New Delhi: Doctors in Mumbai are up in arms against the rules set by the Municipal Corporation of Greater Mumbai (MCGM), which mandate them to physically check a patient for Covid-19 symptoms before prescribing tests, failing which their licences would be confiscated.
According to the guidelines of the Indian Council of Medical Research (ICMR), tests for Covid-19 at private labs should only be done when prescribed by a qualified physician. There is no mention of physical examination in the ICMR guidelines.
But the MCGM guidelines, issued on 10 May, said physicians need to fill up a form, stating they have physically examined a patient before prescribing Covid tests.
If doctors fail to fill up the form, they would be liable for action including “cancellation of their MCI (Medical Council of India) registration”, according to the guidelines.
“Forcing a doctor to fill up a form of this type and sending it where there’s a disclaimer below that if I do any wrong my licence will be cancelled is not something which is legally tenable,” said Dr Deepak Baid, president of the Association of Medical Consultants.
He said some doctors have alleged the MCGM, also known as the Brihanmumbai Municipal Corporation (BMC), has issued the strict testing guidelines to deflate the number of Covid cases in Mumbai as fewer tests would lead to fewer detections.
The association had on 19 May even wrote to the Mumbai municipal commissioner, urging the body to roll back its decision to cancel doctors’ licences for violating the guidelines as it “reduces the moral(e) of the healthcare providers”.
Baid said the municipal corporation still hasn’t addressed the matter.
He also said cancellation of a doctor’s licence isn’t the prerogative of the government, but of the MCI.
“This (the form) is a testing request by a doctor to the laboratory. The Maharashtra Medical Council also came down on it and said the government does not have any right to do any cancellation of any doctor’s licence,” he said.
ThePrint contacted Additional Municipal Commissioner of MCGM Suresh Kakani, who is also the in-charge of health affairs of Mumbai, via calls and texts, but had received no response till the publishing this report.
When ThePrint reached ICMR spokesperson Rajnikant Srivastava, he said the apex research body is not involved in the matter.
“States decide their own policies,” he said, adding: “MCI can take a call on it as all doctors are registered under the MCI.”
As of 2 June, Mumbai reported 41,986 cases and 1,368 deaths, according to the MCGM.
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‘Notices make us feel like criminals’
Apart from issuing guidelines, the MCGM released a notice on 17 May, stating FIRs should be filed against doctors, who prescribed tests without physically examining patients.
“If an MOH (medical officer of health) finds that local private medical practice is giving recommendation letters for swab testing to outside area persons without physical examination, then strict action may be taken against such doctors as show-cause notice for cancellation for registration and to lodge an FIR in local police station,” the notice read.
According to the president of the Indian Medical Association, Maharashtra, Dr Avinash Bhondwe, 20 notices were issued to doctors for “violating” the MCGM’s rules.
“They (the notices) were withdrawn later. I personally spoke to the secretary of health and the matter was resolved immediately,” Bhondwe told ThePrint.
Baid said the notices were issued by ward officers either on the grounds that a physical examination hadn’t been conducted or tests had been prescribed for those, who were asymptomatic.
According to Bhondwe: “For every little thing, the government is flashing notices and it is wrong. We had complained about that. Doctors should be respected, the way they are issuing these notices makes us feel like criminals.”
Harassment for patients too
Apart from the harsh penalties against doctors, the rules have also posed difficulties for patients.
Dr Shahid Barmare, a physician at two private Covid hospitals in Mumbai, told ThePrint he gets revisits by two or three patients every day who come back to get the form filled up again.
“What happens is for instance if I write the name of the lab, say Metropolis, and the patient goes to Metropolis and finds that their appointments are full, they have to come back to me to fill another form before going to get an appointment from another lab. So the patient has to run around,” he said.
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Protocol in other states
Like the MCGM, the government in Gujarat had also implemented strict restrictions based on which approval from health authorities need to be sought for Covid testing.
“It was so difficult. We had to fill a two-page form and mail it to the CDHO (Chief District Health Officer) and even then we wouldn’t get an approval for five-six days,” said Dr Mona Desai, president of the Ahmedabad Medical Association.
But in a relief, the Gujarat High Court, which was hearing a suo motu PIL, Sunday said tests should be permitted based on the decision of the consulting doctor and that only an intimation in this regard has to be given to the authorities.
This applied to certain categories of patients specified in the order.
As of Wednesday afternoon, Gujarat reported a total of 17,617 Covid cases, according to the health ministry’s website.
ThePrint spoke to doctors in Delhi and West Bengal, who said a normal prescription is adequate for Covid testing.
Also read: Why Mumbai is still struggling to cope with coronavirus