March 23, 2010

US House clears landmark healthcare bill

The US House passed the most sweeping health-care legislation in four decades, rewriting the rules governing medical industries and ensuring that tens of millions of uninsured Americans will get medical coverage. Sunday’s 219-212 vote marks the biggest victory for President Barack Obama, who will sign the bill into law. Only Democrats voted for the legislation, underscoring a partisan divide that promises to make health care the defining issue in November’s congressional elections.

Lawmakers hailed the action as a historic follow-on to the 1965 creation of the Medicare programme for the elderly and a way to mitigate soaring health costs that make up a sixth of the US economy. It came after a last-minute deal with anti-abortion Democrats and a lobbying trip by Obama to the Capitol. “It’s a victory for the American people,” Obama told reporters at the White House just before midnight. “This legislation will not fix everything that ails our health-care system but it moves us decisively in the right direction. This is what change looks like.” House Speaker Nancy Pelosi described passage as “history for our country and progress for the American people.”

To finish their work on health care, House Democrats approved a Senate bill passed in December and then voted 220-211 to pass a measure that would amend the Senate legislation to fix provisions they don’t like. The Senate must also pass this second bill under a budget process called reconciliation that requires a simple majority vote.

While Senate Democrats plan to act this week on the second bill, they face a host of challenges from Republicans that may hold up their work or force a new vote in the House. The two bills together will cost $940 billion over 10 years and cover 32 million uninsured Americans, the Congressional Budget Office estimated. That’s more than made up for with a new tax on the highest earners, fees on health-care companies and hundreds of billions of dollars in Medicare savings, which will reduce the federal deficit, the CBO said.

Companies such as health insurer WellPoint of Indianapolis, medical-device maker Medtronic of Minneapolis and drugmaker Pfizer of New York will get millions of new customers with the extension of coverage. Their industries will also face billions of dollars in new fees.

As part of the overhaul, drugmakers agreed to help the elderly more easily afford medicines. Insurers, which opposed the legislation, will have to take all customers, regardless of pre- existing conditions, and face limits on how much revenue can be spent beyond covering medical expenses. “WellPoint is disappointed that after more than a year of debate, Congress has approved health-care legislation that does little to reduce cost and improve quality,” company spokeswoman Kristin Binns said in an e-mail to reporters.

Under the bill, Americans will have to buy insurance or pay a penalty, with the possibility of tapping new purchasing exchanges and government aid for lower-income Americans. Republicans said the costs will balloon, criticised the increases in government programs and held out the possibility that private insurance and medical care would be hurt. “We are looking at a health-care bill that nobody in this body believes is satisfactory,” House Minority Leader John Boehner said prior to the vote. “We have failed to reflect the will of our constituents.”

Business groups, including the US Chamber of Commerce, also lobbied against the legislation, and Peoria, Illinois-based Caterpillar sent a letter to leaders saying the bills would raise its costs by $100 million in the first year alone. The House’s two-step process became necessary after Democrats lost the 60th vote in the Senate generally needed to push through major legislation.

Just weeks after the Senate’s party-line 60-39 vote, Democrats were almost finished drafting a House-Senate compromise bill when Massachusetts Republican Scott Brown won a January 19 special election to fill the seat left vacant by the death of Democrat Edward M Kennedy. The use of the budget-reconciliation tool opens the door for the Senate to pass the second bill with 51 votes, as long as it can withstand Republican challenges and the rulings of a parliamentarian, who will take out any provision he decides have only an incidental impact on the federal budget.

New Hampshire Senator Judd Gregg, who will help coordinate the Republicans’ efforts, said his party can put forth “massive amounts” of amendments on unrelated issues from gun control to immigration. They can also challenge provisions such as the scaling back of a tax on high-end, or so-called Cadillac, insurance plans because it would affect money flowing into Social Security, he said.

Any changes in the Senate would force a new House vote on the reconciliation bill, further complicating the effort. House Democrats particularly wanted to change the Cadillac tax because they say it would affect too many workers. “If those people think they’re only going to vote on this once, they’re nuts,” Senator Orrin Hatch, a Utah Republican, said in a Bloomberg Television interview last week. Illinois Senator Richard Durbin, a member of the Democratic leadership, said on Sunday his party is prepared for challenges and any amendments Republicans might file.

“We’re ready to tackle that if that’s what they want to do,” Durbin said on CBS’s “Face the Nation” programme. “We’re ready to deal with honest amendments. There will come a time when the American people say enough, this is about politics.” Obama, who faced criticism for largely leaving the drafting of the legislation to Congress, swung into high gear in recent weeks. He hosted a Feb. 25 bipartisan summit at the White House, proposed detailed final compromises and lobbied dozens of undecided Democrats. He postponed a trip to Asia to remain in Washington for yesterday’s vote.

Obama benefited in part from the votes of Democrats who are leaving Congress and who were willing to switch sides after voting “no” on a House version in November. He also won support from Democrats, including Representative Dennis Kucinich of Ohio, who had threatened to oppose the final measure because it didn’t include a new government pro-gram, or public option, to compete against private insurers.

The legislation will expand the Medicaid government programme for the poor to cover those making up to 133% of the federal poverty level, and offer subsidies for millions of other Americans to buy insurance through an on-line exchange offering policies at more-affordable group rates. Many employers with more than 50 workers that don’t offer coverage will be subject to a penalty.

Link: Original Article

March 21, 2010

MCI urges private healthcare chains to set up medical colleges

The Medical Council of India (MCI) says it is concerned at the lack of action by private companies in taking advantage of the 17-month-old government decision to allow them to set up medical colleges.

“I am surprised that no one has started yet,” MCI President Ketan Desai told Business Standard. The permission, he recalled, was given to private companies in October 2008, on the condition that no profits were to be made.

With this move, healthcare chains such as Fortis Healthcare, Max Healthcare and Apollo Hospitals were free to start their own medical colleges. Till then, only state-run bodies, universities and private, religious or charitable trusts were allowed to do so.

Desai said to facilitate setting up of new medical colleges in cities such as Delhi and Mumbai, MCI had relaxed the land requirements. Other than relaxing the existing norm of a 25 acres for setting up a medical college, hospitals were told they could increase their floor area ratio. “In the same premises, they could go higher and start a medical college,” said Desai.

All the top private hospitals have excellent doctors, said Desai. The health ministry had hoped that these would become excellent training centres for the next generation of doctors.

There is an acute shortage of doctors at junior levels in most hospitals. As of now, 23,000 students graduate from 300 medical colleges each year. Most enroll for postgraduate courses and some leave to study abroad.

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Apollo commits Rs 1,000 cr for medical education entry

India’s largest corporate hospital chains — Apollo Hospitals, Fortis Healthcare and Max Healthcare — are poised for an aggressive foray into medical education, which was opened to them recently.

While the largest chain, Apollo, committed an initial investment of Rs 1,000 crore on Thursday in medical education, the second largest player, Fortis, announced its plans to offer not only pure medicine courses but nursing, dentistry, and other paramedical courses as well. Max Healthcare said it is contemplating entering medical education “in two to three years from now.”

The Centre has allowed companies to set up medical colleges, as reported by FE on Wednesday. Prathap C Reddy, chairman, Apollo Group, while replying to a FE query said, “We are working out the modalities for setting up a global health academy, which would include an undergraduate medical college with an initial intake of 200 students. The rollout plans are still in early stages, but it could cost some Rs 1,000 crore”, He added that Apollo has appointed McKinsey as its consultant for doing the groundwork on this academy. “A separate team is working on this project, which is expected to come out with a report in the next 90 days,” Reddy said.

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March 20, 2010

Health Minister overrules IMA's objections to rural MBBS course

The Indian Medical Association (IMA) has three problems with the government's plan to create a special cadre of rural doctors through a truncated MBBS course, but the health ministry has refused to yield to its pressure and will push ahead on the subject as planned.

According to a top health ministry official, a seven-member delegation of the IMA met Health Minister Ghulam Nabi Azad and apprised him of their reservations over plans for the rural doctors' course. The IMA is the top doctors' association in the country.

'The IMA has three problems with the plan,' a senior health ministry official told IANS.

'They want to call the new medical institutions for rural doctors as 'schools' and not colleges, as planned by the ministry. They are also opposed to naming these four-year courses as degrees. The IMA wants these to be called diplomas and not degrees, as a normal MBBS course is of five-year duration,' the official said.

'The doctors' association also wants a separate registration for these rural doctors,' the official added.

However, the health minister has rejected their demands.

'The minister listened to their problems patiently but told them that there is no conflict of interest with the regular doctors. The changes as demanded by the IMA will not be incorporated,' the official added.

Bachelor of Rural Health Care (BRHC), popularly called Rural MBBS, is a four-year course for rural students who will work in health sub-centres and primary health care centres.

Azad has often raised the issue of shortage of doctors in India. 'A whopping 80 percent of the doctors are serving just 20 percent of the population. The doctor-patient ratio is not encouraging,' Azad said in a function Wednesday and reiterated that there is a need for more doctors in villages.

According to the medical education regulator, the Medical Council of India, rural doctors are the need of the hour. 'They cannot do surgeries but can treat 300 different types of ailments that rural Indians face regularly,' MCI president Ketan Desai told IANS.

'I am in favour of rural doctors. Those sitting in cities like Delhi and Mumbai cannot understand the trauma of villagers and how they suffer without any medical attention,' Desai added.

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10,000 more medical post graduate seats in India

India will add 10,000 more post graduate seats in medical education within two years, a step aimed at curbing brain drain, union Health Minister Ghulam Nabi Azad said Wednesday.

'Many graduates of medical education are going abroad for studies. I want to assure an additional 10,000 PG seats within two years,' Azad said at the 94th convocation of the Lady Hardinge Medical College.

These seats will be available in central and state medical colleges, he said. Of the 10,000 seats, the minister said 4,000 will be available from the coming academic session.

Currently India has over 13,500 post graduate seats across the country. With the new announcement, the number will increase to over 23,500 seats.

He said the central government has approved a scheme under which the health ministry will fund and upgrade all medical colleges run by state governments.

'It is a Rs.1,350 crore plan for the state medical colleges,' he said.

'The central government will fund them, strengthen them, upgrade their facility and increase the number of seats in post graduate course,' the minister added.

Currently, hundreds of medical graduates are going abroad to pursue higher education as all graduates cannot be accommodated in post graduate courses. The minister said that with this move, the central government wants the medical brains to stay in the country.

'Please don't fly abroad after your post graduation,' Azad said.

Link: Original Article

Tamil Nadu eyes 700 more medical seats in govt-run colleges

Here is good news for medical aspirants. Tamil Nadu is working on increasing MBBS seats by a whopping 700 in the government colleges. The state has already got sanction for 270 more post-graduate medical seats.

The directorate of medical education is expecting sanction from the Medical Council of India to admit 100 students each in two new colleges in Tiruvarur and Villupuram the coming academic year. Also in the pipeline is a detailed proposal demanding increase in the number of seats in the existing colleges.

“We have 15 government medical colleges and we want to increase the medical seats in these colleges. For instance, in the Madras and Madurai Medical colleges we want to increase the seats from 165 to 265. In Chengalpet Medical College, we want to increase seats from 50 to 150. In other colleges we’re looking at hiking seats from 100 to 150. This is based on parameters including bed strength, patient-doctor ratio and specialties,” says director of medical education Dr S Vinayagam.

The directorate until last year offered 1,483 of the 1,745 medical seats in 15 medical colleges to students residing in Tamil Nadu during the single window counselling, leaving the remaining 15% to the all India quota. If the MCI approves two new medical colleges, the seats will go up to 1,653 in June. The selection committee, which is responsible for admitting students, hopes to add another 500 seats during the second phase of counselling.

In the self-financing colleges category, the number of colleges is expected to go up by at least one, which will increase the number of seats by another 85 from the existing 285.

What seems to have impressed doctors and academicians is that there has been an increase in the post-graduate medical seats. Of the 270 post-graduate (degree, diploma and super specialty) seats, the state selection committee will display 135 seats leaving 50% to the all India quota. In February, the Cabinet Committee on Economic Affairs approved the health ministry’s proposal to add more post-graduate seats in 148 state run medical colleges. Tamil Nadu sent its proposal and was sanctioned 270 seats. “Till now, we have had only 998 post-graduate seats. We have increased seats in fields like general surgery, general medicine, neurology, neurosurgery, cardiothoracic surgery and neonatology,” said health secretary VK Subburaj.

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MCI to amend Medical Ethics Regulations

The lively debate sparked off by the promulgation of Medical Ethics and Etiquettes regulations seems to be bearing fruit.

MCI is all set to amend the Professional Conduct, Etiquette and Ethics regulations it issued in December last year. The apex medical body has recommended some modifications in the regulations in a letter sent to the Ministry of Health & Family Welfare.

In the letter MCI has recommended various degrees of punishment for doctors who accept gifts worth 1000 rupees or more from any pharmaceutical or allied healthcare company.

The punishments range from censure (for accepting gifts valued at between 1,000 and 5,000 rupees) to removal from the Indian or State Medical Register for a period of more than one year (for accepting gifts worth more than 1,00,000 rupees). It merits mention that in making this particular recommendation, MCI has done away with the blanket ban on gifts imposed last month when the regulations were first issued.

The recommendations also address other grey areas including sponsorship of travel and lodging of medical practitioners participating in a conference, the issue of monetary grants and the question of clinical research funding. The monetary limits and the punitive clauses for infringing any of these regulations are similar to those defined for gifts.

Said Dr. Ketan Desai, President MCI, “With these recommendations what we are looking at is strict implementation of the regulations. It seems that there was some ambiguity on a few of the clauses in the regulations. By clearly defining these clauses we have resolved any confusion about the exact nature of these regulations. Once the modified regulations are in place it will be the duty of all the stakeholders to make sure that the regulations are implemented in letter and spirit”.

The modifications come in the wake of popular demand for a review of some of the clauses in the regulations. Ever since the regulations have been issued it has been felt by doctors and Industry alike that some of the clauses in the regulations leave a lot of room for ambiguity. The argument is that if the involved parties are not clear on the regulations, they won’t even realize if and when they have infringed them.

To set the record straight and to facillitate a strict implementation of the guidelines MCI has been mulling an amendment in the regulations for quite sometime now. It is expected that MCI will come out with the amended version of the regulations in a few days.

In this context it is pertinent to mention that a lot of debate has been generated in industry circles on the meaning of the regulations as also on their exact interpretations and possible implications.

Experts have been voicing their opinions on the issue from various platforms and have been emphasizing on the need to dispel doubts and ambiguity surrounding the existent clauses. In a seminar organized last month various shades of opinion were expressed on the need to resolve confusions surrounding the regulations.

Organized by HEAL, a health advocacy and awareness platform, Medical Ethics Conundrum – The Road Ahead saw extensive debates and deliberations on the issue. An expert committee, set up immediately after the conference, was assigned the task of coming up with specific recommendations aimed at facilitating modifications in the regulations, something that would ensure strict implementation.

The expert committee comprising doctors, representatives from OPPI (Organization of Pharmaceutical Producers of India), legal experts, regulators and representatives from the medical devices industry met in Mumbai on the 8th of March and after wide ranging discussions reached a consensus on the final set of recommendations to be sent to MCI.

These recommendations, experts believe, have had a significant impact on the recommendations MCI finally sent to the government. Said Mr. Swadeep Srivastava, Principal Consultant HEAL,” I am grateful to the Medical Council of India and to Dr. Ketan Desai for coming up with recommendations for the modification of the MCI regulations. It brings in a sense of fulfillment for us at HEAL for this brings to fruition the efforts we have been making so far in this direction.

We believe that the modified regulations will be implemented in letter and spirit because these represent a consensus that has been arrived at after extensive deliberations. We are happy that the recommendations made by the expert committee we had formed have played an important role in bringing this about”. As it is, this set of recommendations addresses all the major issues surrounding the regulations. This also represents a consensus that has been arrived at after discussions between all the major stakeholders and therefore ensures their active participation vis – a – vis strict implementation of the regulations.

Link: Original Article

Apollo Hospitals to conduct research in ayurveda

Ayurveda, the traditional Indian system of medicine struggling to get due recognition oweing to its inadequate scientific validation, has now found a new patron in Apollo Hospitals. The chain will carry out research to establish ayurveda as potent system of medicine worldwide.

'The Indian system of medicine has faced many roadblocks due to lack of enough research. We are set to carry out scientific study on ayurveda and other systems of medicine,' Prathap C. Reddy, chairman of the Apollo Hospital chain, told IANS.

He said many countries like the US have claimed that several Indian medicines have heavy metals beyond the permissible limit. Many also claim that these treatments are not backed by scientific validation.

'Here, we are taking it up. We will conduct research in our hospitals across India and come up with a database. After that we will offer willing patients these treatments,' Reddy added.

He said Apollo has already tied up with a leading ayurveda house in Kerala.

'Once we provide the scientific validation, we will set up a chain of ayurveda centres to provide treatment for patients,' Reddy said.

Link: Original Article

Surgery removed from rural health course

Facing objections from the medical fraternity over the proposed Bachelor of Rural Medicine and Surgery course for rural areas, the Medical Council of India (MCI) has now reworked the proposal to restrict the course to ‘general medication’ and renamed it as ‘Bachelor of Rural Health Care’. The cases that need surgery will be referred to big hospitals, suggests the new proposal.

The changes in the proposal have been made based on the recommendations made during a two-day workshop held last month to discuss the rural model of undergraduate medical education.

The MCI’s executive committee has also proposed to extend the course tenure from three-and-a-half years to four years, inclusive of six months rotating internship. “It would be institutional in character conducted through medical schools which would be tagged with public district hospitals in the districts where there are no medical colleges as of now,” says the proposal.

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Costly gifts could put doctors out of practice for up to a year

In an attempt to tackle the problem of doctors accepting expensive gifts from the pharmaceutical and health care industry, the Medical Council of India (MCI) has decided to propose that doctors found accepting costly gifts not be allowed to practise for a year and more. The proposal will be sent to the Union Health Ministry for approval this week.

Having decided that a blanket ban on gifts, as proposed earlier, would not work, it is proposed that changes be made in the professional conduct, etiquette and ethics regulation. So doctors accepting gifts would be struck off the Indian medical register for periods ranging from three months to more than one year or as decided by the state medical council if they are found to be indulging in any wrongdoing.

While those accepting gifts worth more than Rs 1,000, till up to Rs 5,000, will be given a warning, those found to have taken gifts for more than Rs 5,000, till up to Rs 10,000, will have their names removed from the MCI register for three months. A gift worth between Rs 10,000 and Rs 50,000 can lead to removal from MCI register/state medical register for six months, and one above Rs 1 lakh would invite a penalty of more than a year.

Link: Original Article

March 13, 2010

Delhi HC asks govt for stand on 3-year course for non-MBBS

The Delhi high court today asked the Centre to make its stand clear on a plea that a short-term course on primary health was required to allow non-MBBS persons to practise medicine in rural areas.

A Division Bench of acting chief justice Madan B Lokur and justice Mukta Gupta directed the Centre to file a detailed affidavit specifying whether government has accepted the recommendations given by the Central Council for Health and the Task Force which recommended a three-year course for the practitioners.

The Medical Council of India(MCI) told the court that it has not accepted all the recommendations of the Task Force and will file anaffidavit in this regard.

The Bench was hearing a PIL, filed by one Meenakshi Gautam through counsel Prashant Bhushan, seeking to decriminalise the practise of medicine by non-MBBS persons.

Bhushan sought a direction to the government to introduce a short-term course for training healthcare workers so that shortage of doctors in rural areas could be removed.

The petitioner pleaded the Indian Medical Council Act, which provides for one-year imprisonment for practising medicine by non-MBBS persons, should be amended.

According to the Act, only a MBBS qualified person can practice medicine and prescribe a scheduled drug. The Act has obstructed the development of mid-level health practitioners who can deliver family health care, the petitioner added.

The petitioner's counsel argued that the government should be directed to provide a three-year course to health workers while treating people in rural areas.

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14 Railway Medical colleges soon!

The railway medical college announced by Mamata in her first budget of UPA-II was put on hold since it didn't have the required land and clearances from various departments. Mysore is among the 14 centres, which has been granted railway medical colleges, which will be attached to the railway hospitals.

But the city railway officials said the proposed college is back on track. An Expression of Interest (EoI) is likely to be called shortly to implement the project, they added.

The project was on hold since the railway officials could not find the required 25-acre land for the college, a pre-condition to start a medical college as specified by the Medical Council of India (MCI).

The railway officials had identified an 18-acre land belonging to the Railway Central Workshop in the city. They had also approached the MCI seeking exemption in this regard. ``It also eyed 15-acre land attached to the Sandalwood Factory, which abuts the identified site. The railways approached the Sandalwood Factory in December and there was no response to it,'' sources said.

After instructions from the Railway Board recently, officials identified and earmarked the 18-acre land near central workshop in Ashokapuram. The decision regarding the same was convened to the ministry.

The Mysore divisional railway manager B B Verma told TOI that the Railway Board will soon invite EoI for the proposed project. The EoI is likely to be called for all the proposed 14 colleges, which is a public-private initiative.

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In a first, Assam to guarantee right to health

A quiet revolution to create a healthier India has kicked off in the east with Assam on Thursday becoming the first state in the country to introduce a bill guaranteeing the right to health and well-being.

Responding to an appeal from the Centre for legislating on health rights, the state government tabled the landmark Assam Public Health Bill, 2010, in the assembly. The bill, which will be put to vote on March 31 and should sail through, proposes path-breaking provisions for health equity and justice to achieve the goal of health for all.

It makes it mandatory for all new development projects to carry out a health impact assessment. It also proposes to make it compulsory for both government and private hospitals to provide free healthcare services and maintain appropriate protocol of treatment for the first 24 hours to an emergency patient.

“Health does not mean just doctors and hospitals, but everything that influences the well-being of a human being. This is a historic bill and we are the pioneers in the country after the Centre requested all states to bring a law on the right to health," said Assam health minister Himanta Biswa Sarma.

After tabling the bill, Sarma said that the statute sought to bind the state health and family welfare department legally to meet its obligations — coordination with other departments concerned and providing people with minimum nutritionally adequate essential food, adequate supply of safe drinking water, sanitation through appropriate and effective sewage and drainage systems and access to basic housing facilities.

Sarma added that the bill provides for the health and family welfare department to take appropriate legal steps for fixing responsibility and accountability of departments and agencies concerned in case of repeated outbreaks or recurrence of communicable, viral and water-borne diseases, which are found in a particular area and proved to have taken place because of the failure to improve sanitation and safe drinking water facilities.

“Every citizen will have the right to health. In case government hospitals fail to provide medical care because of absence of doctors, the patient will be entitled to remedial measures to be prescribed by the department,’’ he said.

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Now e-prescriptions for zero error in medication

A new study has found that there is a decrease in medication errors as physicians turn to electronic prescriptions.

According to Rainu Kaushal and colleagues from the Weill Cornell Medical College in New York, electronic prescriptions can dramatically reduce prescribing errors - up to seven-fold.

In the US there is a strong national push to encourage doctors to adopt ambulatory e-prescribing. An estimated 2.6 billion drugs are provided, prescribed, or continued at ambulatory care visits.

Demonstrating the potential safety gains through health information technology is important to bring small group physician practices on board.

To assess the effects of e-prescribing on medication errors, the authors looked at the number and severity of prescribing errors - such as ordering a medication but omitting the quantity, prescribing a drug to a patient with a known allergy to the active ingredient and injuries from medication - in 12 community-based medical practices in the Hudson Valley region of New York.

The study's authors compared the number of prescription errors between those who adopted e-prescribing (15 doctors) and those who stuck with paper-based prescriptions (15 doctors) between September 2005 and June 2007.

In total, the researchers analysed 3,684 paper-based prescriptions at the start of the study, and 1,543 paper-based and 2,305 electronic prescriptions after a year.

The providers who adopted e-prescribing over the study period used a commercial, stand-alone system with clinical decision support such as dosing recommendations and checks for drug-allergy interactions, drug-to-drug interactions and duplicate therapies.

Kaushal and team found that among those who used e-prescribing, there was an almost seven-fold decrease in prescribing errors after one year - from 42.5 per cent at the start of the study to 6.6 per cent after a year.

In contrast, among those who used traditional paper-based prescriptions, the level of errors remained high: 37.3 per cent at baseline versus 38.4 per cent at one year.

Predictably, illegibility errors were completely eliminated by e-prescribing. "Prescribing errors may occur much more frequently in community-based practices than previously reported," the authors said.

"Our study is one of the first to demonstrate a reduction in prescribing errors in ambulatory solo and small group community practices, where e-prescribing adoption and usage has lagged.

"Our findings suggest that stand-alone e-prescribing with clinical decision support may significantly improve ambulatory medication safety," the authors conclude.

Their study of the benefits of e-prescribing in primary care practices appears online in the Journal of General Internal Medicine , published by Springer.

Link: Original Article

March 12, 2010

India likely to start swine flu vaccination next week

India is 'most likely' to administer imported swine flu vaccine to the high risk groups from next week, a senior health ministry official said.

'Most likely, we will start the vaccination next week,' V.M. Katoch, secretary (Health Research) in ministry of health and family welfare, told IANS.

Katoch said multinational pharma company Sanofi Pasteur has already completed its bridge study and the data has been given to a health ministry committee for analysis.

'The last set of data from Sanofi Pasteur's bridge study in India came to us Feb 28. The data is now with a government committee, which is analysing it.

'We expect the analysis to end in a few days and vaccination most likely to start the coming week,' he said, adding that the high risk groups like doctors and paramedics will be vaccinated first.

India has already procured 1.5 million doses of swine flu vaccine from Sanofi Pasteur. But authorities had asked the pharma major to conduct a bridge human trail in India to test if it suits the Indian population.

Since, the country reported its first influenza A (H1N1) case in May 2009, over 1,300 people have died due to the pandemic virus and over 30,000 have been infected by it.

Link: Original Article

India has 2 lakh fewer doctors than claimed

India has 748,757 doctors, Union Health Minister Ghulam Nabi Azad told Rajya Sabha on December 1, 2009. He got it wrong.
The Medical Council of India’s Indian Medical Register (IMR) data that he quoted — which had gone up to 7,58,866 on February 28, 2010 — is a cumulative list of all doctors who registered to practice in India since 1933, including the thousands who’ve died, retired or left India.
After factoring in doctors who are no longer practicing medicine, the actual number falls to an estimated 5.3 lakh — roughly two-thirds of the number the Centre uses to plan its health programmes and expenditure.
“By conservative estimates, one lakh MBBS graduates from India are working overseas, 75,000 have died, 25,000 retired and 10,000 are in non-clinical fields such as forensics, anatomy, pharmacology, biochemistry, etc, which brings down the number by 2 lakh,” said MCI president Dr Ketan Desai.
Since the MCI has to rely on state medical councils for retirement and death data, doctors live on IMR pages forever.
Another 20,000 or so doctors have been listed twice because they have registered with more than one state board over the years. “Since each state board sends its own list to the IMR, a few thousand doctors are listed twice,” said Desai.
The MCI began getting a fix on the real number last week by using a software programme to weed out duplicate registrations, going by name, date of birth, year of graduation and name of medical college.
“The real number without the revised duplications will be ready in two weeks,” he said.
Tracking deaths and relocations is a bigger challenge, as the MCI has to rely on families and colleagues to inform them.
“It is mandatory for doctors to register every change of address — whether within the state, country or overseas — with the Delhi Medical Council (DMC), but very few do it. Since I’ve been in office from July 2007, no one has reported a single death,” said DMC secretary Dr Girish Tyagi.
Most developed countries — such as the UK and US — insist on re-registration or revalidation under which licensed doctors are expected to prove their professional development and skills every five years.
“Correct data can be collected if India makes it mandatory for all practicing doctors to re-register ever five years,”
said Desai.
“Re-registration periodically would help but to make it efficient and hassle-free, all state councils should maintain a live electronic register that feeds to a national electronic register,” said Dr Srinath K. Reddy, president, Public Health Foundation of India.

Link: Original Article

Govt envisages periodic renewal of doctors’ registration

Currently, doctors are supposed to register with their state medical councils concerned only once, after getting their degrees. Following this, the state medical councils forward the list to the Medical Council of India (MCI) which incorporates them into the Indian Medical Register (IMR).

Sources in the health ministry said the India Medical Council Act, 1956, is being envisaged to be amended to earmark the funds to the MCI to update the IMR in a continuous and periodic manner.

The proposal made by the MCI in this regard has been pending with the government since 1999, the council’s president Ketan Desai told PTI.

Apart from re-registration, the MCI also wants re-evaluation of doctors after every five years.

“Doctors should attend 30 hours of continuing medical education every year. This would amount to 150 hours every five years,” Dr. Desai said, adding that it would help them update themselves with the latest technology and knowledge in their respective medical fields.

Listing the problems in the current system of registration, he said, medical practitioners do not delete their names from the IMR if they leave their country or stop practising.

“Out of the total 7,70,000 doctors listed in the register since 1933, many are either dead or have left the country, but they are still listed, creating confusion about the number of medical practitioners we have,” Dr. Desai said.

There is also a problem with the same person being registered from two different states, he added.

The National Human Rights Commission had recently voiced concern over the doctors with bogus degrees and registration certificates, providing health care facilities in the country.

MCI has detected 200 doctors with false medical degrees or intermediate marks memos in the last four years. It has filed FIRs against them for submitting fake degree certificates.

To register with the MCI, doctors have to submit their certificates for verification.

Though the council gives provisional registration, it sends the certificates for verification to the authorities concerned. In many cases, the fake medical degrees have been secured from Russia and other East European countries.

Verification of these certificates was carried out with the help of Indian embassies in those countries. In some of these cases, the medical degree is genuine, but the intermediate marks memo is fake.

Foreign medical degree holders are required to take a qualification test conducted by the MCI.

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Medical Defence Shield to help doctors of Indian origin in the UK

Doctors of Indian origin working for the National Health Service will now have help at hand, if in difficulty, and will be able to report cases of racial discrimination and harassment to a professional body of peers.

On Monday, the British Association of Physicians of Indian Origin (BAPIO) launched a project, Medical Defence Shield (MDS), to provide its members with “comprehensive support.” The association said that MDS would offer doctors advice in employment and professional issues as well as representation on complaints of bullying, harassment and discrimination.

“The members of the scheme will be able to access advice from an experienced team of doctors with a legal background,” BAPIO president Ramesh Mehta said, describing it as a “landmark” initiative to help the ethnic minority doctors.

The association said there were more than 40,000 doctors of Indian origin in the NHS, and there was a growing demand for a service sensitive to their concerns, especially those relating to racial discrimination and bullying.

“The Chief Medical Officer of England, in his recent Annual Report, acknowledged that the migrant doctors working in the NHS face discrimination and bullying. The MDS has been devised to fill a huge gap in professional services available to ethnic minority doctors,” the BAPIO said in a statement.

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Three doctors trapped in sex determination sting

Three doctors in Jaipur were caught red-handed doing sex determination of foetus on Saturday. The doctors were reportedly trapped by officials of state PCPNDT cell, who sent decoy customers to them at their respective clinics. The cell functions under directorate of medical and health services.

According to sources, the cell is empowered to take action against doctors resorting to sex determination of foetus under Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994. The trap was laid with the support of two city-based NGOs, said sources.

Out of the three medical practitoners, two work at R P Memorial Hospital, Jawahar Nagar and the third doctor runs the Madhur Clinic and Nursing Home at Chandpole Bazaar.

According to officials, while Dr. Basant Kishor Vyas, secretary of the Rajasthan state chapter of IRIA, conducted a sex determination test on a decoy customer at the R P Memorial Hospital, gynecologist Dr Maya Sharma communicated the sex of the foetus to the decoy and her attendant. They had charged Rs 3000 from the decoys, which was recovered. Later, Sharma confessed to revealing the sex of the foetus to the investigating team of PNDT cell.

At the Chandople Bazaar clinic, Dr Madhurani Jain charged Rs 2000 for sex determination test. The investigating teams seized the ultrasound machine and all related documents at both the places.

"We will produce them in the court and a strong case will be registered as they were caught red-handed," said Hardayal Singh, incharge, of the investigating team. The state health department will decide the fate of these doctors, who, as per procedure, will be suspended. Their practising licenses will also be cancelled.

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