I want to place my views as a Doctor on
MCI's latest Guideline which I hope every reader will surely read and
Unfair MCI(MEDICAL COUNCIL OF INDIA): Being a Doctor practicing
Medicine since last 24 years I can clearly see that latest MCI
guideline issued for 'so called"ethical practice are unreasonable.Thet are probably in collusion with MNC pharma companies. Let me explain you why I say so.
++At the outset I must agree that I am not in favor of Heavy and costly
Gifts being Given by Pharma Companies just to get prescriptions for
their products, this is surely a wrong practice and is prevalent very
much. I don’t subscribe to this practice.This should stop.
On the other hand let us try to understand the facts as on today and
what is happening in the real world which is totally dictated by
simple COMMERCE ! and No One Objects to these !
1.Doctors are now being labeled as ‘Health Care Providers’ ( no more
next to God status etc)who, for monetary considerations they are
practicing a ‘Profession’ and that profession and all it’s services
are to be covered under ‘Consumer Protection Act( CPA)’ and Health
Care Seeker is a Consumer.So it is a Commercial Activity like any
2.Insurance companies ,if the patient is covered under a policy, do
have a say in Billings, Rates of Services/Operations, Choice Of
Hospital and Hospital Stay, even Selection Of Hospital for a particular
procedure etc and all this is designed to get maximum from Hospitals
in Best of the patient’s interest with minimum of cost or money spent
by them .and patients do obey their dictats as policy holders.No
3.The practice of having Doctors and Hospitals on panel by different
organizations/MNCs etc is also an effort in the same direction of
getting rebates/.cuts/discounted rates. Money matters prevail.
4.Corpoarte Hospitals in the "Health Care field which is considered
as Health Care Industry and as a Services Industry" and they openly
offer Packages, Incentives, Discounts .They(Hospitals) themselves also
ask for Discounts, Packages, Special Rates while purchasing Medicines,
Appliances, Disposables etc from Pharma and other companies For
example if more then One Stent is to be placed in your Coronary
Artery, the “offer” goes like : First Stent 70,000 Rs and Second for
say 40,000 Rs !
5. Many of the Doctors/Services are Outsourced or Hired on Day To Day
or Hourly basis.
6.Hospitals ,Corporate or others, on one side and Pharma and Equipment
supplying Industry on the other side are totally, openly and blatantly
are all working for one single aim MORE AND MORE PROFITS !. To attract
patients what all is being done around us is clearly visible to all in
print and electronic media.
7.What I mean to say is that it is now a “Big Commercial World of
Health Care” guided by simple commerce and all the relevant “market
forces” ,where each one involved wants to earn .
8. ALL THIS JUST CAN NOT RUN WITHOUT DOCTORS ! THEY ARE THE KEY PEOPLE WITHOUT THEM EACH AND EVERYTHING ELSE IS JUST OF NO USE !
These (Poor! )Doctors have to prescribe Medicines and that is their
job! You can’t cure disease without prescriptions. Choosing a right
drug for a right patient is a doctor’s job. But They ARE NOT SUPPOSED
TO ASK EVEN FOR ANY SHARE IN PROFITS ,THEY ARE NOBLEST OF HUMAN
BEINGS! NOW THEY ARE SUPPOSED TO BE NEXT TO GODS! UNDER OATH AND
BOUND BY ETHICS! WHEN IT COMES TO SHARING PAYMENTS /PROFITS THEY ARE NOT COMMERCE EARNING SERVICE PROVIDERS,CANT ASK FOR BENEFITS, THEY SHOULD KEEP QUIET!
BUT also No Doctor on the Earth will write a Medicine, if it is not
needed in a particular situation. Government has allowed many pharma
companies to produce same drug under different brand names and many of
the Brands are “Brands” just because the share of prescriptions it has
got from Doctors ,which of-course comes because of the years of faith
either in the Company or in The Drug. Many Brand have made Big names
for the Companies!
Choice of that Brand is based upon many factors and that surely
Includes the activities of that company which are designed to improve
that particular Doctors’ Practice.
For years and ages Companies do spend a part of their Profits on the
activities like sponsoring the Doctor For a Conference, a membership
of an organization, tickets for travel to Conference, stay at Hotel
and for things improving Clinic’s performance and efficiency, like
giving Computer Software etc . These are done no doubt to get even
bigger profits ,but in the process the Doctor gets updated in
knowledge and skills, patients are benefitted for sure.
Needless to say that an Indian Doctor, charging 3-4 Dollars as Fees
from his patient can never afford a Conference say in Chicago ,costing
5000 US Dollars!
Banning such activities and Gifts which can improve Doctors' and
Clinic performance is a great injustice to the Medical Fraternity and
to Individual poor Doctor ,BECAUSE OF WHOM EVERYONE ELSE IS EARNING
CRORES !. In fact MCI is playing in the hands of Corporates and
Pharma. They will happily share the booty of “ savings” amongst
9.Amother interesting part keeps happening in all Hospitals: An example: An antibiotic Brand A costs-printed Rs 750/- ,per Injection but Hospital gets it at Rs. 350/- and purchases 1000 Injections, company happily Gifts 2 LCD TVs to the Hospital Reception. This lot can ONLY be consumed if Doctor prescribes Brand A But if Doctor prefers Brand B ,because it has Print Price Rs 550/- and patient gets savings of Rs 200/- ,then Hospital Pharmacy will still push Brand A because Hospital stocks that brand, because Hospital got Gifts of LCD TVs--THIS IS NOT A HYPOTHETICAL SITUATION THis actually is happening in Corporate Hospitals.BUT Doctor who prescribes and Consumes the stock through his prescriptions is NOT supposed to take any Gift from that Pharma Company !
10. If banned, Sponsorships will no doubt then come through dubious sources
involving more corruption or may be even Hawala Transactions! Because
these things are surely are not going to stop !
11.Such activities(Conference Sponsorhips) are fully justified because Doctors Do Deserve some
share in Ethical activities in Ethical ways since Healthcare is now a
Service Providing Industry Guided by all relevant market forces !Pharma Market is not being run by any company for charity! Let
the Doctors decide the fine line of Ethical and unethical ,themselves!
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