in this issue - association of medical consultants, mumbaiin this issue • medico-legal liabilities...

Official Journal of the Association of Medical Consultants, Mumbai Published Quarterly in May, August, November, FebruaryVol. 40 Issue No. 2 Aug. 2011

IN THIS ISSUE• MEDICO-LEGAL LIABILITIES OF

COSMETIC SURGEONS• CRIMINAL PROSECUTING A MEDICAL

PRACTITIONER• WORkSHOP ON PREVENTING MEDICAL

& LEGAL PROBLEMS IN PRACTICE• LIVER TRANSPLANT - MY JOURNEY• FROM THE PRESS

For Private Circulation Only

Mark your Date

AMC MEETVenue:

United 21 Hotel, ThaneDate: 18th Sep. 2011

1Vol.40 • Issue No.2 • August 2011

EDITORIAL BOARD

EDITORDr. Gupta Mukesh

CO-EDITORS Dr. Baliga Pradeep Dr. Shukla Ashok

ADVISORY BOARDDr. Kapoor Lalit M.

Dr. Rao P. N. Dr. Oza Umesh

BOARD OF TRUSTEES MANAGING TRUSTEE

Dr. Kapoor Lalit M.

TRUSTEESDr. Suchak Anil N. Dr. Pandit Bipin Dr. Rao Suresh S.Dr. Nayak AchyutDr. Naik Dilip S.Dr. Shah Bipin V.

WEBSITEwww.amcmumbai.com

WEB EDITORSDr. Checker Vipin

WEB CO-EDITOR Dr. Arshad G. Moh’d.

Dr. Rao Sujata Dr. Dani Saurabh

DISCLAIMERUnless otherwise stated, the opinions expressed by the writers are their personal opinions. The AMC reserves the right to use material published in ‘The Grasp’ for its Website or for any other purpose deemed necessary.

The appearance of advertisement in ‘The Grasp’ is not guarantee or endorsement of the product or the claims made by the manufacturer/ advertiser.

ASSOCIATION OF MEDICAL CONSULTANTS, MUMBAI4, Ganpati Niwas, Old Police Lines, Opp. Andheri Station,

Andheri (East), Mumbai - 400 069.Tel.: 2684 4639 / 2683 6019 (10 a.m. to 6 p.m.)

Telefax : 2682 1109e-mail : [email protected]

MANAGING COMMITTEE (2011 - 2012)President Dr. Agarwal Niranjan President Elect Dr. Hariani Ajay R. Imm. Past President Dr. Walavalkar Rajeev Vice President Dr. Khambay Sabh Singh Vice President Dr. Rao Sujata Hon. Secretary Dr. Adyanthaya Kishore Hon.Treasurer Dr. Arshad G. Moh'dHon. Jt. Treasurer Dr. Pikale Sangeeta Hon. Jt. Secretary Dr. Pandit VeenaHon. Jt. Secretary Dr. Baliga Pradeep Prog. Committee Chairperson Dr. Sharma Smita Office Secretary Dr. Vazzifdar Khurshed Editor- The Grasp Dr. Gupta Mukesh Web Editor Dr. Checker Vipin

ZONAL DIRECTORS

Dr. Agarwal Shivbhagwan N. Dr. Badwe Shrikant Dr. Dave Rajesh Dr. Desai Ajit K. Dr. Kulkarni Gurudas B. Dr. Naik Dilip Dr. Oza Umesh Dr. Shah Bipin V.

COMMITTEE MEMBERSDr. Bahekar Pramod Dr. Begani Manmal Dr. Chawhan Rajendra Dr. Dani Saurabh Dr. Desai Ajit G. Dr. Gandhi Rajesh Dr. Hedge Dinesh Dr. Kate Suhas Dr. Lokras Girish Dr. Matcheswalla YusufDr. Mital Kushal Dr. Patel Manoj Dr. Pattiwar Sanjay Dr. Rao Nitin Dr. Sahetya Raju Dr. Sangoi Manoj Dr. Sawant Ganpat Dr. Shah Suhas Dr. Sheikh Parvez Dr. Shukla Ashokkumar Dr. Vaidya Deepak

CHAIRPERSON OF CELLSConsultants Benevolent Scheme Dr. Shah Bipin V.H & A Cell Dr. Rao Suresh S. Infrastructure Cell Dr. Naik SudhirMedico Legal Cell Dr. Datar NikhilSocial Service Cell Dr. Agarwal Shivbhagwan N. Public Relation Cell Dr. Pikale Sangeeta

Edited by : Dr. GUPTA MUKESHCo-ordinated at JAI GRAPHICS, Kandivali (East), Mumbai - 400 101

Telefax: 2885 1832 • e-mail: [email protected]

For Association of Medical Consultants, Mumbai. (For Private Circulation Only)

Jankharia Imaging

Advantages of HIFU

Piramal Diagnostic Services and Jankharia Imaging Venture

PET/CT, 3T-f MRI & HIFU Ablation

Piramal Tower Annexe, Gr. Floor, G K Marg, Lower Parel, Mumbai -13.

W www.fibroidrelief.in, www.piramaldiagnostics.com, www.jankharia.com

M 0 98202 40709 E [email protected], [email protected] F 022 2382 9595

�

�

�

�

�

�

�

Preservation of uterusNo pre-operative and post-operative hospitalisationNo incision and no external scar on abdominal skinNo anaesthesia (only mild sedation, if required)No radiationNo blood lossNo claustrophobia (as the patient’s head remains outside the gantry of the MRI scanner and only the abdominal portion goes in)

MRI-guided HIFU

High-Intensity Focused Ultrasound

a non-surgical alternative to treatment of fibroids

I N T R O D U C I N G

A window to a new technology

Uterine Fibroids Troubling you?

Pain in the lower abdomen?Heavy bleeding during periods?

Intermenstrual spotting?

Pain during menstruation?

For appointments & more information, contact

0 98202 40709


Jankharia Imaging

Advantages of HIFU

Piramal Diagnostic Services and Jankharia Imaging Venture

PET/CT, 3T-f MRI & HIFU Ablation

Piramal Tower Annexe, Gr. Floor, G K Marg, Lower Parel, Mumbai -13.

W www.fibroidrelief.in, www.piramaldiagnostics.com, www.jankharia.com

M 0 98202 40709 E [email protected], [email protected] F 022 2382 9595

�

�

�

�

�

�

�

Preservation of uterusNo pre-operative and post-operative hospitalisationNo incision and no external scar on abdominal skinNo anaesthesia (only mild sedation, if required)No radiationNo blood lossNo claustrophobia (as the patient’s head remains outside the gantry of the MRI scanner and only the abdominal portion goes in)

MRI-guided HIFU

High-Intensity Focused Ultrasound

a non-surgical alternative to treatment of fibroids

I N T R O D U C I N G

A window to a new technology

Uterine Fibroids Troubling you?

Pain in the lower abdomen?Heavy bleeding during periods?

Intermenstrual spotting?

Pain during menstruation?

For appointments & more information, contact

0 98202 40709

Dear Friends,

There is an interesting point to understand the origin of our National motto.

“Satyameva Jayate” (satyam-eva jayate सत्यमेव जयते) (Literally: “Truth Alone Triumphs”) is a Hindu mantra from the ancient scripture Mundaka Upanishad. Upon independence of India, it was adopted as the national motto of India. It is inscribed in Devanagari script at the base of the national emblem. The emblem and words ‘Satyameva Jayate’ are inscribed on one side of all Indian currency. The emblem is an adaptation of the Lion Capital of Asoka which was erected around 250 BCE at Sarnath, near Varanasi in the north Indian state of Uttar Pradesh, but does not contain the motto. The origin of the motto is a well-known mantra 3.1.6 from the Mundaka Upanishad.[2] The full mantra as follows:

satyameva jayate nānṛtaṁ satyena panthā vitato devayānaḥ | yenākramantyṛṣayo hyāptakāmā yatra tat satyasya paramaṁ nidhānam||[3]

Meaning:

Truth alone triumphs; not falsehood. Through truth the divine path is spread out by which the sages whose desires have been completely fulfilled, reach where that supreme treasure of Truth resides.

An interesting article on Web portrays the History of Corruption in India:-

The economy of independent India was under socialist-inspired policies for an entire generation from the 1950s until the late 1980s. The economy was subject to extensive regulation, protectionism, and public ownership, leading to pervasive corruption and slow growth.

License raj was often at the core of corruption. Dams were constructed, National Highways and roads were built and Infrastructure of the nation was set up by the state in that era. Corruption was limited to the bureaucrats and the elite. Then came the Capitalist era which not only changed the scale of the game but also took it to the root level. So much so that India is now ranked 84th in the Corruption Perceptions Index (CPI) calculated by Transparency International (TI) – A non-governmental organisation that monitors and publicises corporate and political corruption in international development

COLOR CORRUPTION PeRCePTION INDeX 9 - 108 - 8.97 - 7.96 - 6.95 - 5.94 - 4.93 - 3.02 - 2.01 - 1.00 - 0.9No information

EDIT SPEAk Dr. Mukesh Gupta

A report was submitted by the former Indian Union Home Secretary, N. N. Vohra, in October 1993. It studied the problem of the criminalisation of politics and of the nexus among criminals, politicians and bureaucrats in India. The report contained several observations made by official agencies on the criminal network which was virtually running a parallel government. It also discussed criminal gangs who enjoyed the patronage of politicians — of all political parties — and the protection of government functionaries. It revealed that political leaders had become the leaders of gangs. They were connected to the military. Over the years criminals had been elected to local bodies, state assemblies, and even the Parliament. The unpublished annexure of the Vohra Report are believed to have contained highly explosive material. In the old days, particularly pre-1991, when the License Raj held sway, and by design, all kinds of free market mechanisms were hobbled or stymied, and corruption emerged almost as an illegitimate price mechanism, a shadowy quasi-market, such that scarce resources could still be allocated within the economy, and decisions could get made. These were largely distortions created by the politico economic regime. While a sea change has occurred in the years following 1991, some of the distorted cultural norms that took hold during the earlier period are slowly being repaired by the sheer forces of competition. The process will be long and slow, however. It will not change overnight. One of the major problems and obstacles to development that many developing countries face is corruption by greedy, power-hungry politicians, which is endemic in certain parts of the world.

Political and bureaucratic corruption in India is a major concern. Several Indians had first-hand experience of paying bribes or influence peddling to successfully complete jobs in public office. Taxes and bribes are a fact of daily life and common between state borders; Transparency International estimates that truckers pay US$5 billion in bribes annually. In 2010 India was ranked 87th out of 178th countries in Transparency International’s Corruption Perceptions Index.

We have imbibed in our culture the Chanakya niti of SAM, DAM, DAND and BHED for ruling a country effectively. The desensitization against corruption starts from the obtaining of birth certificate to release of dead body…and in crematorium. Bribe is given to expediate the cremation to obtaining dry wood for the Vidhi. This process is continuous. System is running very smoothly. Any disruption in this smoothly going process disturbs us. We don’t like to be disturbed. When will we rise from slumber…Hope we live to see that day. ”Sab Chalata Hai.”…has become our new motto from …”Satyamev jayte”

e-mail: [email protected]

Vol.40 • Issue No.2 • August 20114


Dear Members,Greetings for the forthcoming festive

season. This period of the year witnesses festivals of all religion like Janmastami, Ganesh and Navratri for Hindu’s, Ramzan for Muslim’s, Paryushan for Jains and Navina for Christians. This time is therefore an auspicious time for all and I pray it holds true for AMC too.

The last word on the most nagging of all issues i.e. the COU is PROBABLY said and all l except the pre-1962 will have to get their premises regularised. Our attempt to ease the process have been fruitful and lots of hurdles for people who paid the Demand Notices have been cleared by our successful attempt in getting the Chief Engineer, Building Dept., Mr. kuknoor to visit the Peripheral Zonal Offices and accept the applications. A lot of air has been cleared by his visits and applications are now being accepted and files cleared. Many have received their COU too. Attempts at slums, MHADA and NOC are also underway and some decision will be conveyed to us regarding their regularisation. I thank Mr. kuknoor for his proactive role and handling of the matter. An Architect has also been suggested by AMC to help our members at negotiated reasonable rates. The same rates were also offered to other Architects but none agreed proving that our bargain was a huge discounted offer

compared to the existing market rates. Having done that I need to emphasise the fact that the feedback from our members on the status of their applications is a must as only then can we solve individuals problem. However I must inform you that whenever we take up a matter of a small group of particular problem the Addl. Municipal Commissioner first points out that only 200/800 people who have been issued demand notices have paid and they would first clear the apparently majority files without any problem and then take individual problem. I wonder when the fence sitters will decide!

The second legacy which got carried forward to my Presidential year was the PPN and TPA issues. We have had a series of meetings with the GM and DGM of New India Assurance Co. representing the GIPSA.

Negotiations based on our AGM mandates are being done but I admit that all our views are not being accepted. Though they seem to be more flexible in their approach now, after all they are Business Corporate hell bent upon decreasing their costs and losses. In a nutshell all that is being guaranteed as of now is a total transparency in the manner of their working including further empanelment process. Serious efforts are on to get

PRESIDENT'S REPORTDr. Niranjan Agarwal

the best possible deals for our members and once things are crystallised we will summon a Special Gen. Body Meeting for the same and take a final decision on this. I agree that few of our opportunistic friends have already given into their hands and therefore a cause for heart burn amongst others, but, believe me, it is the majority still united that is ensuring their flexibility, as a year back these people were not ready to bend an inch. We have nothing in writing so far and therefore the lack of communication on this issue. I appeal to all to remain united as that is the only way to strengthen our bargaining power for the larger interest of our members. Our united front has filed their PPN model in Mumbai and raised their claim ratios by approx 20% and while only few amongst us are feeling the heat of loosing, those few members in majority are very happy and wish to continue the boycott. A final decision will however be taken in the SGBM and I request you all to attend the same as and when it is summoned to air your views and help us take a decision.

On both the above I would like to emphasise that being a body of more than 7000 members differences in opinion are bound to be there, not only amongst our members but also amongst the way another similar organisation may work. So long as the basic goal of doctor’s welfare is maintained and respected the path hardly matters and both successful and unsuccessful could make us clever in our further attempts. All differences in opinions can be discussed, deliberated and suitably acted upon but any attempts to malign AMC's image or cast aspersion on its intentions will not be taken lying down.

The PCPNDT issue seems to be erupting as a large volcano and a defensive government

is trying to push all the blames of the declining sex ratio on our fraternity. This is a classical example of how one blacksheep can malign the entire lot. The new rules and regulations being framed may just redefine the way emergency medicine is practiced. We at AMC are making every attempt to get all concerned together and ensure an united fight against the excesses on our genuine members.

AMC Doctor's Day celebrations on 26th June were a big hit with nearly 2500 bottles of blood collected for the blood donation camp. I would like to congratulate Dr. S. N. Agarwal and his team for all their efforts and a special thanks to the Mira Road to Dahanu belt for collecting the highest number of bottles even this year. The evening celebrations with the symposium on trauma saw AMC getting points for MMC accreditations and the gala function at Birla Matoshree is being remembered and talked about even today. We are organising our first zonal meet in the form of a mini AMCON on 18th of September at Thane and request all of you to participate in large numbers there. The details are listed in The Grasp and the brochure.

AMC has now walked out of Mumbai finally and witnessed a highly successful programme on medico-legal issues at Bangaluru on 3rd July and soon AMC Bangaluru, AMC Manglore and AMC kolhapur will be a reality. Before I relinquish my post I assure you all that the seeds of AMC INDIA will have been sown officially.

Friends I need your cooperation and guidance in steering this huge body to fulfill expectations from all its members. Please oblige by doing so.




HON. SECRETARY'S REPORTDr. Kishore Adyanthaya

Wishing you all a happy Independence Day!

DOCTOR'S DAY was celebrated with blood donation drive followed by Symposium on Trauma Management and Doctors Award night. We have issued one credit point for attending the symposium and efforts are being made to get credit points for all AMC programmes.

Doctor's Day award function was a grand success with thousand seater Birla Matoshree hall filled to the brim. Other than dance, music and mimicry our own members who are Padma awardees and B. C. Roy awardees were felicitated. Our past presidents were honoured and the grand finale was Life-time Achievement Award to Dr. Lalit kapoor who has steered the destiny of AMC for last 37 years.

Our association is growing rapidly and our membership has crossed 7000 mark. Now we are growing at the rate of one consultant a day and that is a very healthy indicator. Probably this is the time to spread our wings to other cities. Towards attaining this our association held a seminar in Bengaluru on “Medico-legal Issues in Clinical Practice”. More than 300 attended the meeting. Consultants from there now want to initiate a process to start an association there and we are

working on how best we can help in their venture. There are lots of enquiries from places like Hyderabad, Ahmedabad, Surat, kolkatta and Chennai for forming local Association of Medical Consultants. We are in the process of starting AMC kolhapur and team will be visiting there soon.

Few members accompanied a group of pilgrims to Hemkund Sahib and Badrinath. They conducted medical camps in various remote areas and provided them with much needed medicines.

At last there seems to be light at the end of the tunnel. Change of User and registration of Nursing Home are being done. During our repeated meetings with Chief Engineer Mr. kuknoor, we have been apprising him of problems faced by us with the staff at zonal offices and persuaded him to personally visit these places. He has been doing the same and is trying to solve our problems. Even though more than 200 nursing homes have paid the Demand Note many of them have not submitted the architect plan this in spite of AMC providing them with a licensed architect. We still do not get feedback from people who have change of user certificate as nobody informs us. This is very embarrassing when the Municipal Commissioner and Additional Commissioner asked how many of us have


COU. Those going to court on this issue met the Municipal Commissioner along with the Lawyers who gave a very patient hearing and has promised to give his reply in few days, which is awaited.

On the TPA we had repeated meetings with the Insurance companies. The last one was held in the first week of August with New India Assurance Company. After that we will meet the GIPSA companies and hope to resolve this issue soon.

One bus is already full on tour of Spain

Portugal and Istanbul. Application for Schengan visa is already on process as it takes some time. Group leaves on September 23.

Programme committee has already started work on AMCON. This year its going to be two days affair. Apart usual Oration, lectures and debate much more can be expected. AMC meet is fixed on September in Thane, hoping to meet you all there.


Let me thank you all for appointing me for the post of zonal director of

central suburbs -Thane onwards. The post got vacated due to election of Dr. Achyut Nayak as one of the trustees. I am fully aware of the excellent work done by him and the responsibilities required to carry forward the same. The first event after I assumed was the Blood Donation Camp at Thane and Dombivali. We collected 138 bottles of blood, of which 112 were from Dombivali, thanks to the special efforts put by Dr. Bahekar, Dr. Baliga and Dr. Lokras

ZONAL DIRECTOR'S REPORTDr. G. B. Kulkarni

under the guidance of Dr. Achyut Nayak. Now, the managing committee has shown confidence in us by asking us to host the 1st Mini zonal AMCON at Thane. We have planned it at 'United 21', the 4 star club in city of Thane on 18th September 2011, 4 pm onwards. It will be a blend of academics and cultural events. It is my humble request to book this date for a visit to Thane. We, the zonal members, are eagerly waiting to welcome you all.


.......................................................................


In recent years, there has been an exponential rise in the demand for

cosmetic surgery in this country. Of course there are many obvious reasons for this viz. the craving for youth and beauty in society, no doubt fuelled by images in print and electronic media, movies and other communication channels; the mind-boggling advances in medicine and technology and easy access to these; the steadily rising disposable incomes of people in the wake of economic upturn in the country and the fact that undergoing cosmetic surgery has lost any stigma it may have had in the past. In view of this, cosmetic surgeons have probably never had it so good. Interestingly, this overwhelming demand for surgery has not been dampened by the fact that no insurance company re-imburses medical costs of cosmetic surgery!

However, cosmetic surgeons, and indeed the non-surgical cosmetologists as well, need to recognise that the attendant risks of medico-legal liability are now an increasingly challenging reality. Undoubtedly, as I have always maintained, the best way to deal with medico-legal problems is to prevent them and hence it is worthwhile trying to pre-empt these problems by trying to understand their genesis.

Generally speaking, cosmetic surgery is considered to be a high-risk specialty as far as malpractice litigation is concerned. This is underscored by the fact that Indian insurance companies have steadfastly refused to underwrite risks of liability

DO’S AND DON’TS MEDICO-LEGAL LIABILITIES OF COSMETIC SURGEONSDr. Lalit M. Kapoor

following cosmetic surgery. In the Western countries, this is not the case and one can get insurance cover against this liability. ironically, the insurance companies deny cover to those who need it most, just as banks are eager to give loans to those who don’t need them. Nevertheless, the good news is that AMC fought long and hard on this issue and eventually succeeded in getting its insurance company to cover this liability even though at an added cost . AMC cosmetologists can breathe easy since they can now get malpractice indemnity. They can also consider themselves unique since no other insurance policy in the country affords this protection.

Getting back to the question: Why are cosmetic surgeons considered more vulnerable to medico-legal problems ?

The following factors may explain this:

(a) The quality of results is ultimately assessed by the patient and hence extremely subjective.

(b) There is more than average risk of a mismatch between patient’s expectations and results obtained.

(c) Patients who seek cosmetic surgery could have personalities which are less likely to tolerate imperfection.

(d) Possibility of permanent disfigurement adds to the risk of patient wanting to claim ‘damages’.

Of course, the possibility of per–operative and post-operative complications would be

the same as in other branches of surgery though there are specific complications such as under or over correction, asymmetry, implant failure, disfigurement, and so on.

Perhaps, the key preventive measure lies in patient-selection. One must understand the motivation, expectations as well as sub-conscious desire of the patient before elective surgery. You must discourage wrongly motivated patients especially patients below 18 years. Do not let a patient bully you into an operation as it is safer to say ‘No’ before an operation than “Sorry, I couldn’t give you the result you wanted’ after the operation. And for those whom you decide to operate, build realistic expectations. Beware of the excessively demanding patient who brings photographs, drawings and architectural specifications! In relevant cases, insist on a psychological assessment of the patient prior to surgery.

The other factor that assumes the greatest importance is accurate and diligent record-keeping and cosmetic surgeons cannot afford to be lax in this respect. The pre-operative or pre-procedure photographs are important documents and need to be meticulously recorded and preserved. Good records are not only critical to the delivery of safe and competent treatment, they are also your best defence against patient allegations.

Unquestionably, the importance of pa-tient’s consent for surgery cannot be overemphasised. The following points must be remembered:

(a) Consent taken should not be of the ‘routine’ type. As far as possible take ‘operation-specific’ consent which details the procedure as well as the possible risks and complications .

(b) Preferably, consent should not be in a language the patient does not understand i.e consent forms should be designed in regional languages as well

(c) ‘Informed consent’ is mandated by law in the USA and not taking it is considered as negligence per se. Indian courts too are taking a similar view as evident from a few recent judgments. Informed consent involves making sure the patient understands the nature of his condition, the alternate treatments and procedures available; the nature of the proposed treatment and the chances of success or failure of the procedure.

Another important cause of malpractice litigation lies within us viz. the proclivity of many doctors to criticise colleagues especially the previous treating surgeon. Often this amounts to provoking the patient and many a litigation has its genesis in ill-advised and provocative statements by the second surgeon. This factor can be easily minimised, if not eliminated if only we resist the temptation to exhibit one-upmanship.

Lastly, the incidence of allegations by patients of sexual misconduct, or inappropriate behavior against cosmetic surgeons, is more than the average for all other specialists. Hence special care must be taken in this regard and male doctors must NEVER examine female patients without the presence of a female attendant or female relative.

Recently, three cosmetic surgeons faced medico-legal problems two in cases of Liposuction and one in a case of Mammoplasty. In one case, of Liposuction, the patient demanded that her money be refunded or else she would make a nuisance of herself (hints of blackmail).

Despite all precautions, we may not be able to avoid problems -but we should definitely try to put into place some of the measures outlined above. But these measures should be sincere and not ‘cosmetic’ !!

After all, it is better to be safe than sorry.




In Dr. Suresh Gupta v Govt. of N.C.T. of Delhi & Anr. the Supreme Court of India

for the first time set the law with respect to criminal prosecution of a medical practitioner. The Apex Court said for fixing criminal liability on a doctor or surgeon, the standard of negligence required to be proved should be so high as can be described as “gross negligence” or “recklessness”. It is not merely lack of necessary care, attention and skill.

After the Suresh Gupta’s case, Jacob Mathew v State of Punjab & Anr. came up before a three judge bench of the Supreme Court which was presided over by the Chief Justice of India. Justice Lahoti, the Chief Justice of India, once and for all settled the law in this regard.

Jacob Mathew judgment is known for settling the law on numerous issues vis-à-vis medical practice but it will be forever remembered as, for the first time, the Apex Court has very clearly laid down the guidelines as to how a medical practitioner should be arrested and prosecuted for an act of medical negligence.

These guidelines were very much required

as the law enforcing agencies were indiscriminately using the vast powers vested in them by the Criminal Procedure Code inasmuch as the doctors who were called to record statements were illegally detained. This was not withstanding the fact that the police were lay persons when it came to understanding the intricacies of a medical mishap.

The Supreme Court is of the opinion that the investigating officer and the complainant in a private criminal complaint cannot always be supposed to have knowledge of medical science so as to determine whether the act of the accused medical professional amounts to rash or negligent act within the domain of criminal law.

The criminal process, once initiated, subjects the medical professional to serious embarrassment and sometimes harassment. He has to seek bail to escape arrest, which may or may not be granted to him. At the end, he may be exonerated by acquittal or discharge but the loss which he has suffered in his reputation cannot be compensated by any standards.

The Supreme Court is of a further opinion

CRIMINALLY PROSECUTING A MEDICAL PRACTITIONER – SUPREME COURT GUIDELINESDr. Gopinath N. Shenoy

that the services which the medical profession renders to human beings is probably the noblest of all, and hence there is a need for protecting doctors from frivolous or unjust criminal prosecutions. Many a complainant prefers recourse to criminal process as a tool for pressurising the medical professional for extracting uncalled for or unjust compensation. Such malicious proceedings have to be guarded against.

Therefore the Apex Court felt the need to lay down certain guidelines for the future which should govern the prosecution of doctors for offences of which criminal rashness or criminal negligence is an ingredient.

The guidelines laid down by the Supreme Court for prosecuting the medical practitioner are as under:

A private criminal complaint may not be entertained unless the complainant has produced prima facie evidence before the Court in the form of a credible opinion given by another competent doctor to support the charge of rashness or negligence on the part of the accused doctor.

The investigating officer should, before

proceeding against the doctor accused of rash or negligent act or omission, obtain an independent and competent medical opinion preferably from a doctor in government service qualified in that branch of medical practice who can normally be expected to give an impartial and unbiased opinion applying Bolam's test to the facts collected in the investigation.

A doctor accused of rashness or negligence may not be arrested in a routine manner (simply because a charge has been leveled against him).

Unless his arrest is necessary for furthering the investigation or for collecting evidence or unless the investigation officer feels satisfied that the doctor proceeded against would not make himself available to face the prosecution unless arrested, the arrest may be withheld.

If these guidelines were to be explained in simple terms this is what it means.

Whenever the police get the information of an act of alleged medical negligence or an unnatural death supposedly to have been caused by a medical practitioner, they are to come to the hospital premises and take custody of the body after performing



a “panchnama”. Panchas means witnesses and panchnama is a recorded statement of the witnesses – usually two.

Custody of the indoor case papers (Xerox or original which has to be collected under acknowledgement) is also taken by the police.

The body is then to be sent for a medico legal postmortem. In Maharashtra such postmortems are to be performed by two forensic experts.

In the mean while the police record statements of all concerned.

The police have then got to wait for all the postmortem reports i.e. the gross postmortem report, the chemical analysis and histopathology report and the “final” postmortem report. In Mumbai this can take a lot of time around 3-6 months.

The entire file with indoor case papers, the recorded statements and all reports is then to be sent to a Government Hospital where the Dean or the Superintendent forms an expert committee which goes through the papers and gives a prima-facie opinion as to whether there is criminal negligence or otherwise.

No doctor for an alleged act of medical negligence can be arrested up to this point of time.

A doctor can subsequently be arrested only if the expert committee gives an opinion that prima facie there appears to be negligence on the part of the doctor. Here it is pertinent to note that the negligence referred to herein is “criminal” negligence which is very different from civil negligence.

If the offence is a bailable one, police has to give bail.

The doctor is to be kept under custody only if the offence falls under the non-bailable

category.

Detained doctors are to be produced before the judiciary who usually give doctors bail.

If the doctor is charged for both bailable and non-bailable offences, the whole offence is processed under the non- bailable category. The police are vested with immense powers and can apply any section of the Indian Penal Code like, for example, a table death may be regarded as a murder and Section 302 of the Indian Penal Code could be made applicable.

One cannot predict how large hearted the investigating officer can get. It is therefore always advisable to go in for an anticipatory bail. Applying for an anticipatory bail does not mean that the applicant is guilty of a criminal act. The judiciary is well aware that the same is done to escape harassment and avoid an unnecessary arrest. Anticipatory bail is usually granted to a medical practitioner for an act of alleged medical negligence.

Today the police have been instructed to follow these guidelines and so there is no fear of arrest until the expert committee indicts the medical practitioner.

In Martin F. D’Souza v Mohd. Ishfaq the Hon’ble Apex Court has ruled:

“We further warn the police officials not to arrest or harass doctors unless the facts clearly come within the parameters laid down in Jacob Mathew’s case, otherwise the policemen will themselves have to face legal action”.

If the police do not follow the guidelines as laid down by the Apex Court, a complaint against all the involved police officers can be filed before the State Human Rights Commission.


Call 9920127317 or email us on [email protected] & let us take charge of your recruitments


17th SEPTEMBER 2011 - 12:30 TO 5.00 PMVENUE :

Association of Medical Consultants, 2nd floor, Ganapati Niwas Police lane Andheri (E), Mumbai

TENTATIVE PROGRAMME:

12:30 - 1.00 PM REGISTRATION / LUNCH

1.00 - 1.10 PM SESSION I: LEARNING THROUGH GROUP wORk How often do errors occur? - Dr. Nikhil Datar

1.10 - 2.05 PM SESSION II: ROLE PLAy How errors occur? Can we prevent them? - Dr. Nikhil Datar

2.05 - 3.00 PM SESSION III: QUIz THE ExPERTS How to Communicate adverse event? - Dr. Karthik

3.00 - 3.55 PM SESSION IV: BRAIN STORMING What does the law say? - Prof. Rajan Madhok

3.55 - 4.50 PM BRIdGING THE GAP IN dOCUMENTATION & CONSENT

4.50 -5.00 PM CONCLUSIONS & VOTE Of THANkS

HIGHLIGHTS Of THE wORkSHOP:

No lectures; only interaction, role plays, group work, brain storming and doubt solving etc.

Prof. Rajan Madhok (Medical Director, NHS Manchester UK) will be the international faculty along with other eminent national faculty.

Certificate for attendance and MMC credit points (applied for)

Only 20 seats, On first Cum first basis

registratiOn fees Rs. 1500/-fOr registratiOn: COntaCt amC OffiCe and bOOk yOur seat tOday.

COnvenOrs: dr. lalit kapOOr, dr. nikHil datar & team.

18th SEPTEMBER 2011 - 4 pm. ONWARDS

VENUE : UNITED 21 HOTEL, THANEREGISTRATION: RS 450/- FOR MEMBERS AND SPOUSES

RS 850 FOR NON-MEMBERS

REGISTRATION / TEA AND COFFEE

SCIENTIFIC BASIS OF YOGA THERAPY IN CONVENTIONAL MEDICINE- DR. S. D. PHATAK (CONSULTANT SURGEON AND YOGA SPECIALIST)

LIFE STYLE DISEASESTRESS BOMB OR GENETIC LIABILITY- DR. SHASHANK JOSHI (ENDOCRINOLOGIST & METABOLIC PHYSICIAN)

REDUCING MEDICAL ERRORSIMPORTANCE OF STANDARDISING HEALTHCARE- DR. RAJAN MADHOK (MEDICAL DIRECTOR, NHS, MANCHESTER, UK)

BREAK

AMC ACTIVITIES - DR. KISHORE ADYANTHAYA

PANEL DISCUSSIONDECLINING SEX RATIO A MEDICO-SOCIAL CONCERNMODERATORS: DR. ANAND PARIHAR & DR. PRADEEP BALIGAPANELISTS : DR. DATTA PANANDIKAR - GYNEOCOLOGIST

DR. S. N. AGARWAL - GYNEOCOLOGISTDR. ANURADHA SOVANI - CLINICAL PSYCHOLOGISTDR. PAROPKARI - MEDICAL OFFICER HEALTH, NAVI MUMBAIDR. S. M. SAPTANEKARADV. MADHAVI NAIK - GEN. SEC., STATE BJP MAHILA AGHADIDR. JIGNESH THAKKER - HON. SECRETARY, IRIA

DINNER


LIFE TIME ACHIVEMENT

AMC-AWARDEE-2011

PADMA VIBHUSHAN

PADMA BHUSHAN

PADMA SHREE

PAST PRESIDENTS


The Doctor’s Day programme was celebrated on 26th June 2011. The day

began with the blood and organ donation drives and medical camps across the city. Dr. Suhas kate the Convener of this event has written the details in his report.

The second part of the programme took place at Bombay Hospital. Under the able leadership of Dr. Niranjan Agarwal, AMC introduced an academic symposium in the afternoon at the S P Jain auditorium. The “Symposium on Management of Trauma” was a highly informative and comprehensive session. The esteemed speakers were Dr. N. S. Laud, Dr. Lalit kapoor, Dr. Shailesh Mohite and Dr. Sanjay Oak and each one threw light on different aspects of trauma care. We chose the specialty of trauma as it is a multi- disciplinary concern and unfortunately seems to be the need of the hour. The programme was well attended and for the first time AMC had MMC credit points for the programme.

This was immediately followed by the Doctor’s award and felicitation night at the Birla Matoshree Sabagriha, one of the prestigious large size auditoriums in our city. We felicitated our senior doctors who have been recipients of the Padma awards. The programme was inaugurated by lighting of the lamp by Padma Vibhushan Dr. B k Goyal (the only recipient of all three categories of Padma awards) and the other dignitaries and office bearers. We also felicitated our Past Presidents. One of the highlights of the show was the Life time Service Award, instituted by the Sanjeevani Foundation to our Managing Trustee Dr. Lalit kapoor.

These award ceremonies were interspaced with a variety acts by ZEE TV group. The

DOCTOR'S DAY REPORTDr. Smita Sharma Programme Committee Chairman

performers were the winners of Dance India Dance and SaReGaMaPa shows. Manish Paul with his flair and style compeered the show and got the audience to participate. There were scintillating live performances by Shakti, Sugandha Mishra, Toby and their troop. The show was well directed by Pankaj Bagreecha of ZEE group.

A highlight of the show was a fashion parade in which our lovely ladies from AMC walked the ramp. They were immaculately dressed and presented beautiful ornaments which they adorned. It was an entertaining family evening. Photographs of the programme are available on

AMC DOCTORS AWARD NITE 26-06-2011

https://picasaweb.google.com/ 111164425748829443822/AMCDOCTORSAWARDNITE26062011?authuser=0&authkey=Gv1sRgCKbrzLX9-uCChwE&feat=directlink

We are also considering making the DVDs available for sale.

I thank Dr. Niranjan Agarwal - President and Dr. Bipin Pandit – Organising Chairman for their leadership and guidance and the entire managing committee for their tireless efforts in organising this event. We thank MLAs Shri Gopal Shetty, Dr. Deepak Sawant and Shri Mangal Prabhat Lodha for attending the programme. We acknowledge ALkEM Pharmaceuticals and Opulence Jewelers for their support for the programme. The rain gods also cooperated with us and hence deserve a special mention. I hope our members enjoyed the evening and we look forward to the forthcoming events this year.



REPORT OF DOCTOR’S DAY BLOOD DONATION DRIVE

AMC has been conducting massive voluntary Blood Donation Drives on

occassion of Doctor’s Day every year for past six years.

This year also we had organised Blood

Donation and Organ Donation Awareness Drive at 24 different centers across Mumbai. We could collect 2591 units of blood from voluntary donors from all walks of life e.g. doctors, relatives, friends, students, lay persons etc.

Following is the list of major contributors this year:

POSSA’S HOSPITAL, UTTAN DR. SEVERIN POSSA 661

SEVEN SQUARE ACADEMY SCHOOL, MIRA-ROAD (E) DR. SHILPA AGARWAL 330

SHIVLEELA SADAN, RAM MANDIR ROAD, BHAYANDER (E) DR. S.N. AGARWAL 51

SUCHAk HOSPITAL, MALAD (E) DR. ARVIND GHONGANE 55

DOMBIVLI GYMkHANA, DOMBIVALI DR. ACHYUT NAYAkDR. PRAMOD BAHEkAR 112

kANTA HOSPITAL, PALGHAR DR. RAJENDRA CHAWHAN 50

BOISAR MIDC TIME HALL, BOISAR DR. RAJENDRA CHAWHAN 207

ALICA HALL kANDIVALI (E) DR. SUJATA RAO 47

MUMBRA PHC DR. RAJENDRA CHAWHAN 51

BALAJI HOSPITAL DR. CHARANSINGH JADHAV 320

RAJASTHAN HALL, BHAYANDER DR. LEELA AGARWAL 335

Mr. Anil Gare, Secretary, State Blood Transfusion Council and his team, diligently conducted the blood donations and ensured that all the centers were adequately serviced.

We would like to express ours heartfelt gratitude to all the individuals and organisations, for their co-operation in conducting “Doctor's Day Blood Donation

and Organ Donation Awareness Drive” successfully. It is not possible to mention all the numerous names, but, we need to specifically thank Mr. Anil Gare, Secretary Donor Coordination Committee, SBTC, all centre in charges, all committee members who put in valuable time and effort, and of course our entire team in the Doctors Day Celebration Committee.

Dr. S.N.Agarwal Dr. Suhas Kate Chairman Convenor


A traveller asked a shepherd: “How do you think the weather will be today?” “Oh, it will be weather that I like.” “How do you know, how can you say that?” The shepherd answered: “Long ago I decided that whatever weather comes I will like it. Now I am always sure that I will get weather that is to my liking 365 days of the year. Instead of always trying to get only that thing I like, I decided that it is wiser to like whatever thing I get. Therefore, I always like the weather I get.” - He had the key to happiness.

My Journey of Life goes like this:During my internship in 1978, while

coming back from my rural posting I met with an accident with a truck while driving back on my motorbike. I was brought to our Suchak hospital in a critical state with multiple fractures in the spine and profuse intra-abdominal bleed resulting into hypertension. Immediately I was taken up for Laparotomy and was found to have a ruptured Spleen. On the operation table, I had a cardiac arrest and was revived. I was given 10 units of blood. Spleenectomy was done and after that I was completely fine for next 10 years.

I got married to Abha and was blessed with two children and was working full-fledged in the hospital. After nine years in 1987, for the first time, I was discovered to have Jaundice, which was Acute Viral Hepatitis. On being tested, I was diagnosed Australia Antigen+ and all the liver enzymes were elevated. I was advised rest for a couple of months. Australia Antigen became Negative and the antibodies to the Hepatitis B surface antigen became positive. So I was, very happy that I cleared the B Virus. But, we kept checking my liver functions

every month and, to my surprise, the liver enzymes were persistently high.

I consulted Dr. Roger William and Dr. Sheila Sherlock who were amongst the best in the field. At London I had my Liver biopsy done. During that time I was told that I have Chronic Non-A, Non-B Hepatitis - very early Cirrhosis. Later on it was labelled as Hepatitis C.

In the 1990’s clinical trials were being conducted for Interferon. I was put on this trial. From 1990 to 2005, I took four courses of Interferon. Each time I took Interferon, I responded temporarily and everything looked good. After completion of the Interferon therapy, the Virus reappeared each time.

My activity was absolutely normal till 2006, when my general condition started worsening. I had multiple episodes of fever with rigors and I started developing Ascites and swelling in the feet. I knew I was heading for trouble and my liver was decompensating. At that time I was told I did not have many options. I could go for a liver transplant as it was the end stage of my disease and nothing else could be done.

LIVER TRANSPLANT - MY JOURNEYDr. Anil N. Suchak

At that time I went through a whole gamut of emotions and feelings -- what would my family do without me? Would the hospital function smoothly? I had reflected upon my life and realised there was much for me to do. And giving up was not an option.

After surveying couple of centres in India and abroad in January 2007, I finally decided to get live donor liver transplant done at Apollo Hospital, Delhi. I remember my friends and family that came to Delhi. I asked Dr. Subash Gupta about the prognosis and he gave me quite an optimistic picture and then I said ‘Let’s Go for it’. The divine blessings of Swami Chidananda and gracious and generous gesture of donating part of his liver by Swami Yatidharmanada are responsible for my rebirth.

I was taken for Liver Transplant surgery on February 19, 2007. This surgery normally takes 10-12 hours, but I had lots of complications, because of my previous surgery. There were lots of adhesions and my surgery took almost 23 hours. I was given 60 units of blood and blood components. I was taken in at 6 am and brought out at 5 am the next day. The explanted Liver Biopsy showed two tumors of Hepatoma ( HCC- Hepatocellular Carcinoma ) besides the Cirrhosis of Liver. During my post op recovery, I had decided, I will surely walk out of this place hale and hearty. With that spirit and strong will, I started mobilising myself. Unfortunately on the 6th or 7th

day there was a biliary leak because of the transplant. Almost 1.5-2 liters of bile collected in the abdomen, Doctors had to put a drain and remove it every day. Then on the 9th day I was told they would have to re-operate. That was the only day I felt low; I felt that God was testing me. I talked to my wife and she said ‘We have to do it, we have total faith that everything will be fine as the finest doctors are with us’. That surgery lasted for 6-7 hours and I was in the hospital for 40 days. There was

an excellent team of doctors headed by Dr. Subash Gupta and Dr. Manav Wadhavan. Their expertise and caring attitude is something I owe my life to. Added to this My strong will to survive and my zest for life were also factors which helped pull me through. I had decided not to give up.

I had all the support from my wife Abha, who was standing by me like a rock, along with my son Dr. Suraj Suchak and my daughter Tui Sigman. I had tremendous support from my friends and family members and, above all, my donor. On the day of the surgery there were 80-100 people including 40 doctors from Mumbai at Apollo Hospital. Not only that, there were prayers being conducted at different places, like Sivananda Ashram, Buddhist groups and temples and mosques. At Nutan School, 4000 children joined in offering prayers for me. The entire staff of Suchak Hospital walked barefoot to Siddhi Vinayak temple to pray for my health and recovery.

Several studies have proved the power of prayer when it comes to healing of the sick. In my case, this clearly helped me. I am indebted to everyone because they love me so much I never realised. I am grateful for all the positivity, love and energy they sent out toward me. I had strong faith that I will go through this and come out of this. A strong will and prayers helped me through this crisis. Being a man of science, I have tremendous respect for doctors and the progress of modern day medicine. Although, I also depend heavily on my faith in the higher power that gave me the courage, strength and endurance to go through this ordeal. I have come out of this ordeal a better person with a sense of gratitude towards the miracle of life and my loved ones.

After the transplant, I resumed my normal duties and was fully active in three months. Once again, I was put on Pegylated Interferon with Ribavarine for one year and the good news is that I am free of Hepatitis



C Virus. I have to take precautions because I am on immunosuppressants for life. I am advised to stay away from infective patients, but I still go for all the CPR, intubations and other critical procedures. I participate every year in the Standard Chartered marathon dream runs with a cause to promote the awareness of Organ donation and Cadaver transplantations. I have been exercising and walking regularly. I have also been involved in social and other activities at the Indian Medical Association of Medical Consultants and Malad Medical Association. In spite of my liver transplant I have led as the president of the most active branch of IMA Mumbai West. I am closely associated with the Divine Life Society, a spiritual organisation. We conduct Yoga shibirs, amongst other activities.

I have been counselling patients FREE, who have been advised liver transplants, along with their families from all over the country and abroad. In the past four years I have counselled over ninety patients. Friends, I would take this opportunity to extend my services to counsel affected patients since I have firsthand experience.

I was lucky to get a live donor for my transplant but more than 90% have no recourse but death. However, we all can help through and give them second life if we understand the concept of Cadaver Transplantations which is now termed as Deceased Donor Program.

The message I would like to convey is that Endstage liver disease seems like THE END OF THE ROAD but it is really not. AND I AM A LIVING EXAMPLE OF THIS.

To Remember Me - I will live forever.

The day will come when my body will lie upon a white sheet neatly tucked under four corners of a mattress located in a hospital; busily occupied with the living and the dying. At a certain moment, a

doctor will determine that my brain has ceased to function and that, for all intents and purposes, my life has stopped.

When that happens, do not attempt to instill artificial life into my body by the use of a machine. And don't call this my deathbed. Let it be called the bed of life, and let my body be taken from it to help others lead fuller lives.

Give my sight to the man who has never seen a sunrise, a baby's face or love in the eyes of a woman.

Give my heart to a person whose own heart has caused nothing but endless days of pain.

Give my blood to the teenager who was pulled from the wreckage of his car, so that he might live to see his grandchildren play.

Give my kidneys to the one who depends on a machine to exist from week to week.

Take my bones, every muscle, every fiber and nerve in my body and find a way to make a crippled child walk.

Explore every corner of my brain.

Take my cells, if necessary, and let them grow so that, someday a speechless boy will shout at the crack of a bat and a deaf girl will hear the sound of rain against her window.

Burn what is left of me and scatter the ashes to the winds to help the flowers grow. If you must bury something, let it be my faults, my weakness and all prejudice against my fellow man.

Give my sins to the devil. Give my soul to God.

If, by chance, you wish to remember me, do it with a kind deed or word to someone who needs you. If you do all I have asked, I will live forever.

- Robert N. Test



WHOOPEE! I GOT A WebSITe…Dr. Saurabh Dani

So often we see website of our peers and wonder that we too should create

one for ourselves. That point onwards we embark on the mission to create our or our hospital’s website.

I take it for granted that doctors are tech-illiterate, but no one knows everything… Right!!!

We give this desire a codename “MISSION PRESENCE”. We talk to a few peers and go through some junk and spam emails and decide on a reasonably priced web-designer and get the website functional.

“MISSION PRESENCE” ACCOMPLISHED!!! NOT ReALLY… Where did we go wrong?

Let us first understand the working of the website and its purpose for professionals like us.

A Website is a 24x7x365 online page that is located on some computer always connected to the internet. This computer may in Mumbai, New York, at your Home or any other place in the world.

When a person wants to visit your webpage he needs to know your Internet address, also called as the website address. Once the website address is typed in the internet browser (Internet Explorer, Fire Fox, Opera, Chrome, Safari, Mobile browser, etc) NOT GOOGLe SeARCH… then your Internet Service provider (ISP) converts it into numbers or Internet Protocol (IP) Address. This IP address determines where

your page is located in the World Wide Web (www). Now your browser is connected to the webpage and you see the information published.

Why do you need to know this because your children already know all this.

Coming to the reason of having your own website - SIMPLE - It’s a 24x7 Visiting card which can be accessed by anyone around the world from any internet connected device (PC, Laptop, Mobile and now the tablets – Not medicinal tablets). Website is not fancy magnets that will actually pull all clients towards you but a place away from your premise that has all the info you want to share with your prospective clients – in short a huge visiting card with lots of space – No paper wasted – Hence eCO-FRIeNDLY…

What are the Cons of a website?

Your prospective clients need to have Internet to access your page – In India; it’s a big problem!

Your prospective clients need to be net-savvy to actually think about this medium in the first place. Skilled people are required to keep it functional and up-to-date– which costs!!!

A Website has following important components: Domain Name, Designing, Hosting

Domain Name

This is the actual name that you type in the

browser viz. who.int, google.com, yahoo.co.in, mtnlmumbai.in, etc.

There are 2 parts of a domain name ie Name and Suffix: (Illustrated below)

who.int “who” is the name and “.int” is the suffix

google.com “google” is the name and “.com” is the suffix

yahoo.co.in “yahoo” is the name and “.co.in” is the suffix

mtnlmumbai.in “mtnlmumbai” is the name and “.in” is the suffix

What you can purchase is the Name while you can choose the available suffix which are pre-approved by Internet Corporation For Assigned Names and Numbers (ICANN) or Country specific domains by respective country registars, which is National Internet eXchange of India (NIXI) for India and similarly for other countries.

Eg. “.in” for India, “.uk” for United kingdom, “.pk” for Pakistan

So what’s a Domain Name? Shakespeare said “What’s in a Name?” but I say a lot is in the name. A simple name is important or a self explanatory name is important. Imagine “google.com” being “GlobalOrganisationOfGrowthLearning-Experience.com” or “ankurhospital.com” being “ankurh.com”. Choosing the right name is important.

Domain name is like your property, you own it and you can sell it, only differences being you have to pay for it annually. If you forget to pay it is forfeited and can be sold to someone else. That’s the catch!!!

Modus Operands:

When we hire web-designers to make our website they offer to reserve the domain name for us too, since we are fools we accept their offer and get it

done from them. Now they do not give us a bill for individual components viz. Domain Name, Hosting and Designing but a comprehensive bill. There is no problem in this but in future if you have dispute with your designer he may not release the domain name since he may have it registered under his name.

The way to verify this is to type your domain on the search in this website:

http://easywhois.com If you own a website confirm it today!!!

This will tell us the ownership of your domain name. If it’s your name and email id just take a screen capture of the page and file it for records in case your designer modifies it in future. better still register your domain name with reputed registrants accredited by ICANN ie. indialinks, tata indicom, godaddy

Hosting

Hosting is procuring certain webspace on a 24x7 online computer. This is similar to “Rent-a-womb” – that’s what comes to my mind being a gynaecologist. You have to pay annually for this service. With hosting you normally get a few free email id’s of your choice eg. [email protected], [email protected] this looks professional than the free emails that you have been using and also helps promote your business, but you may continue using your FREE email if that’s what your are comfortable with.

Hosting packages vary on the space required and the backend ie Linux or Windows. Normally Linux (a Free operating System) is all that you would need for purpose like ours, which is cheaper too. Average cost for hosting would be Rs2500-5000/year for a Basic Linux Package.

Web-Designing

This is an “Art” NOT “Artificial Reproductive



Techniques” – Some may buy a MF Hussain painting for Millions but to someone else it may not be worth a penny.

Normally, you would require a few pages with a few images, which should not cost much- maybe onetime of Rs5,000-15,000.

This is negotiable for additional services like certain number of updates in a year, updating content, etc.

Please take a backup cd of your website from your designer- in case you want to change your mind later.

Designing website is easy as creating a word document or a powerpoint, provided you have the right tools. Understanding your website is important so that you can learn to modify it by yourself.

Finally, as often quoted by Certifies Financial Analysts (CFA) - “Do not keep all your Eggs in one Basket” – means don’t give complete control to a single person.

Get your domain name registered from a Registrant Directly

Get hosting from a Hosting provider directly

Get you designer to design and upload the files & update

keep all the passwords and bills with you handy

Pay your renewals on time

Adieus, Happy Surfing.


Get the Most Out of Imaging : Advantage Innovision• The Innovision Advantage :

– Subspeciality radiology interpretations in breast and orthopaedic imaging – Multimodality correlated interpretations: X-Ray, CT, MRI, US and Nuclear Medicine – Radiologists who understand and cater to clinical needs

• Personalised communication and reporting :– Rapid turn around times

– Electronic delivery of reports to patients and clinicians – Easy access for discussing cases

• Reliable expertise :– US trained and board certifi ed* radiologists

– Affi liated with major US medical centres* – Now working with leading consultants in Mumbai

• Going the extra mile :– Image guided injections & biopsies

- Clinical research ideation & development – Contracting with imaging centres nationwide (already in Mumbai & Nasik)

• For more information :– Call 022-2353 8599 (8:30 AM to 3:30 PM, M-F & 8:30 AM to 2.00 PM SAT)

– www.innovisionimaging.com

.......................................................................

O' My Dear Teacher,

To us small creatures,

Give thy knowledge and wisdom,

To make our life richer.

Will you discriminate neither,

Amongst the poor and richer,

Nor give undue importance,

To their external features,

But always shower love and affection,

To all little achievers .

May you worship Saraswati first,

And respect Laxmi next,

Your efforts to uplift the rest,

With vigour, vitality, zeal and zest,

May you try your level best,

Let only then your sou l should rest.

It was a full moon night,Nobody was there in near sight,I was going in bit mood-elite,Walking on my path alright.Then I saw a beautiful miss,She came close and gave me a kiss,I did not wish to take any risk,Because she was Miss Anopheles.If it carried possibly vivax,I would rather think to relax,But if it turns out to be falciparum,Only God could save me fromcrematorium.

Compiled by Dr. Nalin Vesmaker

Awake, arise and stand upright,Time is ripe to show your might,Remove inequality from your sight,Treat equally poor and elite.

Bring some hope and some bright lightcorruption and casteism remove outright,begging for terrorist is not your plight

Let these be no more Wednesday night.Endeavor for everyone a deep insight,Quran, Bible or Geeta whatever you recite,tolerance should not reach any more height,Indians you are, fight till your last rite.



or gmail address, one should have a more respectable looking email address like [email protected].

5. In an extremely competitive atmosphere, where almost same services are offered by most clinics, the site should present one’s clinic as more desirable and manned by more competent and caring personnel.

Now if most if not all criteria above are not satisfied, it is safe to

say that the site is a failure. A giant virtual visiting card or billboard on the internet

does not play much of a role if its visibility is poor.

First let us take a look at what the website should have so as to be able

to satisfy the above criteria. Once that is done, we can analyse as to how we can go about meeting these requirements.

1. We cannot go into the details of search engine optimisation as that is totally an off topic as well as too complicated to be discussed here. But, in short, the website should have loads of content, all or most of which should be relevant to your site. The content should also be frequently updated and in addition the invisible content in the form of image tags and metatags should be well placed by your web designer.

2. There should be adequate storage space for your mails and site content.

IS YOUR WEBSITE A FAILUREDr. Rajesh Bijlani

Compared to five years ago, more and more doctors and clinics are getting

web savvy and are building their presence on the internet by having their own website. But a critical appraisal of these websites belonging to doctors and clinics shows that a lot still remains to be desired from them. Most of these sites are nothing more than “Virtual Visiting Cards”. Someone browsing these sites could get the doctors contact details as well as what services he/she offers but usually not much purpose is served.

Before a project is dubbed a success or a failure, what needs to be done is to draw up one’s list of expectations from the website. From my experience with medical and other sites, the common expectations are:

1. People should be able to locate my site from Google. This I believe is the number one requirement of most people setting up a site.

2. The information of my services should reach out to people and I should be able to generate patients from my website.

3. Portray a web-savvy picture of the doctor/clinic.

4. Instead of a generic hotmail or yahoo

3. Server uptime should be more than 99% and site loading times should be good.

4. At least some parts of the site should incorporate technologies of social networking like Twitter and Facebook.

Putting it all together:

1. Decide your domain name. It is preferable to have a name that will use some part of your specialisation rather than name it generically after the clinic. mumbaisurgery.com might be more suitable than yourclinicname.com but this is a totally personal thing.

2. Select a person who will do the technical work for you like the booking of domain and webspace etc. Make sure these are registered on your name and e-mail address so in future you are not totally reliant on this technical person for each and every detail.

3. The next and most important step is the site design and content management. Most of the medical sites I see are static sites where the pages are designed by someone who knows website languages like HTML, CSS etc. Now if the doctor has to make alterations or additions in the site, he is helpless and is dependent on the designer for each and every minor update. At the same time, the designer has already been paid and for him it is more cost effective to work on new projects and sometimes the updates we need from him might incorporate a ton of work. So these

updates to the website remain on the back bench. For this reason, it is preferable to ask the designer to make the website in some software package like Word press or Joomla where the content of the site can be managed by the doctor himself. These packages are as easy as blogging or writing in MS Word or similar word processing software. If you can type a letter you can update your website as and when needed.

4. Packages like Joomla or Word press also have the advantage that you incorporate in the Social Networking technology. Your website can for example display how many people like your facebook page. Or it could have a module where it automatically updates from your twitter feed. These can let you update your site on the move. A dynamic site where the content is changing is more likely to be a success and get more visitors than a static site displaying information that was entered two years back.

5. Sign up with free services like Google Analytics to see your website traffic and how it is affected by changes to your site.

6. Sign up for a Google Places account which will post your location to Google Maps as well.

Feel free to contact me for technical queries that are too much of geek stuff to be entered in this short article.


ASSOCIATION OF MEDICAL CONSULTANTSM E M B E R S H I P

Total Membership of the Association : 7069Members under Professional Indemnity Scheme of AMC : 4295Persons (Members & Family) under H & A Scheme : 3932Members under CBS Scheme : 1078



MAIL BAG

I am happy that you have published about Dr. Ajay Kothari. Please know that the whole Kothari family is doing good work for disadvantaged population, like son has designed school, his wife Dr. Gopa Kothari has given administrative and community work support to him in his endeavour. Dr. Mukesh Gupta, you have rightly written decisions have to be taken or stagnate with our problems. If not treated ulcer in time, it becomes cancer. Intellectual mind requires philosophy for living life dignified way.

Dr. S. V. Nadkarni is as fearless as he was in writing article on judicial aspect of CPA. May God give him long life with full of health. Dr. Kapoor and Dr. Shenoy have given good articles and enlightened doctors about process and removed their ignorance which itself is appreciable. You may think of keeping one day workshop for doctors entering private practice. - S. N. Nagaonkar It was a pleasure to attend the cultural programme on 26.6.2011. Six members of the Pai Dhungat fam-ily were seated in prime seats and thoroughly enjoyed the programme. We hope that every year at least one such cultural programme is held in South Mumbai. This will also help to increase the awareness regards AMC and help in increasing its membership.

- Dr. Nitin Pai Dhungat

REVISED ADVERTISEMENT TARIFF “The Grasp”

BackCover

SINGLE ISSUE Rs. 20,000/-

InsideCover

SINGLE ISSUERs. 15,000/-

Color (One Side)

SINGLE ISSUERs.12,000/-each

Centre Spread

SINGLE ISSUERs. 27,000/-each

Cover Flap

TWO SIDESSINGLE ISSUE Rs. 30,000/-

Half page Colour SINGLE ISSUE

Rs. 7,000/- each

10% discount for bulk booking of four issuesCLASSIFIED: Rs. 600/- for 40 words/ Rs. 750/- for 55 words maximumINSERTS: Rs. 20,000/- for each issue for Members. Rs. 30,000/- for each issue for Non-members.

It makes a good business sense to advertise in “The Grasp” which is mailedthrough courier in the city of Mumbai ensuring an assured and timely delivery.

Cheques to be drawn in favour of “Association of Medical Consultants, Mumbai”Protocol for Advertisment in “The Grasp”

• All advertisements to be submitted as soft copy (CD format) with a Print-out of the Advertisement. Handwritten copy of advertisement will not be accepted.

• Advertisement charges to be paid with a post-dated cheque at the time of booking.• If the advertisement data have been changed after submitting, kindly inform the printer also about the change in matter.• Technical details: Print Area 20.5 cms. x 15 cms. Printed by Offset Process.• All matter for the printed material to be supplied by the advertiser.Please note: For advertisement material other than the POSITIVE or MATTER FOR TYPESETTING, processing

charges at cost will be charged extra.

ADVANCED RADIOLOGY CENTRE (ARC)Offering international quality,hi-tech diagnostic services

in a warm and caring ambience.

DR. SONALI GANDHID.M.R.D..

BMD - DEXA based MAMMOGRAPHY

NORMAL FACE

SACRAL MENINGOCOLE

BREAST BIOPSYDR. GEET A SHAH M.D.,D.M.R.D.

SONOHYSTEROGRAM in apatient with recurrent miscarriage

shows syneehia aeross the leftcornu of the uterus


May 20, 2011: "Doctors For You" gets British medical award

Mumbai: A team of doctors that helped the victims of the 2008 bihar floods bagged the prestigious British Medical Journal (BMJ) award on Wednesday. Famously knows as the Doctor's Oscar, the BMJ award was given to the team working under the banner of the NGO, "Doctors For You", in the Medical Team in a Crisis Zone category. The award recognises excellence in health care across the world.

May 25, 2011: Finally, state medical council takes shape

Mumbai: After 12 long years, a full-fledged MMC - the only body that patients can approach over medical irregularities and negligence - finally came into being last Saturday. Eighteen members of the council - 10 elected, six nominated by the government and two ex-officio members met and it was promptly decided that hearing a patient’s grievances would top the council’s agenda.

May 29, 2011: Now, a device to detect cases of female foeticide

Pune: A new device to help law enforcing agencies monitor use of sonography machines is being introduced as a measure to curb the growing incidence of female foeticide in the country. The device - Silent Observer (SIOB) - would also provide law enforcing agencies with analytical

FROM THE PRESSCompiled by: Dr. Pradeep Baliga

reports for action warranted under the Preconception and Prenatal Diagnostic Techniques (Regulation and Prevention) Act.

May 30, 2011: Doctors not registered with MMC to be treated as quacks

Mumbai: Doctors not registered with the MMC will be treated as “quacks” and even penalised. This was decided by the newly formed council to ensure that each and every doctor practising in the state is registered with the council. According to sources, over 30% of practising physicians in the state have not bothered to register with the council.

Jun 02, 2011: Law to restrict those who can use machine likely

New Delhi: Misuse of ultrasound machines in India may be curbed soon. The government plans to amend the law so that only gynecologists and obstetricians with qualifications recognised by medical council and practitioners with Diploma of National Board use ultrasound machines. At present, besides a sonologist, imaging specialist and radiologist anybody, with a 6-month training or 1-year experience in sonography or image scanning can use it, the reason behind so many illegal ultrasound clinics.

June 03, 2011: Fine & jail for sex test offenders

New Delhi: Come Saturday, all unregistered ultrasound machines and scanners that

can detect the sex of an unborn child will be seized and the “service provider” be liable for fine and imprisonment. Seized ultrasound machines won’t be returned. A first-time offender will pay a fine of Rs.10,000 and face a maximum three-year jail term. If the offence is repeated, the guilty person must cough up Rs.50,000 as fine and will be jailed for five years. The Union Health Ministry amended the PCPNDT Act on Thursday to enforce these stringent steps.

June 05, 2011: Tighter leash on ultrasound OP trainers

New Delhi: The days of “sex selection shops” in India are numbered. The Union Health Ministry on Saturday asked the Medical Council of India (MCI) to put in place a tough accreditation system for institutes that teach how to use ultrasound machines.

June 7, 2011: HC says any machine used to determine the sex of a foetus can be confiscated

Mumbai: “If any ultrasound machine is used for conducting sonography on a pregnant woman for a sex determination test or sex selection procedure in contravention (of the law), the power to seize and seal any other material object, besides records and documents, would include ultrasound machines and machinery and equipment,” ruled a full bench of the Mumbai High Court.

June 15, 2011: Nursing homes get HC breather

Mumbai: In an order that will affect nearly 1500 nursing homes in the city, the Bombay High Court has ordered the BMC to renew the registration of the nursing homes in Mumbai and give them a hearing with the Commissioner. The BMC had refused to renew the yearly license

of nursing homes and had demanded a change of user certificate along with penalty before renewal.

June 27, 2011: Virtual classrooms to help doctors score a point

Mumbai: Doctors worried about scoring the mandatory points for renewing their registration can now go the e-way. Medical education seminars can now be held online, and doctors could attend virtual classrooms from the comfort of their homes and update their knowledge on a regular basis, said MMC on Sunday.

July 12, 2011: IRDA against TPAs for govt health insurance plans

New Delhi: Insurance regulator IRDA is proposing to ban Third Party Administrators from operating as intermediary for the government sponsored health insurance schemes. IRDA had in 2005 allowed TPA to act for government sponsored schemes.

July 28, 2011: Now, Mumbai posting for postgraduate doctors

Mumbai: The postgraduate doctors will now have to do their year-long bonded service in the civic healthcare centres instead of a rural stint. “Earlier, the list of postgraduate and super-specialty doctors was given to the Central government, who took the decisions on their postings in rural areas; now, we have decided to post these doctors in our own peripheral and specialty hospitals” additional Municipal Commissioner (Health) said. This move will give a boost to the healthcare system in the suburbs.

July 31, 2011: Registration of many seized scanners may be suspended

Mumbai: During the month-long campaign, the civic body sealed or seized 32 ultrasound machines for not adhering to the rules prescribed under the PCPNDT Act. The



civic administration plans to suspend the registration of many of the ultrasound machines that were seized during the State government’s recent Save the Girl Child drive.

August 06, 2011: Doctors, lawyers to pay more for power at office

Mumbai: Lawyers, doctors, engineers and chartered accountants will now have to pay more for electricity at their offices. The bombay High Court has ruled that such professionals who work out of premises used exclusively as offices cannot be charged tariff which is applicable to “domestic or residential users” and must shell out charges meant for “non-domestic or non-residential users”.

August 11, 2011: Test that can tell foetal sex at 7 weeks stirs row

A simple blood test that can determine a baby’s sex as early as seven weeks into pregnancy is highly accurate if used correctly, a finding that experts say is likely to lead to more widespread use by parents concerned about gender-linked diseases, those who are merely curious

and people considering the more ethically controversial step of selecting the sex of their children. The appeal of the test, which analyses foetal DNA found in the mother’s blood, is that it can establish sex weeks earlier than other options, like ultrasound, and is non-invasive, unlike amniocentesis.

August 15, 2011: HC reprieve for 44 super specialist doctors

Forty-four super specialist doctors will not have to waste their expertise working as ordinary medical officers at civic hospitals in the city. Thanks to the timely intervention of the Bombay High Court, which directed the director, Medical Education and Major hospitals of Greater Mumbai, on Friday, to identify vacant posts of assistant professors in any State-run, civic or defence hospital across Maharashtra for the super specialists doctors holding degrees such as DM or MCh.


........................................................................

-----------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------

FORTHCOMING EVENTS AND ACTIVITIESOn 21st August 2011, a team of AMC office bearers led by the Managing Trustee and President will have a meeting in Kolhapur to form the Association of Medical Consultants, Kolhapur branch. This will be the first AMC organization outside Mumbai area. About 150 consultants are expected to attend this meeting.

●

AMC MEET 1 will be held on 18th September 2011 at United 21 Hotel, Thane 4 pm onwards. The details of the same are mentioned in this issue of GRASP.

CLASSIFIEDS

FOR SALE / AVAILABLE A/C CONSULTING ROOMS AT A PRIME LOCATION ON S. V. RD., VILE PARLE (W) CALL DR. MAYANK KHANDWALA 09820035464 KHANDWALA EYE HOSPITAL & HEM POLYCLINIC, D-31, NAVMANGAL CHS., ABOVE VENILAL SAREE SHOP, S. V. ROAD, VILE PARLE (W), MUMBAI 56 CONTACT: 022-26207430.

DOCTOR GROOM REqUIRED ALLIANCE INVITED FROM GUJRATI JAIN DOCTOR MS/MD, MUMBAI BASED BOY FOR A GUJARATI JAIN DOCTOR, SLIM, FAIR BEAUTIFUL GIRL, AGE 25 YEARS, M.B.B.S. CONTACT: 8108382618, 9167780516.

CONSULTANT REqUIRED FOR PRATIK HOSPITAL & MATERNITY HOME, S. V. RD., KANDIVALI (W) A) ORTHOPEDIC B) MEDICINE C) SURGEON D) GYNECOLOGIST NO RENT, ONLY DEPOSIT RS. 20,000/- (REFUNDABLE) CONTACT: 9869106492 / 9167780517.

CONSULTING ROOM AVAILABLE FOR GENERAL PHYSICIAN (MORNING/EVENING SLOT) AT UNIqUE HOSPITAL & POLYCLINIC, OPP. SHOPPERS STOP, S. V. RD., ANDHERI (W), MUMBAI- 56. CONTACT: 9821991765 [email protected], [email protected]

FOR SALE - SPARINGLY USED PORTABLE SLIT LAMP APPASWAMY SLIT LAMP WITH MOTORISED STAND, RETINOSCOPE, LENSOMETER, DIRECT & INDIRECT OPHTHALMOSCOPES, VISION DRUM, TRIAL FRAME & TRIAL BOX, KINDERMAN SLIDE PROJECTOR, WEIGHING SCALES, B.P. INSTS CONTACT: 09820194920 [email protected]

ALLIANCE INVITED FROM MEDICAL POST GRADUATE STUDENT (MS in OPHTHALMOLOGY), JAIN, 14TH JUNE 1987 BORN, SLIM, 5’4 FOR 1983-1987 BORN, MUMBAI BASED JAIN BOY DOING OR DONE WITH MS/MD CONTACT: 9920497319/ 9769274944 [email protected]

AVAILABLE ON LEAVE & LICENSE BASIS RUNNING NURSING HOME (25 BEDDED) APROX. 4000 SqFT., AT NAVI MUMBAI ESTABLISHED IN 1992 HARDLY ANY INVESTMENT EXCEPT HARD WORK FULLY EqUIPPED WITH ALL INFRASTRUCTURE AND MULTIPLE MEDICLAIM ATTACHMENTS CONTACT: 9930992073 [email protected]

RUNNING HOSPITAL AVAILABLE ON LEAVE & LICENSE BASIS FOR 5 YEARS (PERIOD FLEXIBLE) ON S. V. RD., BORIVALI (E) TOTAL BEDS 20 (5 IN WARD, REST IN SPECIAL ROOMS) FULLY EqUIPPED OPERATION THEATRE AND RUNNING POLYCLINIC WITH 4 CHAMBERS, WAITING ROOM & RECEPTION AREA OPTION TO LET-OUT PART PREMISES AVAILABLE CONTACT: 9821592223 / 022-28935475.

AVAILABLE FOR OUTRIGHT SALE 1750 SqFT. REGISTERED NURSING HOME FULLY FUNCTIONAL 10 BEDS, SEPARATE ENTRANCE CHANGE OF USER FCNL OT WITH FURNITURE AT FOUR BUNGALOW, MUMBAI CONTACT: 9892674147

SEEKING MD/MS DOCTORS FOR POLYCLINIC/PATIENT EDUCATION CENTER WE ARE LOOKING FOR PRACTICING MEDICAL CONSULTANTS WITH 5+ YEARS OF EXPERIENCE TO JOIN OUR POLYCLINIC/PATIENT EDUCATION CENTER IN DADAR (E) - HINDU COLONY SEEKING PARTNERSHIPS TO UPLIFT MEDICAL CONSULTATION & COUNSELING CONTACT MRS. JAYASHREE NIPHADKAR - 9833877793, 24454646 MS. ETASHA NIPHADKAR – 9987052104 [email protected].


Vol.39 Issue No.2, Aug 2010

The

Grasp

50

in this issue - association of medical consultants, mumbaiin this issue • medico-legal liabilities...

Documents