‘Voice of doctors’ or ‘den of politics’? Why some doctors swear by IMA, others don’t care

IMA was formed in 1928. Its mandate includes upholding the ethics of the profession, and it is known to organise several fellowship and postgraduate courses.

IMA was established in 1928

New Delhi: In the nearly 100 years since it was formed, the Indian Medical Association (IMA) has undergone a deep image makeover. 

It was set up by the titans of the medical field to represent members of the profession, and in its heyday spearheaded the founding of the World Medical Association (WMA), a global body to represent the doctor community and uphold ethics.

Today, even as members swear by the IMA’s importance, many non-members dismiss it as irrelevant. 

To many in the field, it is a den of politics and an organisation run by medicos with political affiliations or aspirations who are against any attempt at “cleaning up” the sector.

In its early years, the IMA was led by the likes of Dr B.C. Roy, whose clinical acumen is the stuff of medical lore. He served two stints as president and went on to become the chief minister of West Bengal. 

Another luminary to lead the IMA in pre-Independence times was Dr Nilratan Sarkar, who took charge in 1931 and inspired the name of one of Kolkata’s largest medical colleges. 

Cut to the turn of the millennium, and the post was taken over by Dr Ketan Desai, whose stint in the erstwhile Medical Council of India (MCI) — which coincided with his tenure at the IMA — was marked by allegations of corruption. 

In 2001, the Delhi High Court ordered his removal as MCI president over corruption charges and abuse of power. Among other things, the council was accused of irregularities in the process of approvals for medical colleges in the country.

While its image may be up for debate, its reach isn’t. With an estimated 3.5 lakh doctors as members, the IMA is unparalleled in its role as the voice of the medical community, down to the grassroots.

Its mandate includes upholding the ethics of the profession, and it is known to organise several fellowship and postgraduate courses. The IMA also periodically conducts workshops to bring its members up to speed with the latest regulations and laws. 

In recent years, it has also taken up cudgels with the government on more than one issue. Last month, it publicly questioned the presence of a Union minister at an event for Coronil, a purported Covid treatment from yoga guru Ramdev’s Patanjali stable. It has also taken exception to the government’s push for ‘mixopathy’, when doctors trained in one system of medicine practise a different one (for example, an ayurveda doctor conducting surgery).

Rich history

The IMA website explains how the seeds of the organisation were sown amid the Indian freedom struggle.

“The founding fathers way back in 1928, while struggling for liberation of the Motherland from British rule simultaneously felt the need of a national organisation of the medical profession. Before that, some members of the profession — a select few — were members of the British Medical Association, which had opened branches in India to cater to the local needs,” the website reads. 

“These stalwarts ultimately succeeded in formation of Indian Medical Association and reached an agreement with the British Medical Association that they will have no branch in India, and got mutually affiliated,” it adds, saying the “relationship continues till today”.

In 1946, a year after the Second World War ended and a year before Indian Independence, the IMA “helped in organisation of the world body, namely, World Medical Association, and thus became its founder member”. 

“As an organisation it has been, and continues to play an important role in its deliberations.” 

The IMA, now based in Delhi but then headquartered in Kolkata, was very active on the world stage, at one point, even exiting the WMA in 1985 because of its refusal to expel South Africa, which was then a practitioner of apartheid.

The IMA rejoined the WMA in 1993. Desai, who led the IMA from 2000-2002, served as president of WMA for the 2016-2017 period.

A section on the IMA website, on speeches, records Desai’s tenure as WMA chief as a “proud moment for IMA”. This, despite the censure he received from the Delhi High Court in 2001. 

“We cannot allow an unscrupulous and corrupt person to function as the president of the MCI [Medical Council of India],” the court had said while ordering his removal as MCI chief, according to an article published in the BMJ at the time.

Over 3.5 lakh members

The 3.5-lakh-strong membership of the IMA gives it the kind of grassroots reach that no other body has.  

A former civil servant with long experience working in the Union health ministry said its reach is beyond dispute, even as they explained why its call for strikes are often not taken seriously by the government.

“There are two kinds of doctors — one who is completely engrossed in patient care and has no time for anything else, and the other is socially mobile, close to the powers that be. They are basically power brokers, which is why the frequent threats of strikes are not paid much heed to by the government. But you cannot dispute their reach,” the former civil servant said. 

While there is always a perception of closeness to political parties, there is at least one recent example of an IMA president making it to Parliament. Dr Santanu Sen, who was the IMA national president in 2018-19, is currently a Rajya Sabha MP from the Trinamool Congress. B.C. Roy was a member of the Congress.

The IMA’s moment under the sun came in 2018, when it threatened a 12-hour shutdown of OPD services in the country against the “anti-people, anti-patient” National Medical Commission (NMC) Bill, 2017. Hours before the strike was to begin, the government agreed to the IMA’s demand and sent the bill to a Select Committee. 

The genesis of the NMC — which came into being last year as the regulator for medical education and profession, succeeding the MCI — lies in the persistent allegations of corruption against the council.

Earlier this year, the IMA helped rally trust for the Covid-19 vaccine when it announced that its members across the country would actively participate in the vaccination campaign. This was meant to address distrust about the vaccine among the medical fraternity amid suspicions about what was seen as India’s expedited approval process. 

At the same time, it has been on the warpath with the government over the number of doctors who have succumbed to Covid-19 in the past year. It also took on Union Health Minister Harsh Vardhan — a doctor himself — for his prescription of alternative medicines for Covid-19, asking him how many of his own cabinet colleagues had followed that advice.

How it works

The IMA is a body with a pan-India presence with several well-defined national programmes such as partnerships to prevent tuberculosis. 

It organises several fellowship and postgraduate courses, runs a medicolegal helpline, and works to keep members updated about the latest regulations and laws. 

For example, in 2014, two years after the Protection of Children from Sexual Offences (POCSO) Act came into force, the IMA organised a day-long workshop for its members on the law.

It also has a disaster management wing whose members travel to disaster-hit areas, besides a programme to spread awareness about the rational use of antibiotics, and another one for rural service. 

In a 2012 article for the Japan Medical Association Journal, then IMA president Dr Jirendra Patel, along with its honorary secretary general, wrote about the organisation taking up “responsibility to reduce the deaths due to Malaria, Dengue, Chikungunya, Kala Azar and other Vector Borne Diseases”.

The IMA also has state units, which often devise their own programmes and work in partnership with state governments, in the spirit of “constructive criticism”, as one IMA functionary put it while speaking to ThePrint. 

For example, in some pockets of Kerala, like Ernakulam, the IMA played a crucial role in the district administration’s Covid-19 fightback plan. In fact, the government control rooms and command centres there are stationed in the IMA building at Kochi.

Different perceptions 

Within the medical community, the perception of the IMA varies, depending on who you ask. While members swear by it, non-members are dismissive. 

“They do not have much clout within the profession — you see there was a time when the IMA was dominated by institutional people. Then it may have been different. But now nobody even among us thinks too much of them,” said a professor at a Government of India hospital in Delhi.

“They are more politicians than doctors. Any attempt to clean up the system, the IMA will oppose. Look at their stands on the NMC Bill, the Nurses Bill, all of that. Many of them have vested interests and want the status quo to continue.” 

However, a senior doctor at Indraprastha Apollo Hospital, Delhi, who didn’t wish to be named, said theirs “is the only voice that will rise for doctors — be it about denial of support to families who lost their doctor members to Covid or the procurement of substandard PPEs by hospitals or even the matter of violence against medical professionals”.

In a 2019 analysis, researchers from Azim Premji University and other institutions concluded that physicians “themselves seem dissatisfied with the organisation and functioning of major ‘umbrella’ groups such as the IMA”. 

“Despite this, the association has endured for nearly a century as a somewhat unifying body for the profession, particularly in cases where physician views are more uniform,” it said. 

“That said, the IMA varies by state; in some states, such as Kerala, the group plays an active role in engaging with the government, while in other states, their involvement is more nominal; and other associations have variable ties with the IMA, close in some cases, distant in others.”