Monday 14 November 2016

Guarding the Specialty of EM in India ~ A call to Action by Qualified Real Emergency Physicians !

By Vimal Krishnan Pillai, MD, FACEE                                                                                Principal Secretary, The Emergency Medicine Association 

India is at Cross roads of conflict when it comes to Emergency HealthCare.

The Health Care Industry in India is booming with Corporate for Profit hospitals mushrooming across India …thanks to Investments in India’s HealthCare.

The culture in India is that every MBBS Physician in India aspires to be a specialist. There are around 65,000 MBBS seats in India and only around 20,000 PG seats

 Due to the staggering difference was a constant struggle to achieve some sort of an accredited qualification after MBBS.

This also gave birth to a corrupt pathway where non-accredited courses were designed and marketed for monetary gains. These could be anything from paid Fellowships to any type of non-accredited courses.

Even though there are clear guidelines on what should be quoted as a qualification, there are numerous non- accredited courses thriving here due to regional heterogeneity in medical education and the challenge to govern, regulate and track healthcare providers enforcing the rule was tough.

With the rise of International Investments in HealthCare, like the west the expectations from these investment driven hospitals to prove Quality Emergency Care 24/7 grew.

The campaign to get EM Recognized by the regulatory bodies like Medical Council of India (MCI) and the National Board of Examinations (NBE) as a specialty was only was realized after 2009.

Running a Competent for profit Emergency Department needed committed and qualified Emergency Physicians.

That was the elbow gap when vested forces started manufacturing non-accredited Training Courses which are illegal in India.

If unconfirmed estimates have to be believed there are over 1000+ Medical students who have been lured into such courses.

The unregulated manner in which these malignant and corrupt courses have mushroomed has left the academic community in India stunned.

There has been massive anxiety as regards the factors under which such Unrecognized Training Programs are conducted at hospitals without permissions.

Physicians not recognized or qualified to be Teachers are impersonating the role of being trainers and are conducting training programs using the most vulnerable patients presenting to the Emergency Departments as training subjects without governmental permissions.

Physicians/ Institutions/ Associations not permitted to train are handing out qualifications.

These factors raise a lot of ethical and patient safety concerns.

There are all sorts of Certifications in India without prior permission of the Government of India. These Certifications are also causing a lot of confusion and disharmony for the regulatory agencies.

In this era where Government is moving towards One Nation-One Admission-Uniform Training- One Examination- Standardized Model there will be a dire need to immediately regulate and discipline these irregularities.

It is sad that Emergency Medicine has emerged as a front runner in this misconduct as this is a new specialty and the violators are misusing the brand value of Emergency Medicine to fulfill their selfish motives.

The violators try to justify their actions saying that they are doing “Capacity Building”. They forget that when it comes to be being certified as a SPECIALIST …there has been a system in place for India since independence. The Medical Council of India and The National Board of Examinations have that role well mandated.

CAPACITY BUILDING to improve Emergency Care by training physicians to better care is one thing but to assume and impersonate training programs and award non- accredited masters or degree is grossly illegal.

It is a known fact that India needs Specialist not only in EM but in every field. The worst fear is that If EM Violators continue to foster then other specialties will try to do the same and India will be flooded with Surgeons, Physicians, Pulmonologists, and Intensivists with all sorts of certificates.

It’s a Pandora’s Box which will spring open if this misconduct is not stopped.

At One hand Indian Hospitals are boasting of being a Medical Tourism Destination and one the other hand they are involved in irregularities.

I am a firm supporter of Governmental control of HealthCare and Medical Education.

Violations like these grossly undermine the authority of the Medical Council of India and the National Board of Examinations.

The Government is working hard to improve HealthCare at large and standardize the Medical Education system…..

The Emergency Medicine Irregularities have emerged to be its biggest hurdle.

Violators are fooling the medical fraternity and community while the government accredited degree holders MD/DNB face the uncertainty of being in a job market where non-accredited training and certifications are being doctored as the standards for qualification and quality care.

The future of hardworking post graduate qualified MD/DNB Emergency Physicians are in danger if steps are not taken to one and for all discipline the violators.

No Country would allow this indiscipline or forgive the violators.  India is no different!

I call upon my Fellow MD/NBE PG Students and Qualified Emergency Physicians to unite in this struggle against this fraud where the Authority of our Accreditors (MCI/NBE) is undermined and a mockery of Academic Emergency Medicine is being made.

The Time is now before it’s too late !
 Jai Hind !


Wednesday 2 November 2016

Mergers, Acquisitions, and Physicians

From The Desk Of ~ Sagar Galwankar, MD

As I read the media there is never a time that I don't get aware that some group is buying some group or merging with some group.

Merging and Acquiring hold the same meaning : It means Reorganization of Resources and Finances for Better Performance and Stronger Position in the Competitive Landscape.

Each of the above words narrows down to only one thing - SROI - Strategic Returns on Integration- Which is a nicer acronym for Financial Growth.

Financial Growth for the harvesters and the investors who steer these initiatives.

The real question is : Where does it leave US (the emergency physicians) and what is our future in US (the United States)

In this aggressively reorganizing industry called EMERGENCY HEALTHCARE , I see ourselves being repositioned to be skilled laborers. We the laborers have a highly competitive growing segment  called the  Mid Level Workforce.

EM is going through a phenomenon called LEAP FROG.

The IT industry evolved from large computers to a stage of internet in phones. It evolved and expanded.

We in EM are now straight away a part of this technology driven Industrialization without going through phases of evolution. We have become a small part of the the capitalistic revolution.

We have leaped the cycle of Evolution in this capitalistic revolution, I just hope like the cycle of life evolution , we don't face extinction.

 Care and Cost Balancing is driving the industry productivity. 

Customer- client satisfaction is a metric for stability.

We as a speciality have to evolve with this leap and be aggressive to change, we should think and act to stabilize our present and sustain our future.

The specialty we love needs to live on and live in itself.

The time is now and Optimism is the first phase of evolution.

Fear to not sustain is the key to effectively sustenance.

Creating and Encouraging Thinkers and Innovators to come up with solutions coupled with implementation of strategies nationally are steps which can change things for a better future.

Rethinking Leadership and transforming Education And Innovation for a progressive tomorrow which is in sync with  the changing landscape is the need of the hour.

Change is inevitable & we are all able, let's work to make it stable !

Just thought , hence shared !