January 9 2015, Friday,
IMA in the News
• IMA Moots Green corridor for all medical emergencies: Statesman
• IMA Moots Green corridor for all medical emergencies: Dainik Bhaskar
• IMA Moots Green corridor for all medical emergencies: Amar Ujala
• IIMA wants check on Unauthorized Surveys: Deshbandhu
• IMA Moots Green corridor for all medical emergencies: Shah Times
• IMA Moots Green corridor for all medical emergencies: Virat Vaibhav
• 44% surgeries were needlessly advised: Vir Arjun
• IMA concerned over survey on needless surgeries: ET
• Make a safe green corridor for every medical life-threatening emergency:
IMA: Healthy Duniya.com
IMA showed concern on the survey that 44% surgeries were needlessly advised
IMA has written letter to Medical Council of India and Maharashtra Medical Council (copy attached) to call upon the Medi Angles –the 2nd Opinion Center based out at Navi Mumbai who has released their survey to one of the National Daily which has shown that over 44% of the surgeries were advised needlessly. They have released a data of 12,500 patients.

IMA National President, Padma Awardee, Dr. A. Marthanda Pillai and Honorary Secretary General, Padma Awardee Dr K K Aggarwal in a joint statement said that if the findings of this survey are correct, it is a matter of national concern but if the findings of this survey are not correct, it will cause a great damage to “Doctor-Patient Relationship”.

IMA officials said that as per the report, it looked that the 2nd opinion was given via Email Consultation.

As per the IMA guidelines, difference of opinion is not negligence and 2nd opinion of a single doctor would only amount to difference of opinion. By IMA definition, the 2nd opinion is always a peer review which must have an opinion of 2 or 3 more doctors in consultation.

Various Supreme Court Judgments have shown error judgments and difference of opinion is not a professional misconduct or negligence.

IMA officials also said that as per MCI Guidelines, any survey which has a national impact should have been published in a reputed medical journal and/or presented in a medical conference before going to the media.
IMA concerned over survey on needless surgeries

New Delhi, Jan 6 (IANS) The Indian Medical Association (IMA) Tuesday expressed concern over a recent survey which showed that 44 percent of surgeries advised to patients by doctors were not needed.

In a letter to the Medical Council of India and Maharashtra Medical Council, the IMA said: "If the findings of this survey are correct, it is a matter of national concern but if the findings of this survey are not correct, it will cause a great damage to doctor-patient relationship".

The survey, with a data base of 12,500 patients, showed that over 44 percent of the surgeries were advised needlessly.

According to IMA officials, the second opinions which the survey quoted were given via e-mail and as per IMA guidelines, difference of opinion is not negligence and second opinion of a single doctor would only amount to difference of opinion.

"By IMA definition, the second opinion is always a peer review which must have an opinion of two or three more doctors in consultation," IMA national president A. Marthanda Pillai and honorary secretary general K. K. Aggarwal said in a joint statement.

"Various Supreme Court judgments have shown error judgments and difference of opinion is not a professional misconduct or negligence," the statement said. (Source: https://in.news.yahoo.com/ima-concerned-over-survey-needless-surgeries-153211656.html)

IMA concerned over survey on needless surgeries

The Indian Medical Association (IMA) Tuesday expressed concern over a recent survey which showed that 44 percent of surgeries advised to patients by doctors were not needed.

In a letter to the Medical Council of India and Maharashtra Medical Council, the IMA said: "If the findings of this survey are correct, it is a matter of national concern but if the findings of this survey are not correct, it will cause a great damage to doctor-patient relationship".
The survey, with a data base of 12,500 patients, showed that over 44 percent of the surgeries were advised needlessly.

According to IMA officials, the second opinions which the survey quoted were given via e-mail and as per IMA guidelines, difference of opinion is not negligence and second opinion of a single doctor would only amount to difference of opinion.

"By IMA definition, the second opinion is always a peer review which must have an opinion of two or three more doctors in consultation," IMA national president A. Marthanda Pillai and honorary secretary general K. K. Aggarwal said in a joint statement.
"Various Supreme Court judgments have shown error judgments and difference of opinion is not a professional misconduct or negligence," the statement said.
(Source: http://www.newkerala.com/news/2015/fullnews-2223.html)
News around the Globe
• In a small long-term study, obese patients who had gastric bypass surgery were half as likely to die as those who didn't have the surgery. The study is published online in the American Journal of Surgery.

• A new type of magnetic resonance imaging appears to be measurably better at spotting prostate cancer tumors than the current method, suggest the results of a new study. Authors say the finding may also have significant implications for the treatment of prostate cancer. The study is published in the journal Prostate Cancer and Prostatic Diseases.

• Topline results from a phase 2 study show that treatment with a novel oral antipsychotic, currently known as ALKS 3831, was as effective as treatment with the antipsychotic olanzapine with considerably lesser weight gain in patients with schizophrenia.

• Older people with HIV have a weaker antibody response to influenza vaccine than their counterparts who are not infected with the virus, suggest new findings in women published in the Journal of Infectious Diseases.

• A 50% dose of verteporfin is more effective than a 30% dose for photodynamic therapy of acute central serous chorioretinopathy, suggests new research published online in JAMA Ophthalmology.
Rural retention of medical doctors
Dr KK AggarwalOn the invitation received from MoHFW, along with Dr Ramesh Dutta, I attended the meeting on Rural Retention of medical Doctors at New Delhi chaired by Health Secretary, GoI. The MCI president was also present.

Agenda Note 1. The Central Govt, in consultation with MCI, made the following amendments to its Post Graduate Medical Education Regulations to encourage doctors to serve in difficult/remote areas:

• 50% of the seats in PG Diploma Curse shall be reserved for medical officers in the Govt. service, who have served for atleast three years in remote and difficult areas. After acquiring the PG Diploma, the medical officers shall serve for two more years in remote and/or difficult areas; and
• Incentive at the rate of 10% the marks obtained for each year in service in remote or difficult areas upto the maximum of 30% of the marks obtained in the entrance test for admission in PG medical courses.

2. Thereafter, a draft notification was approved by the Ministry in June 2013 to provide that one year rural posting at PHC will be mandatory for medical graduates for admission in PG courses from academic session 2015-16. However, due to agitation by doctors against the proposed amendment in the PG regulations, the MCI was requested to keep the amendment notification in abeyance for publication till further orders from the Ministry.

3. In July 2014, with the approval of the Hon’bl HFM, it was decided to make the mandatory rural posting an integral part of PG course curriculum. MCI was requested to furnish:
• Revised PG Course curriculum
• Draft notification amending PGMER, 2000
• Roadmap for implementation of the scheme

MCI has now sought following clarifications:

• Whether the Central Govt. envisages a PG degree course of 3 years or 4 years including one year rural scheme after completion of MD/MS course or during the course.
• Whether the programme for PG course incorporating the rural posting applies to both govt. & private medical colleges?
• During the 1 year posting that is proposed to be incorporated into the PG course, which authority shall pay stipend to the doctors during their rural posting?

Discussion IMA and Others & outcomes

• It was agreed that at the moment, Govt. will not go ahead in making rural posting compulsory during PG entrance examination. IMA said that they would oppose it if this happens.
• MCI suggested that the Govt. may think of making one year rural training posting of pre and para clinical postings without increasing the duration of PG.
• It was proposed that in pre selected PHCs, any post MBBS student who does one year rural training posting, will get 10% extra marks to be added to his/her PG entrance examination. He/she will get a salary higher than other places and in addition will also get an additional certificate of training in rural medicine and rural surgery

Some suggestions by IMA, not carried forward

• Doctors, who may like to work in Govt. area, may be given income tax exemption and high salary.
• Local GPs may be given extra incentives to run a 2-hour OPD in these PHCs.
• Doctors posted in these PHCs may be given one year diploma in rural medicine and surgery. The same was not accepted by the MCI.
• A 2 years PG course may be started by DNB in rural medicine and surgery. Out of these 2 years, one year may be in the rural area and one year may be in a DNB-recognized hospital. As there was no representation from DNB, the same was not further discussed.
• All district hospitals may be made teaching hospitals and internship & DNB programme may be started. The matter is under discussion.

Some other suggestions and facts from the panel

• Under the existing MCI Act, it is not legally possible to withhold the degree of a person for one year in the absence of completion of rural posting by him/her. So bond theory was not accepted.
• Make PG entrance more difficult so that students are forced to go for rural posting for getting 10% extra marks.
• Out of one lakh, only 6500 postings are without doctors. It is not that doctors do not want to go to rural areas. They do not want to go to these 6500 rural areas.
• At any given time only 10% of the PHCs are without doctors.
• In some states, incentives have been initiated by increasing the retirement age from 60 to 65 to post some specialists in rural areas.
• In some states, hardship area allowances are given and salaries are upto 1.5 lakhs.
• In one state, 10 lakh penalty bond has been kept in for not doing rural services after PG and Rs 18 crore was the revenue. So this is not a solution.
• To have different fee structure, which means people who are ready to go for rural services will have a substantial subsidy in their PG educational fee by the Govt. But this was not again followed as the private medical colleges may not agree for the same.
IMA Stand and Offer

• IMA will invite suggestions from its members through eIMA news
• IMA will connect to its students through facebook.com/imsaindia and facebook.com/imayoungdoctorsforum
• IMA will call representatives of IMSA India and have a discussion in Delhi along with MOH officials. MOH said that have no budget. IMA will call representatives. They will come of their own. IMA will support stay and food.
• Every year one lakh doctors appear in PG examination and only 25000 get admission. Remaining 75000 doctors at given a time start preparing for the PGs.
Final IMA Offer to students and government

Out of 75,000 doctors who appear for PG entrance exam, if 10,000 are willing for a one year positing in selected PHCs, IMA will get them five things

• High pay scales
• IMA certified (Non MCI) fellowship (one year) in Rural Medicine and Rural Surgery
• 10% extra marks in their PG entrance examinations, by the government.
• One year IMA certificate in "Community and Public Health (this may help students who aspire further training abroad)
• IMA will make ensure that government provides them free accommodation and security in the PHCs. IMA presumes that as promised by the new Modi Govt., basic free drugs and investigations will be available in every PHC.
Suggestions are invited. No final decision taken.

Dear Colleague

Your attention is drawn to the following agenda item No. A-2 (a) discussed in the 75th Meeting of the Central Council of IMA held on December 27-28 December, 2014 on Govt. Sponsored Quackery:


Maharashtra Govt. has promulgated an Ordinance permitting AYUSH doctors to practice modern medicine. It is understood that the Governor has sent back the Ordinance without signing. When even a small shortcoming in treatment by qualified doctors of modern system of medicine is taken seriously with civil and criminal liabilities, what justification is there in this action of the Maharashtra Government. IMA should publicise this as a social evil, malpractice and should take it as a very serious issue. At the same time IMA, along with MCI,

Dr. Sandip Mukerjee receiving the Lifetime Achievement Award of the Association of Surgeons of India from the President of the Association at the Annual Conference held at Hyderabad.
CPR 10 
Total CPR since
1st November 2012
– 101090 trained
News on Maps

Twitter of the Day
Dr KK Aggarwal:
Health and Spirituality, a pathway to overall wellbeing http://Blogz.org/A/886144 
Dr Deepak Chopra: Gratitude is a state of being in which we feel connected to everything in the universe http://bit.ly/DC_Ananda #ananda
Quote of the Day
Once you start a working on something, don't be afraid of failure and don't abandon it. People who work sincerely are the happiest. Chanakya
Video of the Day
Dr K K Aggarwal head on with Arnab Goswami of Times Now on MCI Issues http://www.timesnow.tv/
videoshow/4468283.cms Heart Care Foundation of India announces the Mrs Abheeta Khanna Oration on Excellence in Sports and Health
watch?v=6Ktz5-iUINE Betiyan Hain Anmol, Bachao Dil Se, Medanta joins hands with Heart Care Foundation of India https://www.youtube.com/
Law and Health
Dr If mens rea is the basis on which a crime is established, IMA fails to understand the logic of bringing doctors under criminal jurisdiction. There is no criminal intention in any treatment. Cr PC 304 and 304 A should not be applied on medical and allied professionals.

Hospitals are considered to be industries or commercial institutions for tax and regulation purposes. At the same time their services are expected to be in line with medical ethics and etiquette. This mismatch in law is the cause for the perception problem regarding hospitals. This has to be addressed urgently.

Last but not the least is the Clinical Establishments Act. This single act will pave way to the disappearance of small and medium hospitals, with adverse impact on the accessibility and affordability of healthcare to our common citizens. IMA demands unequivocal revocation of this black law.

The advantages envisioned from this legislation could easily be achieved through accreditation mechanisms by professional agencies themselves. IMA will take the lead role for putting in place a suitable mechanism for this to ensure standardisation in service provision and payment mechanisms. Efforts will be made to amend the provisions under the Consumer Protection Act for capping of compensation and enhancement of penalty amount for frivolous complaints. IMA will take every effort to bring in a uniform legislation at the national level for hospital protection.
Link of Pdf

The minutes of 6th meeting of National Council for Clinical Establishments held under the Chairmanship of Dr. Jagdish Prasad, DGHS on 8th December 2014 at Nirman Bhawan, New Delhi.

(Dr. Anil Kumar), Chief Medical Officer (AK), Directorate General of Health Services Room No. 506 D, Nirman Bhawan, New Delhi-110108, Email: dr.anilkumar@nic.in

Quackery Menace

Dear Dr K K Aggarwal, Sharing with you an interesting incident for the benefit of medical fraternity. Two days back, late evening, two young men in their twenties walked into my clinic and wanted me to administer an injection that they were carrying. On my demanding a valid prescription, they said, we don't have one. They started arguing with me and said it's a harmless injection which is being given to us by our gym instructor. I told them to show that injection and to my surprise, it was injection testosterone. It became virtually impossible to refuse as at that late hour, I was alone in my clinic and very tactfully, I had to explain them about side effects of the injection to get out of the situation. It took me almost half hour to convince them. I thought this important to share with you for the benefit of masses. Regards and wishes, Dr. Ish Kathpalia.

See what happens when an Ayurveda practices modern medicine, hold abdomen in place of whole abdomen.
Sameer Malik Heart Care Foundation Fund
The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number or by filling the online form.
Madan Singh, SM Heart Care Foundation Fund, Post CAG https://www.youtube.com/watch?v=Mc3kKDXKWvs
Kishan, SM Heart Care Foundation Fund, Post CHD Repair https://www.youtube.com/watch?v=OTEG7toVkAQ
Deepak, SM Heart Care Foundation Fund, CHD TOF https://www.youtube.com/watch?v=rjOel0aaqt0

MedinewS Humor 
Flashing Traffic Camera
A man was driving when he saw the flash of a traffic camera. He figured that his picture had been taken for exceeding the limit, even though he knew that he was not speeding.
Just to be sure, he went around the block and passed the same spot, driving even more slowly, but again the camera flashed.Now he began to think that this was quite funny, so he drove even slower as he passed the area again, but the traffic camera again flashed. He tried a FOURTH TIME with the same result. He did this a FIFTH TIME and now was laughing when the camera flashed as he rolled past, this time at a snail’s pace. Two weeks later, he got FIVE tickets in the mail…for driving WITHOUT A SEAT BELT.

IJCP Book of Medical Records

IJCP Book of Medical Records Is the First and the Only Credible Site with Indian Medical Records.
If you feel any time that you have created something which should be certified so that you can put it in your profile, you can submit your claim to us at: www.ijcpbookofmedicalrecords.com/
• First person and NGO to trained Maximum Number of Police People trained in Hands only CPR10 in one day
• "First NGO and doctor to provide "hands on training" to 11543 people in "Hands Only CPR 10" in one day.
• First individual doctor and NGO to provide "hands on training" to 8913 females in "Hands Only CPR 10" in one day.
Wellness Blog 

Do I Need Multivitamin Tablets? 

• Multivitamin tablets are not needed unless there is a scarcity of a particular vitamin. 

• If you include all seven colors and six tastes in your food, there is no need for vitamin supplementation. 

• Wheat grass and barley grass juice contain folic acid and vitamin B12. 

• Anything which is green contains vitamin B. 

• Anything which is red contains lycopene. 

• Citrus foods contain vitamin C. 

• All dry fruits contain vitamin E. 

• Sunlight is an excellent source of vitamin D. 

• Carrots contain vitamin A. 

• Folic acid is lost if the food is boiled and the water is discarded. 

• Vitamin D is not absorbed if exposed to sunlight is through glass. 

• Vitamin D is not absorbed through clothes if you are fully-clothed in sunlight. 

Draft National Health Policy: Call for discussions
Dear All A National Health Policy Draft has been released by the Government. The Ministry of Health & Family Welfare (MoHFW) is accepting inputs over a two-month window until 28 Feb 2015.

Draft policy link: http://www.mohfw.nic.in/

For giving suggestions
link: http://mohfw.gov.in/draftpolicy/login.php

Please discuss this Draft in your IMA Branch in detail and circulate your thoughts to IMA for wider discussions. Please consider this on priority as the policy once formulated will stay for atleast a few coming years.

IMA Plan

1. Take inputs from all branches.
2. Take inputs from all state branches.
3. Discuss the same in national office bearers meeting.
4. Discuss the same in President and Secretaries meeting.
5. Take input from all past national presidents.
6. Take input from all national leaders forum.
7. Take input from general membership though e IMA news.
8. Call a meeting of all medical societies and take inputs.

9. Take inputs from AHPI, NATHEALTH, IMA HBI, all sate medical councils, MCI, NABH, and other stake holders.

10. A national level committee is being formed by the national president for a final draft.
Cardiology eMedinewS
• The FDA has approved the IN.PACT Admiral drug-coated balloon for peripheral arterial disease in the superficial femoral artery and popliteal artery.
• Early treatment with the aldosterone antagonist eplerenone plus an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin-receptor blocker (ARB) slows the progression of cardiomyopathy in boys with Duchenne muscular dystrophy, reported a new randomized trial published in Lancet Neurology.
10 Innovations in Medicines
5. Easy to Swallow: The Smart Pill
A tiny ingestible sensor by Proteus Digital Health "is a game changer for medication compliance." The sensor, which costs less than a penny, is placed on a pill. It gets activated by stomach juices when it's ingested. A digital signal is then sent to a Band-Aid®–like monitor worn on the patient's arm. The sensor records when the medication is ingested, as well as the patient's heart rate, body temperature and position, and rest and activity patterns. The data are wirelessly transmitted to a smartphone app, which then sends it to a provider, caregiver, or family member.
Inspirational Story
The Beaver and His Goals

It started last fall when we had a beaver move in the small stream beside our house. He immediately began taking down small trees, and within a couple of weeks our small stream turned into a small pond. Every day he added more to his damn and to his house.

We're sure you've all heard the saying, "busy as a beaver", but we never really appreciated it until we saw the work that this beaver did over a very short period of time.

With the stream now damned and his house built, we thought that would be the last of the beaver's busy activity as winter set in. But, to our amazement, he started chewing on a very large maple tree. And, we mean large. The tree is over 60 feet tall and is approximately five feet in diameter at the base. We were amazed at the challenge this beaver was attempting. Over the winter, he would come out and chew a bit more. He had setbacks as we faced major winter storms and freezing weather. We thought that he would never chew through this tree. But sure enough, when the weather allowed, he kept coming back and would chew a bit more.

With spring finally arriving, we went down to see the beaver's progress and sure enough the tree was going to come down soon!! Our beaver has now almost completely chewed around and through the entire tree.

The beaver's original goal was survival - to build a home for the winter. Working every day with that particular focus in mind, he achieved that goal. But the large maple tree he started chewing on last fall was a future goal - he wanted the large tree for the spring, to provide new food and branches to continue damning in anticipation of the spring thaw. And, even with the setbacks he faced over the winter, he never gave up.

Our point in sharing our beaver experience with you is to remind you that sometimes we have a goal to just survive, but we also need to set goals for tomorrow. And sometimes, just surviving seems to occupy all of our time - working every day, looking after our family, going to school, and so forth. But, if you do just a little bit when times allow, and keep focused on your future goal, you will achieve it.

It is also vitally important that when faced with setbacks in achieving a goal, you need to stay focused and not let the setbacks discourage you.

We know what it means to face setbacks along the way because we were once just like the beaver. We worked it seemed just for our survival, but we also had a future goal and we constantly kept moving forward to achieve that goal. Sometimes, though, weeks would pass before we could work on our goal again, and many times we had to deal with some sort of setback. While at times we felt we would never reach our goal, we never gave up and we never lost our focus. But, over more than 5 years, we did achieve our goal.
The Year in Medicine 2014: News That Made a Difference
2. MOC Debate

Debate around the American Board of Internal Medicine's (ABIM's) changes to the maintenance of certification (MOC) process started in the spring with a cardiologist-led petition. Most physicians registered despite complaints about the process, and more than 3 months later the ABIM promised to ease up on several financial and course work requirements for its revamped MOC program. However, a recent study found that physicians think the MOC process is unnecessarily complex and is "of little benefit to physicians, patients, or society." (Source: Medscape)

IMA in Social Media
https://www.facebook.com/ima.national 27791 likes
https://www.facebook.com/imsaindia 45662 likes

https://www.facebook.com/imayoungdoctorswing         235 likes
Twitter @IndianMedAssn 710 followers

Pediatrics eMedinewS
• Prescribing 5 days of strict rest to a child following a concussion offers no significant benefits in terms of symptoms, neurocognition, or balance, suggests a randomized trial published online January 5 in Pediatrics.
• A test developed by Dutch researchers has the potential to detect peripheral visual field defects in children who are too young or neurologically impaired to perform standard conventional perimetry (SCP), reported a large retrospective study published in JAMA Ophthalmology.
Make Sure
Situation: A patient with gross ascites presents with complaints of difficulty in breathing on lying down.
Reaction: Oh my God! Why did you drain so much ascitic fluid?
Lesson: Make Sure to only moderately tap ascitic fluid as overenthusiastic tapping can be life–threatening.
Dr KK Spiritual Blog
Shiksha and Sabhyata
Suno, Samjho, Jaano and Karo is the mantra for education and involves not only hearing but listening and understanding and converting understanding into wisdom by doing it practically.
One of the components of education is etiquettes or manners which can be at every level of education. In older era, Rajkumars or princes were sent to Gurukuls for formal education including that of warriorship. They were also sent to Gharanas/Kothas to learn tehzeeb the Lucknawi way where they were taught how to talk to each other and respect others. Their language in typically Lucknawi style used to be ‘we’ oriented and not ‘I’ oriented. Today’s education is more oriented towards ‘I-ness’ or ego and not towards the soul or respect.
When we were students, we were taught that a senior is a senior and needs to be respected. Even today, when we meet our teachers, we take blessings by touching their feet but today’s students believe in shaking hands or saying ‘hi’. There is more and more commercial touch in the teacher-student relationship of today.
Ego makes one rude and arrogant with a mentality full of Rajas and Tamas. Road rage, gang rapes, murders, violence, terrorism are all examples of not learning etiquettes at the right time.
eMedi Quiz
The parameters of sensitivity and specificity are used for assessing:

1.Criterion validity.
2.Construct validity.
3.Discriminant validity.
4.Content validity.

Yesterday’s Mind Teaser: The substances present in the gall bladder stones or the kidney stones can be best identified by the following technique:

1.Fluorescence spectroscopy.
2.Electron microscopy.
3.Nuclear magnetic resonance.
4.X-ray diffraction.
Answer for yesterday’s Mind Teaser: 4.X-ray diffraction.
Correct Answers received from: Dr. Rakesh Sharma Nohar, Dr Avtar Krishan.
Answer for 7th Jan Dec Mind Teaser: 3.Gelfiltration chromatography.
Correct Answers receives: Dr Rakesh Sharma Nohar, Dr Avtar Krishan, Dr. Poonam Chablani, Dr Jainendra Upadhyay.
Dr Good Dr Bad
Press Release of the Day
IMA to develop a Model Health Village – Dr. A. Marthanda Pillai

Addressing his first Press Conference, Padma Shri Awardee, Dr. A. Marthanda Pillai, National President, IMA said that under Aao Gaon Chalen Project of IMA, IMA will come out with a Model IMA Health Village in the coming year, which can be replicated at a national level, both by the Govt as well as NGOs including IMA branches.
Explaining further, Dr. Pillai said that the Model Health Village will have all parameters met within a year as defined by Millennium Development Goals.
The Conference was co-addressed by Padma Shri Awardee, Dr K K Aggarwal, Hony. Secretary General, IMA.
In a joint statement, Dr. Pillai and Dr. Aggarwal said that IMA has written to all its 1700 branches to follow Hon’ble Prime Minister, Shri Narendra Modi’s initiative of Swachh Bharat, Swasth Bharat movement. The IMA officials feel that 20% of the disease burden can be reduced if all the doctors in our country are sensitized to have their medical establishments follow hygienic principles and they in turn motivate their patients to follow the principals of respiratory, food, water and hand hygiene. The IMA officials said that they have requested each of its 1700 branches in the country to nominate 9 Medical Icons of their area to lead this campaign in the coming year.
IMA also showed concern about the inclusion of Cross pathy in the National Health Policy, which has been put by the MoHFW, Govt. of India on its website. Under this National Health Policy, the Govt is envisaging training AYUSH doctors for a limited period of time and allowing them to become midcare health providers.
IMA holds the view that it is not against AYUSH as a branch taking the front position and wants AYUSH to progress in their respective fields. However, IMA is against AYUSH doctors practicing modern system of medicine, as it will cause more harm than benefit to the patients.
IMA has already taken opinion of Joint Commission International (JCI) & National Accreditation Board for Hospitals (NABH) and is of the view that Indian Hospitals will never be able to provide quality and safe service to patients if half-baked AYUSH doctors are allowed to practice modern system of medicine.
If the Govt. goes ahead in this venture, it is a possibility that the JCI and NABH may not give accreditation to most of the hospitals, which may affect medical tourism in the country.
IMA, on the other hand, welcomes the Govt. move of making healthcare as a Fundamental Right. However, IMA made a very strong statement that “Nobody in India should die of illness, which is preventable or just because he/she cannot afford it”.
IMA in the statement also said that Govt. should also ensure their commitment of 5% of GDP as budgeted expenditure for their health care budget.
IMA expressed concern about the Govt.’s recent reduction of health budget and its spectacle to increase the GDP from 2.5% to 5% may not actually happen.
IMA’s statement is very clear of providing affordable and quality drugs to each and every person. Therefore, a public distribution system has to be in place, which IMA will support.
Today we have 75,000 Resident Doctors who are waiting for their PG and there are only 6500 rural medical vacancies, which is less than 10% of the total vacancies.
IMA feels that it can help the Govt. of India and be a link between young doctors and the Govt. and help them in filling 6500 vacancies if the Govt provides the following to these doctors:-
• A salary which is twice the normal salary as a hardship allowance.
• A free decent accommodation at the PHCs.
• Security and safety of the persons posted in the PHCs.
• Free basic drugs and investigations, as promised by the Govt. under Universal Health coverage.
• 10% extra marks in their PG entrance examinations if they complete one year of rural service

IMA will issue them a one-year certificate of training in Rural Medicine, Rural Surgery and in Public Health, which can help them to upgrade their biodata.
IMA is of the view that if no vehicle can run on the road without insurance, similarly, health insurance should be compulsory and the same should be provided by the Govt. for those who cannot afford it.
Regarding medical education, IMA is of the view that the curriculum should be revised in every 7 years and IMA should a part of the revision process. Soft skills should be included in the curriculum. IMA wants 10% of the medical curriculum to include Mental Health & Bio Ethics.
Regarding legal medicine, IMA is of the view that doctors should not come under CPA because this is a different profession. If doctors come under the purview of CPA, then they will have to be allowed to advertise, have marketing agents and do all activities, which will no more make this profession a noble one.
‘To err is human’ for this every doctor goes for indemnity insurance. But doctors want this compensation to be capped and IMA is of the opinion that a Medical Tribunal on the lines of CAT should be established by the Govt., which will take care of the responsibilities presently undertaken by MCI and CPA.
IMA is also launching its Grievance Redressal & Mediation Cell, where patients will be able to approach IMA for their redressals.
IMA will also launch many projects like Care of Elderly, Trauma Care, Waste Disposal, National Initiative for Safe & Sound against noise pollution and Reduction in maternal and infant mortality and Initiative for mental health.
Medico Legal
2 of 1930.

61of 1985.
6. In section 2 of the principal Act, for the words and figures “the Dangerous Drugs Act, 1930”, the words and figures “the Narcotic Drugs and Psychotropic Substances Act, 1985” shall be substituted.
Amendment of section 2
7 For section 3 of the principal Act, the following section shall be substituted, namely:

-„ 3. In this Act, unless there is anything repugnant in the subject or context,

- (a) “Ayurvedic, Siddha or Unani drug” includes all medicines intended for internal or external use for or in the diagnosis, treatment, mitigation or prevention of

disease or disorder in human beings or animals, and

manufactured exclusively in accordance with the formulae described in, the authoritative books of Ayurvedic,

Siddha and Unani Tibb systems of medicine, specified in the First Schedule; (b) “bioavailability study” means a study to assess the rate and extent to which the

active drug is absorbed from a pharmaceutical formulation and becomes available in the systemic circulation or availability of drug at the site of action;

(c) “bioequivalence study” means a study to establish the absence of a significant difference in the rate and extent of absorption of an active drug from a pharmaceutical formulation in comparison to the reference formulation having the same active drug when administered in the same molar dose under similar conditions;

(d) “Board” means-(i)in relation to drug other than those specified in sub -clause (iii) or cosmetic, the Drugs Technical Advisory Board constituted under section 5;

(ii) in relation to Medical Devices, the Medical Devices

Technical Advisory Board constituted under section 5A;

(iii) in relation to Ayurvedic, Siddha or Unani drug, the Ayurvedic, Siddha and Unani Drugs Technical Advisory Board constituted under section 33C ;

(e) “Central Drugs Laboratory” means a laboratory established or designated by the Central Government under section 6;
Substitution of new section for section 3



Reader Response
Respected Sir, Non MBBS doctors in UP Govt. Hospitals regularly prescribe allopathic medicines including quinolone groups with the full knowledge of the authorities in the government set up. This is not new. There must be some sort of restriction. Under your leadership this issue needs to be raised with the higher authorities of the UP health set up. Congratulations for bringing this to the notice of all. With regards, Yours Sincerely, Dr BM Das, TC, IMA GFATMPPMRNTCP
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