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Private practitioners? conduct questionable

WITH THE dengue-causing mosquito spreading its wings all over the City, one thing that has come to the fore is that there is considerable difference between the incidence of dengue, a notifiable disease according to the health authorities just like chikungunya, and the actual cases being reported.

india Updated: Oct 09, 2006 01:33 IST

WITH THE dengue-causing mosquito spreading its wings all over the City, one thing that has come to the fore is that there is considerable difference between the incidence of dengue, a notifiable disease according to the health authorities just like chikungunya, and the actual cases being reported.

The health authorities’ emphasis on ‘preventive, promotive and curative’ trinity and prevention of a disease becomes as important as its management. So, whenever an epidemic situation arises, municipal or district health authorities send out a circular to all concerned asking them to inform about the incidence of notifiable diseases. But most of the time, the private sector does not rise to the occasion.

“Whenever we come to know about a case of that particular disease – dengue in this case – we resort to preventive and remedial action. First we send a team for survey and then send the field staff, like malaria workers in cases of dengue, and take the required action,” says CMHO Dr K K Vijayvergiya.

Majority of the population in cities finds it convenient to go to private practitioners for almost all diseases and particularly communicable and notifiable diseases. “Up to 70-80 per cent of the population is being treated by private practitioners in the City (or for that matter anywhere),” said IMA Indore unit president Dr Arun Agrawal.

But even when it is legal and ethical for all of them to provide such information to the health authorities, most of the times it is not done, resulting in an overall wrong picture of the disease in the City.

The Medical Council of India in its notification (March 2002) on misconduct (7.14) says: ‘‘the registered medical practitioner shall in case of communicable/notifiable diseases, inform the concerned public health authority immediately.’’ But is there any accountability for such omissions?

When asked what action the department would take against practitioners who do not inform the authorities about any incidence of dengue, Dr Vijayvergiya said, “The private practitioners and the hospitals are supposed to inform us. But then, we find some of them do not comply.”

For instance, till Saturday evening, the health authorities were unaware of three cases of dengue being tested positive in the City in private hospitals. When asked why they had not informed the authorities, sources at the Choithram Hospital and Research Centre – where two cases were tested positive - said, “Yes, we are aware, this has to be informed to the authorities. But, one thing is they have asked us to give a weekly report, in this case, it is Friday.

And secondly, the format is too complicated. There are a number of diseases and it is a tedious job to fill out those statistics and send to the authorities.”

But as in this case, the question is “Who all come under the ambit of this legal requirement?” The law is very clear. The concerned patient is treated by a doctor, so the onus lies on the doctor to notify the health authorities. But the laboratories, which conduct these tests, cannot be held responsible for not reporting the cases to the authorities.

But even then, what is the action taken against the erring doctors? Declining to comment on the issue of action against private hospitals or doctors who have failed to inform, Dr Vijayvergiya said, “I will have to speak with the higher authorities on this aspect.”

Currently, there are about 18 notifiable diseases to be reported to the health authorities in Indore. These include cholera, typhoid, dengue, chikungunya and hepatitis etc.

However, Dr Agrawal denied having received any circular notifying dengue and said, “We have not received any such communication from the health authorities. If we get any communication, we make sure it is complied with. But in this case, we have not received anything from the authorities.”