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who do not care about patients and unscrupulously insist upon ’unofficial’
payment for free treatment or insist upon private consultations. On the
other hand, many private hospitals and Doctors give the best of treatment
without exploitation, at a reasonable cost, charging a fee, which is
resonable recompense for the service rendered. Of course, some doctors,
both in private practice or in government service, look at patients not as
persons who should be relieved from pain and suffering by prompt and
proper treatment at an affordable cost, but as potential income-providers/
customers who can be exploited by prolonged or radical diagnostic and
treatment procedures. It is this minority who bring a bad name to the
entire profession.
29. Health care (like education) can thrive in the hands of charitable
institutions. It also requires more serious attention from the State. In a
developing country like ours where teeming millions of poor,
downtrodden and illiterate cry out for health-care, there is a desperate
need for making health-care easily accessible and affordable.
Remarkable developments in the field of medicine might have
revolutionalized health care. But they cannot be afforded by the common
man. The woes of non-affording patients have in no way decreased.
Gone are the days when any patient could go to a neighbourhood general
practitioner or a family doctor and get affordable treatment at a very
reasonable cost, with affection, care and concern. Their noble tribe is
dwindling. Every Doctor wants to be a specialist. The proliferation of
specialists and super specialists, have exhausted many a patient both
financially and physically, by having to move from doctor to doctor, in
search of the appropriate specialist who can identify the problem and
provide treatment. What used to be competent treatment by one General
Practitioner has now become multi-pronged treatment by several
specialists. Law stepping in to provide remedy for negligence or
deficiency in service by medical practioners, has its own twin adverse
effects. More and more private doctors and hospitals have, of necessity,
started playing it safe, by subjecting or requiring the patients to undergo
various costly diagnostic procedures and tests to avoid any allegations of
negligence, even though they might have already identified the ailment
with reference to the symptoms and medical history with 90% certainly,
by their knowledge and experience. Secondly more and more doctors
particularly surgeons in private practice are forced to cover themselves
by taking out insurance, the cost of which is also ultimately passed on to
the patient, by way of a higher fee. As a consequence, it is now common
that a comparatively simple ailment, which earlier used to be treated at
the cost of a few rupees by consulting a single doctor, requires an
expense of several hundred or thousands on account of four factors : (i)
commercialization of medical treatment; (ii) increase in specialists as
contrasted from general practitioners and the need for consulting more
than one doctor; (iii) varied diagnostic and treatment procedures at high
cost; and (iv) need for doctors to have insurance cover. The obvious,
may be naove, answer to unwarranted diagnostic procedures and
treatment and prohibitive cost of treatment, is an increase in the
participation of health care by the state and charitable institutions. An
enlightened and committed medical profession can also provide a better
alternative. Be that as it may. We are not trying to intrude on matters of
policy, nor are we against proper diagnosis or specialisation. We are only
worried about the enormous hardship and expense to which the common
man is subjected, and are merely voicing the concern of those who are
not able to fend for themselves. We will be too happy if what we have
observed is an overstatement, but our intuition tells us that it is an
understatement.
30. What we are considering in this case, is not the duties or
obligations of doctors in government charitable hospitals where treatment
is free or on actual cost basis. We are concerned with doctors in private
practice and hospitals and nursing homes run commercially, where the
relationship of doctors and patients are contractual in origin, the service is
in consideration of a fee paid by the patient, where the contract implies
who do not care about patients and unscrupulously insist upon ’unofficial’
payment for free treatment or insist upon private consultations. On the
other hand, many private hospitals and Doctors give the best of treatment
without exploitation, at a reasonable cost, charging a fee, which is
resonable recompense for the service rendered. Of course, some doctors,
both in private practice or in government service, look at patients not as
persons who should be relieved from pain and suffering by prompt and
proper treatment at an affordable cost, but as potential income-providers/
customers who can be exploited by prolonged or radical diagnostic and
treatment procedures. It is this minority who bring a bad name to the
entire profession.
29. Health care (like education) can thrive in the hands of charitable
institutions. It also requires more serious attention from the State. In a
developing country like ours where teeming millions of poor,
downtrodden and illiterate cry out for health-care, there is a desperate
need for making health-care easily accessible and affordable.
Remarkable developments in the field of medicine might have
revolutionalized health care. But they cannot be afforded by the common
man. The woes of non-affording patients have in no way decreased.
Gone are the days when any patient could go to a neighbourhood general
practitioner or a family doctor and get affordable treatment at a very
reasonable cost, with affection, care and concern. Their noble tribe is
dwindling. Every Doctor wants to be a specialist. The proliferation of
specialists and super specialists, have exhausted many a patient both
financially and physically, by having to move from doctor to doctor, in
search of the appropriate specialist who can identify the problem and
provide treatment. What used to be competent treatment by one General
Practitioner has now become multi-pronged treatment by several
specialists. Law stepping in to provide remedy for negligence or
deficiency in service by medical practioners, has its own twin adverse
effects. More and more private doctors and hospitals have, of necessity,
started playing it safe, by subjecting or requiring the patients to undergo
various costly diagnostic procedures and tests to avoid any allegations of
negligence, even though they might have already identified the ailment
with reference to the symptoms and medical history with 90% certainly,
by their knowledge and experience. Secondly more and more doctors
particularly surgeons in private practice are forced to cover themselves
by taking out insurance, the cost of which is also ultimately passed on to
the patient, by way of a higher fee. As a consequence, it is now common
that a comparatively simple ailment, which earlier used to be treated at
the cost of a few rupees by consulting a single doctor, requires an
expense of several hundred or thousands on account of four factors : (i)
commercialization of medical treatment; (ii) increase in specialists as
contrasted from general practitioners and the need for consulting more
than one doctor; (iii) varied diagnostic and treatment procedures at high
cost; and (iv) need for doctors to have insurance cover. The obvious,
may be naove, answer to unwarranted diagnostic procedures and
treatment and prohibitive cost of treatment, is an increase in the
participation of health care by the state and charitable institutions. An
enlightened and committed medical profession can also provide a better
alternative. Be that as it may. We are not trying to intrude on matters of
policy, nor are we against proper diagnosis or specialisation. We are only
worried about the enormous hardship and expense to which the common
man is subjected, and are merely voicing the concern of those who are
not able to fend for themselves. We will be too happy if what we have
observed is an overstatement, but our intuition tells us that it is an
understatement.
30. What we are considering in this case, is not the duties or
obligations of doctors in government charitable hospitals where treatment
is free or on actual cost basis. We are concerned with doctors in private
practice and hospitals and nursing homes run commercially, where the
relationship of doctors and patients are contractual in origin, the service is
in consideration of a fee paid by the patient, where the contract implies
