(Do not ?) Treat Critical Patients

Delhi Government’s recent order regarding only 50 % charges to be paid in case of death within 6 hours of admission must be the most unique “farmaan” in the world. Also the dead body can not be detained for payment of even this 50% Bill. Being socialist is all right but even socialists paid for services themselves in their state run institutions. What now will happen is that the private hospital which requires to do emergency primary angioplasty and stenting to treat a patient of acute myocardial infarction who crashes in emergency will withhold vital treatment and wait till either the patient spontaneously comes out with supportive measures alone or the patient is dead. No hospital can afford to give 50% discount on primary angioplasty which requires exceedingly stringent state of readiness both in terms of human resources as well as equipment and infrastructure. And resources used need to be paid for whether the outcome is successful or not. Same is the situation in Intracranial bleeds requiring coil placement or head injuries.

The recent trend of politicians dictating and interfering with medical treatment protocols may be popular and have society support but is not practical and will lead to unnecessary deaths. Another recent similar order regarding caesarean section under NHPS to be done in private hospital only after permission from Government Hospitals is not only irrational, impractical but also quixotic. People in power who do not have knowledge of medicine should not make laughable statements or issue orders which will be quoted decades later with mirth and as a measure of the intelligence quotient of the political masters of India in 21st century. It should have been upto FOGSI to issue a directive to all its members in their interest not to participate in the Ayushman Bharat Scheme. With fetal distress the patient first has to be shifted to a Government Hospital, a doctor there has to certify the need for caesarean section because the fetus is at risk and then patient should be shifted back to the private hospital for caesarean delivery. The mother, the baby and the Obstetrician all will be dead if such surgery is done in such a manner.

The constant rhetoric that doctors do caesarean unnecessarily has lead the politicians to believe their own words forgetting that it was simply election rhetoric. It is not as if the governments whether State or Central do not have technical experts to guide them but the rational view is not registered for two reasons. Firstly the desire to subjugate the technocrat is so ingrained in the political class as well as the bureaucracy that the saner voices are suppressed. Also secondly those experts who are in various commissions and Ayogs need to retain their position more than anything else so the obvious is not stated if it is not in line with the political thought process.

Dr Neeraj Nagpal 
Convenor,Medicos Legal Action Group, Managing Director MLAG Indemnity,
Ex President IMA Chandigarh
Director Hope Gastrointestinal Diagnostic Clinic,
1184, Sector 21 B Chandigarh 
09316517176 , 9814013735
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