March 3: A reputable surgeon today cancelled all his scheduled surgeries to go into an emergency huddle with his team. The "emergency" wasn't about how to treat a patient - the decision they needed to make was how to treat the prospect of an FIR if the patient died in their care.
The creation of the West Bengal Clinical Establishment Regulatory Commission has put the fear of taking critical medical decisions into doctors.
"We have decided that if a patient is critically ill, we will take a written consent for treatment from the person's family after informing them in detail about the possible consequences. Treatment will start only if they are satisfied with our explanation that the outcome may not be good and give in writing that we may go ahead. Otherwise, we will refer the patient to a government hospital," the surgeon told Metro .
The jitters were felt even more after the West Bengal Clinical Establishments (Registration, Regulation and Transparency) Bill, 2017, was passed by the Assembly today.
Doctors across private hospitals in Calcutta said they feared that the trust factor between them and their patients would wane if the commission formed by the state government starts filing FIRs alleging medical negligence for every other death during treatment.
"You have to accept that the outcome of treatment is uncertain in many cases. Doctors are feeling vulnerable because of the scrutiny they will be under from now on," said a cardiologist attached to a reputable private hospital. "If a patient dies, the family invariably thinks the doctor did not do enough to save the person. This feeling will now be magnified."
A senior official of the health department said the new legislation - the governor's assent is apparently a formality - would empower the commission to file an FIR against a doctor on suspicion of medical negligence and/or criminal intention leading to death. "For an aggrieved family, slapping a fine on a doctor or hospital for negligence is not enough punishment. So, we have introduced the provision of filing an FIR."
According to the official, the strongest step that the state medical council could take until now in a case of medical negligence was cancelling the doctor's licence. Under the new law, the regulatory commission is empowered to file a police complaint against a doctor, if convinced that negligence or deficiency in service led to a patient's death.
"The government filing an FIR against you is a different situation altogether," said a surgical gastroenterologist in a large private hospital.
He is planning to take an unscheduled, month-long holiday and mull his future as a doctor. "I feel that I should not try to treat a critically ill patient. Referring the person to a government hospital after initial treatment seems a safer option."
The veteran doctor said the pressure would be immense on colleagues in oncology and cardiology, both of which are mostly about dealing with critically ill patients.
A paediatrician said he would take the "no-touch approach". If a patient is in a critical condition, he would rather refer the child to a government hospital after "initial management".
"Doctors in government hospitals are not under scrutiny, let them handle such cases," the paediatrician said.
The Indian Medical Association said there was nothing illegal about the state government drafting a bill that empowers a regulatory body to file an FIR against a doctor. "If a patient's relatives can file an FIR, why not the government?" said K.K. Aggarwal, national president of the association.
Another view is that the new law might improve communication between doctors and patients. "In some cases, communication is a problem indeed," a physician admitted.
