Doctors to be penalised if they give poor post operative care
The standards of our medical profession are rising…well, that’s how I look at it when I hear that dubious doctors and malpractices are exposed. It is only when wrong doers are punished that systems improve. As our legal processes are slow and often ineffective, the consumer commission often fills this gap. True, the commission lack teeth but when a case against a doctor goes to the court, it is a great deterrent as doctors are terrified of losing their reputation.
The medical profession came under the consumer commission’s scanner only about a dozen years ago and at first the medical fraternity protested. They even tried to nip this in the bud, but thankfully didn’t succeed. Today there is a mechanism in place that can deliver judgements quicker than the Indian legal system. Over the years several important rulings have been given out by the consumer commission. Again, it is true than doctors get away more often than not because proving negligence beyond doubt is a tough call. Doctors and hospitals in fact resist very strongly. Fudging medical records is fairly easy. Yet, at times the system works wonderfully. Like in this particular judgement where a doctor and a hospital have been pulled up for providing poor post operative care.
This particular judgement is significant as it makes doctors accountable to what happens to a patient even after a successful surgery.
Quoting from a newspaper report:
In a ruling that widens the definition of medical negligence, the commission has directed Apollo Hospital and a consultant eye surgeon, Arun Sethi, to pay Rs 2 lakh compensation to a retired Indian Revenue Service Official after a successful surgery. The surgeon allegedly prescribed post-operative medicine on phone and forced the ailing patient to wait for two days before examining him due to his buys schedule.
So far only cases of blatant negligence, like leaving instruments in the patient’s body for example, have received strong judgments. In fact many strong cases also fail. Research supported by the Indian health ministry and the World Bank and conducted by a consumer organisation across three cities some years ago showed a very poor redress mechanism in hospitals. Totally 81 large hospitals and small clinics and 86 cases of alleged medical negligence filed in consumer courts in Delhi, Hyderabad, and Lucknow were studied. All of these were really serious cases including allegations of causing death, permanent physical injury, or multiple and unnecessary operations. In one case for example, a woman had claimed that the doctor had performed cataract surgery on the wrong eye. The results of the survey showed that inspite of the law providing for it, the complaint mechanism was missing in more than half the hospitals surveyed. When patients turned to the consumer courts it was after failing to resolve their problem with the concerned doctors or hospitals. In fact doctors and hospitals often did not bother to provide even medical records to the patients!
Well, this judgement is a ray of hope. It was a ruling long overdue. I personally know of a case of the father of a close friend where a second bypass surgery had to be conducted purely because the heart surgeon (ironically the most ‘reputed’ in the city) ‘forgot’ to prescribe a particular medication. To be fair to him, he didn’t actually forget. He delegated the job to a young trainee doctor who forgot. It was only during one of the check-ups that it came to light that the patient was not recovering and that an important medication had not been prescribed. It was shocking, and all of us tried to persuade this friend’s father to go to court…but the doctor was apologetic and remorseful and he also happened to be a family friend of the patient. So finally the patient agreed for a second operation and the doc agreed to forego his surgeon’s fee. However the patient had to cough up the hospital expenses (the doctor wanted to keep this hush hush) and ofcourse he suffered needlessly because of the doc’s mistake. God knows how many such cases (which never go to court) there are!
Post operative care on the whole is pathetic in India, even in large hospitals. It is usually delegated to junior doctors and often nurses. But it is the duty of the surgeon himself to take care of it. As a member of the consumer panel said:
Even after an operation, surgeons are expected to devote some time to the operated patients and give regular check-ups, if required, on holidays too.’
If doctors find they have to work on holidays they will perhaps take fewer patients. Right now they take so many that they have no time to attend to those they have operated upon. I remember the time my mother in law had a cataract operation by an eminent surgeon. She was old and very keen to be reassured by the surgeon but he had no time to see her. In fact we had to be content with the nurse.
In this particular case the consumer panel has been more than fair to the doctors. The patient had asked for Rs 1 crore as compensation but got only Rs 2 lakhs because it was ‘agreed’ that some fault lay with the patient too. Well, I am not sure of that as patients tend to leave everything to the medical personnel. But this is slowly changing. People are becoming less trusting.