Do & don't ima recommends

In the wake of recent incidents involving the lives of a pair of twins and a seven-year-old girl, the IMA Medicine, announced some self-regulation procedures for hospitals and doctors, on Monday. A report

Besides exhorting doctors to to practice with compassion and follow the IMA AlERT policy (Acknowledge, listen in detail, Explain, Review and Thank you), the body also the announced formation of an IMA Medical Redressal Commission at the State level to engage in social, financial and quality audits of health care. The commission will have a public figure, an IMA office bearer, a former State medical council representative and two subject experts to consider grievances in a time bound manner. An appeal to the state commission will be heard by the Central IMA Medical Redressal Commission which will have the powers to take suo motu cases and suggest periodic reforms in healthcare.

“We appeal to the Government to come out with an urgent ordinance for one drug-one company-one price policy. Doctors should actively participate in ensuring that no hospital sells any item priced higher than the MRP. No service charges should be added to procure drugs from outside. The MRP should not be dictated by the purchaser,” IMA president Dr K K Agarwal said.

The other points are as follows:

• All doctors should prescribe NlEM drugs.
• All doctors should promote Janaushidhi Kendras.
• The Government should classify all disposables under both NlEM and non-NlEM categories and cap the price of essential ones. Till then all medical establishments should sell the disposables at procurement prize after adding a predefined fixed margin.
• Hospitals and doctors are often blamed for overcharging and over investigations. Billing should be transparent and all special investigations be well informed.
• Every doctor should ensure it becomes mandatory for the hospital administrator to give options at the time of admission to choose cost-effective treatment rooms and treatment and explain the difference in total bill estimates.
• All doctors should ensure that hospital estimates at the time of admission are near to actual.
• The treating doctor must explain the chances of death and unexpected complications and resultant financial implications.
• Emergency care is the responsibility of the State and the Centre should subsidise the costs of all emergencies in private sector.
• Every medical prescription must include counseling on the cost of drugs and investigations.
• Medical establishment should revisit their referral fee system. Billing paid to doctors should be transparent and reflected in the bill.
• No hospital should force consultants to work on targets. Contractual agreements should be in the interest of both parties, that is consultant and hospital. All hospitals should consider not charging service charges from the consultants.
• Choice of drugs and devices should be based on patient’s affordability, not on profitability.
• All hospitals must comply with EWS, BPl and poor patients commitment without discrimination.
• All patient complaints should be addressed in a timely manner through an internal redressal mechanism with an outside as chairman.
• All medical establishments must ensure that their business ethics comply with the MCI ethics.
• The patient has the right to get medical records within 72 hours of request. Acknowledge their request.
• The patient has the right to go for a second opinion. The primary doctors should not get offended by this.
• A hospital should not stop life-saving investigations or treatment for non-payment of bills if the patient is hospitalised. The Government should make a mechanism for the reimbursement for the above for poor patients.