India’s first-ever “Patient & Doctor Rights Manifesto” defining the various aspects of doctor-patient relationship authored by the Mumbai-based surgeons Dr. Aparna Govil Bhasker and Dr. Debraj Shome was released to the Indian people today, on March 28, 2019. Dr. Vipin Checker, President of the Association of Medical Consultants – a Doctor’s body representing over 11,000 medical specialists in India – formally launched the document. Dr. Lalit Kapoor who is the founder of Association of Medical Consultants (AMC) provided critical inputs to this document.
The Manifesto forms a part of the upcoming book “Dear People, With Love and Care, Your Doctors,” authored jointly by renowned surgeons Dr. Bhasker and Dr. Shome. This eagerly anticipated compilation of stories by some of the most compassionate doctors talks about some of the most touching experiences in their careers. This book is at the pre-production stage and will be globally launched in July 2019 by the renowned literary house Bloomsbury, with foreword written by His Holiness the Dalai Lama.
The Manifesto highlights the rights of both patients and doctors. It helps set the perimeter of their mutual relationship and conduct on 17 different aspects, including empathy; trust; information and communication; cost of treatment; identity and professional status; records and reports; emergency medical care; informed consent; confidentiality; second opinion; non-discrimination; safety and quality care; deficiency in service; alternative treatment options; source for obtaining drugs or tests; discharge, referral and transfers; and redressal.
Speaking at the launch of the Manifesto, Dr. Debraj Shome said: “The Doctor-patient relationship is one of the purest bonds that has existed in the society from times immemorial. Unfortunately, in the last few years, there has been a gradual erosion of faith and trust in this equation. Times have changed and from being treated akin to God once upon a time, today we hear stories of doctors being assaulted in public. The aim of this Manifesto is to clearly delineate the rights and duties of both doctors and patients to help restore the pristine balance and sanctity of this sacred relationship.”
Added Dr. Aparna Govil Bhasker: “The systemic problems in society are creating a rift between doctors and patients and we hear many discouraging stories of this strained relationship in the media daily. The lack of trust from both parties is so widespread that today we have come to a state where it almost feels like India is at war with its doctors. There are various reasons for this and deep introspection is needed from both sides to evaluate the reasons for this deteriorating relationship. This Manifesto will help re-establish a dialogue between the two parties and the book attempts to bring back the glory of this wonderful relationship. We hope to change the narrative and initiate a positive discourse in the doctor-patient relationship in India today.”
Said Dr. Vipin Checker, President of the Association of Medical Consultants: “At the end of the day, medicine is about love, kindness and compassion, and we need an urgent dialogue about the crucial need of reviving these values between a patient and the healer. This Manifesto, unanimously adopted by the Association of Medical Consultants, will go a long way in changing the way the world today perceives healthcare and the doctor-patient relationship.”
Said Dr. Lalit Kapoor, Founder of AMC, “We doctors believe that both doctors and patients are two sides of the same coin and without one, the other is incomplete & cannot exist. The relationship is extremely important to the basic fabric and ethos of society as a whole.”
Dr. Debraj Shome, Director, The Esthetic Clinics is involved in Philanthropy though the Debabrata Auro Foundation, which he Co founded with Dr. Bhasker. This foundation takes up patient issues as part of its philanthropic ventures.
Dr. Aparna Govil Bhasker is a renowned Bariatric and Advanced Laparoscopic Surgeon. She is an avid writer and painter. She co founded the Debabrata Auro Foundation, with Dr. Shome.
The Association of Medical Consultants – Mumbai was established in 1972 by a small group of energetic active and concerned medical consultants from distant suburbs who often assembled and animatedly discussed their common problems. Over the years, the Association grew rapidly. It is now one of the fastest growing Associations of Specialist Doctors in Mumbai with a membership strength of 11,000 Medical consultants. AMC is recognised as a front-line Medical Organisation and is an important opinion making body which addresses vital public health issues. Dr. Vipin Checker is the Honorary President of the AMC for 2018-19.
Authors: Dr Aparna Govil Bhasker & Dr Debraj Shome
With critical inputs from Dr Lalit Kapoor- Founder member of the Association of Medical Consultants (AMC) and the President of Federation of AMCs.
A “patient’s rights” charter was adopted by the National Human Rights Commission in August, 2018. This charter currently features on the website of the Ministry of Health and Family Welfare and is in the process of being finalised. While we welcome this charter whole-heartedly, as doctors, we believe that health is a two-way street. Doctors & patients are equal stake-holders when health is concerned. In a progressive society, rights and responsibilities of all stake-holders need to be defined clearly. This maintains an equilibrium and ensures smooth and effective functioning. The Doctor-patient relationship is built on mutual trust and protecting the rights of only one stake-holder and ignoring the other will eventually lead to discord and disharmony. Doctors are human too and have rights just like all other human beings. In fact, patients and doctors have rights and responsibilities that complement each other.
Given this situation, a manifesto of “patient and doctor rights” has been jointly authored by Dr. Aparna Govil Bhasker and Dr. Debraj Shome, with critical inputs from Dr. Lalit Kapoor. This “manifesto” is a better elucidation of the “patient rights charter” and will help to set the perimeter of this mutual relationship. Every right of patients is the responsibility of the doctors. Similarly, every right of doctors, in turn is the responsibility of the patients.
|RIGHTS OF PATIENTS||RIGHTS OF DOCTORS|
|Empathy||• To receive empathy from doctors & healthcare professionals.||• To be treated with respect by patients & their families.|
|Trust||• To be trusted by their doctors
• To be treated without any prejudice.
|• To be informed about all medical details & any other information in entirety.|
|Information & communication||• To receive complete information about the nature & cause of illness, diagnosis, proposed investigations, management & complications.||• To be informed about all the information pertaining to the patient’s symptoms, past illnesses, medications, allergies & every fact relevant for proper diagnosis & management.|
|Cost of treatment||• To be informed regarding the expected cost of treatment & to receive an itemised bill.
• To be informed duly about any additional costs that may be incurred due to any change in physical condition.
• To change the doctor or the hospital if the cost of treatment is not agreeable.
|• To be paid fairly & duly for their expertise & service.
• To be duly informed by the patient and their family if they are unable to afford the cost of treatment at the time of commencement of treatment.
|Identity & professional status||• To know the identity & professional status of the care-providers.
• To know which doctor is primarily responsible for their care.
|• To know the complete identity of their patient in the form of correct name, age, address & any other relevant information with due documentation.|
|Records & reports||• To receive copies of case papers, indoor patient records, investigation reports, discharge summary, death summary etc. within 72 hours of discharge from the hospital & after paying appropriate fees.||• To retain copies of all past & present medical records, reports & any other relevant documents of the patient for their reference & further treatment.|
|Emergency medical care||• To basic emergency medical care in both government & private medical sector irrespective of their paying capacity.
• To be informed about the limitations of the available services after emergency care is provided.
|• To transfer the patient to another centre based on the patient’s condition & the available medical infra-structure after basic emergency care has been provided.|
|Informed consent||• To provide informed consent only after understanding the limitations of the treatment in a language they fully comprehend.||• To not proceed with test/treatment if the informed consent is not provided by the patient.|
|Confidentiality||• To privacy & confidentiality about their illness & treatment.
• To safe custody of all data pertaining to their illness
|• To have an attendant inside the examination room/OPD/IPD while attending to any patient of any gender.
• To follow due procedure in case patient confidentiality is to be weighed against a public health consideration.
|Second opinion||• To receive second opinion from an appropriately qualified & competent medical practitioner of their choice.||• To be duly informed when patients are seeking a second opinion.|
|Non-discrimination||• To receive treatment without any discrimination based on their illness including HIV status or other such health condition, religion, caste, ethnicity, gender, age, sexual orientation, linguistic, geographical, social origins and others.||• To know about any illness that may have a bearing on public health consideration
• To know about pre-existing infectious diseases.
|Safety & quality care||• To safety & security in the hospital premises & to receive quality health care as per the currently accepted standards, norms & guidelines.||• To receive safe & secure working conditions in the hospital premises.
• To withdraw their services, in case they are harmed intentionally, mentally or physically by patients or their family.
• To pursue the lawful course in case of verbal or physical assault.
|Deficiency in service||• To seek redressal in case of alleged medical negligence or damage caused to them due to deficiency in service delivery by a hospital or a doctor.||• To be considered “innocent” until proven guilty by a court of law & to present their side in a fair manner without any prejudice.
• To be protected from media trials.
|Alternative treatment options||• To choose alternative treatment options||• To be informed if the patient wants to change over to an alternative therapy or if an alternative therapy is being followed concomitantly.
• To withdraw treatment after duly informing the patient if the doctor believes that the alternate therapy will interfere with existing line of treatment.
|Source for obtaining drugs or tests||• To choose any registered pharmacy or laboratory to buy medicines or get their tests done respectively.||• To get the tests done in-house or the nearest lab in case of an emergency to prevent delay in patient care.
• To reorder the tests if they are not done from an approved/registered laboratory.
• To not be held responsible for the quality of tests/medications from a laboratory or a pharmacy that the patient has chosen.
|Discharge, Referral & transfer||• To timely discharge & to not be detained in the hospital on procedural grounds.||• To be duly paid for their services before the patient gets discharged from the hospital.
• To have all dues cleared by relatives in case of death of the patient.
|To be heard & seeking redressal||• To give honest feedback, make comments, lodge complaints about the care that they have received from the doctor or the hospital on the right portals.||• To counter the complaints made by the patients in a lawful manner & to provide apt justification.
• To resort to a legal recourse if they believe that the complaint is frivolous & has been made for personal gains or to defame the doctor.