The KGMU V-C’s circular on private practice has brought the issue to the forefront.
THE GENIE of 'private practice' by Government doctors is once again out of the bottle.
Newly-appointed King George's Medical University (KGMU) vice-chancellor Dr Hari Gautam's latest circular has brought this situation about. It is being seen as a fresh bid to enforce a blanket ban on private practice by KGMU doctors.
Through the circular, the V-C has reminded them that no faculty member should indulge in private practice of any kind as it is prohibited under Section 37 (3) of the Uttar Pradesh King George's Medical University Act-2002.
The issue has been hanging fire for a long time. Amid repeated bans and withdrawals, doctors have been doing private practice over the past 37 years.
This has been the case though the Supreme Court has also upheld the Government's decision to ban private practice, while rejecting various writ petitions. But, the government has failed to develop a mechanism to enforce the ban effectively.
The government made an abortive bid to ban the practice in 2003 by issuing a circular to the principals of all the medical colleges and the KGMU V-C, saying that earlier orders were not being implemented. Commissioners and DIGs at the divisional level, and DMs and SSPs at the district level were made members of the then vigilance committees. They were asked to identify doctors indulging in private practice and send their names to the government. However, no committee sent a name and the issue died down.
The ban on private practice by Government doctors was first imposed in January 1973. It was lifted in January 1974. No reason was given for either the ban, or the withdrawal. It was reimposed in February 1978 and withdrawn in October 1982.
The ban was imposed once again in August 1983 in the public interest. It has remained in force since then, albeit on paper. Doctors have flouted it with impunity over the years.
When the Government and the doctors were busy playing 'ban-ban and lift-lift', the Allahabad High Court delivered its verdict on February 5, 1996. The court dismissed various petitions of doctors and upheld the ban. The Supreme Court also gave its judgment in 1997 in a case (State of West Bengal Vs Others), upholding the State Governments' right to impose and strictly implement a ban on private practice. The court rejected various objections raised by doctors.
It is no more a secret that the 'game' between doctors and the Government stems from the desire of unscrupulous politicians to realise huge sums from practising doctors, who have been minting money by taking advantage of poor medical infrastructure.
Some of these doctors have evolved new ways to fleece patients. Ironically, members of this noble profession were once considered next to God by the people.
Many of doctors, including those working in medical colleges and Government hospitals, allegedly take commission for referring patients to private pathological labs for costly tests. Patients run from pillar to post get the tests done without knowing whether they are needed.
Rate for referring a single case of CAT Scan now vary from Rs 500 to Rs 1000 depending on the patient's paying capacity.
This 'unholy nexus' between private clinics/labs and doctors, who conveniently forgot the Hippocratic Oath, after passing out of their respective institutions, is one of the reasons for various equipment in medical colleges and government hospitals remaining out of order most of the time.
In fact, the pitiable situation in Government hospitals and medical colleges due to laxity and lack of funds is the main cause of doctors' roaring 'malpractice'. They know that patients have no option, but to go to their expensive nursing homes and clinics.
The concept of 'pay clinics', introduced in 1978, proved an exercise in futility.
Under the scheme, a government doctor was allowed to do private practice, within a hospital or a medical college and a charge prescribed fee which was a meagre Rs 16 for professors, Rs 12 for readers and selection grade PMS doctors, Rs 8 for lecturers and Rs 4 for others. Doctors were supposed to deposit the total fee in the treasury and claim 50 per cent of it at the hend of every month.
Doctors cite poor salaries and facilities, while justifying private practice. But none of them are ready to resign and become full-fledged private practitioners.
Reason: They divert most of the patients from government hospitals or medical colleges to their clinics/nursing homes. They are so busy in private practice that they hardly have any time, or interest to serve their hospital or medical college. As a result, research, education and academic activities suffer. No wonder, State medical colleges have a poor image.