PRIVATE PRACTITIONERS have expressed concern after the Directorate of Medical Education and Research (DMER), through a notification dated May 4, asked them to mandatorily serve at hospitals treating COVID-19 patients for at least 15 days or face action.
While private doctors have been advised to convey their willingness and place of choice for work, many have pointed out that the order lacked clarity on several fronts: place of stay while they were posted at these hospitals or what would happen to patients when their clinics are shut. There was confusion among ophthalmologists, dentists and dermatologists, who have no direct role in treating COVID-19 patients.
The May 4 order, restricted to Mumbai and its suburbs, comes in view of the increasing patient load — the city reported 9,945 positive cases and 387 deaths till Tuesday — and related stress on available health infrastructure and manpower. There are over 25,000 registered medical practitioners in Mumbai.
As several private clinics and nursing homes closed operations in fear of the infection, the BMC, on April 23, had asked all private clinics and nursing homes to reopen out-patient departments (OPDs). While a few resumed emergency procedures, several remained shut, affecting availability of health services.
Following a surge in demand for medical certificates as migrant workers, seeking to return their home states, started to register for travel passes, a few more clinics had reopened last week.
State officials said after it was observed that several doctors were sitting at home, it was decided to rope them in for treating COVID-19 patients. “We did a survey of clinics and nursing homes that are shut. Only those doctors have been asked to join government hospitals and treat COVID-19 patients. Doctors who are already running their practice need not join,” Dr T P Lahane, director of DMER, said. The survey, officials said, had found there were nearly 10,000 doctors who had shut their clinics or stopped going to work since the outbreak. The May 4 notification also states, “Non-attendance of duty will be considered as a breach of Medical Council of India Code of Ethics that we administered at the time of obtaining degree, and action will be initiated according to provisions of the Epidemic Diseases Act, 1897.”
Private practitioner Dr Siddharth Lalitkumar, who runs a clinic in DN Nagar, said he was “more than willing” to join forces to treat COVID-19 patients. “But I have elderly parents at home. I don’t know where I will be posted, or if I have to stay away from my family for several days to keep them safe. I have not yet filled the form as I am waiting for more clarity on this,” he said.
Dr Lalitkumar said he had shut his clinic for 10 days and reopened towards end-April after several critical patients approached him. Dr Parthiv Sanghvi from Indian Medical Association said he had continued to work despite the lockdown. The surgeon said if he joined government service for 15 days, his clinic will have to remain shut. “What will happen to my patients? If I already consult in Nanavati hospital and Jogeshwari Trauma hospital, am I still supposed to join government service? We still have no clarity on all this. Since it is a government order we cannot refuse, but even homeopathic, ayurvedic and unani doctors should have been approached,” he said.
Milind Kamble, BMC protocol and liaison officer, said he was still receiving email on queries about the notification. “We are yet to check how many doctors have filled forms to work in hospitals.”
“So far, the state government has not told us what action to take against doctors who refuse to comply with the notification. The Epidemic Act gives vast powers to the state government,” Dr Shivkumar Utture, chairman of Maharashtra Medical Council, said. Under the notification, a doctor’s licence can be suspended or cancelled.
Meanwhile, the state government on Wednesday said it will provide private practitioners Rs 50,000 to Rs 1.5 lakh as remuneration and accommodation for the 6 to 8 hours’ shift for 15 days and, later, a place to observe quarantine. It will also provide an insurance cover for treatment if they contract COVID-19. Doctors have been directed to submit the forms within next two to three days.
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