Vol. | Issue No. | November · Vol. 45 Issue No. 3 November 2016|| 3 Statistics is a very important tool in lies and statistics'. Lilian Hellman made medicine and its use is vital

ELECTIONS

AHEAD

Vol. 45 | Issue No. 3 | November 2016

The

GRASP

For Private Circulation Only

Official Journal of the Association of Medical Consultants, Mumbai.Published Quarterly in May, August, November, February

MMC Electionsth

on 18 December 2016Please Exercise your Franchise

AMCON

at Hotel Leela,

Andheri (East)

Refer Page No. 14

th

on 27 November 2016

MMC

Elections

Refer Page No. 12

Vol. 45 Issue No. 3 November 2016| | 1

President Dr. Veena PanditPresident Elect Dr. Smita SharmaImm. Past President Dr. Sudhir NaikVice President Dr. Mukesh GuptaVice President Dr. Vipin CheckerHon. Secretary Dr. Ashokkumar ShuklaHon. Treasurer Dr. Sushmita BhatnagarJoint Treasurer Dr. Sanjay PattiwarJoint Secretary Dr. Vivek DwivediJoint Secretary Dr. Kritika DoshiOffice Secretary Dr. Jayesh P Shah

Prog. Committee Chairperson Dr. Ajit K. DesaiEditor - The Grasp Dr. Nitin Rao

Director Dr. Lalit Kapoor

Office Bearers (2016 – 2017)

Dr. Dilip S. Naik Dr. Shivbhagwan N. Agarwal

Dr. Bipin V. Shah Dr. Kishore Adyanthaya

Dr. Ajit K. Desai Dr. Sabh Singh Khambay

Dr. Gurudas B. Kulkarni Dr. Sujata Rao

Zonal Directors

Area Representatives

Consultant Benevolent Scheme Dr. Bipin V. Shah

H & A Cell Dr. Suhas Kate

MMC Cell Dr. Bipin Pandit

AMC-NoAH Dr. Niranjan Agarwal

Medicolegal Cell Dr. Sudhir Naik

Social Service Cell Dr. Shivbhagwan N. Agarwal

Media & Communication Cell Dr. Mukesh Gupta

Affiliate Unit Cell Dr. Kishore Adyanthaya

Chairperson of Cells

EDITORIAL BOARD

Editor

Co- Editors

Advisory Board

BOARD OF TRUSTEES

Managing Trustee

Trustees

Website

Web Editors

Web Co-Editor

Dr. Nitin Rao

www.amcmumbai.com

Dr. Vipin Checker

Dr. Aashish Mody

Dr. Kritika Doshi

Dr. Pratik Tambe

Dr. Lalit M. Kapoor

Dr. Pradeep Baliga

Dr. Sushmita Bhatnagar

Dr. Shrikant Badwe

Dr. Suresh Rao

Dr. Umesh Oza

Dr. Bipin Pandit

Dr. Suhas Kate

Dr. Achut Nayak

Dr. Niranjan Agarwal

Dr. Aashish Mody

Disclaimer

Unless 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 1109

E-mail : [email protected] Website : www.amcmumbai.com

AMC INDIA Project

Edited by : Dr. Nitin Rao

Co-ordinated at JASMINE ART PRINTERS PVT. LTD.

Plot No. A-737/3, TTC Industrial Area, Khairane MIDC, Navi Mumbai - 400710. India.

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

Dr. Ashok ShettyDr. Debashish Das Dr. Pratik TambeDr. Deepak Baid Dr. Rajeev AgarwalDr. Hitesh Bhatt Dr. Rajendra ChawhanDr. Indrani Chincholi Dr. Rajendra NagarkattiDr. Jayesh M. Shah Dr. Rajiv GokhaleDr. Kartikeya Bhagat Dr. Reena WaniDr. Manoj Patel Dr. Ritesh AgrawalDr. Milan Balakrishnan Dr. Suhas ShahDr. Nilima Vaidya-Bhamare Dr. Supriya ArwariDr. Pradeep Baliga Dr. Vikram KarmarkarDr. Pradnya Kulkarni Dr. Vivek ShethDr. Prakash Patil Dr. Yogen Bhatt

Dr. Pramod Bahekar

CONTENTS

Vol. 45 Issue No. 3 November 2016| |2

Edit Speak - Dr. Nitin Rao . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 03

President’s Precept - Dr. Veena Pandit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 05

Hon. Secretary’s Report - Dr. Ashok Shukla . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 07

AMC Pragati Panel for MMC Elections. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

AMCON Programme . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

DOs AND DON’Ts - Dr. Lalit Kapoor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

HUF can help you save tax - Ms. Nehal Mota . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

Delay in Diagnosis and Treatment is Negligence - Dr. Suganthi Iyer . . . . . . . . . . . 37

Best Practice Guidelines - Dr. Sushmita Bhatnagar . . . . . . . . . . . . . . . . . . . . . . . . 41

From The Press - Dr. Pradeep Baliga . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

Vol. 45 | Issue No. 3 | November 2016


Statistics is a very important tool in lies and statistics'. Lilian Hellman made

medicine and its use is vital in diverse areas wonderful use of the pun when she said:

s u c h a s e p i d e m i o l o g y, r e s e a r c h 'Statisticians do it with confidence,

(pharmaceutical / clinical) and in the frequency and variation'.

management of public health. It helps toA simple document like the Death Report is

organize data systematically and present itan important piece of information, and its

more logically, rather than depending upon compilation can help our health officials to

anecdotal evidence. It aims to influencemonitor the well being of the population, to

medical practice through concrete evidencestrategize and plan for the future and to

and this forms the backbone of evidencecompare health indicators across various

based medicine.geographical regions. Yet, in a recent survey,

Unfortunately, numbers are vulnerable to the MCGM found that in more than 50% of

manipulation, and this is what happens the cases, the Death Certificate was not

more often than not. filled as per established criteria. This is

astounding and there are several reasonsTorture numbers and they'll confess to

for the same. More often than not, theanything.....................George Easter brook.

certificate may be written by a non-

allopathic doctor. Even amongst allopaths,In fact, the widespread conning of figures

the approach is usually casual and thehas given statistics and statisticians such an

unenviable reputation, that they are the document is considered more necessary to

butt of all jokes. Mark Twain had once said: complete the final formalities of the

'There are three kinds of lies- lies, damned deceased rather than as a statistical tool.

EDIT SPEAKDr. Nitin Rao

MEDICAL STATISTICS AND LIES

There are two kinds of statistics - the kind you look up and the kind you make up.

- Rex Scout


found that deaths from Tuberculosis in

Mumbai averaged about 6688 per year over

the past five years, while the MCGM figures

for the same are only 1367 per year. When

these numbers were shown to a health

official, he went on the defensive, and

cowered behind statements like improperly

conducted survey by the NGO, etc. Any

practicing clinician would know which figure

A few years ago, when dengue was just is closer to the truth.

raising its ugly head in Mumbai, and fewStatistics is the art of never having to say you

cases were reported, a Municipal Medicalare wrong................................Anonymous.

Officer told me not to mention the cause of

Statistics is a very powerful subject whichdeath in a particular case as dengue merely

can be used by medical practitioners to offeron suspicion, unless the diagnosis was

patients the latest and best line ofconfirmed with laboratory evidence. On

treatment. The bugbear of inaccuraciesprobing further, he revealed that if any

starts with data collection, sampling errorsdeath is reported as dengue, the health

and ends with improper interpretations andofficials from that ward have to conduct a

conclusions. If one follows statisticalsurvey in the area of the deceased, and also

principles and guidelines, clinicians willcarry out intensive anti-mosquito

have a potent weapon to counter theoperations, which increases their work load

myriad illnesses afflicting mankind and intremendously! I condoled the demise ofthe best interest of our patient population.truth on that day.That it will also help medicolegally, is an

Facts are stubborn but statistics are more important tangential benefit.

pliable......................................Mark Twain.Statistics are like a bikini. What they reveal is

Recently, an NGO compiled data gathered in interesting, but what they conceal is

Mumbai through household surveys and vital.................................Aaron Levenstein.

through RTI, and found there was absolute

discrepancy between its own findings and

the MCGM data. For example, the NGO [email protected]


Greetings, dear friends! unnecessary, that too without peer opinion.

The Urology Society and AMC met theTeam AMC has been very busy since the lastHealth Minister to make him aware of theGrasp and most of the events andfacts, request for certain amendments inhappenings will be covered elsewhere inthe verification of documents for transplantdetail, so let me take you to the two mostprocess and to press for early bail for theimportant events on the horizon…. Thearrested doctors.AMCON and the MMC elections, after

touching lightly on these. Simultaneously, we have had several

meetings with the insurance sector to betterAMC took a lead during the PCPNDT issueour Professional Indemnity and H & Aand brought several organisations like IMA,policies.IRIA, MOGS, FOGSI, AFG, NMOGS together.

Meetings including with the Press were It's now very difficult for me to decide what I

conducted in the AMC office. When there should write first: The AMCON is our much-

was no response from the Government to awaited showpiece conference that takes

the demand for amendments to the up a lot of effort that is appreciated for just

draconian PCPNDT Act, where minor clerical one day. Whereas the MMC elections are for

errors are equated with sex determination, one day, need a lot of campaigning and can

there was a call for a nationwide strike. The influence our doctor community for the

strike was withdrawn by the IRIA after next five years!!

assurances from the government. Even now Let's start with the AMCON that is closer.the group continues to confer online. The AMCON has always presented a feast of

Then came a stressful time for the varied topics that widen our horizons. For

Urologists, and of course all of us, when the this AMCON we are extremely lucky to have

CEO and several doctors from Hiranandani our Rakshamantri Shri Manohar Parrikarji

Hosp were put behind bars. When anything with us as Chief Guest. I request you all to be

medicolegal is involved, AMC is the first present in large numbers to hear him, and to

thought. Arrest of the doctors was show our support and appreciation.

PRESIDENT’S PRECEPT

Dr. Veena Pandit


The prestigious Dr. C. L. Jhaveri Oration will Many of our consultants have Nursing

be delivered by Sindhutai Sapkal, who did Homes of different bed strengths and single

not get an education beyond the fourth or multiple speciality. They always feel

standard, who was married off at 10 years, threatened by large corporate or trust superlater abandoned by her husband and speciality hospitals. The doctor owner isrefused shelter by her mother, who then hassled by the several permissions rules andbegged for her food but later went on to be regulations required for setting up andknown as "Mother of Orphans". I am sure

running his nursing home. He constantlyher words will inspire and motivate us to

fears violence, the media and consumerovercome the obstacles in our lives and

activist and local netas, and several othercome up winners.

difficulties. The patients too have becomePadma Bhushan Naseeruddin Shah, a more demanding. Are the days of Nursingfantastic actor from the stage and screen, Homes over? Are super speciality hospitalswill share his thoughts with us. Our other the need of the day? We have a panelspeakers Dr. Swaroop Sampat (yes, she has a

discussion "Survival of Nursing Homes"Ph.D in Education from the University of

where our learned panelists will try to find aWorcester), Anal Pandit who can know all

way ahead.about you from your handwriting & who

I do hope to see you all in large numbers at appears in court to authenticate hand-

the AMCON. Don't forget that ourwritings, Dr. J. K. Sharma, Kunal Vijaykar the

Rakshamantri will be there too, so pleasejolly foodie and author(who will talk about

Home Chef revolution pre-lunch, making us register early and come in time.

hungrier) are all stars in their own right.Now for our MMC Elections 2016 scheduled

They will surely brighten our day. thfor Dec 18 . The last MMC elections held in

After a sumptuous lunch, we can offer our 2009 saw a very poor voter turnout onadulation appreciation and congratulations Mumbai, only 1200 voters. Voting is yourto our own doctors, who are doing right and responsibility, but since it issomething entirely different from their

optional, many take the option not to vote.fields of work, and excelling. We all know

When a voter feels my single vote doesn'tDr. Ganesh Choudhari through his cartoons,

count and many take such an attitude, theso now lets meet the cartoonist in person.

balance tilts often with disastrous long termThen we have Drs. Mahajan Brothers who

consequences. So remember each votebecame the first Indian Team to complete

counts and mark December 18th in yourthe RAAM cycling race across USA, a total of

calendars. Your vote will help pick not only4800km from West to east coast of USA inthe candidate but also the policy.eight days and 14hours. Let us applaud this

feat of endurance. ....continued on page no. 8


ndDear Friends, Zonal meet on 2 October was held at

Riddhivinayak Hospital on Medico Legal issues &Wishing you an enlightened and glorious festivehow to prevent them which was attended byseason. The past few months have been various

more than 250 delegates.activities in AMC. We are preparing up for

AMCON 2016 and MMC Elections. Zonal meet was held on 9-10-2016 at Dombivali

There are simultaneous thrust on revamp and Gymkhana on Medicolegal issues & Clinic to

dynamic changes in our various insurance court well attended by more than 250 delegates.

schemes mainly PI and H&A with changing The most awaited AMCON 2016 is going to bepractices in the field of insurance. In held at Hotel Leela with various interestingcontinuation with various Zonal programmes topics highlight would be the problems faced by

thZonal meet was held at Vashi Tunga Hotel on 28 Nursing Home owners. Please do come in largeAugust 2016 attended by more than 250 number & make it a grand success.delegates. Organ donation awareness was

Lastly would be the MMC elections. We wouldconducted at Wockhardt Hospital in September

request all come & exercise your voting rightswhich was conducted with local NGO was well

covered by Local medico/newspapers. [email protected]

HON. SECRETARY’S REPORT

Dr. Ashok Shukla

Shop & Establishment Act

If you receive a Notice from the Inspector of Shop & Establishment Department, you can send him the following reply.

To,

The Inspector

Shop & Establishment Department

Mumbai Municipal Corporation

Sub : Surrender of Shop & Establishment act license.

Sir,

I ……………………….......................hold the Shop & Establishment License issued by your department for

my………………………................Clinic/Nursing home. You are aware that a division bench of the Bombay

High court has in the Writ Petition No 1731 of 2002 ruled that the Shop & Establishment act of 1948 with its 1997

amendments is not applicable to medical professionals and clinics/nursing homes. I am attaching a copy of the said

judgment for your perusal. I request you to take note of the above judgment and accept the surrender of my license

as it is no longer required.

Dr. .……..................................... (courtesy Dr. Sudhir Naik)


continued from page no. 6....After the council office, should have confidence that

he will be treated with respect and getsuccessful winning formula of 2009

justice, and will be defended if wronglyelections, we at AMC were dismayed when

accused by anyone.IMA did not offer us 2 seats. After a lot of

deliberations, multiple meetings, weighing Your Association with a Mission and

pros and cons, the decision to form a panel Commitment has stood by you through the

aligning with like minded candidates from years. Who springs to mind when any doctor

outside Mumbai was arrived at. has a medico legal difficulty? AMC. AMC has

always taken the lead when other issuesAMC was part of the battle to get postalaffecting all of us arose: like violence againstballot converted to a physical ballot in 2009.doctors, separate staircase, change of user,The last council has worked hard to clearIRDA regulations, Shop and Establishmentsome backlog of the pending medico legalAct, CEA, fire, biomedical waste and many

cases, to smoothen the registration andmore.

renewal process, but much remains to beIt is hence imperative that AMC candidatedone. Besides the many reforms that areshould be in MMC. Do vote for our entirerequired, we need to make MMC doctorpanel, the Pragati Panel, as mentioned onfriendly.page no. 13. Remember, if you don't vote,

As Dr. Lalit Kapoor always says, Whenever a thyou lose your right to complain. On Dec 18 ,

person is called to MMC for his Medico legalthink "I can shape tomorrow by voting

case, he feels this is a punishing body. Atoday”

parent reprimands his child when the childHope to see a large turnout for the AMCON

does a wrong, but springs to the child'sand for the MMC Elections.

defence when outsiders attack the child, soJai Hind!!!should be our parent council. A doctor

should feel at home when he visits the [email protected]

ASSOCIATION OF MEDICAL CONSULTANTS

MEMBERSHIP

Total Membership of the Association : 9375

Members under professional Indemnity Scheme of AMC : 6672

Persons (Members & Family) under H & A Scheme : 5140

Members under CBS Scheme : 1211


Dr. M. J. GANDHI - A Committee appointed him as 'Emeritus

Great Visionary and Professor of Cardiology'.

Cardiologist.During his tenures in Sion Hospital and

MANSUKH JINABHAI Nanavati Hospital he contributed to the

GANDHI (Dr. M. J. growth of the department in a phenomenal

way by starting the electro physiologyGandhi) was bornst laboratory, vector cardiography, modernon 21 November,

cardiac catheterization laboratory. In the1932 in the city of

year 1996 Dr. Gandhi developed the firstBillimoria, Gujarat to Jinabhai & Deviben

radiat ion stent (P32) in India inGandhi.

collaboration with BARC. All these yearsDr. Gandhi graduated from KEM Hospital

Dr. Gandhi was prominently seen in alland GS Medical College, Parel, Mumbai in

academic meetings and conferences acrossthe year 1955 and passed his MD with merit

the country and outside - in particular in CSIin 1959.

and API meetings.

Soon after that he had the opportunity toHe has been the Founder Chairman of

work in the department of Cardiology. ThisMahavir Heart Foundation (1980-2002). He

was the time when Dr. K.K. Datey thealso founded the Indian Society of Electro

pioneer in the field of Clinical Cardiology of cardiology in 2002 and was its first

his time was heading the department atPresident.

KEM Hospital. Dr. Datey was assisted byDr. Gandhi has been Postgraduate ExaminerDr. Gandhi in establishing the first cardiacof DM Cardiology at Mumbai University;

catheterization laboratory in Mumbai andAIIMS (New Delhi); PGI (Chandigarh);

started a separate department for cardiacHyderabad, Ahmedabad and Bangalore

disorders. Dr. Gandhi followed Dr. Datey'sUniversities.

path and subsequently established the

Dr. Gandhi was awarded Warner HeartCardiology department in LTMG Medical

Oration in the year 1980 (conferred byCollege and Sion Hospital.

Cardiological Society of India). He receivedstOn 1 October 1965 Dr. Gandhi joined

Netaji Oration in the year 1988 (API).Dr. Balabhai Nanavati Hospital and

H e h a s b e e n co nfe r re d l i fet i m eestablished first private ICCU in Mumbai. Heachievement awards by followingbecame Head of Cardiology in 1970. Hisorganizations :services were continued till January, 2005.

Thereafter, the Chairman and Managing 1. IMA - Mumbai West

OBITUARY - Dr. M. J. Gandhi


2. Indian Society of Electro Cardiology, 2003 scientific mind, objective in his approach to

the profession and to his colleagues. Not to3. Cardiovascular Society of India, 2008

say about his ethical commitment to4. Master Teacher Award by Indian College patient's at large. A great Teacher, a

of Physicians and APT, 2012 Visionary a Leader - par excellence, Mentor,

Patient Listener, Learning Enthusiast, True5. Cardiological Society of India, 2013

Researcher all in one made him differentDr. Gandhi was in various positions in

from many of our other senior colleagues.academic bodies and had been Associate

Editor of Indian Heart Journal. He had Dr. Gandhi is no more in our midst but the

organized various conferences and was entire fraternity of doctors' of Nanavati

Chairman and President of these meetings. Hospital, his patients' and Cardiology

His contribution to the academic field is colleagues of Nanavati Hospital in particular

enormous. miss him but his spirit always guides us.

For me and many of my colleagues, - Dr. M. G. Pillai

Dr. Gandhi is considered as a "GURU" in true Prof. & Head of Cardiology

sense. He has been impartial with a Nanavati Super Speciality Hospital, Mumbai

Dr. Mansukh Gandhi as I knew him............. reluctantly had to be content with practicing

as a physician with Cardiology as a sideOn October 12, 2016 one of the brightest

specialty. He wanted to practice Cardiology-star in the sky of Cardiology suddenly wenthis passion and love. He was striving hard tooff. Dr. Mansukh Gandhi a well-known and establish specialty of Cardiology at LTMGrespected Cardiologist of this country andhospital and medical college. While I wasinternational repute left for heavenly abodealso trying to get my foothold on someafter having served the Cardiologyspecialty, he motivated me to take upcommunity of this country for over 5

Cardiology and join him in the endeavor todecades. I was fortunate to have been

develop the department of Cardiology afterassociated with him since 1969 when I

my return from USA. His patience,joined LTMG Hospital and Medical College

perseverance and focused efforts toas Hon. Assistant Professor and Hon

develop Cardiology yielded fruits when inPhysician. We both worked together since

1978 we finally succeeded in establishingthen. Those were the days when Cardiology

Cardiology department at LTMG Hospitalwas in its nascent stage in this country. Dr.

and Medical college. It looked as if his dreamGandhi after training as a Cardiologist from

KEM hospital and then from Boston, had come true.


While striving to develop Cardiology at the and a gem of a human being. We both

medical college he was fortunate to get the travelled far and wide in this country and

opportunity to establish cardiology at abroad and enjoyed the scientific

Balabhai Nanavati Hospital in Vile Parle. conferences. I could only sum up and sayAfter my return from USA a full-fledge

that he was a source of inspiration to me andcardiac catheterization and angiographic

many of his peers and students. Men aredepartment, open heart surgery program

mortal, however, their deeds leave behindwere established there.

marks on the pavements of time - someHe trained and motivated his residents to

made up of sand and some of solid rock.present and publish papers. Without doubt

Dr. Gandhi's marks are unquestionablyhe deserves the credit for promoting

engraved deep on rocks that will last fara g g r e s s i v e a n d e v i d e n c e b a s e d

beyond we last. He has left behind a richmanagement of coronary artery disease in

legacy of Cardiology department, studentsthis country. He had the great knack of

and friends and scores of patients whom heallowing everyone in the department to

treated diligently. I will always miss him.grow and persue new procedures and

techniques. More than being a teacher , and Vacuum left behind by him cannot be filled

voracious reader was a keen student to easily. I pray for his soul wherever it is to rest

learn even from the most junior resident. He in peace.believed that the greatest teacher is one

- Dr. Dev PAHLAJANIwho is constantly eager to learn. He

a c h i e v e d t h e p r e s i d e n t s h i p s o f Head Department of Cardiology Breach

CARDIOLOGICAL society of India and various Candy Hospital and formerly Head

other organizations. department of Cardiology Balabhai

He was a great friend, a wonderful company Nanavati Hospital Mumbai

Dr. M. J. Gandhi was President of AMC in where he was highly respected. He was

always available to solve any problemthe year 1980 . It was a time when AMC was

faced by the office bearers and will bein its nascent stage and taking baby steps.

remembered for his affable ways andDr Gandhi made a significant contribution

committment to the cause of AMC. May histo the Association by motivating severalsoul rest in peace.consultants to join the AMC especially from

the central suburbs and Sion hospital - Dr. Lalit Kapoor


AMC Pragati Panel for

MMC Elections

1. Dr. Nitin Bhagali, M.S., Pune

2. Dr. Jignesh Thakkar, MD., Mumbai

3. Dr. Sudhir Naik, M.D.Gynae, Mumbai

4. Dr. Niranjan Agarwal, M.S., Mumbai

5. Dr. Avinash Yelikar, M.Ch., Aurangabad

6. Dr. Nilesh Nikam, M.S., Nasik

7. Dr. Abhay Kadam, M.D., Latur

8. Dr. Sharad Ghadge, M.D.Paed., Sangli

9. Dr. Pinak Dande, M.B.B.S., Nagpur


Maharashtra Medical Counci l , the great fighter), IMA to challenge the MMC

regulatory Body of the medical profession in goings-on and the fraudulent way in which

Maharashtra has had a chequered and elections were conducted . As a result of the

tumultuous history in the past several combined efforts , the Bombay High Court

decades. AMC was the first medical upheld our contention that elections should

organization to identify the various lacunae be held by physical ballot and not postal

in the functioning of the Council. Over the ballot to ensure that the elections were not

past 3 decades AMC organized at least 3 rigged. This was a great achievement.

Panel discussions on the subjects "ShouldThe MMC was in suspended animation for

MMC be revamped?" "Urgent need forseveral years and hence non-functional due

reforms in MMC", "Is MMC Act outdated ?to the machinations of the Government.

Do we need to amend it ?". Each panelThe last term of the MMC had 9 popularlydiscussion was in the nature of a heatedelected members 2 of them from AMC viz.brainstorming with MMC and GovernmentDr. Suresh Rao and Dr. Bipin Pandit. Togetherrepresentatives being asked uncomfortablewith the other members they a made aquestions. All these have been documentedsincere effort to improve the working of theand the detailed reports appeared in thisMMC. Fresh elections were called upon thepublication (GRASP) which you are holdingdissolution of the MMC by the Governmentin your hand. These can be accessed in thefor unclear reasons.archives of the publication. AMC submitted

its wish-list of reforms to the Government of It will be thus obvious that AMC has a long

the day without any response from them. history of involvement in the working of the

MMC apart from considerable know-how ofAMC was also a part of the effort by athe areas which need to be improved.number of activists and organizations such

as ACASH (more specifically Dr. Arun Bal-a ....continued on page no. 18

MMC Elections

Dr. Lalit Kapoor


AMCON 2016 th

at Hotel Leela on 27 November 2016



thAMC organised a Zonal meet on 28 August revisited and this was today's subject for the

Panel discussion. Dr. Prakash Patil and2016, Sunday at Hotel Tunga Reganza at

Dr. Sonali Shete moderated the PanelVashi, Navi Mumbai. The programme was indiscussion. The part ic ipants werecollaboration with Raigad Obstetrics &Dr. Rajendra Saraogi, Dr. Bipin Pandit,Gynaecological Society.Dr. Ganpat Sawant, Dr. Reena Wani, and

The topics chosen were very significant and Dr. Supriya Arwari.close to the heart of every Medical

Another Panel discussion topic was "Clinicconsultant and more so to the Obstetricians

to Court", which has been widelyand Gynaecologists.

appreciated throughout India. Dr. Bipin

Emergencies in Obstetrics, is the hot topic in Pandit and Dr. Nilima Vaidya-Bhamare were

the recent scenario, which requires to be the Moderators. The Panelists were Dr. Lalit

AMC - Zonal Meet at Vashi

Dr. Ajit DesaiProg. Comm. Chairman, AMC


Kapoor, Mr. Jehangir Gai, Dr. Veena Pandit, We concluded this programme with Musical

Adv. Amit Karkhanis and Dr. Ajit Desai. Orchestra by Doctors and a sumptuous

dinner.The programme was attended by more than

300 delegates and it was a grand success.I would like to especially thank Dr. Sanjay

Ms. Nehal Mota from Fenovate andPattiwar and Dr. Prakash Patil, the

Ms. Uttara Vaid from Landmark, gave veryConveners of this event, for giving usimportant tips regarding finance and riskinvaluable help in making this programme aexposure management for Medical

Professionals. gala event.


continued from page no. 13....Having briefly various agencies, doubtlessly without

scanned the history, it is incumbent upon us compromising on its basic ethos, to achieve

to refer to the forthcoming elections of the its wish-list for its members---which is

MMC which are scheduled to be held on indeed the bottom line.

18th December 2016.Here's wishing for a dignified and honorable

As you are all aware, the last election was election-----after all, all contestants arejointly contested by IMA and AMC and the

well-meaning colleagues and some, evenresults were gratifying.

friends. The theory that in elections you

However, this time around, IMA firstly must throw mud on your opponents, with

decided unilaterally in their own wisdom the hope that some of it will stick , should be

that AMC could nominate only 1 member as given a go-by in the current elections, even if

a candidate and made it obvious by non- the temptation is strong !! Let us show we

verbal communication that they would are different!rather not have AMC along with them in the

As far as making sure you MUST vote, pleaseelections. IMA was unable or unwilling to

ponder on the following :relent. The sensitivity of AMC, which is now

a Body of 9000 consultants of all shades of EACH VOTE COUNTS

specialization was brushed aside, ignoringIn 1645, one vote gave Oliver Cromwell

the pioneering work done by thecontrol of England.

Association over the years. As a result, the

In 1649, one vote decided the execution ofpresent team of candidates emerged, all of

Charles I.them respected in their geographical areas.

The 2 AMC candidates Dr. Niranjan Agarwal In 1776, one vote gave America, English

and Dr. Sudhir Naik are well known to all of instead of German as a language.

you and we can expect them to give a goodIn 1923, one vote made Hitler the leader of

account of themselves in the new Councilthe Nazi party.

should they be elected along with the other

And in 1998, the Vajpayee government waspanelists.

defeated by one vote.AMC would contribute meaningfully

Therefore, remember your vote istowards crafting an MMC which is fair, just

and efficient and take the assistance of important !


Very few of us are aware of the existence Protection Act. The justified need for

and increasing incidence of this well- accountability of doctors got carried to an

defined syndrome--MLSS. It is time we extreme and over a period of time

recognize it, analyse it and do everything in transformed into hostility against doctors.

our power to mitigate and manage it As a result, most doctors developed a sense

effectively. In the USA, it is referred to as of insecurity and a sense of vulnerability to

MMSS viz. Medical Malpractice Stress unfounded allegations of negligence by

Syndrome. I am averse to using the word patients. Large awards of compensation by

'malpractice' as it connotes 'wrong-doing' courts aggravated the situation further.

and 'guilt' which is 'alleged' and not provenThough facing a malpractice litigation is now

and hence prefer the more generic term-being considered a predictable hazard of

'medico-legal'.medical practice, most doctors are ill-

MLSS refers to a set of symptoms common prepared to deal with the devastating

among those doctors facing medico-legal psychological effects of such a situation

problems including legal notices from especially when an unexpected outcome,

patients alleging negligence in treatment; especially, unanticipated death occurs in a

facing cases before Consumer Forums for patient.

compensation;, complaints before MedicalAllegations of malpractice are uniquely

Councils; Police enquiries leading tostressful to doctors because they are

criminal prosecution; patient aggressionperceived as an assault on their competence

and so on.It includes the impact on theand integrity and strike at the core of their

family of the doctor as well.self-image and self-esteem, especially those

We are all aware of the exponential rise of who may have spent a life-time in impacting

medical litigation in the last decade the lives of their patients who come to them

especially after the medical profession was for treatment. They may be extremely

brought under the purview of the Consumer traumatic regardless of whether or not the

Dos AND DON’Ts

MEDICO-LEGAL STRESS SYNDROME (MLSS):

Managing a largely ignored condition

Dr. Lalit Kapoor


allegations have merit. The emotional

turmoil can be debilitating.

professionals will question as well. We may

feel betrayed and wonder if we can trust any

patient".Allegations of malpractice and legal notice

from a patient can trigger off emotional In the US one study revealed that 95 % of

reactions in the recipient which may range doctors reported significant emotional or

from shock, anger, anxiety; denial, physical reactions to being sued. Being a

frustration and even guilt. close witness to hundreds of such situations

i n v o l v i n g c o l l e a g u e s w h o h a v eMichael H. Gendel, Medical Director of the

unfortunately got caught up in a medico-Colorado Physician Health Program, sums

legal tangle, I can corroborate theup the situation beautifully in the

observations of Michael H. Gendel, andnewsletter of the CPHP :

confirm that the impact of medico-legal"Among the stressful aspects of a problems on individual doctors is nomalpractice suit is the unalterable and different here in India. I can vouch for thedisturbing fact that one of our patients same, having personally faced suchbelieves that we harmed him or her. Even in situations in a couple of cases of patientcases of a clear bad outcome, the physician aggression with threats to sue and a legalmay or may not have erred in providing notice as well on one occasion. Those whotreatment, but regardless of fault we usually have faced similar problems will, I am sure,feel guilty. If sued we start receiving confirm the above observations.documents that refer to us as "defendants".

Undoubtedly, the stress may continue longAnd list the harmful things that we are

after the conclusion of the case even if theaccused of doing or failing to do. Many

doctor was exonerated by the court. Facingdoctors feel stricken to see their names

a litigation is thus a no-win situation for theassociated with such accusations, even if

doctor i.e. the trial itself is the punishment,they recognize the hyperbole and stylizing of

no matter the outcome of the case.the language. Our self esteem is painfully

punctured. Classically, the syndrome includes the

following symptoms, though not all areWhen we are sued for malpractice our

necessarily present in each and every case :professional integrity is shaken. We feel

unsafe, and we may dread going to work. Symptoms : Mental : Anger, outrage,

Without understanding why, we may feel excessive worry, frustration, distrust,

ashamed. Self-confidence may suffer, and negative self-image, depression, grief for

regardless of the facts, we may question our the patient involved, Apathy, decreased

competence and assume our fellow- interest in recreation/work, sense of having


been assaulted, fear of being sued, fear of

financial losses and loss of professional

reputation. Physical : Fatigue, inability to

concentrate, insomnia, loss of sex drive,

alcohol consumption or drug use , anorexia,

GI symptoms.

when most doctors were very secretive

about the whole thing and sometimes, even

did not let their family members know and

very few even sought the moral support of

their peers! Such was the feeling of shame

and guilt and sense of stigma.

While most cases can be handled with It was very clear thus that we needed toeffective stress management, a few are create a support system to help the doctorknown to progress to extreme levels. I know to face the attendant problems andof a Physician who was so terrified following minimize, if not eliminate the stress andlitigation that he stopped treating indoor improve the eventual outcome.patients and would only treat outdoor

Accordingly, almost 35 years ago, a Medico-patients. I know of a surgeon who stoppedLegal Cell was constituted by AMC to spear-doing surgery for several months and ofhead this "support system" dedicated to thecourse there was this Gynec-surgeon coupleaffected member. The comprehensivewho ended up in divorce followingassistance integrated professionalprolonged litigation in an a malpractice caseindemnity insurance through a tailor-madewhich was decided against them .Cases of

group insurance closely monitored by AMC,practice-disruption following a traumatic

24x7 helpline, and generated a feeling in thelitigation are frequent. I also know of at least

member that he could share his fears and2 cases, both of whom were AMC members,

concerns (many times 'imaginary') and findin which extreme depression led to physical

answers to his queries.self-harm.

It is extremely important for a doctor facing Dos and Don'ts for colleagues of the

any medico-legal problem to be able to affected doctor :

discuss it with some of his own colleagues,• Empathise with him or her. Hindsight is

preferably those who have developedalways 6/6. The chain of events could

adequate know-how of such matters. Manyhave occurred with you as well. Hence

years ago AMC identified the non-existencedon't be judgmental. Offer whatever

of a support system for a member who had help you can. Merely doing that can also

to deal with the profound stress of patientsprovide comfort.

challenging their competence and alleging

• Offer to scan the literature and providenegligence. Quite literally, they had no one

him/her with reference which couldto turn to and were left to fend for

themselves. In fact, I remember the days possibly help defend the case.


• In case supporting affidavit is required to

show that there was no deviation in the

standard of care, do not hesitate to give

the same. Especially in consumer courts

you are extremely unlikely to be

summoned to the court for cross

examination.

• In case you detect symptoms or signs of

MLSS, as listed above, help him or her to

meet a counselor.

considered when trying to manage the

problem. The members of the family too get

involved -and in some cases even more than

the doctor. Hence, management efforts

must inc lude the fami ly. Shar ing

experiences could be a source of strength

and hope. Essentially, the self-help group

conveys to the affected doctor: "Others

have gone through the same thing you're

going through, and they've survived and "so

can you!”

It is true that only a fraction of what needs toThe group would also help the doctor to

be done is currently on offer to memberscounteract negative feelings by reminding

and we need to do much more to handle thehim that litigation is about 'compensation'

Medico Legal Stress Syndrome affecting theand not 'competence' and as a lawyer

member.advised:"Don't take this accusation

Firstly, we at AMC propose to survey the personally, it is a professional hazard and

extent of the problem and the incidence by the cost of doing business!”

getting reactions from affected membersIn conclusion, Medico-legal Stress

and collating the data.Syndrome must be pre-empted as far as

Secondly, it will be our aim to establish self- possible by providing maximum support to a

member who may have a potential tohelp groups to make available advice from

develop it and mechanisms to cope with themembers who have faced similar problems

problem should be provided by ourso as to provide psychological, emotional

Association.and social support and develop mechanisms

to cope up with the impact of the crisis. TheI have always believed and said it several

efficient handling of the original problem times that if an Association does not help awith appropriate logistic support obviously member at the time of his time of his mostought to be central to the efforts. Family traumatic situation, it is not worth the papermembers could be part of the group. It is on which its Constitution is written.equally important to understand the trauma

which the spouse and members of the

family undergo and they have to be [email protected]


Dr. Chandrakant G. Command over English and sharpness in talk wasnd

Saraiya was born on 22 well beyond normal and one has to be sharp in

October 1916 as he talking with him.st rd

entered 101 year on 23 Even today, with his completion of 100 years on ndOctober 2016, alive but 22 October 2016, the brain is functioning as it

not kicking but with the was in the past. No news is new to him as

same powerful brain and somehow he has received it before most people.

number of grey cells. An He fully well knows all the major and worth

eminent Obstetrician and Gynecologist with knowing minor events. His talks are interesting

sound and perfect knowledge of the subject. and always with humor. No dimming of sharp

Indeed, Teacher of Teachers. He practised what intellect even today.

he preached and he preached 'Diagnosis must He had an enviable Obstetric and Gynecolgicalprecede the treatment' and words of practice in the era of colleagues Dr. V. N.

Hippocrates that 'Do No harm'. He Graduated Shirodkar and Dr. B. N. Purandare, which

from Grant Medical College and J.J. Hospital and includes delivery of wife Jaya of the legendary

later was appointed as Honorary Consultant and most loved Amitabh Bachhan besides USA

Obstetrician and Gynecologist at Grant Medical Consuls etc.

College and J.J. Hospital and Nowrosjee Wadia He has slept in the hospital on numberless nightsMaternity Hospital for few decades, till his and examined a woman in labour with wait-n-retirement. He had MD and MS with distinction watch approach, half hourly or 4 to 5 times withand later walked through FRCS (Edinburgh) caesarean section rate of less than 5%. Thereexamination. In fact, at FRCS exams in Edinburgh was no difference in attending to the patient

in the nineteen forties, the examiner himself was whether she was at J.J. Hospital or in his private

stumped by his answer to the first question that practice at Sir Hurkisondas Hospital or Breach

was asked to him. Candy Hospital.

He served as president of All India Federation of His beloved wife Mrs. Annie Saraiya, with

Obstetric and Gynecological Societies of India Lawyer's genes was great. Poetry writer and with

(FOGSI) in 1975-76 and president of Bombay literacy outputs. She had written books for

Obstetric and Gynecological Society (BOGS) in children and was a member of Senate of Bombay

University. She once led the Annual convocation1973-74. He was miles away from politics and

procession along with the Chancellor.manipulations.

He has liberally donated to Nowrosjee WadiaStudents would wait to attend his lectures.

Maternity Hospital, Shanti Avedna (Bandra),Indepth knowledge that he imparted with

School for Blind (Dadar), Ophthalmic outdoor atincomparable sense of humour. His comments

SNDT College (Santacruz) and even in Gondalwould be the last word. They were eagerly(Gujarat).awaited to carry the message home. Class room

or hall would be packed to listen to him. [email protected]

Dr. C. G. Saraiya, MD, MS, FRCS -

- Dr. Shirish S. Sheth NOT OUT


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In life, few things are as hurting as criticism. and they agree to "live and let live.”

Even more excruciating is unwarranted Ignore : Some people stick to their opinions,criticism, that is, criticism based on whatever the facts or however valid themisunderstandings or untruths. counter-arguments. About such people, it is

rightly said, "A man convinced against hisWe tend to respond to such criticism in one

will is of the same opinion still.”of three broad ways.

With such people, clarifying and counteringClarify : We try to defuse the antagonism by

are both wastes of time. The more theclarifying the situation. If the critic is too

discussion prolongs, the more acrimonioushostile to have a rational discussion with us,

it becomes. The only way to stop thewe may clarify through an intermediary

nastiness is by ignoring the criticism.whom both parties see as trustworthy or at

least as neutral. Clarification offers the best No doubt, ignoring is extremely difficult. Wepossibility for resolution, all the more so if fear that others may think we have beenthe critic is reasonable. If the clarification defeated - that in our refusal to argue anyworks, both sides understand each other further, we have admitted our inability tobetter and may even come closer than argue any further. If such a fear goads us intoearlier. dragging on an unfruitful interaction, we can

check ourselves by contemplating a graphicCounter : A more instinctive response toquote of George Bernard Shaw: "I learnedcriticism is to refute it, to objectively pointlong ago, never to wrestle with a pig. You getout errors in the criticism. Such counteringdirty, and besides, the pig likes it.”can work if the critic is intellectually honest

and is ready to admit limitations in their Characterizing a critic as a pig might be

perspective. They acknowledge the validity uncharitable and inaccurate even. If so, then

of our perspective of things, even if it is we can use this metaphor to drive home not

different from theirs. Sometimes, even if the nature of the critic but the nature of the

o u r p e rs p e c t i ve d o e s n ' t b e co m e fight - some battles are just not worth

acceptable, it becomes at least intelligible, fighting. ....continued on page no. 30

Criticized ?

Clarify, Counter - or Ignore?

Swami Chaitanya Charan Das


AMC ActivitiesAMC participated in Health Summit organised by CII in September 2016 at New Delhi.

Organ Donation Workshop along with Wockhardt Hospital


AMC ActivitiesAMC Seminar on Medico Legal Issues at Nalasopara on 2nd October 2016.

AMC Dignitaries Participating in

a Meet at Raipur, Chattisgarh.

Zonal Meet at Dombivli at on 9th October 2016.


continued from page no. 27....Either way, to purging alloys from it, exposure to criticism

ignore criticism, we need to exercise our makes a person's core character more

tolerance muscles. In this context, tolerance evident. Their capacity to tolerate reveals

means calling off our war with reality - the how they are far higher than most people,

unpalatable reality that some people are who can't resist the impulse to argue

going to have negative opinions about us, endlessly.

and nothing we do is likely to change theirStill, while the increased shine of gold can beopinion.seen by everyone, the exalted character of

The Bhagavad-gita urges us to toleratethe criticized person who tolerates is not

distresses by meditating that suchseen by everyone - critics may believe they

distresses are temporary (02.14), whereashave proven their rightness. Such critics are

we ourselves are eternal (02.13). We arelike those who close their eyes to the gold's

indestructible spiritual beings whoseincreased effulgence. Little do they realize

essential core can't be hurt by anything that their unrelenting criticism and self-(02.22) - not even criticism, no matter how congratulation ends up exposing theircaustic. The more we realize our spiritual petty-mindedness and vindictiveness - justessence, the more we get the inner as a goldsmith's face gets blackened.fortitude necessary to tolerate criticism.

Just as those with eyes appreciate the gold'sThe easiest way to gain such spiritual effulgence, the intelligent appreciate therealization is by practicing bhakti-yoga fortitude of those who refuse to engage in

diligently. In fact, bhakti offers an even an arguing match. Most importantly, God

higher real izat ion - not just the appreciates their fortitude. And ultimately,

indestructibility of our souls, but also the his view is the only view that matters.

infallibility of God's love for us. When we

relish the comforting shelter of absorption

in God and feel reassured that he loves us,

no matter what the world thinks about us,

we recognize that our critics' opinions are

not all that consequential. And the hurts Chaitanya Charan Das is a researcher and

thereof become more bearable. author in science and spirituality. He has

been an invited speaker at severalTo further boost our determination to

international conferences on the interface oftolerate, we can contemplate a traditional

science and spirituality.metaphor: Just as exposure to fire makes

the gold's effulgence more evident by (contributed by Dr. Ashok Shetty)

[email protected]


It was a late afternoon at our hospital today, also extends to Jains, Buddhists and

my colleague Dr. Ravi was searching for Sikhs.

something on the internet. When I• A karta who is generally the senior most

enquired, he told that he was to shortlymale member of the family has the right

receive some inheritance from histo sign all documents & take all decisions

grandfather and some distant relative hadin best interests of HUF.

suggested him to form an HUF to save on

tax, however he was totally lost as he did not • A will can also bequeath assets to the

know the ABC of this animal known as HUF. HUF if it is specifically mentioned in the

Smiling within myself, I suggested him that will.we should discuss it over a hot cuppa & so

• An NRI can also create an HUF and it iswe headed for a cup of tea.

not limited to resident Indians only.Know the basics first However, the practical aspects and

Joint family system forms the base of our convenience of opening bank account,

Indian culture. The informal personal getting PAN etc. sitting outside India has

financial planning that Indian families do to be evaluated.

almost always involves a consideration ofTaxation aspects

leaving "something" for the children and

Following are some of the pertinent taxgrandchildren. So, what is an HUF? It stands

provisions on HUF :for "Hindu Undivided Family". In simple

words, it means a family devolving from a• Section 2 (31) of the Act recognises

common male ancestor and includes wives"Hindu Undivided Family" as a separate

and unmarried daughters.unit of taxation, like an individual or a

Some important points to note on HUF are company. Being a separate unit, it gets aas follows : separate basic exemption limit of

` 2,50,000 and deductions u/s 80 CCC• It is a misconception that HUF is meant

only for Hindus. Apart from Hindus, it while filing the tax return.

The lesser known secret :

How HUF can help you save tax

Ms. Nehal Mota, Founder - Director

Finnovate Financial Services Pvt. Ltd.


• As per Section 56, if an HUF receives any

money / property / gold from its

members, it is not taxable in the hands of

HUF.

• Section 64 (2) provides for clubbing of

income on transferof self-acquired

property to HUF without adequate

consideration, So if there is a transfer of

self-acquired property it should be with

adequate consideration.

• In case of partition, Section 171 requires

Assessing Officer to conduct a thorough

enquiry on the same. Also, partial

partition is no more recognised.

Case Study

Simple idea of reducing tax liability by How to create an HUF

creating HUF is to shift a portion of income Now that Dr. Ravi is clear on the tax benefit(from inherited property) to a separate of HUF, I tried to explain how to create one.entity & claim the available basic exemption As per Hindu law, HUF comes into existencelimits & reduced tax slabs under the Act.

as soon as there are two or more members

Let us understand with the help of Dr.Ravi's in the family, one of them being a maleexample. Suppose Dr. Ravi earns ` 15 lacs member. However, certain minimumper annum & receives a property as documentation steps need to be takeninheritance, which generates a rental to "create" the HUF as a separate entity inincome of ` 10 lacs a year. Now, if Dr. Ravi the eyes of the income tax authoritiesdoes not divert this rental income to the as follows :HUF, he'll be taxed additionally @30.90% on

• Create an "HUF deed" on stamp paperthis ` 10 lacs. But if he does so, he'll save a

which recognises the HUF, the Karta, itsgood amount of tax & let's see how.

members and any property belonging or

being merged into the HUF. If needed,

take help of a CA or a lawyer.

• Open a bank account in the name of the

HUF.

• Apply for a PAN for the HUF.

That's it, you're done! Once you've created

an HUF, income from HUF property should

Case A : No HUF in place

Particulars Self

Salary Income 15,00,000

Rental Income 10,00,000

Total 25,00,000

Less: Deductions u/s 80C 1,50,000

Net Income 23,50,000

Tax Payable 5,30,000

Case B : Inherited property

forms part of HUF

Particulars Self (A) HUF (B)

Salary Income 15,00,000 0

Rental Income 0 10,00,000

Total 15,00,000 10,00,000

Less :

Deductions u/s 80C1,50,000 150000

Net Income 13,50,000 8,50,000

Tax Payable 2,30,000 95,000

Total Tax Payable

(A) + (B)3,25,000

Tax Savings calculation :

Savings in tax (INR) 2,05,000

Savings in tax (%) 38.67


be credited in HUF bank account & separate of a dispute between family members

tax return of HUF should be filed every year. later on, you'll not be able to reclaim it.

Any gifts, inheritances etc. received should • Members should not mix personal fundsbe made part of the HUF with a clear record with HUF funds. Each entry in HUF bankof the donor and date of receipt. account should be supported by proper

documentation.Before taking the leap, read this

Conclusion :While a tax saving every year can look very

appealing, I cautioned Ravi to keep the HUF in a relatively less known way to reducefollowing points in mind before taking the tax liability on income arising from inheritedleap : property. Tax changes like clubbing of

income & de-recognition of partial partition• Given that many people use HUF route tohave ensured that people cannot use it as aescape normal incomes from tax, the ITconduit to evade tax. As for Dr. Ravi, by thedepartment watches HUF transactionstime we closed our discussion, I could sensewith extra scepticism. Hence, never usea great deal of relief and clarity on his faceHUF as a tax evasion mechanism as it cannow that he know's how to go about thehave penal consequences.whole thing towards creating an HUF and

• Before vesting personal property intousing it to reduce his tax liability.

HUF, think ten times. This is because

once you vest the property in HUF, you

lose your individual right over it. In case [email protected]

CONDOLENCES

Dr. Vyomesh Parikh

Sr. Neurosurgeon

Passed Away :th

16 August 2016

Dr. Mansukh J. Gandhi

Sr. Cardiologist

Passed Away :th

12 October 2016

Dr. Sharad D. Dixit

Sr. Anaesthesiologist

Passed Away :th

15 October 2016



Response to Beti Bachao - ‘The GRASP’ August 2016

Compliments to Dr. Sushmita Bhatnagar for creating awareness of the sad plight of the

unwanted girl child in many sections of our nation. The fact that a new born, when

discovered to be a girl, and if found to be bodily lacking by defects of nature, if often

neglected, abandoned or left to die amongst several social/economic/cultural classes is

well known to most health care professionals in India.

Stringent laws that do not permit termination of pregnancy beyond a certain time, even

when the child is found to have a difficult congenital anomaly, have compounded the

problem.

While laws made are meant to save the unborn girl child, as also to protect minor males as

well as females from physical and mental abuse, the practical implementation of the laws is

often lacking. Things may seem rosy on paper in India, but the reality is harsh and unbending.

There are laws that forbid minors from begging and penalise them and their guardians, if

found so. But haven't we all seen hordes of children, alone or with their guardians, begging in

almost every public place in India….on roads, trains, in markets and outside places of

worship? I have been seeing this very common site for as long as I can remember….cannot

recall any worthwhile action ever being taken against beggars by the law preservers!

Dr. Bhatnagar asks, Why should a girl child suffer due to the gender bias which is still rampant

in our society? The question is rhetoric…..the girl suffers because of the gender bias. And

laws, though necessary, are not enough in themselves to remove this bias and prevent the

girl from suffering. Asking for and giving dowry has long been illegal. In reality, this practice

goes on unabated in many, many communities in our nation. Child marriages are illegal; that

they happen regularly is a well known secret in Rajasthan and many other areas.

Abandoning minors may be illegal and punishable, but goes on unhindered, without any

effective check. A few years ago, I saw a beggarly looking woman at Bandra station telling a

boy who seemed to be under her care, to get into any train and disappear! The boy could

have been 7 or 8 years old, possibly her son. The woman had a baby in her arms and was

shouting at the boy to run away. The poor boy kept crying, pleading at her to keep him!

Only a few weeks ago, as I waited at a red signal at Saki Naka, Mumbai, I saw through the

window of my car a young girl about 10 or 12 years old, forcing a younger boy, 3 or 4 years of

age, to put his hand out to beg from motorists! The poor boy couldn't even understand what

he was being forced to do. He seemed so intimidated and fearful! This was happening in

broad daylight, in a very busy area of the capital of Maharashtra, where almost always there

are police present!

Laws seem great on paper, but in a country like ours which is overpopulated, overtly corrupt,

FORUM


has misplaced priorities on many, many social and governmental levels, they are often

destined to lie in dusty law books, uncalled for.

What are the causes for this apathy we have for human lives in our nation?

The foremost, I think, is that there are too many of us, demanding a piece of the sky and the

pie (roti, for most of us). A huge, huge population eats into most of our resources only to

survive. It is very often a struggle just to keep our mind and body together, for the vast

majority of us Indians……can we, then, expect any goodly niceties to descend upon us? An

exploding population, tearing away at the seams of our resource box will inevitably draw the

corollary of life draining evils. Unemployment, short changing others for money, huge

corruption, gross inefficiency at work and home greed and insecurity are all constant

occurrences for many, many of us, whether we are aware about it or not.

In such a tight and grim social scenario, it is often a mammoth task for a poor family to raise a

girl, spend on her upbringing, food, education and health - only to pay for her dowry and see

her go away to another home, with no financial returns to be expected. And if that girl

happens to have a defect or disease - whether inborn or acquired- these become compelling

reasons for the poor parents to neglect or abandon her.

Another incident comes to my mind. Many years ago, when I was an intern at a primary

health centre at Palghar, about 60 kms. from Mumbai, a woman delivered twin girls. As

happens often in twins, one of the two girls was born well built and nourished and the other

was poorly weighed and ill nourished. The mother was a tribal woman from a poor family. I

think the birth of two girls probably overwhelmed her psyche and meagre resources.

The mother would breast feed the well nourished baby girl often but would neglect the

other girl who was poorly built and actually needed more milk and care. She would be often

left crying for food, as the mother gave her milk to the stronger baby. I often told her to feed

the weaker baby more often - something she would pretend to do when a doctor or nurse

happened to be around. I spoke to one of the nurses. The nurse confided in me….two girls at

the same time would be an unbearable burden for a poor tribal woman. The woman

probably wants to let one of the girls die. And this actually happened the weaker girl,

uncared and unloved for, died in a few days.

Laws are good, but not enough. We need to raise our social, material, mental and wisdom

equities to a level that survival and space for every new born male and female are

automatically taken care of, by the parents and the society. Only when roti, kapda, makaan,

school and medical care of a good order are actually and assuredly provided to every child

and adult, healthy, sick or defective, will the abuse and abandonment of children truly cease.

Unfortunately, for a nation sorely lacking in the equities of ethics, value for life, physical,

mental and spiritual space for all and respect for integrity and efficiency, this remains a tall

order.

Dr. Arun Sheth, Plastic Surgeon


Proper di fferent ia l d iagnos is and Opposite Parties delayed the diagnosis and

treatment of the patient which resulted in management of the patient in adherence to

the death of the patient.standard of care by a reasonable prudent

medical practitioner is the duty of a doctor. Held : It was clear that the patient hadHowever, the same has to be rendered to abdominal distension which needed

the patient in a timely manner. Delay in urgent proper investigations and surgical

arrival at a proper diagnosis or delay in the intervention. However, only IV fluids and

administration of treatment amounts to medication was given. Investigations like

negligence as is illustrated by case laws USG, CT Scan to know about abdominal

below pathology/injury were not performed. As

per the Opposite Parties, the relatives of theI(2016) CPJ 624 NC----A A Vs K MedicalComplainant did not consent to urgentCentresurgery. However, there is no record of

Kulbushan Abbi suffered serious injuries todenial of consent on the medical record. It is

his chest; abdomen and head injury on nightan unsolved question as to why the doctors

thof 11 September and was admitted waited for the Complainant's brother forimmediately to K Medical Centre. IV fluids consent when wife was available. As perand medication was given. The patient was medical record, semi-solid food was

thtaken up for surgery on 17 September. permitted by the doctor without anyPost-operatively, the patient expired within justification and the patient deterioratedshort time. As per the Complainant, severe further. The decision for surgery was taken

thabdominal injury necessitated emergency only on 17 September. Preoperativelaparotomy which was not done. assessment revealed that the patient was

Investigations like USG, CT Scan were not drowsy, dehydrated with poor general

performed. Surgery was performed at a condition. As per the Opposite Parties, there

belated stage i.e. after six days and hence was unavailability of Anaesthetist due to

the patient suffered post-operative strike. Despite strike, however, emergency

complications, coma and death. The services are always available. However, the

Delay in Diagnosis and

Treatment is Negligence

Dr. Suganthi IyerDy. Director - Hinduja Hospital, Mumbai


Hospital did not refer the patient to any was lack of post-operative care resulting in

other Government Hospital either which death of the patient.

should have been done if non-availability of Held : Investigations revealed leucocytosisAnaesthesiologist due to strike. It was and high neutrophil count. There was rapidbounden duty of the doctor to treat the increase in abdominal pain and need forpatient as per standard line of treatment emergency surgery. The primary consultantand the doctor should act in the interest of examined the patient only twelve hoursthe patient. The Opposite Parties adopted a after admission the patient was managed'wait and watch' policy on the serious by only pain killers for over sixteen hours.patient which caused further deterioration The patient was then taken for surgery.of the patient resulting in death. However, the appendix was burst by the

time he was operated with considerable foulHence, there was negligence in conducting

smelling pus. Though it was necessary totimely investigations and treatment. Five

take a large incision for toileting thelakhs were awarded.

abdominal cavity to prevent septicaemiaII(2016)CPJ 348NC---- Roy & Anr. Vs B

and second incision for drain to drain out theHospital & Anr.

pus, no drain was kept. The appendix wasth

Mr. Roy suffered acute abdomen on the 27 gangrenous and perforated. HigherJune. The family physician diagnosed acute antibiotics were not used despite cultureappendicitis and advised immediate report. Despite need, patient was not keptsurgery. The patient was admitted to B in the Intensive Care Unit. Injection Kesol

Hospital and there was rapid increase in was given despite low urinary output

abdominal pain. The patient was managed without monitoring electrolyte levels. There

by only pain killers for over sixteen hours. was absence of close monitoring including

The appendix was burst by the time he was doctor's visit leading to sudden death of thethoperated and the patient died within thirty patient on 29 June. No doctor or nurse was

six hours of surgery and two days of with the patient in the last twenty minutes

hospitalisation. The Complainant made of deterioration of the patient. Thus a young

allegations of where there was delay in the healthy woman died within thirty six hours

admission process by one and half hours for of surgery and two days of hospitalisation.

want of deposit moneys. In addition, the The patient had gone to a reputed hospital

Opposite Parties failed to care for the to get prompt and efficient treatment from

emergency condition of the patient and highly skilled doctors. The doctors made a

ignored the vital lab reports and need for wilful delay of 17 hours despite clinical signs

urgent surgery. There was wilful delay in and diagnostic reports indicative of acute

surgery. In addition, proper surgical emergency. Expert opinion was rendered

procedure was not adhered to and there on behalf of the patient by Dr. M, who said


ththat there was delay in carrying out the back. MRI was carried out on 20 May which

surgery of appendicitis, resulting in burst indicated presence of tumour outside the

appendix leading to peritonitis and pus in spinal cord at D-10-11. Ms. Sharifabai wasthe pelvic cavity and septicemia. He also taken up for surgery by Neurosurgeon,

thstated that no drain was kept which should Dr. Turel on 25 May. However no tumourhave been done and that higher antibiotics was found at D-10-11 and hence the surgeryto which the organism would be more was of no utility for the patient. Repeat MRI

rdsensitive should have been used and the ICU performed on 3 June revealed tumour at D-was needed for close monitoring of the

7-8. Second "laminectomy" surgery waspatient which was not done. Standard th

performed on 4 June and the tumour wastextbooks were produced which stated that

removed. For this purpose, the patient wasemergency surgery was the standard line of st th

required to stay from 21 May to 28 June incare. Literature revealed that early

the hospital and incur heavy expenses.detection of sepsis and prompt aggressive

Hence there was negligence in performingtreatment is necessary for improving

the uncalled for surgery on behalf of thepatient outcome. If untreated, it couldhospital and the doctors.result in septicaemia and multi-organ

failure. There was violation of Code of Held : The MR Scan is done by a Technician

Ethics which specifies duties of physicians and supervised by Senior Resident. The

towards patients. In addition, emergency Consultant Radiologist relies on the SeniorUSG Scan should have been conducted to Resident who is a qualified Radiologist torule out causes of acute abdomen and the perform a complete and accurate scan ofpatient should have been operated on an the patient. The Consultant Radiologist thenemergency basis. The hospital is a tertiary interprets and makes the report based oncare hospital where emergency diagnostics the localisation and identification of theare available.

level by the Senior Resident and Technician.

Failure to perform emergency surgery Though the Senior Resident may do theresulting in death amounts to negligence on scan, however, before taking the patient offpart of the surgeon. The doctor failed to the scanner, the Consultant Radiologist hasforesee the risk of a patient with perforated to make sure that no error is done.appendix in a case of acute abdomen. There Consultant Radiologist was present duringwas deviation from standard line of the second scan and thus localisation of thetreatment. Compensation of Rs. Forty Lakhs

tumour was done at D-7-8. Consultantgranted.

Radiologist was not present during theI(2008)CPJ432(NC)----Ms. S Vs B Hospital & earlier scan when the same was wronglyOrs. reported as tumour present at D-10-11.

Hence, concluded that the ConsultantMs. Sharifabai, was having difficulty in

walking due to suspected tumour in her Radiologist was.........continued on page no. 51


INTRODUCTION : reached, it is the duty of the doctor to

provide information to the patient /A patient plays a vital role in existence ofrelatives.hospital and its functioning. The entire

The various types of information neededhospital infrastructure and manpower are

by patients / relatives can be categorized ascreated to meet his personal requirements.

follows :The information needs of patients differ

from one to another, and it is the 1. Disease related

responsibility of the medical professional to 2. Investigations relatedeither provide him with the relevant 3. Treatment relatedinformation he seeks or guide him to the

4. Outcome relatedpoint of information. The patient expresses

5. Long term prognosis relatedimplied consent when he walks in the

6. Alternative forms of treatment relatedchamber of the doctor that he will be

7. Implications of non-treatment relatedquestioned about the problems and also be

8. General issues relatedexamined by the doctor in whichever way

deemed necessary to arrive at a diagnosis or The details of the information under

a differential diagnosis. Once this stage is subheadings 1 to 4 are tabulated as under -

TREATMENT

RELATED

OUTCOME

RELATED

Type of treatment Whether he will be

cured completely or

partially

Medical or surgical

treatment

Whether cure is

permanent or the

disease can recur

Can surgery be

avoided

If it recurs, what

would be the

problems

Sr.

No.

DISEASE

RELATED

1 What is the

disease

2 Nature of

disease

3 Seriousness of

disease

INVESTIGATIONS

RELATED

Type of

investigations

Whether painful or

not

Where will the tests

be done

BEST PRACTICE GUIDELINES - SERIES : 1

PATIENT INFORMATION

Dr. Sushmita BhatnagarHon. Treasurer


TREATMENT

RELATED

OUTCOME

RELATED

Sr.

No.

DISEASE

RELATED

INVESTIGATIONS

RELATED

7 Whether

hospitalization is

needed for

investigations

Details of medicines

prescribed including

durations, side-

effects, adverse

effects

When can normal

activities be

resumed

8 Details of surgery (if

indicated), timings,

type of anesthesia,

duration of surgery,

pre-operative

preparation, post-

operative recovery,

complications of

surgery and its

treatment

What precautions to

be taken during or

after therapy

9 Success rate of

treatment

10 Reason for planning

or prescribing a

particular form of

treatment

4 Curable or not

curable

What will be the

cost

Duration of

treatment

What form of

treatment will be

given if there is

recurrence

5 How long will the

disease last

Can the

investigations be

avoided

Is hospitalization

needed

Will there be

morbidity or

physical handicap

following treatment

6 Risk of death of

disability due to

disease with

treatment as

well as without

treatment

What are the risks

involved in the

investigations

If yes, then for how

long

Major risk

associated during

the recovery phase


11 Risk of death or risk

of serious disability

due to treatment

TREATMENT

RELATED

OUTCOME

RELATED

Sr.

No.

DISEASE

RELATED

INVESTIGATIONS

RELATED

The details of the information under subheadings 5 to 8 are tabulated as under -

Sr.

No.

LONG TERM

PROGNOSIS

RELATED

ALTERNATIVE FORMS

OF TREATMENT

RELATED

IMPLICATIONS OF

NON-TREAMENT

RELATED

GENERAL ISSUES

RELATED

1 Will the patient

need to take

treatment life

long

Availability of

alternative

treatment

modalities

Is the disease self

limiting

Rules, regulation of

the hospital and

Visiting hours

2 Will there be

repeated tests

required in

future after

treatment with

current illness

Feasibility of using

alternative modes

What will be the

immediate effects if

no treatment is

taken

Payment details, bill

settlement including

deposit payment

details

3 What problems

can arise over

long term even

after successful

treatment

Effectivity of

alternative modes

What will be the

long term effects of

non-treatment

Food details – type

of food permitted to

patient, whether

food can be brought

from home

4 Who is competent in

alternative therapy

Is there a risk of

death or disability or

spread of disease if

not treated

Whether visitors will

be allowed?

Number of relatives

allowed to stay with

the patient

5 Mediclaim details

6 Issuing certificates –

under treatment as

well as post

completion of

treatment


Some other principles to be followed the level and type of information they

want. Based on this, give the patient (andregarding information to be provided to

their family members and/or careers ifPatient / Relations are listed herein :appropriate) clear, consistent, evidence-

• Provide patient information, and thebased, tailored information throughout

support they need to make use of theall stages of their care.

information towards promoting active• This should include, but not be limitedpart ic ipat ion in care and sel f -

to, information on :management.

o their condition and any treatment• Provide patient both oral and written

options.information.

o where they will be seen.• Provide patient information in an

o who will undertake their care.accessible format, at the first and

o ex p e c t e d w a i t i n g t i m e s fo rsubsequent visits. Possible formats may

consultations, investigations andinclude using written information,treatments.pictures, symbols, large print, Braille and

different languages.

• Explore the patient's preferences about

• Ensure that mechanisms are in place to :

o p r o v i d e i n f o r m a t i o n a b o u t

Whether relatives

can donate their

blood and the same

be used for the

patient – the

procedure and

formalities needed

Availability of

medical records of

the patient if treated

as in-patient

Blood donation

details, blood issuing

details, risks of

blood transfusion

details

IMPLICATIONS OF

NON-TREAMENT

RELATED

GENERAL ISSUES

RELATED

8

9

7

Sr.

No.

LONG TERM

PROGNOSIS

RELATED

ALTERNATIVE FORMS

OF TREATMENT

RELATED


appointments to patients who out self-care and self-management.

require information in non-standard • Advise the patient where they might findformats. reliable high-quality information and

support after consultations, fromo alert services of any need for

sources such as national and localinterpreters and non-standardsupport gro ups , networks andformats to be available when patientsinformation services.move between services.

• Provide patient regular, accurate• Ask the patient whether they want to beinformation about the duration of anyaccompanied at consultations by adelays during episodes of care.family member, friend or advocate, and

whether they would like to take notes Conclusions :

and/or an audio recording of the Patient information component is the key toconsultation. involve the patient in the care of the

condition for which he/she has presented• Provide patient (and/or their family

which not only reduces the burden of caremembers and carers) information toand responsibilities on the treating medicalenable them to use any medicines andprofessional, but also allows for a soundequipment correctly. Ensure that thedoctor-patient relationship and thepatient and their family members anddevelopment of the much needed bond ofcarers feel adequately informed,trust.prepared and supported to use

medicines and equipment and to carry [email protected]


Since a year our President was contemplating on where the next AMC conference tour

should be and finalised Iceland after a lot of deliberations. A year later, Google has named

this place Reykjavik (Iceland) as the most emerging hot-spot for tourism in the world.

Uncertainties of a new place and high costs were put to rest and finally, even a few of our

members, could not be accommodated in the tour. Iceland has a population of 3.3 lacs (less

than any Mumbai suburb)and cannot cater to a large number of tourists. Therefore, two

groups were made and they followed the same itinerary a day later over the 9 days.

Before leaving Mumbai, all of us were given snacks / food packets from Chheda and all over

the trip these were found moving around in the bus we travelled .The importance of these

snacks was that it helped to break the ice amongst us in this new land. The flight was via Paris

after a brief halt and here, many stocked up stuff to combat the temperatures of Iceland .We

reached Reykjavik the capital city and crashed to catch up on lost sleep. The symbol of

Reykjavik is the Hallgrimskirkja church that has a design inspired by basal lava columns,

which is a common site of volcanic rock formation in Iceland. A visit to the Perlan glass dome

gave a spectacular 360 degree view of the of this beautiful capital of Iceland.

Next day we headed for the countryside to the National Park Thingvellir which carries a

historic legacy and geological intrigue. It has the oldest existing parliament in the world

(established in 930 and held sessions until 1798) and a canyon formed between two tectonic

plates, which is a visual representation of the continental drift. At this no-mans land, we

Viti crater Kafla The Blue Lagoon

AMC CONFERENCE TOUR

ICELAND

Divya Prabhat


celebrated a birthday by cutting an Icelandic cake. This park forms an integral part of the

popular Golden circle tour of Iceland. Then, we proceeded to witness the Golden waterfall -

Gulfoss and numerous Hot springs with boiling mud pools. On the way we stopped at the

familiar Black sand beach with rock formations seen in the song-Gerua of the film Dilwale.

We also had our share of SRK's getting clicked onto the rock formations and also the

beauties in-a la Kajol mode. We then continued along the south shore admiring more

waterfalls leading to the village of Vik. Innumerable rainbows, all along, made this journey a

treat to the eyes and cameras.

Next was the stunning site of the Jokusarlon glacier lagoon with floating icebergs,

supposedly over 1000 years old. We travelled into this lagoon in boats which becomes a

vehicle on land. This has been the locale of the popular James Bond movies.

After this we travelled from the south towards north-west,a long tardy journey to Akureyri.

Practically all (from the youngest kid to the senior most) sang songs in different languages

and one couldn't resist admiring how multifaceted and talented our members are. We had a

great time in the company of gifted singers, humourists, poets and enjoyed the home made

snacks which were in constant circulation in the bus.

Akureyri is the nation's second largest city. Here we witnessed the most powerful waterfall

of Europe-Godafoss. In Iceland, whale tourism ie. watching and eating too is a big industry.

Floating Icebergs

in the Lagoon

The man made tunnel

under the Glacier

The Godafoss Waterfall

in Autumn colors

Under the Indian flag at

our hotel in Borgarnes.


Most of the people had a whale of a time watching these fascinating creatures at the bay

while others ventured out to explore this vintage sleepy town. At night we met up with our

colleagues (as if long lost ) and heard some words of wisdom from our President Dr. Veena

Pandit.

Next day we explored the natural beauty of Lake Myvatn area with the spectacular autumn

colours, that made it look like a picture postcard. From here we proceeded to the Husafell

glacier tunnel for the Ice-Age tour to enter into an awesome man made ice burrow.

A refurbished army monster truck transported us to the tunnel situated on a 1900 feet thick

ice cap. It was indeed an exihilarating experience to hear the 'Jana Gana Mana' reverberating

in these glacier caves sung by our esteemed members. From this marvel we checked into the

lakeside small town Borgarnes.

Around midnight we got a surprise call and all rushed out of the hotel to see the Northern

lights spectacle. These are seen above the magnetic pole of the northern hemisphere and

referred to as Aurora Borealis; but only a fortunate few could witness it here. However as

luck would have it, just after leaving Iceland, inflight the pilot made an announcement, we

got a better and convincing view of the Northern lights from the plane.

On departing from the hotel at Borgarnes (last night) it was a moment of great pride when all

of us stood beneath the high flying Indian flag and had our group picture there.

Then we travelled back to Reykjavik ,thus completing a full circle of this scenic country. A

walk around the city looking at the beautiful houses, wonderful sculptures by Bruno around

his residence and a stop for lunch was indeed refreshing. Iceland is supposed to have the

healthiest diet in the world and vegetarians too got to taste a mix of the best of theplas from

Mumbai.

After some short photo- stops we reached the famous Blue Lagoon, a highlight of the tour.

This milky blue Lagoon fed by geothermal seawater from deep under the lava has a capacity

of 6 million litres of water. All of us soaked in this bliss and pampered ourselves with mud

packs, massages and drinks at the sunken bar!

After this last stop, we proceeded towards

the airport and enroute had a lovely dinner

served by a very caring Indian couple. Hats off

to Dr. Alka Karnik who raised the spirits of the

group by her constant smiles, laughter and

songs in spite being on a wheel-chair. We left

Iceland, with memories etched in our minds

and have also made friends for life.

[email protected] of city Akureyri


Rajput doctor parents invite matrimonial alliance from well settled tall handsome doctor

preferably from Mumbai / Pune for their fair, beautiful and slim daughter 28/5'6"

presently pursuing fellowship in Cornea from L.V. Prasad Eye Institute, Hyderabad

Contact No : 94251 88638 Email : [email protected].

Suitable post-graduate medico / engineer match for BDS MDS Mumbai based

1987 born girl 5.6 height dentist working as lecturer and consultant in Mumbai.

Contact : 98672 79447 Email : [email protected].

27yr old beautiful medico girl, coming from a doctor family based in Delhi seeks,

preferably suitable medico match, caste no bar. Contact No. 098100 63988 or

[email protected].

Alliance invited from Jain doctors or professional for 89 born daughter pursuing MDS.

She is 5'5 tall fair and well mannered. Contact : 98900 99255.

Suitable Post graduate Medico Match for October 1990 Born, Fair, Smart, Good

Looking Rajasthani Girl, MDS In Prosthodontics and Implantology, From PCDS Bhopal.

Contact : Dr. Madhu Agarwal 98208 61455 Email : [email protected]

For outright Sale : X-ray Sonography Centre Reputed well furnished fully equipped

Running X-ray Sonography Centre at Prime Location in Sion For Outright Sale.

Contact : 98200 96325.

FOR SALE - Mulund X-Ray & Sonography Clinic, 1st floor. 1 minute walk from Mulund

West Railway Station. Most wellknown building in Mulund for medical practice. Available

with equipment to radiologist or without equipment to clinician of any speciality. Area

CARPET 330 Sq Ft. Ownership Contact : Dr. Bhooshan Sandh - 97572 23620;

98691 08109, [email protected].

CLASSIFIEDS AVAILABLE / REQUIRED

CLASSIFIEDS MATRIMONIAL

** CONGRATULATIONS **

Our Life Member, Dr. Natasha Kate Kothari D/O Drs. Pervin & Suhas Kate

obtained her degree of MRCPsych UK in first attempt, with flying colours.


For SALE in South Mumbai, Lamington Road, ownership premises, well equipped for

long standing 10 bedded Maternity & Gynaecological Nursing Home of approximately

1500 Sq. feet plus Lobby. Contact : Ms. Kavita 2308 4949. 1 to 4 p.m. Monday to Friday.

Email : [email protected].

At Last: Your worry is over. Now you can Contact Jayraj Shah for your need of

buying and selling of Flats/Clinic/Office and also for Portfolio Management.

Mobile No : 93207 76715, Email-id [email protected].

Rigid Bronchoscopes 3.5 X 30, 6.5 X 43, 8.5 X 43, 8 X 40, 5 X 30, Straight Forceps,

Crocodile Serrated, Light Carrier, Suction Cannula. Contact : 98201 65435.

Exclusively Done up, AIR CONDITIONED CONSULTING ROOMS, Fully furnished, for

Consultants & Surgeons on HOURLY BASIS, at VILE PARLE EAST, on GROUND FLOOR, Long

hours possible. Close to station and highway. Prime Location. Contact : Dr. Tripathi

98200 65981 Email : [email protected].

CLASSIFIEDS AVAILABLE / REQUIRED

continued from page no. 39.........not vigilant in compensation awarded to Ms. Sharifabai.

verifying whether the labelling made by the Take Home Messages :Senior Resident was correct or not. A

• Consultant to make initial assessment ofConsultant would be negligent if he

patient as early as possible so as to judgedelegates the responsibility to his Junior

the urgency of diagnostics/interventionwith the knowledge that the junior was

needed.incapable of performing his duties

• Consultant responsible for delegation ofproperly.

responsibility to Junior Doctor.As a neurosurgeon, failure to clearly and

• Consultant has to verify the reports bycorrectly demonstrate the level of a tumour

within the spinal cord is a serious error. Junior Doctor before signing off the

Marking the level of tumour wrongly diagnostic reports.

misleads the surgeon and leads to fruitless • Surgeon has to verify site of surgerysurgery at a wrong level as in this case. A prior to taking up patient for surgery.second surgery with its attendant risks then

• Non consent for surgery/procedure tobecomes necessary to remove the tumour.

be documented in the medical record.It was also the surgeon's responsibility to

• Delay in surgery/procedure in casescheck and demarcate the level of the

where urgent intervention is neededdisease.

amounts to negligence.Both Hospital and the Doctors were held

liable for deficiency in services and [email protected]


Aug 05, 2016 : Kidney racket probe finds 3

doctors negligent

Aug 10, 2016 : To help students, govt may

soon rate medical institutes

Aug 08, 2016 : Fight over polls - cases hang

in fire as medical council & state spar

Aug 10, 2016 : Medical students expelled

for providing fake caste certificates

Mumbai :

New Delhi :

Mumbai :

Mumbai :

found guilty of submitting fake caste

certificates to secure admissions under the

quota reserved for the scheduled castes orThe preliminary report of a three-tribes candidates.member state health inquiry committee

probing into the kidney racket at LH

Hiranandani Hospital has found a

nephrologist and two urologists "negligent"The government plans to unveil

on several counts. The state's directorate ofa rating system for medical institutions to

health services has also written to the Powaihelp students make an informed choice. It

police to analyze the call records of one ofwill serve as a warning for poorly-rated

the doctors.institutes to improve standards. It is also

aimed at ending ‘inspection raj’ in the

medical education sector, which flourished

under the MCI. "The task of periodic ratingThe tussle between thewould be assigned to the proposed NationalMaharashtra Medical Council and the stateMedical Commission, which will replacegovernment has put the fate of over 600MCI," said an official.medical negligence cases in limbo. Some of

these cases have been pending for 8 to 10

years.

In what could be the country's

biggest medical admission scam, which was

exposed by a retired Mantralaya staffer, 17

MBBS students were expelled on Tuesday

from state and civic-run medical colleges in

Mumbai and Kolhapur. These students were

Aug 11, 2016 : Govt has failed to implement

noise pollution rules, says HC

Mumbai : The Bombay High Court said the

Maharashtra government has failed to

implement noise pollution rules in the state

and violation of norms is rampant during

religious festivals. Further, the government

did not follow in letter and spirit the orders

passed by the high court in this regard

earlier, said the judges.

FROM THE PRESS

Dr. Pradeep Baliga


Aug 11, 2016 : Niti Aayog to scrap MCI, back

common entrance

Aug 16, 2016 : Govt seeks to scrap MCI,

doctors up in arms

Aug 16, 2016 : Hospitals start protocolAug 12, 2016 : City urologists to stop review for transplantstransplants

Aug 12, 2016 : JJ doctors threaten stir after

student 'slapped’

New Delhi :

New Delhi :

Mumbai :Mumbai :

Mumbai :

initiate a probe," he said. Doctors from the

unit have given eight days for the

investigation.The controversial MCI could

soon be history as a new bill to replace the

Indian Medical Council Act, 1956, is out for

public consultation, replacing the body with The tussle between doctors anda National Medical Council. Drafted by the the state over the control of medicalNiti Aayog, the preliminary report on the councils continued after the Centrereforms proposes to scrap the MCI. The proposed scrapping the Medical Council ofsystem of electing officials will be replaced India and replacing it with the Nationalby a selection process by an independent Medical Commission, which will have onlypanel, and NMC will be assisted by a Medical 10 per cent of its members from the medicalAdvisory Council representing states and fraternity.Union Territories.

Almost all transplant centres inThe Mumbai Urological Society the city have begun a stringent review of

decided that they will stop performing their protocols that guide live-relatedorgan transplants in the city with immediate surgeries, where organs are transplantedeffect. The urologists, who carry out from a living donor related to the recipient.

transplant surgeries, want the state to Most have already held sensitization

provide clarity on the duties of a doctor as sessions with their transplant teams,

well as the fast release of medical including doctors and coordinators,

practitioners arrested in connection with reiterating rules and violations.

the kidney racket.

JJ Hospital resident doctors have

threatened to go on strike after a student

was allegedly assaulted by the head of

gynaecology, on Thursday. Dean said he had

received a complaint about assault and

verbal abuse. "The resident doctor said she

was slapped inside a ward. We have written

to the DMER to constitute a committee and

Aug 16, 2016 : SC-appointed panel

overturns MCI ban on 26 pvt med colleges

New Delhi : The Supreme Court-appointed

Lodha committee has given private medical

colleges the permission to teach courses

they had been forbidden from running after

being found to be lacking the required

infrastructure and other facilities. During

inspections by teams of the MCI, as many as

86 colleges were denied the permission for

lacking faculty and infrastructure.


Aug 17, 2016 : Now, rural stint to earn docs Aug 19, 2016 : SC to lay down norms for

marks in PG admission post-surgery care

Aug 18, 2016 : Radiologists threaten to go

on strike again

Aug 22, 2016 : Top private hospitals under

CAG fire for billing poor patients

Aug 19, 2016 : Hospitals to treat organ

donors' kin all their lives

Aug 19, 2016 : Doctors call for better

communication with patients

New Delhi : New Delhi :

Mumbai :

Mumbai :

Mumbai :

Mumbai :

The Supreme Court has upheld In the wake of increasing

numbers of medical negligence complaintsthe regulation of MCI to give incentive

against private hospitals, the Suprememarks to doctors working in rural areas for

Court has decided to lay down guidelines togetting admission to PG courses, saying it

be followed during operations and post-would encourage medical practitioners to

operative care. A bench issued notices toopt for assignments in remote areas.

the Centre, MCI and all state health

secretaries after it was told no proper care is

taken by hospital staff to save critically illRadiologists have threatened to patients after they are operated.

go on an indefinite nationwide strike from

September 1 against actions taken by state

health officials for technical errors underIn an audit of 11 leading privatethe PCPNDT Act . Assoc iat ions of

charitable hospitals in the city, thegynaecologists and radiologists have alsoComptroller and Auditor General of Indiacome together against the same.has found that seven were wrongly billing

poor patients and charging hefty deposits

during admission. Most hospitals reservedIn a bid to promote organ less than the stipulated number of beds for

donation, the state government is the poor, thereby depriving many of qualityconsidering to formulate a law which would healthcare. The charity commissioner toomake it mandatory for private hospitals to has been pulled up for bad implementationprovide lifetime medical assistance to the of the scheme.

donor's family.

Doctors across city's civic-run

hospitals participated in a day-long

workshop on 'communication skills in

patient management' at KEM Hospital, Parel

on Thursday. The speakers said that over the

last few years, poor communication

between doctors and patients in public

hospitals has led to resident doctors being

manhandled by patients' relatives.

Aug 25, 2016 : Nod for surrogacy bill that

bans 'rent-a-womb' trade

New Delhi : In a bid to put an end to the

"surrogacy industry", the Union Cabinet

cleared the surrogacy (regulation) bill that

proposes a complete ban on the 'rent-a-

womb' trade, barring foreigners, single

persons and divorcees from opting for

surrogate births. Making commercial

surrogacy illegal, the bill proposes "altruistic

surrogacy" that will be restricted to married

Indian couples with a biological or adopted


child and only through a close relative as the

surrogate mother.

Sep 29, 2016 : Doctors can't be tried under

sex selection law for small errors

Aug 27, 2016 : To curb overcharging, Centre

wants MRP displayed on stents

Oct 25, 2016 : Show proof of stem cell

therapy benefit

Sep 08, 2016 : Stricter rules check abuse of

platelets for dengue patients

Oct 26, 2016 : 1m Indian TB patients fall off

radar every year

Sep 24, 2016 : After court intervention,

state announces MMC election date

(Sourced from various agencies)

Mumbai :

Mumbai :

Mumbai :

Mumbai :

Mumbai :

Mumbai :

In a major reprieve for

radiologists, the Bombay high court on

The government has directed Tuesday said that mere discrepancies andcardiac stent manufacturers to display the inadvertent mistakes in maintainingmaximum retail price on unit packs as well records, as envisaged under the PCPNDTas on their websites to bring in transparency Act, 1994, cannot itself be the basis onin an industry where overcharging patients

which action is initiated against the doctor.has been prevalent. At present, medical

devices like cardiac stents do not carry the

MRP tag on individual packs.

Looking at the rampant use of

stem cells in the country despite little

research, the Indian Council of MedicalThe BMC's internal evaluation ofResearch has asked the scientif icblood bank data has shown that the use of

platelets dropped 12-15% when dengue community to present evidence of its

was at its peak between June and November therapeutic benefit. The country's highest

2015. A similar dip in the use of the crucial research body has asked doctors,blood component was also witnessed companies, government and privateduring December last year and May this hospitals to submit their `letter of claim' byyear, when dengue cases were relatively

December 31.fewer. Doctors say calculated use has

reduced overall demand for platelets as well

a s c a s e s o f t r a n s f u s i o n - r e l a t e d

complications. Almost 28% of the patients don't

have access a government TB centre and

around half a million patients either never

complete their long diagnostic process orThe state government has finally

medical treatment, found a joint study byannounced the date for holding the MMC

elections after protests were held and a Indian and US scientists published in PLOS

court case filed. The elections will be held on Medicine on Tuesday. The 'missing' patientsDecember 18 and a physical ballot will be are important because each patient withused, the state announced. Earlier this active TB can infect 1015 other peoplemonth, the Bombay High Court had asked

within a year.the state government to let the council

management hold elections `without

interference'. [email protected]


Medical errors is a topic

that one tends to sweep

under the carpet, and is

spoken about only if

absolutely necessary. The

author has taken a bold

initiative in not only

analyzing the issue, but

also in offering solutions

to minimize errors.

The emphasis is on

patient empowerment

through knowledge, which we as clinicians must impart. We also need to have systems and

protocols in place to improve patient safety. At the same time, the patient needs to use a

judicious blend of probing and accepting.

In an attempt to be holistic and cover the topic from all perspectives, that of a doctor, nurse,

patient and other healthcare professionals, it is possible that parts of the book may be

overbearing or irrelevant to some readers.

The various contributors are all stalwarts in their area of specialization and this makes the

book very informative.

BOOK REVIEW

Dr. Nitin Rao

PATIENT SAFETY

Protect yourself from Medical Errors

Dr. Aniruddha Malpani, MD

The book is online at www.safetyforpatients.in

It can also be downloaded free at http://www.slideshare.net/malpani/patient-safety-

protect-yourself-from-medical-errors

Vol. | Issue No. | November · Vol. 45 Issue No. 3 November 2016|| 3 Statistics is a very important tool in lies and statistics'. Lilian Hellman made medicine and its use is vital

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