Archive

Archive for the ‘Opinion’ Category

Can Manipur become medical value travel destination of South East Asia?

December 8, 2011 Leave a comment

Can Manipur become medical value travel destination of South East Asia?.

‘Future belongs to those who believe in the beauties of their dreams’.

I am a passionate believer of human potential and so also of Manipur. We have abundance of opportunities because of our location, hospitality nature of our region, comfortable weather, land, lake, hills, short surface connectivity with Myanmar, Trans Asia Highway, possible International Airport at Imphal, India’s “Look East” policy etc. We can very well visualize Manipur becoming the healthcare hub of South East Asia. We can solve most of our problems by addressing the advantages rather than the disadvantages.

‘If you really understand the problem, the answer will come out of it, because the answer is not separate from the problem’.
– Jiddu Krishnamurti
Healthcare is one of the fastest growing industries in India. Manipur is not an exception. A recent CII-McKinsey study on healthcare says medical tourism alone can contribute Rs 5,000- Rs 10,000 crore (Rs 50-100 billion) additional revenue for upmarket tertiary hospitals by 2012, and will account for 3-5 per cent of the total healthcare delivery market and  only 10% of the opportunity has been tapped in India.

India’s medical tourism is through Non-Residential Indians, Patients from countries with underdeveloped facilities and Patients from developed countries because of long waiting list. India has adopted NABH (National Accreditation Board for Hospitals & Healthcare Providers) program to improve the quality to international standard for attracting more foreigner medical tourists.

Healthcare is a major service Manipur can sell to neighboring states and countries. Myanmar is our advantage. First we need to have good hospitals. Till now there is no NABH hospital in NE India. Myanmar patients are going to Bangkok and Singapore for their advanced medical treatment which is costlier than India. Health Visa is not issued to Myanmar nationals to visit Manipur as it is issued to Bangladeshi at the border to visit India for medical reasons. Bus service between Mandalay and Imphal is yet to be materialized for different reasons. India’s Look East Policy is delayed in implementation. The situation is now difficult but not impossible to go ahead because of Chinese speed and dominance in Myanmar. After all nobody wants to go to a war zone for treatment. Good relationship with Myanmar cannot be established so long as they are arrested for illegal entry to Manipur in spite of PAP removal. We need a leader who will take 100 percent responsibility for successful implementation of the policy.

New trend of diseases and our focus areas.
Infectious diseases, caused by invading microorganisms, were the leading causes of death a century ago. Chronic diseases, caused by a variety of lifestyle and other factors, are the leading causes of death today. Leading causes of death overall are heart disease, cancer, stroke, chronic lower respiratory diseases (emphysema, chronic bronchitis), diabetes, accident and emergency.

And the main objectives of Tourism are in the specialities of Cardiac  Care, plastic and Cosmetic surgery, organ transplantation, reproductive IVF and ICSI procedures, Joint replacement. The medical care can be combined with related tourism activities such  as spiritual and  eco-tourism. Flow of Myanmar medical tourists depends upon our pricing, branding, hospital accreditation, quality control, categorization of hospitals etc.

Healthcare is investment intensive for technological advancement and nothing is free. In May 2008, McKinsey and Company reported that primary considerations in medical tourism are:
* 40% seek advanced technology,
*  32% seek better healthcare,
* 15% seek faster medical services
* while only 9% of travellers seek lower costs.

We need to update the facilities to attract medical tourists. Organ transplantation act needs to be passed in our state. Government alone cannot handle healthcare of 1.2 billion populations in India. Private sector participation is the need of the hour. Public Private Partnership is now the new ‘Mantra’ to provide affordable quality healthcare to the masses. Categorisation of healthcare institutes and quality control may be undertaken.

We need to rethink our healthcare planning and develop Infrastructure and HR, Quality and Accreditation, Law and Order, Accessibility, Affordability according to our opportunity.

In 2006 more than 2 million medical tourists availed services in South-east Asia from all corners of the world. Revenues close to US$ 450 million generated. But India had only 2% share. In 2007 India had 0.2 million medical tourists only. Singapore and Bangkok are healthcare destination in South East Asia. A single hospital in Bangkok, Brumugrade, first to get JCI (Joint Commission International ) accreditation in Asia is treating  0.45 million foreigners per year.

‘India is home for 16% of total world population and 21% of total global diseases.  In India the Health Care spending is 3.4% and Military 18.6% of its total spending. Developed National spends 12-17% in Health.  India needs a holistic massive USD 80 Billion investment to bring up the quality of healthcare matching to developed nations. Every new bed creates employment for 5 personnel directly and about 25 personnel indirectly. There is a huge requirement for health care workforce estimated to be 70 to 80 million jobs in the next 10 yrs, adding 2 to 3 % p.a. to GDP.’

India currently has 0.6 beds per 1,000 and the global average – 4.7 beds per 1000. India needs 1.7 million beds to meet 2 beds per 1000 only. There is a shortfall of 1.4 million doctors and 2.8 Nurses million. North Eastern India needs 52000 nurses immediately. MCI (Medical Council of India) has recommended the centre to establish 500 medical colleges in 5 years to meet the gap. Till now Eastern India has the lowest number of medical colleges compare to rest of the country. Manipur needs more beds and medical colleges to increase state exchequer.  More than 300 students who are going privately outside the state per year for medical studies.

In Manipur, a task force constituted by Ministries of Health and Family Welfare and Tourism may assess the opportunities for promoting our state as one of the health destination and formulate policy to promote and control the quality of healthcare of the state. Only quality service will attract more medical value tourists and generate nearly 2 lacs of employment in turbulent Manipur.

Can Manipur become healthcare destination of South East Asia? The choice is ours. Grow or die.

The writer is CMD and Consultant Plastic Surgeon, Shija Hospitals, Langol.

Vice President, Manipur Chamber of Commerce and Industries.

President, Indian Medical Association, Manipu State Branch. And he can be reached at drpalin@shijahospitals.com

Categories: health, Opinion Tags: , ,

Healthcare for the needy: Opinion

November 24, 2011 Leave a comment

The announcement by the Health and Family Welfare Minister L  Jayantakumar while inaugurating the Primary Health Centre at Kakwa to initiate the process for the recruitment of 270 doctors is yet another much needed move towards making health accessible to the general public. With liberal funding from the centre, the state did see some development in terms of strengthening health delivery system, a number of Primary Health Centres (PHC) and Community Health Centres (CHC) in various parts of the state came up during this period. But there have been numerous complaints from the people of the localities where they have been set up about the non- functioning of the same. While the building stands, these centres are sometimes without the most basic component of any health delivery system – doctors and nurses. The most oft repeated answer from the government in answer to non posting of doctors to these remote and rural areas is the inadequacy of doctors at its disposal. Hopefully this latest recruitment of doctors will be able to address the problem to a great extent. And if this proves insufficient the state government should go in for recruitment of more doctors, there should not be any compromise on ensuring access to health care to the most needy. But even after the government has the adequate number of doctors at its disposal to man the various health centres and district hospitals, the problem of absentee doctors and nurses would still persist. This, our past experience tell us. Most of the doctors who get posted to rural and remote areas try their level best not to go there and use every means at their disposal to avoid going to these places. And in most cases, an open secret here, this works to the advantage of those at the helm of affairs who can affect these transfers. There have been numerous cases of transfers being revoked, transferred doctors getting deputed to some other duties, some going on study leave etc. On the ground people are still deprived of the services of the doctors even after their posting at their concerned health centres. To ensure doctors are present where they are needed, the government or those in charge of the Health department should work out effective policies so that doctors posted in rural and remote areas do not view these posting as discriminatory or punishment. For starters, those who passes out from the state medical college, JNIMS can be made to serve for a certain number of years as part of their internship. Along with this, it should be made mandatory for all the doctors in the service of government of Manipur to serve in rural and remote areas for certain number of years for certain number of times, the exact modalities can be worked out by an expert committee. Whatever means the government adopts, the important thing is to ensure health care services is available to the people. But here again, it is clear that no policy will bring any relieve or pan out advantageously for the public, if those who are responsible for implementing the same are not sincere. Side by side, the practitioners of the medical profession usually termed a noble profession for its ability to give life and hope to the sick and infirm, should reignite the willingness to come to the aid of the most needy and not be perpetually distracted by considerations of career and financial returns.

Sources:- Hueiyen Lanpao

A doctor’s touch: a powerful, old-fashioned tool

September 26, 2011 Leave a comment

Abraham Verghese: A doctor’s touch, a powerful, old-fashioned tool
Modern medicine is in danger of losing a powerful, old-fashioned tool: human touch. Physician and writer Abraham Verghese describes our strange new world where patients are merely data points, and calls for a return to the traditional one-on-one physical exam.

Categories: health, News, Opinion

Should ayurveda doctors be allowed to practise allopathy?

September 20, 2011 1 comment

Sir,

I shall be much obliged if you kindly publish this letter in your widely circulated paper. At the outset, I want to make myself very clear that I have the utmost respect and don’t have anything personal against anyone practising AYUSH (Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy) as long as they confine themselves to their respective expertise.
Medical Council of India Acts says “candidates registered in Ayurveda have no right to practice in allopathy.” Although in some states of India like Maharashtra, they are allowed to some extent with a big reservation. Members of the Indian Medical Association (IMA) condemn such a practice. They say that an ayurvedic medicine practitioner is in no way qualified to practise allopathy and should not indulge in such unethical practise. Even the Supreme Court of India has passed a judgement in this matter. Section 2 of the Indian Medical Council Act, 1956 clearly defines who is qualified to practise ‘modern’ system of medicine. No deviation is allowed. To practise allopathy, registration in State Medical Register is a must. According to Indian Medical Council Act, these amounts to quackery and the accused doctors can be booked under anti-quackery law.… Read More

via Hueiyen Lanpao

Practice with conscious and dignity. And The basics…

September 19, 2011 Leave a comment

I needed some uplift.

And look what I saw hanging distantly on a dusty wall of the basement: I read it, again. There was a churn, from within. Sometimes it helps to remember the basics—the bottom line, the real meaning, the forest, not the trees or the CPT codes, or the…(many) negative things that draw our hearts, our minds, and our souls from the basics. At least it helps me.

I liked what the words said.

Service of humanity…Check.

Respect our teachers…Check, no, double-check that one. Thanks to all those who taught (teach) me.

Practice with conscious and dignity. RT!… Read More

via Dr. John M

Categories: Articles, health, Opinion

Are doctors really protected

September 11, 2011 Leave a comment

Are doctors really protected – Presentation Transcript

  1. ARE DOCTORS REALLY PROTECTED? DR. AVINASH BHONDWE PRESIDENT, IMA, PUNE
  2. PROTECTION
  3. ARE DOCTORS REALLY PROTECTED? PUNCHING BAG
  4. ARE DOCTORS REALLY PROTECTED?
    • POLITICIANS
    • HOOLIGANS
    • LAW
    • MEDIA
    • SO CALLED SOCIALISTS
    • DOCTORS’ COMMUNITY
    • PATIENTS
  5. POLITICAL ATTACKS
    • 1. A WELL KNOWN POLITICIAN TREATED & DIED IN A BIG HOSPITAL
  6. ATTACKS ON DOCOTRS & HOSPITALS
    • ON August 26, POLITICAL PARTY activists reduced to rubble the 200-bed Sunitidevi Singhania Hospital in Thane
    • A POPULAR LEADER Mr. Anand Dighe,
    • treated for a fractured leg, died.
  7. ATTACKS ON DOCOTRS & HOSPITALS
    • In three hours of mayhem, they torched the building and smashed ambulances, medical equipments and everything in sight. Patients, doctors and nurses were sent scurrying for cover.
    • A six-month-old child with a respiratory problem and a 65-year-old man suffering from a kidney ailment died after their life-support machines were wrecked.
  8. HOOLIGANS ATTACKS
  9. HOOLIGANS ATTACKS
    • IN PUNE’S CANTONMENT HOSPITAL,
    • POONA HOSPITAL, SAHYADRI
    • HOSPITAL, SURYA HOSPITALS
    • HOOLIGANS ATTACKED AFTER
    • DEATH OF A PATIENT
    • DOCTORS WERE MANHANDLED & ABUSED
    • EXTERIORS & OTHER THINGS DESTROYED
  10. ARE DOCTORS REALLY PROTECTED?
    • WHATEVER IS HAPPENNING IN PUNE IS OCCURING EVERYWHERE IN MAHARASHTRA
    • MUMBAI- ANDHERI,MALAD
    • NASIK, AURANGABAD, NAGPUR,KOLHAPUR
    • JUNNAR,TALEGAON,REMOTE PLACES
  11. LAW:- AGAINST DOCTORS
    • CPC
    • CIVIL CASE
    • MEDICAL COUNCIL OF INDIA
    • CONSUMER PROTECTION ACT
    • PNDT
    • CLINICAL ESTABLISHMENT ACT
  12. LAW ENFORCEMENT
    • Should IPC Section 304A be applicable to doctors?
    • Whoever causes the death of any person by doing any rash or negligent act not amounting to culpable homicide, shall be punished with imprisonment of either description for a term which may extend to two years, or with fine, or with both.
  13. On August 05,2005 a Three Judge Bench of Supreme Court of India of Chief Justice R.C.Lahoti, Justice G.P.Mathur and Justice P.K.Balasubramanyam by order quashed prosecution of a medical professional under Section 304-A / 34 IPC and disposed of all the interlocutory applications that doctors should not be held criminally responsible unless there is a prima-facie evidence before the Court in the form of a credible opinion from another competent doctor, preferably a Government doctor in the same field of medicine supporting the charges of rash and negligent act.
  14. LAW ENFORCEMENT
    • Should IPC Section 304A be applicable to doctors?
    • 304A is a cognizable offence, which means that the police can act without a warrant for arrest.
    • Therefore, it is proposed that the Indian Penal Code be amended in such manner that for cases involving complaint with respect to medical negligence, a warrant for arrest from a magistrate would be required before the practitioner could be arrested.
  15. LAW ENFORCEMENT
    • 1.Concept of negligence is different in civil and
    • criminal law.
    • 2. Doctors and medical practice have to be treated
    • differently.
    • 3. The alleged negligence should be of gross nature to
    • attract criminal liability.
    • 4. Many a complaint prefer recourse to criminal
    • process as a tool for pressuring doctor for extracting
    • unjust compensation
  16. LAW ENFORCEMENT
    • 5. A private complaint may not be entertained
    • unless the complainant produces prima facie
    • evidence.
    • 6. The service done by doctor is the noblest of
    • all.They have to be protected.
    • 7. The loss of reputation suffered by a doctor
    • cannot be compensated by any standards.
  17. LAW ENFORCEMENT
    • 8. A doctor should not be arrested in a routine
    • manner.
    • 9. Guidelines have been prescribed by apex
    • court.
    • 10. Statutory rules need to be framed by the
    • Government of India and State Govts. in
    • consultation with Medical Council of India.
  18. 3.MEDIA
    • Summary of the current situation
    • Use brief bullets, discuss details verbally
  19. DOCTORS COMMUNITY
    • DOCTORS DO NOT SUPPORT THEIR COLLEAGUES IN CRISIS
    • DOCTORS CRITISIZE EACH OTHER
    • MANY A TIMES MAIN VINDICTIVE REASONS ARE GIVEN BY OUR COLLEAGUES
    • WE ARE NOT UNITED
  20. US & THEM
  21. PATIENTS
    • LOOK UPON DOCTORS GET EASY MONEY
    • FIRMLY BELIEVE THAT WE LOOT THEM
    • LESS MONEY – MORE SERVICE IS EXPECTED
    • WHEN SOMETHING GOES WRONG ALWAYS BELIEVE THAT WRONG TREATMENT IS GIVEN
    • NO MORE CONSIDERS DOCTORS AS DEMI GODS
  22. DOCTOR PATIENT RELATIONSHIP
    • BASED ON MERELY A BUSINESS RELATION- BOTH SIDES
    • DOCTORS STILL RECOGNISE A PATIENT BY A DISEASE- NOT BY NAME
    • THE MORALITY & ETHICAL BELIEFS OF THE SOCIETY IS CHANGING
    • FAMILY- FROM UNITED FAMILY TO NUCLEAR
  23. DOCOTRS’ PROTECTION ACT HISTORY-ANDHRA
    • Thousands of Doctors continued their strike in Government Hospitals across Andhra Pradesh, from
    • 2 December to 18 December 2007.
    • OPD services were hit as doctors went on strike after a legislator of the MiM party allegedly manhandled medical staff at Hyderabad’s Niloufer children’s hospital.
    • Doctors demanded that a non-bailable case be registered against the MIM MLA Afsar Khan
    • Doctors wanted the Government to pass an ordinance to ensure security at Government Hospitals.
  24. DOCOTRS’ PROTECTION ACT HISTORY-ANDHRA
    • (a) Registered Medical Practitioners, working in Medicare Institutions
    • (including those having provisional Registration;
    • (b) Registered nurse;
    • (c) Medical students;
    • (d) Nursing students;
    • (e) Practical workers employed and working in Medicare Service Institutions.
  25. DOCOTRS’ PROTECTION ACT HISTORY-ANDHRA
    • Any act of violence against Medicare service person or damage to property in a Medicare service Institution is prohibited.
    • Any Offender who commits any act in contravention, shall be punished with imprisonment for a period of Three years and with fine, which may extend to
    • fifty thousand rupees.
    • Any offence committed under Section , shall be cognizable and non cognizance of Bailable. O ffence
  26. DOCOTRS’ PROTECTION ACT HISTORY-ANDHRA
    • In addition to the punishment specified in section the offender recovery of loss for the damage Caused to the property shall be liable to a penalty of twice the amount of purchase price of medical equipment damaged and loss caused to the property as determined by the Court trying the offender.
  27. DOCOTRS’ PROTECTION ACT HISTORY-ANDHRA
    • If the offender has not paid the penal amount under sub-section (1),the said sum shall be recovered under the provisions of the Andhra
    • Pradesh Recovery Act, 1864 as if it were an arrears of land revenue due from him.
    • The provisions of this Ordinance shall be in addition to and not in Ordinance not derogation of the provisions of any other law, for the time begin in force.
  28. DOCOTRS’ PROTECTION ACT HISTORY-MAHARASHTRA
    • In December 2007 IMA Maharashtra demanded similar act in Maharashtra
    • The then Deputy Chief & Home Minister Mr. R.R. Patil assured the better law in six months
    • In June 2008- IMA Pune, demanded the quicker decision about the Law
    • On 10 th Oct. 2008, IMA, Mah. Organised a State wide Token Strike- 100% successful
  29. DOCOTRS’ PROTECTION ACT HISTORY-MAHARASHTRA CURRENT POSITION
    • The draft given by IMA accepted by State Cabinet meeting
    • The Bill is still pending in Legislative Assembly for discussion- even after 2 sessions
    • There seems to be some hindrance from Political Parties
    • DOCTORS’ LOBBYING
  30. THANK YOU

View more presentations from Avinash Bhondwe

Letters to The Editors: NEIGRIHMS, Shillong In Distress

Source: The Shillong Times

It was a proud moment when our children joined NEIGRIHMS MBBS course three years ago. It was an upcoming institute of excellence we were told. But now we find that the institute is lacking in several aspects of MBBS teaching. The Institute is highly understaffed, not meeting even minimal faculty strength. Several faculty who have joined from various prestigious institutes, have already left and more are preparing to leave for various reasons. No new faculty have joined since the past two years. Going through the MCI website we learnt that this is a very serious matter and chances are that the Institute will not get full recognition or may even be derecognized.

Construction of basic amenities like proper hostels and dedicated undergraduate classrooms for teaching-learning are yet to start. Some batches of students are in Polo campus from where they have to commute for not less than an hour to attend classes, go back for lunch and return for evening classes wasting precious academic time. Dinner is served in the evening so that the cooks can leave early and food is prepared elsewhere, so no quality check can be done. Every student complains of gastroenteritis soon after joining. And the list goes on!

My question is, if this is the status, then why was the MBBS course started in the first place? At the end of five years will our children get a MBBS degree or a diploma in Medicine & surgery (MDDS) similar to the quasi-medical degrees offered elsewhere to cater to the rural population or will they just be told to “pack off”? Will they be competent enough after training in this facility to treat us and other family members? Will the doctors and other administrative staff of NEIGRIHMS go to him/her for treatment? If NEIGRIHMS is brave enough to introspect then probably little is left to change at this stage and all the medical students should be transferred to “recognized medical colleges” so that their future is not marred. I have learnt that the parents of students selected from CBSE PMT have already made such an appeal. I request the administration to spare our children too.

Yours etc.,
Aggrieved Parents of MBBS Students