NATIONAL PRESIDENT IMA HQ 2023-24 SPEECH

Beloved Immediate Past President Dr Sharad Aggarwal, our chief guest of the day and the face of Kerala in the Government of India Shri. V. Muraleedharan, Honorable Minister of State for External Affairs, our own guardian of medical profession and my leader Past President of World Medical Association and Medical Council of India Dr Ketan Desai Sir, our Guest of Honor and pride of Kerala Shri Shashi Tharoor MP, our Guest of Honor and the defender of the medical profession in the Parliament and the firebrand MP of my constituency Shri NK Premachandran MP, Past National President and my mentor Dr Vinay Aggarwal, statesman of Kerala and visionary of IMA Dr A Marthanda Pillai, Honorary Secretary General of IMA Dr Anil Kumar Nayak, Honorary Finance Secretary Dr Shitij Bali, Organizing Committee Chairman Dr Sreejith N Kumar, illustrious Past Presidents of IMA, Patron of AHPI Dr Alexander Thomas, office bearers of 2023 and 2024, State Presidents and State Secretaries, State President of Kerala Dr Joseph Benevan, President of IMA Thiruvananthapuram Dr Vijaya Krishnan,the organizing team of the conference,delegates from all over India, young doctors and medical students, members of the press and public as well as our guests .

I dedicate my Presidential speech to my parents, wife Dr Laila Asokan, daughter Dr Vijayameenakshi and our family for their lifelong sacrifice. I also acknowledge with gratitude Late Dr VC Velayudhan Pillai for whatever I am today. My gratitude is due to my beloved IMA Kerala State Branch which has instilled sense of purpose, cosmopolitanism and sophistication in me. I’m grateful to my own little branch of Punalur and Late Dr Y Baby for the motivation and critical appraisal.

Renaissance and Justice

It was the best of times. It was the worst of times said Charles Dickens in the Tale of Two cities. No parabole is more apt in describing the medical profession today. While the profession is leapfrogging into the future with Artificial Intelligence and robotics the foundation of modern medicine is being mercilessly shaken from within and without. If we manage to retrieve the dignity and leadership of the profession in our times that will define the patient care and safety of future.

The foremost priority and responsibility are to ensure the identity and integrity of modern medicine as we know today. Concerted efforts to dilute and eliminate modern medicine have been made. While we respect all systems as verticals contributing to the history of medicine, we will resist with all the forces at our command any attempt to mix the systems of medicine. The war against mixopathy will be taken to the people. The purity of modern medicine is non-negotiable. What happened to Chinese Traditional Medicine by mixing is there for all of us to see. Modern medicine is robust science. Dilution will be catastrophic. The corollary would be the loss of employability of our young medical graduates.

Every single law enacted after independence impacting the medical profession has an element of injustice to doctors. Starting from criminalization of medical negligence to legislations like PCPNDT and POCSO laws require to be desensitized of the prejudice. Laws with the goal of eradicating social evils have unfortunately been used to target the profession as a whole.

We are grateful to Shri Amit Sha Ji for what he said in the Parliament on exempting doctors from criminal prosecution. That Indian Medical Association could intervene to stop a catastrophe is a tribute to our leadership and the team which maintained vigilance. This remains an un-finished work requiring our undivided attention.

In a new low, alleged and perceived medical negligence is being used to close down institutions under the Clinical Establishment Act. The draconian effects that this law has unleashed on small and medium hospitals will be a historic case study of future.

The industrialization of Health Care, redesignation of patient as a consumer and reducing the doctor to a provider coupled with the withdrawal of Governments from Healthcare with the share of the Governments hovering perpetually around 1.1% of GDP are the root causes of violence against doctors. Violence in hospitals is a national shame and cannot be justified in any civilization.

Relentless increase in the number of medical colleges and the high cost of medical education are raising concerns about the quality and the profile of the medical graduates. Lack of accessibility and affordability are compromising equity. It is important to take affirmative actions to ensure that the medical profession remains a slice of the community we live in representing all the socioeconomic stratifications.

All India seats in the Government medical colleges should be left to the respective States. Abolition of the anachronism of NRI seats could be a beginning of the reforms in medical education. If these seats could be offered in open quota this would bring down the migration of our children for medical education in less than desired settings in foreign countries.

Suicides amongst doctors and medical students fail to raise anyone’s conscience. The inappropriate work load and the exploitation of young interns and doctors require remedial action. Unemployment amongst fresh MBBS graduates is a reality. The oft repeated lie that India has shortage of doctors has to be contested. The stagnation of employment opportunities in Government sector several years on row and ad hoc appointments on temporary basis are an admission of systemic collapse.

There is a crying need to increase the number of Medical Officers in the Government sector several folds as per the increase in the population. Justice should be done by recruitment on permanent cadre through a transparent process.

Chaining by bonds is nothing but slavery. Why single out medical students to remain slaves in an incompetent system? What is that is different in other streams that exempts them from this slavery. Judicial sanction and complicity for slavery of medical graduates should be withdrawn.

Across the country Doctor entrepreneurs opening new clinics and hospitals are an endangered species. While extending MSME benefits to this sector is in the right direction much more needs to be done for the startups of doctors venturing to set up hospitals. Such a middle sector is an asset. Doctors running hospitals as part of their medical practice is unique and is a buffer of solace to the people.

Health insurance is a failed model and a mirage. The missing middle concept of NITI Aayog is a let down from the revolutionary 2012 High Power Expert Group recommendations of the 12thPlanning Commission. Missing middle is not a business opportunity.

Well intentioned Ayushman Bharat PM JAY should be re envisioned by restricting it to strategic purchase from private sector on the basis of scientific costing. Direct Benefit Transfer to the patient removing all middlemen could be our tool to Universal Healthcare. Large Public Health measures need to be sensitive to the space of clinicians and the privacy of the patients.

While we the medical profession get vocal about the injustices there is an important blind spot. Nothing short of a Renaissance will suffice. We are accountable to the fall in values. Consumerist culture and Corporatization have blown us off our feet. I hold this generation of doctors culpable for the forwarding commissions, scan commissions and other unholy nexuses. We owe it to the nation to sanitize the medical profession of these unacceptable practices. Unless we are capable of doing this the silent majority of doctors upholding the ethics and etiquette of the profession will be short changed. If we fail to do this by ourselves, we invite eternal shame on this noble profession.

India’s 706 Medical Colleges enabling 1,08,915 fine MBBS medical graduates every year is an asset and opportunity. India will not only be the Hospital to the world, our fine medical graduates are competent to be a Global Doctor. Time has come to actively facilitate our doctors to be deployed all over the world.

While we resist our injustices, we need to impart a Healing Touch to ourselves. We are a young nation and an ancient profession. We are not only nation builders we are the conscience keepers of the Human civilization. The Burden of legacy and expectations is heavy on our shoulders. We rededicate ourselves to redeem the glory of the medical profession. We shall overcome the frustrations and helplessness by patience and sophistication.

- JAI HIND,Jai IMA.

- Dr. R. V. Asokan
National President, IMA