Doctors take ethics pledge

New Delhi: After two decades of practising gynaecology, Arun Gadre decided to turn whistleblower and seek out others like him who could articulate what he says are disturbing practices in India's healthcare system that hurt patients.

Gadre, while running a private clinic in Lasalgaon in western Maharashtra, had seen women prescribed hysterectomies without justification, women coaxed into opting for Caesarean sections when normal deliveries may have been possible, patients prescribed drugs they did not need.

Gadre knew general practitioners who had stopped referring their patients to him because he refused to give them any commissions, diagnostic centres willing to send him commissions if he referred patients to them, and doctors accepting gifts from drug companies.

"It was painful to see what was, and is still, going on," said Gadre, who quit practice and moved to Pune about 10 years ago to campaign for stricter regulation of the health sector and began his search for like-minded medics.

He found a fellow gynaecologist in Calcutta, an ophthalmologist in Alibagh, a paediatrician in New Delhi, community medicine specialists in Pune, among others - each doctor shared his concerns about unethical and irrational medical practices across the country.

Some of those doctors today announced plans to launch a forum called the Doctors for Rational Ethical and Decommercialised Healthcare, a nationwide group of medics calling on their colleagues to take a three-point pledge and adhere to it.

"The pledge is simple - no commissions, no gifts and no irrational or unnecessary tests or treatment," said Abhay Shukla, a public health physician and co-ordinator of the Pune-based non-government Cehat-Sathi. He collaborated with Gadre in the whistle-blowing exercise.

"We want more and more doctors to speak up and say no to unethical practices," Shukla told The Telegraph. "It is possible far too many doctors are enmeshed in such things or unable to extricate themselves, but speaking up is a necessary, although not sufficient, condition for things to change."

Members of the forum who met today at the All India Institute of Medical Sciences (AIIMS), New Delhi, said they are convinced that many doctors across the country are uncomfortable with current trends in the healthcare sector, but are increasingly feeling isolated and frustrated.

"This forum is intended to convince doctors and the public that there are voices within the medical community unhappy with the rampant unethical practices," Sanjeeb Mukhopadhyay, a consultant gynaecologist in Calcutta who will be among its founding members.

Mukhopadhyay, citing an example of an irrational practice, said some gynaecologists prescribe progesterone hormone to pregnant women in their first trimester, claiming it will help sustain the pregnancy. "This is completely unnecessary. No textbook or medical study prescribes the routine use of progesterone in pregnancy, but I've seen doctors".

The Telegraph, 27 February, 2015, http://www.telegraphindia.com/1150227/jsp/nation/story_579
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