Ostrich Syndrome!

Thursday, May 6, 2010

Certificate of Good Standing from the MCI- Who Needs it?

For any Indian doctor applying for a course or even employment outside the country, it is usually essential to procure a “Certificate of Good Standing” from the Medical Council of India (MCI). I have gone through this arduous task on a couple of occasions. Correctly enough the validity of this certificate is for a year and for re-certification you have to again go through the same procedure. That is to say the Council keeps a check on your character as a doctor on an annual basis.
A couple of weeks back, Dr. Ketan Desai, the President of MCI was nabbed by the CBI on charges of taking a bribe of Rupees 2 crores in lieu of recognizing a Medical College from Punjab. How ironic could that be! President of the Council which issues Certificates of Good Standing to thousands of doctors has a dubious character himself. No wonder, the Certificate of Good Standing of the MCI is not signed by its President. This task is left with the Registrar of the Council.
It is funny (and scary) how often our government system and its characters are an oxymoron to their own value system. How often we are betrayed by those in whom we dispose our faith and belief. Judges, civil servants, politicians, journalists, doctors. You name it and every single profession has betrayed the common Indian in the country’s short history of sixty three years. It makes me think. Are we heading in the right direction or have we lost the plot already?
We all remember the first few lines of “tryst with destiny” speech of Jawaharlal Nehru on that eventful midnight but we rather prefer to forget the concluding part of his speech. He had said, “We have hard work ahead. There is no resting for any one of us till we redeem our pledge in full, till we make all the people of India what destiny intended them to be”. Surely destiny didn’t mean this for the people of India to be! Against the back drop of Nehru’s “tryst with destiny”, the destiny of common Indians is written not by themselves but by thugs who are at the helm of affairs.
Loss of faith of the common man in government machinery is an open secret. People like Dr. Desai only reaffirm this loss. It is this breach of faith which throws a life-line to the ever expanding private sector. Day in and day out, new hospitals and private medical schools pock mark the Indian landscape. Rules are twisted. Illegal permissions granted. The party goes on. The loot goes unabated. I am not arguing that the Private health sector should not exist. Unarguably the government health sector should be supplemented but not substituted by a robust private sector. In fact some of the best brains in Medical sciences in our country are the product of a vibrant private health sector.
Unfortunately, the problem is not the private sector. What can we accept from Institutions which are formed and run with an open intent to earn money? Dr. Ketan Desai was not from the private set up. It is us, people working in the public sector who are guilty of betraying our clientele again and again. It is us who defy rules. It is us who get lured to money. It is us who are an easy prey to temptations of wealth, power and mammon.
The acceptance of “gifts” from pharmaceutical companies is a common occurrence in thousands of government hospitals across the country. How conveniently a “bribe” can be changed into a “gift” is something on which we all need to ponder. Gifts are given to someone you love, not to doctors meant to treat patients! Pharmaceutical companies set out big sums in their budgets to lure doctors into writing their drugs and implants. It is ironic that the corridor of most government hospitals across India are filled with sick and dying patients as well as a good number of neatly dressed medical representatives with well polished shoes. In fact I could see the class difference here too, bigger the company, more suave the representative!
The most dangerous part of the story is that with exponential (and selective) economic growth, there has been an intrusion of foreign companies on the Indian scene. Most CME programs, medical conferences and surgical workshops are now sponsored (read hijacked) by these profit making machines. The promotion of implants and drugs in the name of scientific research in a country with no clear guidelines and checks is a matter of urgent concern. The rampant use of implants actually meant for the western population is riddled with intrinsic complications. But who cares? The flow of money washes away the ethical concerns.
The corruption in the Indian medical fraternity is not limited to the MCI or Dr. Ketan Desai. The rot goes deep. He just headed the juggernaut which steam rolls over human life and suffering in the pretext of alleviating it. The disintegration of ethical values is near complete. Entice of wealth has taken its toll. The question is whether we can break out of this free fall or are we ready to land with our faces flat on the ground. The task is cut out for the MCI. There is an urgent need to set the house in order. The need of an honest and transparent system at the MCI cannot be over emphasised. It’s my belief that India cannot cleanse itself of people like Dr. Desai. They will keep coming back like seasonal pests. But we can surely have a system to identify and neutralise them. If checks and balances are in place the likes of Dr. Desai can be kept at bay. In all honesty, the Medical Council of India needs a Certificate of Good Standing for itself more than anyone else.


Nagendra said...

Another good article sir, now in your own area. So no need we commenting on it. Needless to mention I thoroughly enjoyed this article. Let us see if something happen to this bigger thug in recent time. It shows why doctors in pvt hospitals are asking for spine surgery in few day back pain( I have gone through it you know it :)) as so much they had paid that recovery is a must in quick time. I think AIIMS and AIIMS like institutes are best gift in such scenario.

RM said...

What is the govt. policy?
MCI conducts regular inspections of medical colleges. Most of the times, it is the government medical colleges that are found to be deficient in their infrastructures. As a result some of their courses, either undergraduate or postgraduate courses, are derecognized. The state governments are not bothered to encourage recruitment of faculty. They are not interested to invest money in these institutions as they are not money making projects for the government. Lack of faculty and physical infrastructure is gradually eroding the very existence of these colleges. The situation of medical education and health facility provision is quite like that of primary education. Basic health education of service providers is lacking; basic health facilities for the masses is lacking. Yet the government announces the opening of many tertiary care facilities (obviously in the cities). Even these remain on paper as making of buildings does not equate to making of an institution. There are numerous examples in Delhi. Therefore the situation must be even worse in other parts of the country. If there are no medical colleges in public sector, imagine the situation for the next generation. The situation remains rosy for the private medical colleges all the time even without the basic facilities. Thanks to MCI.
It does not regulate, guide, control or promote the medical education the way it should. Then why should the public money be spent on maintaining this body? Let there be a free for all policy and let the people decide what is right or wrong?

Ashini Srivastava said...

Well said! You've hit the nail on the head!! MCI has been corrupt for the longest time. And then they go around threatening to derecognize medical colleges such as JNMC... but that could be another story altogether!
Good article, as always.
Best wishes,

Irfan said...

Nice article. Thanks. Corruption is an accepted fact of life in India therefore I will not even comment on it.

Mubashir Ahmed said...

Superb piece from an "insider" himself! Keep them coming

Mumtaz Ahmed said...

Dear Dr. Alam,
You have addressed a very good topic. Leave the politicians alone, the ethical, moral degeneration and corruption in the institutions, agencies, offices has become part and parcel of our society. Individuals’ professional commitment, honesty in the duties and responsibilities has become a rare phenomenon of our society.
However, the degeneration in ethics and values in the medical profession and medical institutions is really a matter of great concern and reflection of the culmination of how irresponsible we have become. The emotional relation of the patient with his/her doctor has become a relation of doubt and mistrust over time.
Hope the article will make both at the individual and policy level to think and to do something to improve the sorry situation of the institutions, agencies, machanisms we have become accustomed to.

Mumtaz Ahmed

rajeev kapoor said...

Dr. Alam,
Well said. Last 2 weeks I have been writing to all editors of major TV channels trying to get them to understand the importance of this arrest! As expected, my efforts are of no use. IPL hogged the limelight, when this arrest should have the prime news! The 'media savvy' press is not bothered! IPL corruption is news worthy, but this event has far reaching implication for the people of India - only if they understand. Journalists also come from the same society, a society so immune to the corruption around.
At this stage, the ownership of MCI is not clear; seemingly so the Health Ministry cannot do anything. What luck for the Hon Health Minister! Who will set the house right?
People have talked about medical colleges and its quality. A public hospital is an integral part of any medical college. A good doctor is a product of a good public hospital. Who is responsible to design, maintain, implement and monitor the standards of all public hospitals. I agree with you that the private sector should supplant the public health care structure of our country. Unfortunately it is the other way around. These private hospitals have no bearing in the medical education of our country.
Your articulate article should be sent to all major newspapers and media houses. Please make it a point to send a copy to the Prime Minister.
We,like minded people, should find each other and make a movement so strong that the government listens!
Maybe we should have a web page devoted to this issue and then form a chain with sending emails to our friends. Lets get the ball rolling.

ahmed41 said...

One could have mentioned the scandal of MRP on the price of drugs & medicines, as well as other hospital
The real cost may be a very tiny fraction of the stamped MRP.
This is how the cost of health care
is unaffordable to the common BHARATi.
We all know it.
Does anyone care !1?


SR Mahajir said...

Dear Dr Khan
this is mahajir advocate from hyderabad
i congratulate you on the excellent piece you've written
please circulate it widely - we need greater awareness all round
best regards, mahajir

S R Mahajir, Brainstorm Legal, Advocates Hyderabad INDIA

Watch Dog said...

Why are so many members of the Parliament in jail or being sued? Is this not the epitome of corruption? What can all the achievements do for India if this is allowed to go on at the highest level? Maybe the law the police the people need to govern a lot better. We all need to be more cognizant of our smaller or larger shortcomings and try to correct them too!.......Watch Dog

Watch no Dog said...

On the other hand our system in India is much better than in Pakistan, Russia, Ghana or South Africa! The question is do we care to be compared with these countries??

Rajeev Kapoor said...

I have created an exclusive blog on MCI. Please go through it and leave your comments. This blog draws inspiration from this article by Dr. Khan

stoneheart said...

does any one know within how many days does MCI dispatch the GOOD STANDINGS CERTIFICATE?