As you have recently taken over as IMA, Bihar president, what do you think are major challenges and priorities ahead of you?

The state is currently plagued by incidents where doctors, many of whom are our members, are assaulted by attendants of patients. In many cases, the doctors have resorted to strikes. To bring such situation under control is an important task ahead of me. On one hand, I appeal to the doctors not to lose their temper in such situations. On the other hand, I want to take up the issue with the government to be more sensitive in situations like these. Recently, the Medical Service Institution and Personal Protection Act was invoked in the state. But it has not been effective in ensuring doctors’ security.

IMA has suggested some amendments in the act based on Andhra Pradesh and Madhya Pradesh models. We hope the government listens to us. Our priorities include carrying out projects supported by the IMA headquarters, working with national and international NGOs in health, sanitation and health education sectors, quick response to situation, arising out of disturba-nces in health delivery system, and social activities .

IMA has been up in arms against Clinical Establishment (Registration and Regulation) Act, guidelines of which have not been laid down yet. What’s your opinion on that?

We are not against such a regulatory law but oppose its present form. The government has brought the act in such a form that it will only suit the interests of big, corporate hospitals. When the bill was being drafted, IMA was consulted and the rough draft that emerged was totally agreeable for our association. However, the format the government later chose was an exact copy of the central act, which does not fit in the state’s circumstances. It would hamper both medical professionals and patients. A fresh MBBS or postgraduate doctor who wants to set up a clinic will be burdened to fulfil so many formalities that he will have to find sufficient sponsorship for doing so and maybe he will need to go for a bank loan. Ultimately, he or she will try to realise the expenditure from patients and hospital bills will get inflated.

The statute also talks about “stabilising” emergency patients before referring them to bigger hospital but this makes no sense. How can a pediatrician help a woman who is about to deliver a baby if she is brought to his clinic in such a situation? The registration act has provisions that medical professionals could be jailed if they do not comply with the norms. Our association does not support this.

The state is grappling with acute shortage of doctors, especially in the government sector. What ways do you suggest to overcome the problem?

In the first place, the government should make its selection process flexible and then offer more incentives to doctors so that they find it lucrative to go to block-level hospitals and work. There are about 1,700 contractual doctors in the state who need to be regularised at once as they are treated like bonded labourers by the government. They get no perks and benefits of a government job. Besides, the government has failed to enlist the youth in state health delivery system. The government should go for campus selection or hire fresh medical graduates after strengthening primary health centres at the block level. If the infrastructure and pay package is healthy and resources are sound, the doctors would be attracted towards govern-ment jobs.

How do you see Bihar progressing in health sector in the last few years? How do you think state has fared in implementing National Rural Health Mission (NRHM) projects?

The situation has improved a lot in the recent past but the gaps in terms of infrastructure and services are so vast that the state has a long way to cover before it can claim of having made substantial progress. The conditions of primary health centres and district-level hospitals, or even medical colleges leave much to desire. The State Health Society — responsible for implementing NRHM schemes is under the heading of a dynamic personality (referring to its executive director Sanjay Kumar). But due to some administrative issues, fate of many projects has not been very good. The government needs a sort of overhaul in the system and vision to work.

Tell us about your life journey so far.

I was born at Athari village of Sitamarhi district on December 25, 1949. My father was a doctor. I went to a village school till matriculation, after which I got district scholarship and enrolled in Patna Science College. I was a bright student. Patna Medical College and Hospital sent me an acceptance letter when I applied there upon completing my intermediate degree. I got my MBBS degree in 1972. I did my MD from there in paediatrics.

Later, I joined Bihar health services and served at various government hospitals before being transferred to Patna Medical College and Hospital in 1977.

What had you been had you not been a doctor?

(Laughs) A mining engineer. One of my relative was a mining engineer and his profile fascinated me when I was a child. However, I later developed a great respect towards my father’s profession who was a benevolent doctor and decided this is what I wanted to do since it is one of the best ways to serve humanity.

Generic drug homework

Ever since Aamir Khan took up the issue of generic drugs in his reality TV show, the issue has come into prominence in the state. The health department recently showed interest in involving the superstar to promote the practice of prescribing generic drugs.
Those who advocate the prescription of generic drugs should first do the homework. While we do feel that drugs should be available to patients at lowest possible price, there are technical aspects that could not be overlooked. If the doctors prescribe generic drugs to patients, who will ensure the quality of drugs that patients buy from chemists? In cases of mixed composition, it is not possible for the doctors to write chemical names of medicines in length. The most feasible way out for the government is to enlist 50-100 quality pharmaceutical companies, which are also cost-effective. Their drugs can be easily prescribed by medical professionals.