A council in need of therapy

The President of the Indian Medical Council was recently arrested by the CBI for the alleged offence of demanding money from a prospective medical college for issuing it a licence for carrying out its operations. Soon thereafter, the Government of India used its special powers to dismiss the entire elected body of representatives of the Council and appointed a group of doctors as administrators to run this august institution.
This incident is an indicator of the depths to which this professional body, which is in charge of medical ethics and discipline in the medical profession, has fallen to in recent times. The sad part of the entire episode is that the same person had earlier been indicted on grounds of corruption by the High Court a few years ago and dismissed from the same post. In years that followed, he managed to get himself re-elected to the same body and was chosen as its president by the other members of the Council, all of whom are elected as the representatives of the medical profession in the country. If this is the sad state of eminent medical bodies, why should we blame poor, uneducated, starving people in Uttar Pradesh and Bihar for electing criminals as their members of Parliament and legislative assemblies?

Rampant politics and corruption
The Indian Medical Council (IMC) has been created by statute as the watchdog body to enlist doctors, to set up the standards of medical education in the country, to formulate a code of ethics and to discipline erring doctors who do not adhere to the strict, narrow path enunciated by the code. The Council has its counterparts in each and every state which carry forward the work of administration of these duties at state and local level. As a professional body, it is supposed to act as a beacon of light and source of inspiration to doctors and patients alike. Unfortunately, as in all other standards of Indian life, it has been found to be wanting in performance of its duties. Rampant politics in these otherwise highly sensitive and key bodies has seen the standards of medical education and discipline among medical practitioners reach unimaginably low levels. The mushrooming of private medical colleges with abysmal standards, the rampant malpractices and exploitation of consumers who visit medical institutions and doctors, and the mushrooming of quacks are some common examples of how this august body had abdicated its duties in recent times.

Falling standards of medical education
It is sad but true that medical education in India is now at high standards in only a few chosen institutions around the country. Most private medical colleges (almost universally operated by politicians) are producing doctors who are not proficient in English, leave alone the nuances of medicine. Medical Education as a whole has seen a large dip in its efficiency because of the inadequate incentives and rampant nepotism and favouritism at all levels in the hierarchy of medical colleges. The passion for teaching in most doctors has been either stifled or not encouraged by those in charge of the situation. Prestigious medical colleges in the metropolitan cities are facing a severe brain drain as corporate hospitals mushrooming all over the country are luring them away with guarantees of service, salary and stability which the education system is unable to offer. Consequently, the colleges are left either with little or no staff to meet the stringent standards laid down by the Council. In such a situation, the threat of derecognition is an excellent tool of blackmail in the hands of inspectors who visit these colleges for renewing their licences. Is it then any wonder that most medical institutions in the western world prefer to carry out their own tests to check the proficiency of Indian doctors rather than rely on the degrees handed to them by the Indian Medical Council?
If the fall in the standards of medical education was not a big enough blow to the system, a drastic drop in ethical standards has further blighted the Indian medical system as a whole. A profession which is supposed to rise above its own needs, and in the words of the Supreme Court of India in Indian Medical Association vs. V.P. Shantha, supposed to have a “commitment to moral principles which go beyond the general duty of honesty and a wider duty to community which may transcend the duty to a particular client or patient;’’ has today generated into a commercial enterprise where patients are subjected to all sorts of procedures and operations which bleed them to financial death.

Unethical practices have reached the nadir
It is no secret that caesarean sections are done by most Gynaecologists and Obstetricians for economic rather than medical reasons. It is common knowledge, that doctors receive commissions from pharmaceutical companies in cash or kind, in cash from pathology laboratories and all investigative modalities which are used on the human body like X-rays and scans, and even from their own colleagues and nursing homes and hospitals for patients referred. This has not only increased costs for patients, but has led to unholy activities like subjecting patients to unnecessary tests and procedures/operations like Hysterectomy, Appendicectomy and the like without there being adequate indication for the same. Even on issues like unrelated kidney transplants and tests to determine the sex of a child, it was necessary for the government to enact statutes because the Medical Council could not rein in its members from practising such unethical activities.

Public has lost faith in doctors and hospitals
Faith in the disciplinary powers of the Medical Councils has reached such a nadir that complaints filed with the Council have been decreasing over the years, as the affected consumers felt that the Medical Councils are either incapable or do not have the guts to take on the powerful lobby of doctors who had made the medical world and the Councils their fiefdom. As a peer body, the Council has the onerous task of looking into and adjudicating on allegations of medical negligence, professional misconduct and unethical practices among doctors. Cumbersome procedures, long-winding trials and uninspiring judgments led to a systematic loss of confidence of the average consumer in the Medical Councils.
Public anger and loss of confidence in the system also arises from the fact that meetings of the Medical Councils are closed door meetings and the element of bias in favour of a professional brother seems to hang heavily on those who are supposed to dispense justice without fear or favour. This same anger then finds an outlet in the sporadic incidents of violence against doctors and hospitals, which are both preventable and unnecessary.
There is hence a dire need for the Medical Council to heed to the old adage of ‘Physician, heal thyself’. If Indian Finance and Business Management Schools can achieve international standards, there is no reason why the Council cannot get its act together, raise the bar and undo and set right decades of unjust, impractical systems and unfair methodologies to restore self-respect among upright doctors and smoothen the ruffled feathers of the rising number of unhappy patients.

The writer, a Medico-legal Consultant, has done his MBBS and LLM from Mumbai University. He is presently Hon. Secretary of the Consumer Guidance Society of India and teaches law and Consumer Protection to students of Mumbai University.

Contact the Writer .