“History repeats itself, that’s one of the things that’s wrong with history.” -Clarence Darrow

“Double Dipping” by State Doctors is Unethical and Must End

by | Dec 23, 2010 | Blog

Kashmir Images rolls out a 1-2 punch with an editorial about “throw the bums out,” based on an investigative report by Zeenat

(Ms. Zeenat Zeeshan Fazil, 26, was born in Srinagar, Kashmir. She did her schooling from King George (Mumbai) and later Cambridge (New Delhi), and received her Masters degree in English Literature from the University of Kashmir in 2008. Presently, she is also pursuing her second Masters degree in Mass Communications through the Indira Gandhi National Open University (IGNOU). In 1998, she began her career as a freelance journalist with leading national newspapers and simultaneously joined ‘Fazil Kashmiri Publications’ as Editor and Publisher, and is also an editor of the ‘Focus’. Ms. Fazil has written a book on Mass Media and Linguistics (2006), and ‘Falcons of Paradise'(2009), a reference book contains 100 Eminent Personalities of J&K starting from 14th century till date. After working for ‘Daily Etaalat’- a Srinagar based Newspaper in 2007-2008; she joined ‘Daily Kashmir Images’ as a Senior Correspondent by the end of 2008. She is also currently associated with ‘Charkha’, a foundation that highlights the developmental concerns of marginalized section of Kashmiri society particularly in rural areas and to draw out perspectives on women through their writings. Ms. Fazil is also associated with ‘Interchurch Peace Council Netherlands’ which is intensely involved in several conflict areas such as in Kashmir. In 2009, she joined the South Asia Free Media Association (SAFMA). She has received numerous awards for her meritorious contribution in the field of literature. Her interests are reading, writing, poetry, music, travel,and gender related topics.)

Show Them Door
(Editorial)

Better late than never! Finally the government seems to have woken up to the problems posed to the premier tertiary-care hospital SKIMS by the private practice of its doctors. Now that a disciplinary committee has been set up under the state Chief Secretary to check the private practice by SKIMS’ doctors, it is expected to act as a necessary deterrent. Since the doctors of this hospital draw huge sums month after month as non-practicing allowance from the state exchequer, ethically speaking, they should not have indulged into anything amounting to the breach of their work ethics and service rules. But then, in this land of unaccountability where people pride their ability to hoodwink the other, including the law of the land, ethics are certainly too sparse to figure in societal conscience and consideration. No wonder doctors too being part of this largely corrupt society are any different. On one hand they draw non-practicing allowances but on the other they also indulge in private practice, thereby cheating both their conscience as well as gullible public – government of course is no consideration at all!

SKIMS, as an institution, in fact one of the biggest in the entire state has a very fat and elaborate administrative set-up headed by a director. Besides director, there are so many other officials down this hospital’s, as well as up in the state’s administrative hierarchy who wield lot of institutional powers to keep the unruly and unscrupulous elements within SKIMS as well as elsewhere at bay. Unfortunately, it is the abject failure of these officials in the administrative ladder of SKIMS and the state in general that has brought the situation to the point where the government finally had to set up an extra committee to work as the ring-master to take the ‘wild’. The gravity of the institutional rot that has come to plague SKIMS could be gauged from the fact that despite clear warnings from the Chief Minister to the doctors to stop cheating the state and its people, private practice continued unabated. Such is the extent of the carelessness on part of doctors that the Chief Minister was forced to repeat his warning again this year on another annual day function of the hospital. And yet the situation refused to change.

As happens in such cases, Director SKIMS and others in the top positions may choose to feign ignorance about the doctors engaging in private practice, but how many people actually believe this possibility. Is it possible that Director and others are unaware of things that are common knowledge for the ordinary population? Certainly not! Mere setting up of disciplinary committee or any other such mechanism won’t help much unless and until government fixes responsibility of the wrongs that have cost SKIMS its place of pride among the health institutions in the subcontinent. How-so-much one may like to differ with his politics, it goes without saying that SKIMS is one of the best contributions of the National Conference founder Shiekh Mohammad Abdullah to the people of the Jammu and Kashmir. Isn’t it true that SKIMS was once one of the best health-care institutions in the entire subcontinent, at par with the institutions like AIIMS New Delhi and PGI Chandigarh? Then what went wrong and how? Slamming blame for everything on the political turmoil has become a boring cliché so much so that it no longer amuses anyone now. It is just an absurd excuse to shield the corrupt and the inefficient. Omar Abdullah’s government will be better served by initiating a culture of fixing responsibility for the wrongs and setting the heads of the wrong-doers rolling. Those who resort to excuses blaming militancy for their own inefficiencies are non-doers. These administrative white-ants must be bug-juiced to rid the system of their corrupt and immoral impacts.

Private Practice of SKIMS Doctors

Need is to catch the bull by the horn – Zeenat Zeeshan Fazil

In clear violation of the J&K government ordinance that bans private practice of the doctors and paramedical staff of the Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura a large number of doctors and paramedics openly run their private clinics. And this private practice of doctors and paramedics severely upsets the healthcare in valley’s premier tertiary care hospital. Kashmir Images spoke to renowned doctors to know their take on the issue. Excerpts:

Prof Mehrajudin
(Ex Director SKIMS)

I do not favor private practice by doctors of SKIMS, Soura. If you go for private practice while serving, then your dedication and association with the institution suffers. Anyone related to the SKIMS needs to be loyal to it. The doctors of this institute draw huge sums month after month as non-practicing allowance from the state exchequer. Ethically speaking, they should not indulge into anything amounting to the breach of their work ethics and service rules.

In this institute medicos are supposed to do research besides teaching and patient care and by indulging in private practice they are not doing justice to their job. If a medico is interested in private practice then he must resign from his job.

To end this menace, state government needs to be firm on its policies. In fact, Director SKIMS himself should take action against those private practitioners and if he terminates one private practitioner from services surely others will close their shops immediately.

Dr S. Jalal
(Ex Director SKIMS)

In a teaching institute like SKIMS, Soura private practice from senior residents or Professors is unaccepted. This private practice not only affects patient care badly but simultaneously affects teaching of our young talent (doctors) who are the future of medical science. By indulging in private practice, these medicos are degrading the institute to a sub district hospital level. If SKIMS administration closes its eye towards the menace, the day is not far when institute (tertiary care hospital) would be like any primary health care unit.

Private practices of doctors is affecting the health of poor patient as it takes a common man almost three months to complete his basic investigation at SKIMS.

When I, as head of the institute, took action against those private practitioners who were supposed to be teachers and academicians, a conspiracy was hatched jointly by these doctors, some members of Bar Association, some bureaucrats and relatives of people in power and I was removed.

I am sad, dream of SKIMS founder Shiekh Mohammad Abdullah has been shattered by those who indulge in private practice.

Dr Shahida Mir
(Principal, GMC)

Private practitioners cannot do justice to their job – be it patient care or teaching part. Mostly, a senior doctor is busy with his patients in causality till 4 pm and after that he needs to rush to his teaching class and if he is a private practitioners then obviously he would not put his best in his teaching with the result teaching of young doctors suffers at the cost of his private clinic.
I must tell you that the head of the state (CM) is well aware of this menace but lacks will to impose the ban strictly. This year thrice the issue of private practice has been discussed in the governing body meeting headed by CM but nothing concrete has come out so far and I firmly believe nothing will again come out of the recently committee constituted by government to look into the menace of private practice.

Dr Waseem Qureshi
(Director AIDS, Kashmir)

There should be strict ban on private practice in institutes like SKIMS because then only the standard of tertiary care will be up to the mark. By paying Non Practice Allowances government trust a doctor but when a medico indulges in private practice he not only is violating his service rules but breaching the trust of government.

I firmly believe government is not able to stop private practice. I remember, in 1984 when Jagmohan was heading as Governor of state, he ensured that the ban on private practice was strictly adhered. Even many renowned doctors at that time resigned from government job and opted for private practice.

But now time has changed and if government becomes strict to its policies then surely many senior consultants will submit statewide resignation which will be a big problem for health sector. Instead of taking action against doctors government should allow them to go for ‘Public Privateship module’ under which medicos should be given a place inside hospital where he can see patients privately and the same activity will reduce load on hospitals.

As far as disciplinary committee constituted recently to look into the matter of private practice is concerned, I am sure without doing favoritism it will scrutinize private practitioners who will be dealt according to law.

Dr Ashraf Ganie
(Endocrinology SKIMS)

Being illegal, I absolutely do not favor private practice of medicos especially of SKIMS, Soura. But I must add that CM Omar Abdullah himself is responsible for this menace and is being befooled by his lobby by providing him wrong information and with the result he is signing the promotion orders of those medicos who are in the trade for long. By promoting such private practitioners he is encouraging them.

Dr Altaf Rather
(CMO, SMHS)

Those involved in private practice are basically clinic oriented. Before coming to the hospital they are usually in hurry to leave the premise. This way they are least bothered about their job as a doctor or a teacher.

As far as search committee is concerned, I don’t believe it will do any miracle. Private practice is open in the market and private practitioners are known to everybody so what’s the fun of constituting committee.

Instead of constituting disciplinary committee government should have given the case of these doctors to some investigating agency so that agency might have done justice to the job assigned. Otherwise till date we have seen many committees but nothing positive had ever come out.

Bottom Line

The other day, Chief Minister while addressing a function of SKIMS warned the doctors who indulge in private practice. He told them that he knew them and their clinics too and warned that they should desist from doing private practice. The next day Kashmir Images identified the doctors and clinics and then a committee was formed to look into the matter. Will the formation of committee help. No, Mr. CM – you know them and we know them too. Act, if you want to before it is too late and the dream of your grand father is tuned into a nightmare for ordinary Kashmiris.