoretical scrutiny. (2)Permitting relatives to be present whilst a procedure or surgery is in progress may denote transparency but is it always advisable. There could be divergent views on this.

There are several other examples of ‘accidents’ occurring while treating patientse.g. a patient sustaining cautery burns during surgery; hot water thermal injury (say, if patient develops hypothermia underanaesthesia and needs application of heat); accidental fall while shifting the patient, and so on.

What is the best thing to do in such a situation? Should you own up the liability and accept responsibility? Should you deny culpability and insist that an accidental injury such as this is a risk which the patient accepted by signing the consent form?



There is no easy solution to this dilemma. As I said earlier, your response will have to be tailor-made. The best thing, of course, is to put yourself, for a moment, in the shoes of the affected patient. What would you have expected from the doctor? Perhaps, this would give you an answer.In the above case of the obstetrician, the issue was resolved with the doctor undertaking to correct the damage. But there could have been several permutations and combinations to the possible outcome of the situation. For example, the patient could have been unreasonable and demanded some huge compensation. There will be some patients who would go beyond the genuine outrage at having suffered injury, and use it as an opportunity for extortion. Such patients must be dealt with fi rmness if they are not amenable to a fair solution. They can be told that they are free to obtain redressal as per the law of the land. Your insurance Company would be duty-bound to deal with it.The latest concept in such matters is what is called the Alternate Dispute Redressal Mechanism wherein litigation is sought to be avoided and matters are resolved with mutual consent. It has a lot to be commended and many cases can be concluded if there is reasonableness on both sides. AMC has made some initial efforts in this direction within the ambit of our Group Professional Indemnity Policy. It is still too early to predict the long-term effi cacy of this initiative. Of course, like any system there are merits and de-merits to it.Undoubtedly, ways of preventing ‘accidents’ and putting in place the so-calledpatient safety measures need to receive

top priority and be widely circulated amongst doctors.It is also a fact that despite all the conceivable ‘safety’ measures in the world some ‘accidents’ are still going to take place. Some of these could come under the category of ‘acts of God’--- but try telling that to a patient who is the victim of an injury, no one is going to listen to you, more so in this era of consumerism. Hence, you can only try to be as vigilant as possible and hope minimum such ‘acts of God’ come your way!!


Condolences

Dr. Ajit G. PhadkeSenior UrologistDate of Final Journey :26th August 2012

Dr. Mandakini PariharGynaecologist andInferti lity SpecialistDate of Final Journey : 10th September 2012

Dr. Vijay PataniSenior GynaecologistDate of Final Journey :24th October 2012

Dr. Shobhana DevarajanSenior GynaecologistDate of Final Journey :27th October 2012



Date: 30th August 2012

REVISION OF MEMBERSHIP FEES FOR AFFILIATE MEMBERS

In view of levy of Service tax it has been decided to charge the same with eff ect from 10th September 2012.

The total charges payable fornew membership will be as under:

Single Life Membership Fees: Rs. 3200 + 12.36% Service Tax = Rs.3596/-

Joint Life Membership Fees: Rs. 4800 + 12.36% Service Tax= Rs.5393/-

PLEASE NOTE THE ABOVECHANGES IS EFFECTIVE FROM 10TH SEPTEMBER 2012.

Date: 30th August 2012

REVISION OF MEMBERSHIP FEESIn view of levy of Service tax it has been decided to charge the same with eff ect from 10th September 2012.

The total charges payable for

new membership will be as under:

Single Life Membership Fees: Rs. 8000 + 12.36% Service Tax = Rs.8989/-

Joint Life Membership Fees: Rs. 12000 + 12.36% Service Tax= Rs.13483/-

PLEASE NOTE THE ABOVE

CHANGES IS EFFECTIVE FROM 10TH SEPTEMBER 2012.




The 2002 Code of Medical Ethics as laid down by the MCI – New Delhi was

amended again in 2009. Regulation 6.8 was added to the Code. Regulation 6.8 reads thus:

6.8 Code of conduct for doctors and professional association of doctors in their relationship with pharmaceutical and allied health sector industry.

6.8.1 In dealing with pharmaceutical and allied health sector industry, a medical practitioner shall follow and adhere to the stipulations given below:-

a) Gifts: A medical practitioner shall not receive any gift from any pharmaceutical or allied health car industry and their sales people or representatives.

b) Travel facilities: A medical practitioner shall not accept any travel facility inside the country or outside, including rail, air, ship, cruise tickets, paid vacations etc. from any pharmaceutical or allied healthcare industry or their representatives for self and family members for vacation or for attending

Prof. Gopinath N. ShenoyMD, LLM, PhD(Consumer Laws),DGO, DFP, FCPS, MNAMS

conferences, seminars, workshops, CME programme, etc. as a delegate.

c) Hospitality: A medical practitioner shall not accept individually any hospitality like hotel accommodation for self and family members under any pretext.

d) Cash or monetary grants: A medical practitioner shall not receive any cash or monetary grants from any pharmaceutical and allied healthcare industry for individual purpose in individual capacity under any pretext. Funding for medical research, study etc. can only be received through approved institutions by modalities laid down by law / rules / guidelines adopted by such approved institutions, in a transparent manner. It shall always be fully disclosed.

e) Medical Research………f) Maintaining Professional Autonomy:

In dealing with pharmaceutical and allied healthcare industry a medical practitioner shall always ensure that there shall never be any compromise either with his / her own professional autonomy and / or with the autonomy and freedom of the medical

BEWARE – PHARMA FREEBEES / SPONSORSHIPSDOCTORS / MED. ASSOCIATIONS

MIGHT BE DISASTROUS



institution.g) Affi liation: A medical practitioner

may work for pharmaceutical and allied healthcare industries in advisory capacities, as consultants, as researchers, as treating doctors or in any other professional capacity. In doing so, a medical practitioner shall always:

(i) Ensure that his professional integrity and freedom are maintained.

(ii) Ensure that patient’s interest is not compromised in any way.

(iii) Ensure that such affi liations are within the law.

(iv) Ensure that such affi liations / employments are fully transparent and disclosed.

h) Endorsement: A medical practitioner shall not endorse any drug or product of the industry publically. Any study conducted on the effi cacy or otherwise of such products shall be presented to and / or through appropriate scientifi c bodies or published in appropriate scientifi c journals in a proper way.

With the introduction of Regulation 6.8, it has now became unethical for all registered medical practitioners to avail of freebees, going on cruise, paid vacations, accepting travel facility by air / rail and hotel accommodation for self / family, inside and outside the country.

It has now also become illegal for registered medical practitioners to attend conferences, seminars, workshops, CMEs programmes, etc. as “delegates” at pharmaceutical expense.

Regulation 6.8 was a provision meant to restrain the medical practitioner but in-spite of the regulation in place; medical practitioners along with their families were taken on cruise by the pharmaceutical

industry as these MCI regulations had no control over the pharmaceuticals.

The pharmaceuticals, on the contrary, used such incentives literally to lure the doctors and the expenses so incurred were shown as business expenditure in their profi t and loss account thereby reducing their tax liability. On top of that, they made the doctors commit to prescribe about 85-90% of the amount spent on them. It was a win – win proposition both ways for the pharmaceuticals and the allied health sector industries.

At this point the Central Board of Direct Taxes (CBDT) stepped in.

The CBDT came out with circular - 5 of 2012, dated 1st August, 2012 declaring inadmissibility of expenses incurred in providing freebees to medical practitioners by pharmaceuticals and allied health sector industry. The circular reads thus:

“It has been brought to the notice of the Board that some pharmaceutical and allied health sector Industries are providing freebees (freebies) to medical practitioners and their professional associations in violation of the regulations issued by Medical Council of India (the “Council”) which is a regulatory body constituted under the Medical Council Act, 1956.

2. The council in exercise of its statutory powers amended the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 (the regulations) on December 10, 2009, imposing a prohibition on the medical practitioner and their professional associations from taking any gift, travel facility, hospitality, cash or monetary grant from the pharmaceutical and allied health sector industries.

3. Section 37(1) of the Income-tax Act



provides for deduction of any revenue expenditure (other than those falling under sections 30 to 36) from the business income if such expense is laid out/expended wholly or exclusively for the purpose of business or profession. However the explanation appended to this sub-section denies claim of any such expense; if the same has been incurred for a purpose which is either an offence or prohibited by law.

Thus, the claim of any expense incurred in providing above mentioned or similar freebees in violation of the provisions of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 shall be inadmissible under section 37(1) of the Income-tax Act being an expense prohibited by the law. This disallowance shall be made in the hands of such pharmaceutical or allied health sector industries or other assessee which has provided aforesaid freebees and claimed it as a deductable expense in its accounts against income.

4. It is also clarifi ed that the sum equivalent to value of freebees enjoyed by the aforesaid medical practitioner or professional associations is also taxable as business income or income from other sources as the case may be depending on the facts of each case. The Assessing Offi cers of such medical practitioner or professional associations should examine the same and take an appropriate action.”

What does this mean? The following is the interpretation:

(a) Pharmaceutical companies will now not be in a position to show the expenses incurred by them on doctors / their families as expenditure to reduce their tax liability.

(b) Doctors who receive such benefi ts

will have to compute the said benefi ts in rupees as income from other sources / business income and pay income tax on the same.

(c) The pharmaceutical might be directed by the Income Tax department to provide the names of all the doctors they have paid / sponsored.

(d) This list will be given to (i) the Medical Council of India and (ii) the doctor’s income tax assessing offi cer.

(e) The concerned doctor will then get a notice from the MCI to show cause as to why his registration should not be suspended / cancelled.

(f) The concerned doctor will get a scrutiny notice from his income tax offi cer calling upon him to present all fi nancial records for inspection.

(g) The ITO will penalize the doctor for concealing this taxable income.

MISCONCEPTION: After the enforcement of regulation 6.8, most of the doctors felt that asking the pharmaceutical to make the pay-outs to medical association was the safer way out. These medical associations would then sponsor the doctors. This belief is just a delusion.

Although the Medical Councils have no control over the professional medical association in regulation 6.8, the words


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“professional association of doctors” is expressly mentioned. Therefore pharmaceutical giving money to professional association of doctors and such associations accepting money from pharmaceutical is illegal. Can Medical Council take action against the offi ce bearers of such medical associations for violation of the Code of Ethics? This is a very interesting question! Indian Medical Association, New Delhi offi ce bearers had bad trouble with the MCI for Code violation.

Similarly the income tax circular also expressly mentions the words “professional associations”. Therefore if such professional associations accept money from pharmaceuticals, the said amount will be taxable in the hands of these professional associations. Needless to say that tracing the benefi ciaries of the money paid to such associations by the

pharmaceutical can be very easily traced.So beware. The medical council /

income tax department might soon be breathing down your neck.

Luckily the above regulation is not applicable to conference faculty, medical practitioners in advisory capacities or pharma consultants as this is a permissible activity.

Prof. Gopinath N. Shenoy is a medico-legal consultant and specializes in the defense of doctors in the Consumer Courts all over India. He was a Judge of the Consumer Court – Mumbai, Govt. of Maharashtra. For any queries or assistance, contact Dr. G. N. Shenoy on 09869877871 / 022 24927403 at N. A. Shenoy Memorial Shenoy Nursing Home, 199, G. K, Marg, Lower Parel, Mumbai 400 013.

E-mail : [email protected]



Negative mental attitude attracts misery, while positive mental

attitude attracts wealth & happiness. Negative mental attitude is like unwanted weeds in a garden & positive mental attitude is like beautiful roses in garden. Decide to have prosperity-consciousness instead on poverty-consciousness. Pain & pleasure are two sides of the same coin. Mistakes, failures, handicaps and problems are just stepping stories to success.

Thank God for your problems! You can learn something more now & overcompensate for them to become more successful. Everyone has unique talents to exploit. Therefore use them to fulfi ll your role in this world. You are greater than your problems. Mistakes

are simply Miss-takes. Just do a retake. Making mistakes is your birth right as well as your destiny. Accept yourself as an imperfect human being. No one is absolutely white or black. All are just grey.

You are your own best friend. Therefore love yourself the most fi rst of all. You can only get from yourself or from this world whatever you expect to get.

Your thoughts determine who you are today or what you will be in future. First of all conceive a successful image of yourself to achieve real success in your life. Remember always that “YOU WERE BORN TO BE A CHAMPION”.

[email protected]

Mrs. Pushpa EswarManager-AMC

AMC_GRASP_Nov-2012_#637.indd 17AMC_GRASP_Nov-2012_#637.indd 17 01-12-12 5:07:57 PM01-12-12 5:07:57 PM


AMC has recently organized a very successful Medical Conference at Moscow, Russia. The

venue was Hotel Radisson Blu Belorusskaya. It was attended by both Indian and Russian delegates. The scientifi c deliberations were very useful and opened the doors for further academic exchange programs and medical tourism for the Indian delegates. The history and culture of Russia is familiar to us. The lesser known Baltic regions provided a unique experience. We visited 2 out of the 3 Baltic States, Riga and Estonia (Lithuania being the third). These are relatively young counties having found their freedom from the “Soviet Occupation” in 1994. Their struggle is so recent and history so fresh, that it can be seen on the streets. We met people who were part of the

Baltic way Human Singing chain.

Our 10 day excursion began on 7th September at Riga and I was surprised to see an Ayurvedic centre just outside the airport! We spent an enjoyable 2 days in Riga known for its Art Noveau architecture. A walk of the Old Town covered the Riga Castle, the Dome Cathedral, St. Peter’s Church, the Swedish Gate, The Three Brothers, the Large and Small Guilds and the Freedom Monument. The museum of Occupation is

RUSSIA ANDRUSSIA AND BALTIC TOURa must see. It depicts the pain, the struggle for freedom and the pride of the Latvian people.

The next day we left for Tallinn, Capital of Estonia. As you walk in through the Viru gate into the Tallinn Medieval Old Town and step into the twisting cobblestone lanes and iron street lamps one feels that you have stepped a few centuries back. Enter the Town Hall square and step into very modern looking stores and cafés. This was probably the best shopping opportunity for fashion merchandise on this trip. The Tallinn City Museum takes us from medieval beginnings to modern times. We also saw the exotic Lutheran churches. A unique experience was an inside tour of The Toompea Castle. We got to even sit on the parliament seats (Much easier to do so in a foreign country than our own!)We also happened to come across several couples tying the famous lover’s padlocks.

On the 5th day we started out for St Petersburg. It was a long journey and traffi c reminded us of Mumbai (They even break signals!) However, we covered several monuments on the way. The next day we drove to Peterhof, (The Russian Versailles) a huge and luxurious estate on the Baltic Sea coast. It has several layers and levels of gardens, huge fountains and beauty that cannot be put into words. We were given a tour of the Grand Palace. Magnifi cence waited for us in the form of “Hermitage Museum” on the banks of Neva River. It has 5 buildings,

Old Town, Riga Town Hall Square, Estonia Peterhof St Petersburg

St Basil’sCathedral Moscow




400 rooms and 3 million items -Couldn’t see all, of course. What we did see will stay in our memories for a lifetime.

Our last destination was Moscow for our Overseas Medical Conference. The overnight nonstop train from St Petersburg was a luxurious experience. The Red square (Krasnaya ploshad) is the central part of Moscow connecting all major streets. One would assume that” red” stands for communism but it actually means beautiful. In fact the name Red square is inspired by the beauty of St Basil’s Cathedral. Next to it is the Kremlin, a historic fortifi ed complex and now the offi cial residence of the President of Russia. We did the tour of Kremlin and the State Armoury, one of the oldest museums that has displays of almost every article important to Russian history. The Moscow metro underground stations are an artistic masterpiece. Each station has a theme

of its own. This tourist attraction is an exclusive feature for this city. In addition we enjoyed river cruises, a folk show and a circus and some very pleasant weather.

our tour operator we were very comfortable. The food was excellent. Not a day went where the Indian palate was not satiated. We wish to acknowledge Smart tours and travel, Mr. Vikas Dandekar who accompanied us for this incredible experience of a life time.

We returned home on the 17th of September 2012, a very bonded group looking forward to the next AMC tour which will be announced in a few months.

Dr. Smita Sharma Joint Secretary, AMC

Russia had roadside chapels just like we have temples in India. In fact we discovered that religion was always a part of Russian life even through communist times. Surprisingly, for all the splendor, structures in Russia are gold plated or bronze, and not real gold. The locals do not speak English or have any use of it and there are very few signboards in English. However due to the perfect arrangements of

BALTIC TOURBALTIC TOURToompea Castle, Estonia Hermitage Museum and Winter Palace

Hermitage Museum St Petersberg

Viru Gate- Entrance To The Old Medieval Town, Estonia




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16 BEDS RUNNING NURSING HOME. FULLY EQUIPPED WITH OT IN VILE PARLE (EAST), AVAILABLE ON RENT/PARTNERSHIP. CONSULTING ROOMS AVAILABLE ON HOURLY BASIS AT VILE PARLE (EAST) AND JOGESHWARI (EAST) CONTACT: 9820080116 26180196 28242713 EMAIL: [email protected].

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August 01, 2012: Doctors harassed over paperwork, not gender tests

Mumbai: Two months after the statelaunched an offensive against doctorsfl outing PCPNDT Act, FOGSI has complied information of about 16 doctors charged and claimed that “not a single case was about sex determination”. The legislation, on the other hand, is clear that any violation calls for penalty or punishment.

August 04, 2012: Nursing homes protest hike in bio-medical waste disposal ratesMumbai: Nursing homes across the city are up in arms after the BMC-appointed company responsible for collecting bio medical waste suddenly hiked its rates. AMC has written a letter of complaint against the company, SMS Envoclean, to the municipal commissioner.

August 07, 2012: Doctors’ freebies to be taxedMumbai: The income-tax department will tax the amount pharmaceutical and allied health sector industries spend on freebies for medical practitioners and their professional associations. Those who accept the freebies will also be taxed.

August 09, 2012: 75% of sex determination cases in state stuck in court

Mumbai: Maharashtra’s frightening child sex ratio refl ects unmistakably in its court fi gures. For most of the last 10 years, the number of cases related to foetal sex determination that reached court fl uctuated below 50. In 2011, however, the tally hit a high of 179; between 2002 and June 2012, 342 cases under the PCPNDT Act were fi led in courts. Of these, 248 are pending till today.

August 15, 2012: 18 years on, MMC begins negligence probe

Mumbai: There are at least 200 negligence complaints pending for over 15 years out of 960 pending cases at MMC, according to ethics committee. The reason for the long list of pending complaints is because till 18 months ago, the MMC did not exist at all. Dr. Lalit Kapoor, medico-legal expertand advisor to AMC, said the state government was responsible for the systemic failure. He said it was unfair for both parties. “For the doctor, it is like a sword hanging over his head all these years, and for the complainant, it is an

FROM THE PRESSFROM THE PRESSCompiled by: Dr. Pradeep BaligaCompiled by: Dr. Pradeep Baliga(Sourced from various Agencies)(Sourced from various Agencies)



endless wait for justice.”

August 16, 2012: Public Health System hit by low spendingNew Delhi: According to the Planning Commission’s draft, the government run healthcare system is hamstrung because the number of doctors is short of the target by a jaw-dropping 76%, there are 53% fewer nurses, specialist doctors are short by 88%, radiographers by 85% and laboratory technicians by 80%.

August 18, 2012: Code soon againstdoctor-pharma linksNew Delhi: The government is all set to crack the whip on doctors found prescribing medicines of drug companies, in return of gifts or favours. Central Health minister said on Friday that the ministry has received complaints on this unholy nexus, and the matter has been referred to the MCI.

August 21, 2012: State has more homeopaths and ayurvedsMumbai: The state government’s recent proposal seeking to allow non-allopathy doctors to practise modern medicine after a one-year course in pharmacology has stirred a hornet’s nest. For every

doctor practising allopathy in the state, there are two practising ayurveda and homeopathy.

August 22, 2012: After crackdown, 17 doctors shut abortion clinics in ThaneThane: A showdown between district health offi cials and gynaecologists conducting abortions within a legally-approved time-frame here has resulted in the closure of 17 abortion clinics across Thane. All doctors are said to have volunteered to de-register their clinics and given a written undertaking to the Thane civil surgeon.

August 29, 2012: Prescribe legibly and in caps, Karnataka doctors toldBangalore: Taking a path-breaking initiative, the Karnataka Medical Council (KMC) has issued a directive to all 96,920 doctors registered with it to improve their handwriting while prescribing medicines. KMC has requested all its members to write their prescription ‘legibly and readable by a pharmacist’ and preferably in capital letters. “The trade name and within brackets the generic name of the drug prescribed along with signature and registration number of the prescribing doctor is a must.

September 08, 2012: City nursing homes to lift ban on cashless mediclaimMumbai: After a gap of two years, nursing homes across the city are all set to lift the ban on cashless mediclaim facility through private insurance companies. AMC president Dr. Kishore Adyanthaya said, “Discussions are on with multiple private insurance companies. We want the patients to be benefi ted at the end.” Bajaj Allainz, Future Generali, ICICI Lombard, Star Health



and Max Bupa are some of the insurance companies who have met the AMC members. “Till now, the consumer was bearing the brunt of the tussle between the healthcare providers and insurance companies. However now the consumer is more powerful with the insurance portability option,” said AMC vice-president Dr. Sudhir Naik. AMC is now working on a concept called Network of AMC Hospitals (NoAH) which will guarantee transparency in medical treatment and billing as well.

September 09, 2012: 60 hospitals on PPN list say they are not part of programme

Mumbai: As many as 60 of the 149 nursing homes listed as part of the Preferred Provider Network programme by the public sector insurance companies say they never enrolled for the scheme.Dr. Niranjan Agarwal, member of AMC said: “These insurance companies are trying to portray that PPN is highly successful by showing large number of hospitals and nursing homes on their list. When we wrote to the nursing homes to verify this claim, majority were actually amazed that their names were on the PPN list.”

Septemper 10, 2012: Govt cracks down on medical graduates seeking to settle in US

New Delhi: India has fi nally cracked down on medical students going to the US for higher studies but deciding to settle down there after completion of their course. In an effort to cut down on the brain drain that is crippling India’s medical sector, the health ministry has suspended issuing the all important ‘No Obligation to Return to India’ certifi cate, mandatorily required by

the US government for any Indian doctor wanting to settle down after a maximum of nine years of medical education.

Septemper 13, 2012: Doctors’ pleas heard: Govt to review sonography rules

Mumbai: With an increasing number of doctors protesting against what they call unfair and rampant seizures of sonography machines across the state, the Centre has set up a 12- member committee to re-examine the format of Form F, a mandatory record to be fi lled by pregnant women undergoing an ultrasound scan. The committee will also evaluate the provisions of the PCPNDT Act to strengthen its implementation and curb female foeticide.

September 14, 2012: State makes retrieval of organs easier

Mumbai: In a major attempt to spur organ donations, the Maharashtra government has allowed a non-transplant hospitals equipped with an ICU and operation theatre to retrieve organs and made it mandatory for them to offi cially identify brain dead patients. The state on Thursday passed four resolutions based on the



Human Organ Transplantation Act, 1994. In the aftermath of former Maharashtra CM’s death, the state seems to be in a rush to push a cadaveric organ transplant programme.September 18, 2012: HC relief for doctors using USG machines Mumbai: The Bombay high court on Monday allowed portable ultra-sonography machines to be taken to patients’ home for any purpose other than sex determination. However, this will be subject to installation of the silent observer (SIOB), a device which monitors scans done by USG machines. September 24, 2012: MCI approves three-and-a-half-year medical course New Delhi: The Medical Council of India has fi nally cleared the introduction of the three-and-a-half-year long medical course from April next year. To be called B.Sc. in community health, it will be open to anybody after Class 12. This special cadre of health workers will be trained mainly in district hospitals, be placed in sub-centres or primary health centres and will be taught “some module of clinical work”. October 04, 2012: State asks ayurveda doctors to move Centre over USG testsMumbai: The state has advised the ayurveda doctors to approach the Union government to amend the existing PCPNDT Act so that they are allowed to conduct sonography tests. According to the Act, only docto r s registered with the MCI can perform sonography test. October 08, 2012: Private hospitals will have to display treatment costsNew Delhi: In a major move aimed at checking unnecessary medical tests and procedures, the health ministry on Sunday

said it was working on a plan to make it mandatory for all private hospitals to declare and display the treatment costs of different diseases. The guidelines will be introduced under the Clinical Establishment (Registration and Regulation) Act 2010, which was notifi ed recently.

October 15, 2012: MCI bans 25 docs for posing as fake faculty members

New Delhi: Doctors who fake being faculty members in private colleges so that theinstitutes get a clearance to admit studentswill now have to watch out. In the fi rst-everaction against this shameful yet common practice among doctors, the Medical Council of India has banned 25 doctors from medical practice for three to fi ve years.

October 15, 2012: MCI to use Transfer, migration certifi cates to fi ght ragging

New Delhi: The all important migration and transfer certifi cates, issued to students of medical colleges/institutes/ universities, will now have an entry, saying whether the student has been punished for committing or abetting ragging or not. Dealing with ragging with an iron fi st, the MCI has written to medical institutes across India reminding them that ragging is a criminal offence.

October 16, 2012: Govt to stop sale of branded drugs?

New Delhi: Medicines in India may not be sold under brand names in the near future. In its biggest move to push generic drugs and do away with brand names, the Union health ministry has ordered states to stop issuing licences for the manufacture or sale of drugs on the basis of their brand name.




Just when one thought that miracles are nothing but

folklore, one is stunned by disbelieve at the appearance of this phenomenon called the AMC’s H&A Policy 2012-2013.

When the H&A Policy was formulated Dr. Mahendra Sheth our past president and founder managing trustee nearly 25 years back, it was really the acceptance by the insurer of a plea by AMC to include hereto taboo condition of PED (Pre Existing Diseases). At a modest surcharge of 10% of the premium rates, our Policy saw light of the day.

Over two and half decade later, is the various teething problems and differences between the insurers reluctance and insured hopes and demands, structurally modifi ed the Policy in into what is available today.

However your H&A Policy for the renewal year 2012-2013 has truly surpassed the wildest imagination of every proponent of the scheme.

To sing paeans on this Policy has not been the culture of those who struggled long and hard to carve this health product into the present structure it sees itself today.

What really had made the renewal Policy so spectacular?

It is the attainment of a long long felt dream of making this scheme not only just another health product but displaying it as a truly social

security scheme.

Features which make it stand out when comparing with present mediclaim or health policies are briefl y tabulated below:

There is hardly any comparison really possible to tell you what is so different in our unique health product.

NEW H & A POLICY 2012-2013NEW H & A POLICY 2012-2013Dr. Jayesh Shah



IT REALLY IS ANOTHER ELIXIR FOR LIFE!! OUTSTANDING FEATURES

General Mediclaim H & A1. Medical checkups before accepting a health

cover could easily cost over thousands of rupees, and gets costlier as you age.

We do not ask for any checkup even if you are seventy nine years at joining.

2. Try getting a policy when you are above 60-65 years of age…. If you do ,…consider yourself VERY LUCKY.

We admit fresh entrants till 80 years of age and after that the insurance cover if unbroken, will be provided for life.

3. Costly investigation like a MRI, CT Angiography, will have to be paid from your pocket, if hospital stay is not taken, or even refused reimbursement should the investigation does not show any evidence of disease.

We will honor such costly investigations without your need to be hospitalized.

4. Day care procedures, mostly rebutted, rarely reimbursed.

We defi nitely will look after this too.

5. Congenital disease, … a favorite taboo from the pre-existing disease complex which rarely would even merit their concern.

Procedures necessary to correct any functional disability is readily covered by us.

6. Your bed charges during a hospital stay is titrated against your CSI for reimbursement i.e. if your CSI is 3 lacs, you can avail of a room up to only 1% i.e. Rs. 3000/day.

We cover your bed charges reimbursement up to 1.5% for all CSI 3 lacs and over and 2.5% for any needed ICU treatments.

7. Portability from one insurance to another is a veritable mine fi eld of obstacles.

We have all but removed most mines here also.

New unbelievable features:Health insurance premiums are known to become prohibively expensive as one gets older; sadly often they become unavailable or increasingly diffi cult for senior citizens above 60 years of age.

This H & A cell has turned this scenario right on its head.

Our charts show how premium for all members and their spouse above 60 year is frozen at approx 5% (Rs. 5140 per 1 lac cap sum insured). It gets better now. Those who have continued to keep their faith in the AMC H&A Policy for 10 continuous years or more pay Rs. 4500/per lac when between 60-70 years of age, Rs. 4000/-

per lac for those between 70-80 years and an astonishing low Rs. 3000/ per lac for the above 80 years age group…Truly a masterpiece of economical jugglery, when you consider that the claims Ratio are constantly fl uctuating if not going up all the time.

Removal of co-payment till 60 years of age is again an amazing achievement which defi es the logic of insurance but justifi es the end of social security.

The H&A policy has always had many fi rsts to its credit. More feathers in the cap will be a part of its increasing ability to mould this policy into an all time favourite.



ASSOCIATION OF MEDICAL CONSULTANTS AMC MANGALORE BRANCH




ASSOCIATION OF MEDICAL




CONSULTANTS MEET 2012



Association of Medical Consultants has over the years emerged as a true representative body of the Medical Consultants in the city of Mumbai and its extended suburbs. It has extended a helping hand to its members whenever they have faced medico-legal trouble. With a total membership of close to 7500 it has been at the forefront of all efforts to liaison with the government on various issues concerning the welfare of its members. With such a large membership it is only fair to expect that the needs/problems of different groups of members will be different. In the past few years members who are running small and medium healthcare setups have increasingly come under government scrutiny. The issue of separate staircase for Nursing homes was one such issue on which it was AMC which took the lead in fi rst mounting a legal challenge and subsequently even convincing the state government to amend the DC rules to make an exception to this rule for already existing health care institutions. The issue of Change of User and NOC from fi re department continue to haunt the members who own/run small and medium health care establishments, and it has been AMC which has taken up cudgels on behalf of its members to try and resolve this issue amicably. This sometimes led to a piquant situation wherein other members at times felt all AMC efforts were directed to help Nursing home owners. This however is an erroneous perception as AMC has also in the past taken up issues concerning members who are attached to larger corporate hospitals. In its earlier Avatar it was the Nursing home cell of AMC which took up the issues of the nursing homes and it was later revamped into a Health infrastructure Cell.It is now accepted that the small and medium healthcare providers namely the nursing homes are being increasingly pushed to a

corner. Patients are becoming more demanding necessitating the doctor to spend more time with Patient/Relatives to explain to them the medical conditions of patient. The insurance companies are also demanding lower tariffs to cover for their losses which they claim is due to excess billing and malpractices of some of the providers. Their system of Cashless services had inherent problems such as delayed payment and non-payment after preauthorization and increased burden of paperwork. The Local Tax, Business & Labour laws are becoming stringent and the skilled manpower scarce. The subtle pressure from the larger corporate hospitals also has resulted in Government regulations becoming too overbearing and impossible to comply with. In such scenario, the Nursing Home Owners need a representation & support system so that they can focus on their core competence namely Medical Deliverables. In view of the aforesaid, it was felt in AMC that though the Nursing Home Cell (Infrastructure Cell) has been addressing these diffi cult issues in a dedicated manner, there was a need to carve out within AMC a more focussed and specifi cally empowered outfi t to fi nd innovative solutions to these problems with a greater sense of urgency. Accordingly, AMC Managing Committee considered the re-incornation of the Nursing Home Cell to AMC-NoAH with the avowed objective of creating a cohesive group of small health providers to focus on Nursing homes problems exclusively ,and therefore, more effectively. It would of course function as any of the other Cells of AMC. The AMC-NoAH is designed to be a highly disciplined and motivated unit with adequate checks and balances .It would be empowered to create effective disincentives for non-compliance with directives of the AMC-NoaH issued in the common interests of its members.

NoAH - Preamble




DECLARATION(on Letterhead of Nursing Home/Hospital)

I,________________________________________________________________Indian Inhabitant, aged_____years, residing, at____________________________________________________________________________________________________, do hereby solemnly declare and state as under :-A) That, I am the Owner/ Proprietor/ Partner of the [name of the Nursing Homes/ Hospitals] and I

am the life member of Association of Medical Consultants. OR That, I am the Director of the Company that runs the Nursing Home/ Hospital and I have the

authority to sign the declaration. A copy of the board resolution dated [insert date] authorising me as the signatory is attached hereto and marked as Annexure A.

B) That, I have the decision-making powers in running of the Nursing Home/ Hospital.C) That, I agree to abide by all the rules and bye- laws of the AMC-NOAH and I will also abide by

the decisions of the disciplinary committee of AMC-NoAH. All the owners/trustees/directors/employees/agents/servants of the hospital/nursing home whether or not they are members of the AMC will also abide by the decision of the disciplinary committee of AMC-NoAH.

D) That, my nursing home/ hospital has less than 75 beds. A copy of the registration certifi cate of the nursing home/hospital is attached hereto and marked as Annexure B.

E) That, I accept that the quantum of fees payable will be decided by the incumbent Governing Council of AMC-NoAH and I will pay the admission and annual fee for the membership and I also agree to pay any optional fees for selected ‘value added services’ as may be intimated to me from time to time by the Governing Council of AMC - NoAH.

F) That, I will abide by the obligations cast upon me by AMC-NoAH which are mentioned in the constitution document of AMC-NoAH in its true letter and spirit.

G) That, I will not do any such acts which would invite disciplinary action against me and my nursing home/hospital.

H) That, I accept that there will be a graded disciplinary action grid. The escalating grid will be warning, temporary suspension and fi nally expulsion. I also accept that all disciplinary action will be the responsibility of the Governing Council of AMC-NoAH and the same shall be fi nal and binding upon me.

Solemnly declared at )aforesaid this ____ day of 2012 )Before meIdentifi ed by me

Advocate

Declartion form to be submitted with along with NoAH Form



MEMBERSHIP APPLICATION FORM FOR AMC - NoAH

Details of the MemberName : Dr. (Mr./Mrs./Ms.) (Name)

(Middle name) (Surname)Date of Birth : AMC Membership No:Residential Address :

Contact No : (M) (R) Email : Educational Qualifi cation : MMC Reg No :

Details of the Healthcare UnitName of the Healthcare Unit : Residential Address :

Contact No : (M) (R) Email : Website : Nursing Home Reg No : MTP Registraton No : PNDT Reg No :FEQH Accreditation Yes /No Minimum / Optimum / ExcellentNo. of Bed : Carpet Area in sq Feet No. of OTs :

Facilities: Please Tick: Medical Surgical ICU NICU Obstetric / Gynec Laboratory X-ray CT Scan / MRI

Details of the other Members / Partners:

Sr. Name and address Contact noAMC Member

Yes or NoIf Y then AMC No:

I hereby solemnly affi rm that all the data provided by me in this form is true to the best of my knowledge.

Name of MemberCurrent Fee structure:a. The Joining fee would be Rs. 2,500 for Nursing Homes & Hospitals having bed capacity of 10 or less.

For Nursing homes & hospitals having bed capacity of 11-25 Rs. 5,000 and 26-50, the joining fee would be Rs. 7,500. More than 50 beds it would be Rs. 10,000.

b. The Annual fee would be Rs. 500 for Nursing Homes & Hospitals having bed capacity of 10 or less. For Nursing homes & hospitals having bed capacity of 11-25 the annual fee will be Rs. 1,000 and for hospitals having beds 26 or more, the annual fee would be Rs.1,500 and Rs. 2,000 for those with more than 50 beds.

Passportsize photo

of themember


MUMBAI DIARY2012 is nearing its end already or the dreaded 21st December 2012 is

approaching fast. Rather than brainstorm on the validity of the 2012 prophesies, do you notice a giant tsunami of corroding quality of life in every sphere? We are living in two worlds, one where a human can be created in vitro, congenital defects can be repaired intrauterine, various organs are being transplanted like spare parts and our eyes are actually call the shots replacing the remote, while on the other hand, human imagination, abilities have reached a saturation point in real & virtual world causing absolute erosion of basic human qualities. Need we wait for a real-time destruction of the world to validate or otherwise, the prophecy or declare this period as an emergency to indulge in eco-friendly habits?

We at AMC have reached a nadir point to resolve the mystery of the missing Fire safety norms being enforced on us. The AMC drafted norms has had a kaleidoscopic journey in the various corridors of the Government and we are still hopeful that it will assume a pleasant pattern soon.

While the anti noise pollution activists (including yours truly) have made a silent noise over preserving the festival ambience, how does one combat the perpetually increasing ambient noise levels on streets, highways, etc.

The year has seen demises of signifi cant personalities and the most recent one struck a chord of pride on reading that the Commissioner of Police excused himself from his daughter’s wedding to attend his call of duty to maintain law & order in the city, while on the other hand we condemn the vandalism perpetuated on a Clinic while the miscreants escaped unscathed in spite of the Ordinance against Violence on Doctors being in place.

Finally, a rejoinder to our Editor’s thoughts on “thinkers & doers”;

“Thinkers think and doers do. But until the thinkers do and the doers think, progress will be just another word in the already overburdened vocabulary of the talkers who talk.” By Anonymous


Dr. Sujata RaoPresident Elect AMC

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winter cover.indd 2 01-12-12 4:36:32 pmeditorial board editor dr. gupta mukesh co-editors dr. baliga...

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