doctor and the patient unique relationship

8/7/2019 Doctor and the Patient Unique Relationship

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DOCTOR

AND

THE PATIENTBY : Dr. Sanat Trivedi


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THE DOCTOR AND THE PATIENT-A UNIQUE RELATIONSHIP

BY: DR. SANAT TRIVEDI.

About the author

Dr.Sanat Trivedi has served government for 32 years. He has retired from

active service in 1995. He was the Director of Medical Services, at the time ofretirement. He is professionally a medical doctor and he works for the welfare

of the patients. He has a variety of interests in life in addition to his medical

field. He is voracious reader. His subjects of interests are philosophy, yoga, and

classical literature. At present he is writing book on RAJYOGA.

He is very active even after his retirement. He is engaged in numerous activities

even to-day at the age of 65.His main hobbies are classical music, photography,

and writing on various subjects. He is also the president of Drugs and

Cosmetics Consumers Association. The aim of this organization is to protect

the rights of the patients and consumers using various types of cosmetics.

Citizens Vigilance Movement Trust is thankful to Dr.Trivedi for writing such a

useful book for the benefit of the patients.

- CVM TRUST


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Preface

My friend Dr.Sanat Trivedi has worked in government health department fornearly thirty two years. He was Director of Medical Services, when he retired.

During his service period, he used to solve the problems of hospitals, doctors,

and patients. Many times he used to discuss such problems with me. He always

had a desire to write one book for the benefit of the patients.

Most of the time common citizens want to know their rights as patients. But as

there is no literature available in simple language, it is not possible for them to

know their rights. This booklet will fulfill their demand.

Dr. Trivedi has started this book with the history of medical practice. He has

beautifully written evolution of medical practice. There are rules and

regulations for medical practitioners which are administered by medicalcouncil. He has also mentioned that doctor must practice with the same system

of medicine in which he is trained for. Besides he has mentioned regarding

patient doctor relations.

Most of the doctors read the Hippocratic Oath during their study, but then with

the passage of time they easily forget it. To-day hardly ten percent of the

practicing doctors might be aware of the Hippocratic Oath.

He has also written about the unwritten contract between the doctor and the

patient. He has also briefly mentioned about the rights of the patients and

responsibilities of the doctors. To-day doctors are giving evidence basedtreatment. It means that the treatment is not as per the personal belief of the

doctor but it should be standardized and approved by medical science. The

effectivity of this treatment depends upon both, the doctor and the patient. Any

treatment will not be effective without the co-operation of the patient. Patient

must fully understand the severity and the prognosis of his disease, and also the

mode of his treatment. Dr.Trivedi has discussed this chapter in much more

detail.

Dr.Trivedi has also written regarding importance of doctors prescription. He

has also mentioned regarding various components of the prescription.

In short this small booklet has tried to clarify various aspects of doctor and

patient relationship. I hope the book shall give better insight and shall hence

help to remove misunderstanding between the patients and the doctors.

Dr. Jyotindra Bhatt

M.D. Cardiologist

Ahmedabad.


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Index

Subject

1. History

2. Hippocratic Oath

3. Geneva Convention

4. Medical Practice To-day

5. Doctors Responsibility

6. Patients Rights

7. Drugs and Prescription

8. Regulatory Authorities


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CHAPTER 1

HISTORY

In India during the early period, modern medical science was not known.

Most of the patients were treated by Ayurvedic doctors. The Ayurvedic medical

system was prevalent during those days. As per the Ayurvedic tradition, the aim

of treatment was not to earn money but to treat and cure sick patients. Doctors

main aim was to look after the patients welfare. Doctor used to pray that,

I desireth not the Kingdom on earth;

I desireth not heaven after death;

Nor do I desire a better rebirth.

I desireth only to heal the unhealthy bodiesAnd soothe the disturbed minds of my patients.

During British rule, modern medical science was introduced in India by British

doctors. Special medical schools were started to train Indian doctors. Gradually

Ayurvedic practice was replaced by modern medical practice. During those

days also patients welfare was the first priority of the doctor. The doctor was

enjoying high status in the society. He was respected by the people. He was

considered as a kind and an unselfish individual who will treat the patient as per

his knowledge and skill and in return will receive a reasonable fee. There were

number of doctors in the society at that time, who would not charge fees to poorand non- affording patients. In those days doctor patient relationships were

cordial. Some of the doctors were as good as family members of the patient.

The patient and his family members used to have complete trust in their doctor.

Doctors advice will be always for the welfare of the patient. Advice of family

doctor was considered as final for all the family members.

Now the time has changed. Doctor has become more professional. The aim of

treating the patient is replaced by the aim of earning more money. Doctor has

become more self-centered and money oriented. His aim is to earn more money

within a short period. This is because he has spent a huge amount of money for

his medical education. Today hospitals are established, not for the sole purposeof treating the patient but for getting enough returns from their investment.

Today big corporate bodies and rich persons are interested to establish hospitals

because they know that medical profession is more profitable then any other

profession. On the other hand patients have also become aware of their rights.

An expectation of the patients is to get better medical services in return of their

money paid as fees. Today medical profession has altered to be a profitable

business. Today doctor-patient emotional relations are no more present. Those

emotional human relations are replaced by provider- consumer relations. Today


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patient pays the fee and purchases the treatment. He expects maximum return of

his money paid.

In this changed circumstances, it is desirable that the patients rights areprotected. Not only that, but a patient must become aware of his rights as a

patient. For the same purpose, he must know and understand his constitutional

and legal rights which are sanctioned by the government and society. At the

same time one should also know the responsibilities of the doctor. Most of the

people in the society, are neither aware of their rights as the patient nor are they

aware of doctors responsibilities.


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CHAPTER 2

HIPPOCRATIC OATH

In the ancient period there were no schools or colleges for learning medical

science. In those days medical teachers used to teach medicine to their selected

students. The medical students have to stay with their teacher to study

medicine. The teacher used to teach his students by the way of lectures,

discussions, and practical demonstrations on the patients. The student was

taught the method of diagnosing the disease, selection of correct medicine,preparations of various mixtures and other techniques for treating patients. In

Greece there was an eminent doctor whose name was Hippocrates. He made

various experiments and research in the field of medical science. So he is

considered as the father of the medical science. He made various rules for the

doctors. Those rules were known as the HIPPOCRATIC OATH. It was

mandatory for each doctor to obey those rules while practicing medicine. At the

time of completion of medical training, each doctor was supposed to take those

oaths in front of his teacher. The doctor was supposed to follow those rules for

the life time. As per the belief of the Greek people Apollo is the lord of health.

So those oaths were taken in the name of Apollo. The Hippocratic oaths are as

given bellow.

I swear by Apollo physician, by health, by heal all, and by all Gods and

Goddesses , making them witnesses, that I will carry out according to my

ability and judgment, this oath and this indenture.

To regard my teacher in this art as equal to my parents; to make him partner in

my livelihood, and when he is in need of money to share mine with him, to

consider his offsprings equal to my brothers; to teach them this art if they

require to learn it, without fee or indenture; and to impart precept, oral

instruction, and all other learnings , to my sons, and to the sons of my teacherand to pupils who have signed the indenture and sworn obedience to the

physicians law, but to non other.

I will use treatment to help the sick, according to my ability and judgment, but I

will never use it to injure or wrong them. I will not give poison to any one

though asked to do so, nor will I suggest such a plan. Similarly I will not give

pessary to women to cause abortion. But in purity and holiness, I will guard my

life and art. I will not use the knife on sufferers from stone, but I will give place

to such as craftsmen there in.


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Into what so ever houses I enter, I will do so to help the sick, keeping myself

free from all intentional wrong-doing and harm, bond or free.

Whatsoever in the course of practice I see or hear [or even out side my practicein social intercourse] that ought never to be published abroad, I will not

divulge, but will consider such things to be holy secrets.

Now if I keep this oath and break it not, may I enjoy honor, in my life and art,

among all men for all time; but if I transgress and forswear myself, May the

opposite befall me.

These rules and ethics were suggested by Hippocrates in past. To-day even the

same rules and ethics are abiding to doctors. At the end of completion of

medical training each doctoris supposed to take this oath in front of his senior

teacher. And he should abide the rules for life time during his medical practice.

After the period of Hippocrates, there were major changes in the medicalscience. Number of new drugs and methods of treatment, were added in

medical practice. Doctors were equipped with more knowledge and better

technique for treating the patients. Medical profession was a noble profession,

where doctors can get enough money, prestige, and respect in the society. With

the effect more and more persons were attracted towards this profession.

In 1949 members of world medical association, felt the need of framing certain

rules for this profession. General meeting of the members were called in

Geneva. The members discussed various aspects of medical practice and finally

passed certain resolutions, which were known as Geneva convention.


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CHAPTER 3

GENEVA CONVENTION

In October 1949, members of world medical association prepared the document

for the responsibilities of doctors. The rules and regulations mentioned in this

document are obligatory for all the doctors. These rules are called the Geneva

Convention.

DECLARATION OF GENEVA

[Adopted by the General Assembly of the World Medical Association atGeneva, Switzerland, September, 1948]

AT THE TIME OF BEING ADMITTED AS A MEMBER OF THE

MEDICAL PROFESSION:

1) I SOLEMNLY PLEDGE myself to consecrate my life to the service of

humanity.

2) I WILL GIVE to my teachers the respect and gratitude which is their due.

3) I WILL PRACTICE my profession with conscience and dignity.

4) THE HEALTH OF MY PATIENTS will be my first consideration.

5) I WILL RESPECT the secrets confided in me.

6) I WILL MAINTAIN by all means, in my power, the honor and the noble

traditions of the medical profession.

7) MY COLLEAGUES will be my brothers.

8) I WILL NOT PERMIT consideration of religion, nationality, race, party-

politics or social standing to intervene between my duty and my patient.

9) I WILL MAINTAIN the utmost respect for human life from time of

conception.

10) Even under threat, I will not use my medical knowledge contrary to the

laws of humanity.I MAKE THESE PROMISES solemnly, freely and upon my honor.


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International Code of Medical Ethics is as follows:

A] Duties of Doctors in General

1. A doctor must always maintain the highest standards of professional conduct.

2. A doctor must practice his profession uninfluenced by motives of profit.

3. The following practices are deemed unethical.

a) Any self-advertisement except such as is expressly authorized by the

national code of medical ethics.

b) Collaboration in any form of medical service in which doctor does not have

professional independence.c) Receiving any money in connection with services rendered to a patient

other than a proper professional fee, even with the knowledge of the patient.

Any act or device that could weaken the physical or mental resistance of a

human being may be used only in his interest.

A doctor is advised to use great caution in divulging discoveries or new

techniques or treatment.

A doctor should certify or testify only to that which he has personally verified.

B] DUTIES OF DOCTORS TO THE SICK

A doctor must always bear in mind the obligation of preserving human life.

A doctor owes to his patient complete loyalty and all the resources of his

science. Whenever an examination or treatment is beyond his capacity he

should summon another doctor who has the necessary ability.

A doctor shall preserve absolute secrecy on all he knows about the patient

because of the confidence entrusted in him.

A doctor must give emergency care as a humanitarian duty unless he is assured

that others are willing and able to give such care.

C] DUTIES OF DOCTORS TO EACH OTHER

A doctor ought to behave to his colleagues as he would have them behave to

him.

A doctor must not entice patients from his colleagues.

A doctor must observe the principles of The Declaration of Geneva approved

by the World Medical Association.


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CHAPTER 4

DOCTORS RESPONSIBILITY

1) As per the Hippocratic Oath and the Geneva Convention, it is very clear

that every doctor must follow medical ethics and certain rules during his

medical practice. Medical profession is altogether a different profession. It is

considered as a noble profession. So a doctor must have a humanitarian

approach while treating patients. It is desirable that each doctor should

follow medical ethics and maintain high standard of medical profession.

2) The first and the primary duty of the doctor is to treat the patient. He

should apply his knowledge and skill for the welfare of the patient and forthe treatment of the sick human beings. He should be always faithful to his

patient. His advice to the patient must be for curing the disease and for the

maintenance of good health. Most of the time, the patient does not have the

right knowledge of his disease. For receiving right knowledge, he

approaches the doctor. So it is prime duty of the doctor to advise him

correctly.

3) A Doctor must not give such an advice, which is harmful or injurious to

the health of the patient. Harmful effect may be for short term or for long

term.

4) Doctor must not use such medicine or method of treatment for the patient,

which is not approved by medical science.

5) It is the primary duty of each practicing doctor to offer emergency

treatment. So doctor should not refuse the patient who is in need of urgent

medical treatment.

6) All patients should be equal for the doctor. Treating disease is doctors

primary duty. His medical approach should not be affected by caste,

religion, nationality, or social status of the patient. He should treat the

patient as per the medical need.

7) Whenever the patient visits the clinic, he is examined by the doctor for thepurpose of diagnosing the disease. During medical examination, the patient

reveals his private and personal matters to the doctor. Not only has that but

the doctor has got full knowledge of the patients physical and mental status

through medical examination. It is the duty of the doctor, to keep it secret

and confidential. Legally nobody can compel the doctor, for revealing the

confidential matters of his patient except judicial court.

8) A Doctor must take due care while examining the patient. This is truer

when he examines the female patient. His manner of examination should not


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be such that it creates embarrassment to the patient. It is advisable to

examine the female patient either in the presence of her relative or nurse.

9) The doctor should not have any immoral relations with the patient. Suchrelation will spoil the image of doctor patient relationship.

10) A Doctor can take a reasonable fee from the patient as reward of

services given to him. But doctor should not accept undue fee or gifts from

the patient.

11) A Doctor must never prescribe or give poison to the patient, even though

a patient may request for the same. Because the doctors primary duty is to

give life and not death.

12) If a doctor desires to use either patient or patients medical record for

any type of medical research or training, he must take prior permission from

the patient. Patients body or his medical record can not be used for anypurpose without patients permission.

13) The Medical profession is a noble profession; it is obligatory duty of

each of his member to maintain respect, status, and dignity of the profession.

14) As per the code of conduct of this noble profession, members of this

profession should not advertise for themselves. A Doctor is not supposed to

directly or indirectly advertise through any media. Like other businessmen,

doctors can not apply means of advertisement for the purpose of attracting

patients.

15) A Doctor can not offer either kind or cash to anybody for bringing orreferring cases to him.

16) Same way the specialist can not reward the practicing doctor, either in

kind or in cash, for referring him patients.

17) A Doctor should not use immoral means for the expansion of his

practice.

18) A Doctor should practice only that system of medicine for which he is

trained and in which he is expert. E.g. allopathic doctor should practice only

allopathic system of medicine and homeopathic doctor should practice only

homeopathic system of medicine.

19) A Doctor must not use any medicine, method of treatment or method of

operation, which is not approved by medical science.

20) If at the time of examination, treatment, or operation, doctor feels that it

is beyond his capacity to diagnose, treat, or operate the patient, then for

benefit of the patient, he should take opinion of another expert. Or he should

refer the patient to the institute where the patient can be treated effectively

and efficiently. He should write full details of the patients sickness, while

referring him to another specialist or an institution.


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CHAPTER 5

PATIENTS RIGHTS

When a patient visits the doctor for the purpose of treatment, and doctor

accepts him as his patient, automatically it becomes an unwritten contract

between the patient and the doctor. As per the contract doctor is supposed to

diagnose and treat the patient, while patient is supposed to pay a reasonable

fee. The law of contract confirms certain rights to the patient. In the same

way Constitution of India, has also confirmed certain rights for an Indian

Citizen. The Patient being an Indian Citizen, he enjoys certain rights as per

the Indian Constitution.

The patient is a consumer of medical services. Being a consumer he enjoyscertain rights under Consumer Protection Act.

So the patients rights are based on:

1] The Law of contract

2] The Indian constitution

3] The Consumer Protection Act.

Considering all these three acts together and considering doctors

responsibilities, patients will have following rights:

In legal terms the body is considered as the property of the patient. In

other words he is the master of his body. So he enjoys all the rights to utilize it

as per his own desire. When the same physical body is either sick or unhealthy,

he will decide the mode of treatment. He can decide whether to treat it or not. If

he decides to give treatment, he can decide whether to treat it with allopathic,

homeopathic or ayurvedic system of medicine. He has also right to choose his

doctor, laboratory, or treatment centre. Nobody other then the patient have a

right to make a selection for him.

Before selecting the doctor, the patient has a right to know about the

qualifications and the medical experience of the doctor. In early days, doctors

and consultants used to keep their degree and registration certificates in theclinics, at the place where the patient can easily verify it.

The patient gives reasonable fee to doctor, so he expects good and

effective treatment; and the doctor is thereby bound to provide him the most

effective medical treatment.

The patient has the full right to know the nature of fees he is supposed to

pay. A Doctor should tell him in detail, regarding the nature of fees; he is going

to charge to the patient.


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Same way when the patient is admitted in the hospital, he has right to

know various charges of the hospital.

The Patient has also right to know the various facilities offered by thehospital.

After accepting the person as a patient, doctor examines him clinically. If

required for the purpose of diagnosis, he performs laboratory and x-ray

investigations. He diagnosis the disease and finally advises the treatment. The

Patient has full right to know about his physical condition, diagnosis, mode of

treatment and prognosis. It is the duty of the doctor to inform the patient

regarding all the details about the disease, the nature of treatment and the

probable chances of cure. All the questions and queries of the patient should be

satisfied. A Patient being a non-medical person will not be in a position to

understand high technical words. It is the duty of the doctor; to inform him in amore simplified language, which can be understood by the patient.

The Patient must be informed regarding effects, side effects and probable

complications of the drugs used. He should be made aware of the probable short

term and long term complications of the treatment prescribed. If patient is

informed well in advanced regarding probable complications of the treatment

and side effects of the drug, he will be mentally prepared to accept it.

In the same way when an operation is the main part of the treatment, the

patient must be fully informed about the method of operation, the type of

anesthesia, the probable complications, and the effectivity of the operation. It isthe duty of the doctor to prepare the patient mentally for the purpose of

operation. The Doctor must inform the patient about the probable risks of the

operation. At present in number of hospitals, the patient is asked to sign on the

acceptance form, which he signs without fully understanding it. This is not the

correct method. The doctor, preferably the operating surgeon must spend

reasonable time with the patient, for the purpose of informing him fully

regarding the proposed operation.

At the time of the medical check up, the patient reveals all his personal

matters to the doctor. The Doctor gets information about his physical and

mental status, his thought process, his emotions, his aspirations, his desires, and

his secret wishes. These all are revealed by the patient for the sole purpose of

getting correct and effective treatment. The Doctor must not divulge this

information to any one. No authority can compel the doctor to disclose this

information except judicial court.

A Patient has the right to refuse utilization of his body or his medical

record to be used for the purpose of either research or training.

During the course of treatment if a patient desires to change either the

doctor or the hospital, it is within his right to do so. If he leaves the hospital


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CHAPTER 6

DOCTORS PRESCRIPTION

After diagnosis the doctor decides the line of treatment. He prepares the list

of drugs to be used for treatment which is called as the prescription. The

prescription is given to the patient. The patient purchases the drugs from the

drug store as per the prescription. As per the law, the drug store keeper can

not sell the drugs to anybody without a standard prescription from registered

medical practitioner.

The prescription should be in standard form. It should contain doctors

name, his qualifications, doctors registration number, date, list of drugs,

method of taking the drugs, dose suggested and signature of the doctor.Most of the drugs are harmful and injurious to health if not taken as per the

prescribed dose. Only doctors can select the drugs and decide the dose for

the patient. So such drugs are not available from the medical store without a

proper medical prescription.

The person should take the following precautions while purchasing drugs

from a drug store:

A] The drugs supplied by the drug store must be as per the prescription. It

may happen that if same drugs are not available with the store, store keeper

may supply some alternative drugs, having same effect. This is not goodpractice. The store keeper being non-medical person can not decide the

drugs for the patient. He may not have detailed knowledge of drugs effects

and its side effects. On the other hand, the doctor might have prescribed the

drug with specific reasons that are not known to the store keeper. So it is

advisable not to purchase the drugs which are not as per the doctors

prescription. The doctor can not be held responsible for the side effects and

complications of the drugs taken, which he has not prescribed.

B] Drug must be purchased only in a sealed packing. No drug should be

purchased which is not in the sealed packing. If drugs packing is broken

there are chances of it getting adulterated. At the same time some drugs getspoiled and ineffective once the packing remains open for long time. The

manufacturing company cannot be held responsible for adulterated, spoiled,

and ineffective drugs, if original company packing is broken.

C] The packing should contain the standard labeling for the drug. The label

should contain the name of the drug, its various constituents, the strength of

its various constituents, and the date of manufacturing, date of expiring,

batch number, and name of the manufacturing company.


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D] The drug whose expiry date is over, should not be purchased, and should

not be used in any circumstances. The expiry date is the time limit, decided

by the manufacturing company for the effectivity and competency of thedrug. The drug may lose its efficacy after expiry date.

E] The patient must know the correct method and dose of using the drug. If

he has any doubt, he should consult his doctor and get clarification. The

drugs meant for local use can not be taken orally. It may create severe

complications.

F] Patients should not use old drugs already lying in the house. It may

happen that the doctor might have prescribed some drug in the past for some

disease for one of the family member. The same drug might be lying in the

house. It is common practice to take the same drug when similar symptoms

are shown by another family member. This is not correct method for severalreasons. Being old, the drug might have lost its efficacy. Secondly the

symptoms may be similar but underlying disease may be different. For

example chest pain may be due to purely muscular in origin or it may be due

to serious heart trouble. The drugs for both the conditions are different.

F] The drug must be properly stored in the house. It should be kept at cool

and dry place so that temperature and humidity may not spoil the drug. It

should not be kept within easy reach of children. Certain drugs are

poisonous. And if taken by children it may create serious complications.


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CHAPTER 7

MEDICAL PRACTISE TODAY

There are spectacular changes in the medical science and its medical practice

within the last fifty years. The major changes in the medical field are:

1) Number of new researches and inventions have given new hope to the

doctors for treating hard and difficult cases.

2) Medical treatment has become more costly.

3) Medical practice has become more commercial.

Medical Research and Discoveries.

There are innumerable researches in the medical science which have

completely changed the scenario of the medical field. Number of new drugs

are discovered which are more powerful and more effective than its older

counterparts. Revolutionary discovery of anti-biotics have given very

powerful tool for fighting infectious diseases. Now with the help of

antibiotics, doctors can confidently treat the patients with diseases like

typhoid, bronchopneumonia, bronchitis, and many other diseases caused by

various bacteria. In the same way number of other new drugs has made it

easy to treat complicated cases. There are new laboratory and medical

investigations which have made diagnosis easier and more accurate. With

the help of such investigations the doctor is more confident for detecting the

disease. Inventions of sonography, C.T.SCAN, M.R.I and other

investigating procedures have made it easier for the doctor to detect number

of severe diseases. Number of new operative procedures are added in the last

fifty years. I.O.L for cataract, by-pass surgery for the heart diseases,

transplantations of new organs like kidney transplantation and bone

transplantations, and other new operative procedures have given new hope

and more confidence for treating various diseases. New operativeinstruments are added to help the surgeons. Laparoscopy, gastroscopy,

arthroscopy etc have made operations more easy and safe. As a result of all

these new medical researches, the mortality and morbidity rates have

declined. Certain diseases like small pox have been completely eradicated

from the surface of the earth. Average life span of the man is now increased.

Now there are more means to protect the man from various diseases.

Average life is not only longer but healthier than what it was in the past.


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Cost of treatment

The second spectacular change is the colossal increase in the cost of

treatment. There are multiple reasons for the increase in the cost oftreatment.

A] There is an over all increase in the cost of living.

B] Drugs have become more costly.

C] Laboratory and other medical investigations have become more costly.

Not only that but trends in the modern medical practice is to advise for more

such tests for reaching to final diagnosis and to decide the mode of

treatment.

D] Consulting charges and medical fee of the doctor have increased. This is

because doctor has to pay more for the maintenance of his clinic.

E] Hospital charges have increased because hospitals have to spend more forits staff and other overheads.

There are so many other factors which contribute towards the increase in the

cost of treatment.

Medical practice

Medical practice is more commercial now days. There is a spectacular

change in the attitude of the medical practitioner. He is more clever and

shrewd compared to his ancestors. He is not only the healer of the disease

but he is also a smart business man. He knows various lawful tactics to get

satisfactory returns of his investments. A doctor has invested a huge sum ofmoney for his education and for the establishment of his practice. With the

effect he has to increase the rate of his various charges. As far as the rates

are moderately high, patients dont mind to pay the same. But the rates are

disproportionately high in certain fields like cardiac and neuro- surgery.

Rates of certain operations are so high that ordinary patients can never think

of having such costly operations for his cure.

Government Hospitals and Institutions

There are government hospitals and institutions which provide treatment at

much cheaper rates. But very few persons have their faith in effectivity of

their treatment. Most of the time the government hospitals are not having

enough drugs and medical equipments to satisfy the needs of the patients.

With the effect the patients have to purchase drugs from the market which

makes the treatment costlier. It is also observed that the attitude of medical

staff in the government hospitals is mostly indifferent to the patients. So in

the government hospitals patients do not get personal attention.


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Effect of Consumer Protection Act on medical practice.

Government has enacted Consumer Protection Act [CPA] for protecting the

rights of consumers. Medical practice is also included within the sphere ofCPA. With the effect there are number of litigations against the doctors

under CPA. This act has created adverse reactions amongst the doctors. It

has disturbed the humanitarian relations between the doctor and the patient.

Now doctor treats the patient as a mere consumer of the services. He has

become more alert and cautious while treating the patient. Doctor has to

protect his own interest while treating the patient. Now he can not depend

only on his knowledge and experience, while diagnosing and treating the

patient. He has to confirm his diagnosis by performing various laboratory

and other medical tests. With the result patient has to submit himself for

various tests, which were not ordinarily performed in the past. Ultimatelysuch procedures increase the cost of the treatment. Now the family physician

does not take the risk of treating complicated cases. He prefers to refer such

cases to either a specialist or to the hospital .It again increases the cost of

treatment as well as causes hardship for the patient.

Health services have now become a health industry. At present it is one of

the biggest industries of the world. Multinational corporate bodies are

engaged in manufacturing various drugs and various medical equipments.

They apply various tactics for the promotion of their sale. They motivate the

doctors to prescribe more and more drugs. Some of the doctors are rewardedby such companies for prescribing their drugs. With the effect most of the

doctors prescribe multiple drugs for the patients. Some of the prescriptions

contain more then eight to ten drugs, out of which hardly one or two are

specifically required for the treatment. Rest of the drugs are either vitamins,

tonics or some non-specific placebo.

Health industry being a profitable trade, now a days big corporate bodies

have started establishing luxurious hospitals. These hospitals are well

equipped and having modern gadgets. The charges of such hospitals are very

high. Such hospitals are managed by non-medical personals whose main aim

is to get maximum profit of their investments. With the intention of

expanding their business, they apply various business tactics and sometimes

they overlook medical ethics and the rules of Geneva Convention.


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CHAPTER 8

REGULATORY AUTHORITIES

There are a number of regulatory authorities who are responsible for the

maintenance of rules and regulations of various medical practices.

The Medical council of India:

The Medical Council of India is the highest body which looks after the

ethics and the conduct of the doctor. Each doctor has to register his name

with the medical council after medical graduation. As such no doctor can

carry out his medical practice without getting registration from the medical

council. Medical council has full power to check the conduct of the doctor.If a doctors medical practice is found not as per the norms, and regulations

of the medical council, the doctors registration can be cancelled. No doctor

can practice without medical registration. Indian Medical Council has its

branches in each state. In Gujarat there is the Gujarat Medical Council. The

office of the Gujarat Medical Council is situated at Civil hospital,

Ahmedabad.

Department of Health and Medical Services.

This department is run by the government. The maintenance of health of the

people is the responsibility of the state government. So as per the Indian

Constitution the state has to provide services for the maintenance of health

of the people. The department of health looks after the various aspects of

health of the people. Number of hospitals, dispensaries, and primary health

centers are established by the department in the state. These institutions are

responsible for providing total health care to the community. The main

office of the health department is working at Gandhinagar. Head of the

department is called the Commissioner of Health and Medical services. Any

complain regarding services of the health department and hospitals run bythe department can be made to commissioner of health.

The Department of Food and Drugs.

This department is responsible for controlling the manufacture of various

food items and drugs.

There are a number of rules and regulations which are meant to prohibit the

manufacture of adulterated and substandard food items and drugs. The


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authorities of the department of food and drugs supervise the manufacturing

processes of various companies. Whenever there is any deviation from the

standard procedures, department can take action against the company. In thesame way the department looks after the sale of foods and drugs. It is the

licensing authority for various drug stores. Any complain for the adulterated

or substandard drugs can be made to the commissioner of the department.

The head office of the department is in the Gandhinagar.

In addition to that there are various private institutions which look after the

rights of the consumers. Such institutions are equipped with the knowledge

and the trained staff for the purpose. Drug and cosmetic consumers

association {DCCA} guides the people for the protection of their patients

rights.

doctor and the patient unique relationship

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