Too much protest, too little practice
A FURIOUS debate -- even one that degenerates into fisticuffs -- can offer some clear insight at the end of it. Crosstalk, a regular feature in the monthly video magazine, Newstrack, admirably puts across all aspects of a problem as well as all the personalities involved, under the spotlight on the same platform so that the issues at stake can be thrashed out.
The October edition of Crosstalk dealt with the move to bring private medical practitioners under the ambit of the Consumer Protection and Redressal Act (COPRA). Present at the debate were many of Delhi's better known doctors, victims of medical negligence, consumer activists, journalists, representatives of various bodies such as the Medical Council of India, and National Consumer Disputes Redressal Commission chairperson Justice V Balakrishna Eradi.
On the warpath
The doctors clearly felt threatened by the move, and several of them were extremely voluble and, at times, combative, to put it mildly. One excitable gentleman even became violent, causing Janata Dal MP Dinesh Trivedi to declare loudly, "I want to know if he's behaving like a doctor or a terrorist -- if this how doctors behave, we need protection against them."
One pertinent point that emerged from the noisy arguments was that the Medical Council of India (MCI) has so far had neither the power nor enough inclination to bring erring doctors to heel. Consumer affairs columnist Pushpa Girimaji gave a lucid example of a patient dying on the operating table in a Karnataka hospital. When the case went to MCI, far from taking any action, it let the doctor off without even a warning. The Mangalore district court, on the basis of the same evidence, awarded the deceased's next-of-kin Rs 5 lakh as compensation. A man whose 21-year-old son died after a simple operation in a reputed private hospital in Bombay, said MCI did not even reply to his letter bringing the case to its notice.
Doctors argued that making them accountable under COPRA would only lead to them practising defensive medicine and turning away patients. It would also force doctors to seek insurance coverage, which would, in turn, lead to medicare costs becoming prohibitive. Some said it was demeaning to be brought under the control of a consumer act, almost as if they were the ones who had spread the disease in the first place. Others said they were willing to go before a consumer court if other professions were also brought under its ambit, and provided the screening body included doctors. Justice Eradi pointed out that he would consider no case of this kind without seeking expert medical advice.
A consumer activist pointed out that 90 per cent of the cases filed under COPRA were dismissed, a statistic seized upon joyously by doctors on the warpath. They argued that the move to bring them under COPRA would only lead to more frivolous litigation.
The president of the All India Hospitals and Nursing Homes Association revealed that fear of litigation was already forcing doctors in Madhya Pradesh to plead lack of infrastructure and refer patients to government hospitals instead of treating them. One question that was not satisfactorily resolved was why government doctors had been excluded from COPRA's ambit.
In a show charged with emotional excitement and frayed tempers, what emerged most clearly was that doctors had lost the respect of their clientele because their professional standards as a whole had fallen. Newstrack veteran Manoj Raghuvanshi, who compered the show, was an effective moderator, frequently forcing people to take a stand or answer questions they were trying to avoid.