April 24, 2009

Refusing emergency patients

The Supreme Court judgment had made it mandatory for hospitals to provide medical intervention under any circumstances, but many hospitals and other healthcare institutions are not following the order.

Hundreds of people die for want of timely treatment. Increasingly, rules and procedures are over-riding the concept of `Save life', and accident victims are the worst hit.

Hospitals' reply

In a situation of medico-legal case, it's mandatory for the hospital to register a case, inform the police, document injuries in several registers, attend courts as and when called for and provide certificates and other papers.

According to many hospital managements, it's a cumbersome process. Doctors must be physically present for inquiries and court hearings, which consumes a lot of time.

A study by NIMHANS found that medico-legal issues were a problem for hospitals because they feared police and legal investigations. Dr C R Chandrasekhar of NIMHANS, who deals with forensic psychiatry cases, said it's the duty of hospitals to take up medico-legal cases.

"Hospitals can't refuse and should help the court. The life of a person is far more important than legal formalities. Avoiding medico-legal case is a crime under law. In 2007-08, of 11,500 neurosurgery cases, 75% were medico-legal cases in NIMHANS," he explained.

Difficult for doctors

Doctors say it's not a pleasant job for them to wait in court and stand in the witness box, where his/her credibility is questioned. "These are long legal procedures, where we have to face many cross examinations," Chandrasekhar said.

Also, many doctors say it's easier for private hospitals to refer patients to government hospitals because the former is not under government control.

Who pays the bill

"In 70 to 80 per cent medico-legal cases, patients are unable to pay for their treatment. Many a time, the person who has brought the patient to hospital doesn't come anymore as he has to foot the bill," RMO of Sanjay Gandhi Trauma and Accident Hospital Dr T Prabhakar said.

A majority of patients are migrants and don't have salary certificate, ration card, etc, without which treatment cost can't be claimed from the CM's Relief Fund. "Hospitals have no choice but to waive the cost. At least patients should have some insurance cover to face any crisis," he felt.

Sanjay Gandhi Trauma and Accident Hospital receives 8 to 10 medico-legal cases every day. The hospital doesn't admit cases related to gangwars, assault, head and burn injuries. In case of injuries related to gang wars and assault cases, if the nature of the emergency is severe, the hospital gives primary treatment and stabilizes the patient before referring him/her to other hospitals. "In such cases, legal formalities are much more complicated," a hospital source said.

Link: Original Article


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