The Ministry of Health and Family Welfare’s Gazette Notification of June 5 2012 – restricting radiologists/ sonologists from visiting no more than two clinics within a district to perform ultrasound and making it mandatory to specify their consulting hours at each clinic evinced very strong reactions from the Indian Radiological and Imaging Association (IRIA). Dr Harsh Mahajan, National President, IRIA termed the order as “unconstitutional, undemocratic and ill-thought”, asserting that it would increase and worsen the shortage of radiologists, and thereby hurt patient welfare and lead to higher prices for ultrasound tests of all parts of the body, although the directive is actually meant to curb pregnancy ultrasound.
Dr Harsh Mahajan further elaborated, “There’s no doubt that India’s female sex ratio has been falling progressively over decades. But to conclude that restricting sonologists from visiting more than two centres within a district will solve this problem is fallacious because the real problem lies elsewhere. On the other hand, charitable clinics and patients in critical need of ultrasound for other ailments will be directly affected, since it will worsen the shortage of sonologists, creating a greater artificial shortage.”
IRIA’s stance is that restrictions imposed by the new order will cause overall reduction in the number of sonologists, leading to lesser ultrasound machines and medical centres being served leading to patients being underserved; thus, adding to their problems by creating long waiting lists and a possible increase in charges. This notification will deprive the general public, and especially poor patients, as radiologists who go to more than two centres will quit those centres where the volume of work and fees are lower. The artificial shortage will increase morbidity and mortality rates due to lack of diagnosis or delayed detection, resulting in chaos in the healthcare delivery system, as ultrasound examination is a basic investigation for many diseases.
IRIA also claims that this new norm goes against the Medical Council of India Act as well as contradicts a Supreme Court ruling, which states that any doctor has to provide help to a patient in an emergency situation. Moreover, in case a colleague falls sick or goes on leave, a radiologist will not be able to take his or her place in attending patients.
Dr Mahajan cautions, “These unwanted outcomes could ultimately create a crisis scenario due to lack of quick diagnosis, even increasing death rates in emergency situations. All this only because the Government has drawn unsubstantiated conclusions that restricting radiologists from practising in more than two centres would reduce female foeticide. This is simply not true. The authorities are overlooking the fact that pregnancy sonography constitutes barely 5 per cent of all ultrasounds conducted for various parts of the body to diagnose numerous diseases.”
“It should also be noted that, as independent professionals and citizens of India, radiologists/ sonologists are guaranteed the right to practice their profession, whereas this notification impinges on their constitutional right to livelihood,” he further asserted.
The new norm now also requires 30 days’ advance notice on purchase of a new ultrasound machine or on joining of an ultra-sonologist at the clinic. Previously, one could inform the authorities within 30 days of installation or hiring. Additionally, the new request can only become operational after it is duly incorporated in the certificate of the clinic. IRIA claim that the new norm is illogical because no centre will know one month in advance about an ultra-sonologist leaving; thereafter, it could take anywhere from three months to several years for the change to be incorporated in the certificate. During this period, the new machine or new ultra-sonologist will be rendered useless.
“In conclusion, as responsible professionals, doctors at the Indian Radiological & Imaging Association are as concerned about female foeticide as the rest of the country. We will gladly extend all cooperation and support required by the Government in combating the menace. However, for this to happen, the Government needs to seriously engage with radiologists and seek their suggestions too in overcoming the scourge of female foeticide. Ill-thought, unfair laws that target law-abiding radiologists will not stop this practice but instead hurt the well-being of poor patients. The IRIA is willing to meet the Government and discuss ways to identify and punish the real culprits behind female foeticide. In the interim, the IRIA appeals to the Government to withdraw this illogical law,” Dr Mahajan said.
EH News Bureau
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