28TH December, 2014:
New Team IMA started its year on 28th December, 2014 at Ahmedabad along with the Ordinary Meeting of Central Council. On that day a meeting of RNTCP-NWG and Disaster Management Cell was also held.
Some of the Main IMA Central Council Decisions passed
1) Directions are being given to hospitals and doctors not to appoint Ayush Doctors as RMO/Assistant. Strong action should be taken against those violating the directions.
2) Hon’ble Supreme Court has said in one of the judgments that although it is unethical for doctors to resort to strike but the Supreme Court cannot put a stay to any such strike. IMA central council resolved that though strike is a right but should be the last resort.
3) IMA has asked for defined protocols for medical professionals for organizing medical and surgical camps. IMA is against any unrealistic targets given to government doctors.
4) IMA condemned cut commissions and corrupt practices any of the IMA member. IMA will not support any member indulge in corrupt practices. IMA will ask all its members hospitals to display declaration Code of Ethics for Health Care Providers at the Reception of their hospitals.
5) IMA will come out with a White paper on “When not to use Antibiotics”.
6) IMA will come out with a White paper on “What is not unethical in terms of Doctor – Industry Relationship”.
7) IMA wants Consumer Protection Act should be amended/ empowering councils to award compensation/ establishing to separate Medical Tribunal for such cases.
8) IMA wants a cap on the compensation awarded in medical negligence. Even in a plane crash a cap is there. Also IMA want the awarding formula not to be based on the income of a person. If that so the poor will not get the same treatment as the rich will get.
29th December, 2014:
· A meeting of staff members of IMA HQs with the HSG
· A meeting of Office Bearers stationed at Delhi
· HSG office shifted from old office to the present office of RNTCP at Ground Floor.
IMA White Paper : Not reporting TB a violation of MCI ethics regulation 7.14
Dr KK Aggarwal
Wide letter number Z-28015/2/2012-TB, the Government of India, Ministry of Health and Family Welfare on 7th May 2012 declared TB as a notifiable disease. As per the circular
" TB continues to be a major public health problem accounting for substantial morbidity and mortality in the country. Early diagnosis and complete treatment of TB is the corner-stone of TB prevention and control strategy. Inappropriate diagnosis and irregular/incomplete treatment with anti-TB drugs may contribute to complications, disease spread and emergence of Drug Resistant TB.
In order to ensure proper TB diagnosis and case management, reduce TB transmission and address the problems of emergence and spread of Drug Resistant- TB, it is essential to have complete information of all TB cases. Therefore, the healthcare providers shall notify every TB case to local authorities i.e. District Health Officer I Chief Medical Officer of a district and Municipal health Officer of a Municipal Corporation / Municipality every month in a given format.For the purpose of case notification, a TB case is defined as follows: A patient diagnosed with at least one sputum specimen positive for acid fast bacilli, or Culture-positive for Mycobacterium tuberculosis, or RNTCP endorsed Rapid Diagnostic molecular test positive for tuberculosis OR a patient diagnosed clinically as a case of tuberculosis, without microbiologic confirmation, and initiated on anti-TB drugs.
For the purpose of this notification, healthcare providers will include clinical establishments run or managed by the Government (including local authorities), private or NGO sectors and/or individual practitioners.
For more detailed information, the concerned State TB Officers / District TB Officers, whose details are available onwww.tbcindia.nic.in, may be contacted.
(Manoj Sinha) Under Secretary to the Government of India".
A copy of this circular was sent to all Principal Secretaries / Secretaries of Health of States / UTs With the request to kindly immediately; All Directors of Health Services of bring this order to the notice of all States / UTs concerned for compliance, in their respective State / UT; All State TB Officers of States / UTs; PS to Union Minister HFW / Union Minister of HRD & CIT / MOS (HFW); PPS to Union Secretary HFW / DGHS / Union Secretary AYUSH/ Union Secretary HR (DG-ICMR) / union Secretary — NACO / DG-NIC; All Addl. Secretaries & Joint Secretaries in MOHFW / GOI All Dy. Director General / DteGHS / MOHFW / GOI; Director (Media) MOHFW / Got; All Regional Directors (HFW/GOI) — with request to facilitate wide dissemination of this Govt. Order, for compliance, in respective states / UTs; Websites of MOHFW/GOI (www.mohfw.nic.in) and Central TB Division (www.tbcindia.nic.in); DDG (NIC) & Sr. Technical Director (NIC) / MOHFW / GOI.
The above circular was not sent to Medical Council of India for reasons only known to them. Not reporting a notifiable disease is a violation of Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002 under regulation 7.14 : "The registered medical practitioner shall not disclose the secrets of a patient that have been learnt in the exercise of his / her profession except –
1. in a court of law under orders of the Presiding Judge;
2. in circumstances where there is a serious and identified risk to a specific person and / or community; and notifiable diseases.
In case of communicable / notifiable diseases, concerned public health authorities should be informed immediately.
Under the regulation the word used is 'SHOULD' but under the notification the word used is 'SHALL.' It means it is mandatory to report but for the violation the MCI may take a lenient view if it is the first violation. In most of the municipal corporation acts for example DMC Act ( Delhi) TB is defined as a dangerous disease under 2 (9) "dangerous disease" means— (a) Cholera, plague, chicken-pox, small-pox, tuberculosis, leprosy, enteric fever, cerebrospinal meningitis and diphtheria; and (b) any other epidemic, endemic or infectious disease which the Commissioner may, by notification in the Official Gazette, declare to be a dangerous disease for the purposes of this Act; Prevention of dangerous diseases.