MCI Needs a major surgery
Medical Council of India and all national bodies should start doing their job for a better India
(Dr.P.KSasidharan, Former State President KGMCTA,
Former Prof & HOD General Medicine, Government Medical College, Kozhikode)
Going by guess, common sense or available statistics or any other method, India has the highest disease burden in the world, all diseases are multiplying here, we have the unique situation of carrying double burden in diseases: the flourishing infections and non communication diseases simultaneously- this is because we ignore health care and are manufacturing diseases. Our people do not know what is balanced diet, even if they know of it, in the near future, they will not have access to a balanced diet, they have no access to safe drinking water and clean surroundings- thanks to neglected waste management system, poor sanitation facilities and carelessness towards the environment and no facilities to do exercise. In short we ignore all the basic health needs- because our people in power, and their all- powerful doctor advisers have no vision on public health- they are busy repairing and replacing damaged organs using imported technologies. The highest paid and most respected doctor even on public health issues and for making policies in India is now the persons who are doing investigative and damage repair procedures that too the high tech ones including transplants. We have systematically eliminated the General Practitioner doctors of the Family doctors too- when all the developed countries have GP/family doctor as the most important doctors in the society and there is a strict referral system to avoid over-investigation and overtreatment. Even the General Medicine doctors are now facing the threat of extinction. We thus have failed in containing diseases due to lack of provision for basic health needs and have failed miserably in providing the well accepted basic cost -effective GP -based disease care.
BUT SYSTEMATICALLY WE ENCOURAGE OUR PEOPLE TO 1) Eat more (more often junk food, fast food, fried or preserved food) 2) They are made to drink less of water- if at all they drink only the bottled and packaged drinks (beverages, bottled juices) 3) They do not take any vegetables, neither they know of its importance- if at all they take, the vegetables are thoroughly washed and cooked to remove useful bacteria and the folic acid, which our body need very much. 4) Our people do not take any fruits; if at all they now they take only the canned and bottled juices which do not provide any thing that we ought to get from fresh fruits. In the name of fruits, some take dried fruits, boiled or fried fruits and fast foods made of fruits-which provide only extra calories and do not give anything useful that the fruits are supposed to provide. We consider potatoes and other roots and tubers as vegetables and do not take any pulses saying it produces gas and are therefore deprived even of protein in the diet. 5) Those who take fish and meat fry it to destroy even protein and B12 and finally contains only carcinogens 6) We do not believe in supplying safe drinking water through pipes but believe only in supplying them in bottles or in tankers 7) We do not do any exercise- and we do not provide open spaces for out door activities, but we encourage health clubs to enable some crooked minds to sell their machines and some business men to do business 8) We buy more, eat more – produce more wastes and then throws them all around, or dump somewhere or in the rivers and canals because we are unmindful of our surroundings 9) We need plenty of oxygen available around us and we get them in plenty only if have adequate ventilation in our places of work and sleep and that too only if have plants and trees in abundance around us and we get oxygen to all the tissues optimally only if we do exercise; but we destroy our forests- and do not plant any trees, we are deprived of oxygen and water because of this inhuman act 10) We need sunlight exposure to get vitamins and energy but we encourage the people to stay indoors and cover the body and do not provide opportunities for outdoor exercise or activities. We convert all free spaces into concrete jungles 11) We ignore all the health- needs, India has ended up us the museum of all diseases and is number one in disease burden in the world; But we are busy producing more and more doctors and start more and more medical colleges to cater to the ever increasing number of patients. To top it all majority of the doctors who come out now are not interested in basic issues and they are not going to be GPs or family doctors since they had joined medical college not out of any social concerns it was only to make money- that is maximally possible only if they become a single system specialist.
Remember anywhere in the world, the patients are the marginalized ones- one or other from of marginalization makes people transform into patients-our people need empowerment and avoid the marginalization – the more marginalized ones get more diseases- marginalization may be in terms of availability/accessibility of basic health needs, awareness/education, information, financial, empowerment etc - Sound mind is possible only in a sound body, similarly sound human beings are possible only in a sound society- healthy individuals are the reflection of the social security and human development that is happening in that society. In the name of health care whatever resources we have now are being diverted to build hospitals, buy medicines, equipment and for the costly procedures like organ transplants. Transplant surgeons have become the stars in the health care(no it is only disease care) system – In fact there is no health care and we do not have any health care system, we have only a poorly organized and disorganized disease care machinery trying to exploit the meager savings of the people who are already impoverished.
At this juncture look at the objectives of MBBS
1. Diagnose & manage common diseases
2. Use essential drugs, IV fluids, blood, or its substitutes and use laboratory services.
3. Manage all types of emergencies
4. Decision for referral when necessary.
5. Implementing and monitoring of the national health programmes and schemes.
6. Provide preventive and promotive healthcare services to the community
7. Develop leadership qualities for a health team
8. Skills to communicate to/patient & community.
9. Identify health problems, analyze them in physio-chemical, biological, behavioural and socio-economic terms.
10. Capacity for continuing and life long medical education
Is any of the objectives being satisfied by us these days? The 9th objective is very broad we need to identify each health problem for its relation to larger issues in the society; because all diseases known to us and the disease yet to come are due to problems in diet, lifestyle and environment. This is the result of my lifetime observation of patients and healthy individuals
We prefer to start medical colleges in private sector only, to prepare doctors who transform into moneymaking machines without any awareness or concern on health of the individuals. What should be the role of the MCI in this scenario?
Unethical marketing and unethical practices have become the order of the day. We see several overt advertisements; I have nothing against the hospital or the doctors mentioned in that advertisements- there is no point taking any disciplinary action against those hospitals or the doctors to show that MCI is the super body concerned about all these issues- Unethical practices are happening all over India- let MCI do its job the way it is supposed to do
Something about why all this is happening?
In spite of being the richest nation in the world, there is a criminal imbalance in distribution of wealth and thereby a failure to provide social security and human development aimed at taking the nation forward. That is the real cause for all these ills in India and the rest of the world where similar situation exists. Money is accumulated or is being deposited or wasted as dead investments due to lack of good economic policies or lack of implementation of good policies. Due to lack of resources we do not provide social security and we do not focus on human development; we make our people money minded, they work only to earn money and they are forced to accumulate money for their next generation. Because of an education that does not do its job properly, we make our people money minded and corrupt, the society here encourage hawala deeds and even encourage to deposit money in secret havens. Thus we make our people to engage in corrupt practices and accumulate wealth then we make them hoard money in secret places, buy gold, build huge houses, engage in all kinds of unholy activities. Because of a corrupt education system, the very same people who make money by corrupt practices now build schools and colleges or even universities are under them- all with one purpose of making more money. Religions are also failing in their duties. Religions here build walls among human beings, they are supposed to refine human minds and help them transform into better human beings, religion alone grows here, human beings are not growing here. We now need a world humanities day to remind us of the humane behavior.
Urgent reforms by the MCI to save Medical Education in India
Introduced a strict referral system
All PHCs to be manned by competent GPs/Family doctors
We need large number of GP doctors to act as the pillars of our disease-care machinery and to augment genuine health care- to act as guardians of health care- to act as friend, philosopher and guide to each person, each family-in the community- to give preventive and promotive health care
The existing doctors may be asked to give options to decide whether they are willing to become GP/Family doctor- if they are willing they may be empowered by a short course training in the medical Colleges- this short course training can also be given by the department of General practice
All the existing General Medicine departments must be transformed into Department of General Practice. The PG degree may be MD General Practice
All the existing PG seats to be converted to MD General Practice till we have adequate number of GPs
MD GP should not be allowed to go into super-specialization degree of DM
DM courses can be converted to 5 year direct courses- but they should have a two year rotation posting in Medicine and allied specialties in the first two years of which one should be in Department of General Practice
All of them to be posted to all the departments by rotation
The salary and remuneration to all the doctors should be uniform all over India- to enable doctors to choose specialty due to social reasons rather than money mindedness- now what is happening is cut-throat business and money minting and all the plans and projects including MCI is now working only to support this money minting machinery-
The draft prepared for this programme has to be widely circulated among NGOS and national bodies like IMA and NGOs basically to sensitize them and to invite opinions and comments by all the doctors in India. Major suggestions which are socially relevant only are to be incorporated- all taking into the consideration only of public health, social health and cost effectiveness not to bend to the pressure tactics of powerful business lobbies- Protests in reforms is often due to lack of awareness or apprehension or false more
(Dr.P.KSasidharan, Former State President KGMCTA,
Former Prof & HOD General Medicine, Government Medical College, Kozhikode)
Going by guess, common sense or available statistics or any other method, India has the highest disease burden in the world, all diseases are multiplying here, we have the unique situation of carrying double burden in diseases: the flourishing infections and non communication diseases simultaneously- this is because we ignore health care and are manufacturing diseases. Our people do not know what is balanced diet, even if they know of it, in the near future, they will not have access to a balanced diet, they have no access to safe drinking water and clean surroundings- thanks to neglected waste management system, poor sanitation facilities and carelessness towards the environment and no facilities to do exercise. In short we ignore all the basic health needs- because our people in power, and their all- powerful doctor advisers have no vision on public health- they are busy repairing and replacing damaged organs using imported technologies. The highest paid and most respected doctor even on public health issues and for making policies in India is now the persons who are doing investigative and damage repair procedures that too the high tech ones including transplants. We have systematically eliminated the General Practitioner doctors of the Family doctors too- when all the developed countries have GP/family doctor as the most important doctors in the society and there is a strict referral system to avoid over-investigation and overtreatment. Even the General Medicine doctors are now facing the threat of extinction. We thus have failed in containing diseases due to lack of provision for basic health needs and have failed miserably in providing the well accepted basic cost -effective GP -based disease care.
BUT SYSTEMATICALLY WE ENCOURAGE OUR PEOPLE TO 1) Eat more (more often junk food, fast food, fried or preserved food) 2) They are made to drink less of water- if at all they drink only the bottled and packaged drinks (beverages, bottled juices) 3) They do not take any vegetables, neither they know of its importance- if at all they take, the vegetables are thoroughly washed and cooked to remove useful bacteria and the folic acid, which our body need very much. 4) Our people do not take any fruits; if at all they now they take only the canned and bottled juices which do not provide any thing that we ought to get from fresh fruits. In the name of fruits, some take dried fruits, boiled or fried fruits and fast foods made of fruits-which provide only extra calories and do not give anything useful that the fruits are supposed to provide. We consider potatoes and other roots and tubers as vegetables and do not take any pulses saying it produces gas and are therefore deprived even of protein in the diet. 5) Those who take fish and meat fry it to destroy even protein and B12 and finally contains only carcinogens 6) We do not believe in supplying safe drinking water through pipes but believe only in supplying them in bottles or in tankers 7) We do not do any exercise- and we do not provide open spaces for out door activities, but we encourage health clubs to enable some crooked minds to sell their machines and some business men to do business 8) We buy more, eat more – produce more wastes and then throws them all around, or dump somewhere or in the rivers and canals because we are unmindful of our surroundings 9) We need plenty of oxygen available around us and we get them in plenty only if have adequate ventilation in our places of work and sleep and that too only if have plants and trees in abundance around us and we get oxygen to all the tissues optimally only if we do exercise; but we destroy our forests- and do not plant any trees, we are deprived of oxygen and water because of this inhuman act 10) We need sunlight exposure to get vitamins and energy but we encourage the people to stay indoors and cover the body and do not provide opportunities for outdoor exercise or activities. We convert all free spaces into concrete jungles 11) We ignore all the health- needs, India has ended up us the museum of all diseases and is number one in disease burden in the world; But we are busy producing more and more doctors and start more and more medical colleges to cater to the ever increasing number of patients. To top it all majority of the doctors who come out now are not interested in basic issues and they are not going to be GPs or family doctors since they had joined medical college not out of any social concerns it was only to make money- that is maximally possible only if they become a single system specialist.
Remember anywhere in the world, the patients are the marginalized ones- one or other from of marginalization makes people transform into patients-our people need empowerment and avoid the marginalization – the more marginalized ones get more diseases- marginalization may be in terms of availability/accessibility of basic health needs, awareness/education, information, financial, empowerment etc - Sound mind is possible only in a sound body, similarly sound human beings are possible only in a sound society- healthy individuals are the reflection of the social security and human development that is happening in that society. In the name of health care whatever resources we have now are being diverted to build hospitals, buy medicines, equipment and for the costly procedures like organ transplants. Transplant surgeons have become the stars in the health care(no it is only disease care) system – In fact there is no health care and we do not have any health care system, we have only a poorly organized and disorganized disease care machinery trying to exploit the meager savings of the people who are already impoverished.
At this juncture look at the objectives of MBBS
1. Diagnose & manage common diseases
2. Use essential drugs, IV fluids, blood, or its substitutes and use laboratory services.
3. Manage all types of emergencies
4. Decision for referral when necessary.
5. Implementing and monitoring of the national health programmes and schemes.
6. Provide preventive and promotive healthcare services to the community
7. Develop leadership qualities for a health team
8. Skills to communicate to/patient & community.
9. Identify health problems, analyze them in physio-chemical, biological, behavioural and socio-economic terms.
10. Capacity for continuing and life long medical education
Is any of the objectives being satisfied by us these days? The 9th objective is very broad we need to identify each health problem for its relation to larger issues in the society; because all diseases known to us and the disease yet to come are due to problems in diet, lifestyle and environment. This is the result of my lifetime observation of patients and healthy individuals
We prefer to start medical colleges in private sector only, to prepare doctors who transform into moneymaking machines without any awareness or concern on health of the individuals. What should be the role of the MCI in this scenario?
Unethical marketing and unethical practices have become the order of the day. We see several overt advertisements; I have nothing against the hospital or the doctors mentioned in that advertisements- there is no point taking any disciplinary action against those hospitals or the doctors to show that MCI is the super body concerned about all these issues- Unethical practices are happening all over India- let MCI do its job the way it is supposed to do
Something about why all this is happening?
In spite of being the richest nation in the world, there is a criminal imbalance in distribution of wealth and thereby a failure to provide social security and human development aimed at taking the nation forward. That is the real cause for all these ills in India and the rest of the world where similar situation exists. Money is accumulated or is being deposited or wasted as dead investments due to lack of good economic policies or lack of implementation of good policies. Due to lack of resources we do not provide social security and we do not focus on human development; we make our people money minded, they work only to earn money and they are forced to accumulate money for their next generation. Because of an education that does not do its job properly, we make our people money minded and corrupt, the society here encourage hawala deeds and even encourage to deposit money in secret havens. Thus we make our people to engage in corrupt practices and accumulate wealth then we make them hoard money in secret places, buy gold, build huge houses, engage in all kinds of unholy activities. Because of a corrupt education system, the very same people who make money by corrupt practices now build schools and colleges or even universities are under them- all with one purpose of making more money. Religions are also failing in their duties. Religions here build walls among human beings, they are supposed to refine human minds and help them transform into better human beings, religion alone grows here, human beings are not growing here. We now need a world humanities day to remind us of the humane behavior.
Urgent reforms by the MCI to save Medical Education in India
Introduced a strict referral system
All PHCs to be manned by competent GPs/Family doctors
We need large number of GP doctors to act as the pillars of our disease-care machinery and to augment genuine health care- to act as guardians of health care- to act as friend, philosopher and guide to each person, each family-in the community- to give preventive and promotive health care
The existing doctors may be asked to give options to decide whether they are willing to become GP/Family doctor- if they are willing they may be empowered by a short course training in the medical Colleges- this short course training can also be given by the department of General practice
All the existing General Medicine departments must be transformed into Department of General Practice. The PG degree may be MD General Practice
All the existing PG seats to be converted to MD General Practice till we have adequate number of GPs
MD GP should not be allowed to go into super-specialization degree of DM
DM courses can be converted to 5 year direct courses- but they should have a two year rotation posting in Medicine and allied specialties in the first two years of which one should be in Department of General Practice
All of them to be posted to all the departments by rotation
The salary and remuneration to all the doctors should be uniform all over India- to enable doctors to choose specialty due to social reasons rather than money mindedness- now what is happening is cut-throat business and money minting and all the plans and projects including MCI is now working only to support this money minting machinery-
The draft prepared for this programme has to be widely circulated among NGOS and national bodies like IMA and NGOs basically to sensitize them and to invite opinions and comments by all the doctors in India. Major suggestions which are socially relevant only are to be incorporated- all taking into the consideration only of public health, social health and cost effectiveness not to bend to the pressure tactics of powerful business lobbies- Protests in reforms is often due to lack of awareness or apprehension or false more
Viewed by 36
Present trend in private hospitals is to fix high salaries for doctors giving a target income for the hospital. This leads to all wrongful and unethical and prohibition Ely high cost treatment, unwanted hospitsl isation, including ICU/CCU/Ventilator. Must be checked more
May 17
Respectfully Sir, It seems you have written this piece in anger, and instead of talking about MCI you have gone all over the place. All PHCs are manned by basic doctor or PHC Medical Officer. PHCs are owned and operated by State Government, it has nothing to do with MCI. It seems you should copy some of the things here and make separate topics, like Nutrition should be one topic, lack of city planning and lack of recreational space should be another topic, I am going to use this for MCI ONLY--= -MCI is already under scrutiny, Supreme Court has already put a committee of people on top of MCI so it can be MONITORED and ADMINISTERED. (I personally think they will make the private colleges pay money and make a killing, like the British East India Company officials, I may be wrong.) So Let us start this again to see what is going on but kindly FOCUS on MCI only. It will be a good idea to first go to MCI sites and familiarize yourself with its jurisdiction and see what it has been doing. more
May 17
