

PUNE: The Supreme Court 's order awarding the highest-ever compensation in a medical negligence case to a doctor who lost his wife, has created a flutter in the city's medical fraternity.

Hospital authorities say that now doctors may shirk complicated cases and suing for medical negligence could become as rampant in India, as it is in the US and the UK.

However, health activists welcomed the apex court's verdict, pointing out it had sent a strong message that if a case of medical negligence is fought doggedly, it is possible to win even against big and powerful hospitals and doctors. Activists also said that the verdict would make doctors more cautious.

"In a country where the doctor-patient relationship is already in a fragile state, this judgment will add fuel to fire and doctors and patients would try and exploit each other even further. Such massive compensations are awarded in the US, and they are now regretting high healthcare costs there. In the US, obstetricians, cardiac surgeons and neurosurgeons are already threatening to withdraw their services. Are we going to commit the same mistakes here," said Dhananjay Kelkar, a cancer surgeon and medical director of Deenanath Mangeshkar Hospital .

The Supreme Court on Thursday awarded a record Rs 5.96-crore compensation for medical negligence to a US-based NRI doctor, Kunal Saha, who fought for 15 years to fix the charge of gross medical negligence on four doctors and Kolkata's AMRI hospital, for the death of his wife Anuradha in 1998.

"This judgment will push us on a path of collision, not progress. The purpose of the law is to find a solution to a conflict and not worsen it. Before it is too late, let us be responsible citizens, doctors and lawmakers and heed to this wake up call," Kelkar said.

Hospital administrators said that doctors don't make mistakes intentionally and such a penalty was harsh. Bomi Bhote, chief executive officer of Ruby Hall Clinic said, "One must know that negligence on the part of a doctor treating a patient is never by desire. Doctors will now shirk from treating complicated cases out of fear. Like US and UK, suing will become rampant here also."

"After the Supreme Court's order, many physicians and surgeons will possibly look at patients in a different way and will start analysing the risks of treating them. Beyond treatment, the doctor will be worried about possible complications and the outcome," said George Eapen, chief executive officer of Jehangir Hospital.

Eapen pertinently noted that certain practices should be put in place to ensure patient safety. Elaborating, Eapen said,"Hospitals must encourage medical professionals to interact more with their colleagues and discuss cases that are complicated. They must commit to patients in terms of timely attention, care plan, review, treatment progress and good communication with patients' relatives. If this is not practiced, several complications and doubts can arise," he added.

Some doctors also warned against being carried away by western healthcare modules. Orthopaedic surgeon Nitin Bhagali said, "Unfortunately, we are adopting a western module of healthcare very rapidly in India. This will force hospitals and doctors to go in for high indemnity insurance policies to get damages reimbursed in medico-legal suits and this, in turn, will eventually be recovered from patients, as in the US. This is going to affect hospital bills enormously."

"Secondly, medicine is not a fool-proof science and response to the treatment varies from individual to individual, as does the opinion among doctors about the diagnosis and treatment. Now, after the Supreme Court's decision, doctors will become more defensive," said Bhagali, who is also president of the Pune Clinic and Nursing Home Association.

"Moreover, unrealistic expectations from medicos and wrong publicity will discourage intelligent students from opting for a career in medicine," he added.

Meanwhile, health activists said the Supreme Court's order had sent out a strong message.

"Compensation depends upon the deceased person's age and estimated loss of income, if deceased was an earning member. The lady who died in 1998 was a practising doctor in the US, so the compensation to her husband must have been calculated considering her income in that country. The point of importance here is not the money. What is of importance is the fact that, if a case against medical negligence is doggedly followed, it is possible to win even against big and powerful hospitals," senior activist Anant Phadke said.

"Dogged pursuance of the case can lead to justice that is what needs to be kept in mind. This case sends out a strong message to doctors and hospitals that, they may be big and powerful, but cannot be casual and negligent while treating patients," he added.

