Frequently asked Questions on Private Practice

Frequently asked Questions on Private Practice

TAMILNADU GOVERNMENT DOCTORS’ ASSOCIATION

State Office: 208, DAS Quarters, Govt. Rajaji Hospital, Madurai

14^th June 2009

PRIVATE PRACTICE

What is the choice of the TNGDA if the government bargains the private practice with central pay?

The central pay cannot be bargained for the central parity, but it can be bargained only with NON PRACTICING ALLOWANCE (NPA). The NPA given to central doctors is 30% of basic pay and it will be calculated for DA.
With central parity, this NPA will vary from Rs 10000 to 25000 for various grades of doctors. The total extra expenditure will work out to about 80 crores per annum to the govt.

What is the choice of the TNGDA if the government bargains the private practice with NPA?

The TNGDA will choose NPA, if compelled.

But, very unlikely for the following reasons…

• the govt. or the public will not benefit in any way – already the duty timings are more than prescribed for any govt. servant.
• NPA cost will be about Rs 80 crores per annum.
• Almost all the states permit private practice as it benefits the public.

What if govt. bans Private Practice?

• Very unlikely. Especially with a people friendly CM and govt.
• Please see the disadvantages given below.
• No advantage to public or govt.
• In case if PP is banned, we would gain central pay + NPA.
• It will be easy for TNGDA to persuade govt. to repeal ban in a year or two - as it wont cost any financial burden.
• Even during the ban, in evitable practice, due to patients’ compulsion cannot be stopped. If at all any action is tajen it can be done only on conduct rules. (this will be dropped once the ban is repealed)
• Repeal will be natural – in the capitalist economy, also in public interest, pressure of the association. Similar repal was done three years back in Andhra after a ban of about 1 year.

What are the disadvantages of banning private practice?

1. Among the total actively practicing 40000 doctors in TN, about 12000 are in govt. service ie about 1/3^rd of the total doctors. Ban will deprive the public of the private services of every third doctor. The demand will up and will be the cost – directly affecting the public.
2. About 60% of the specialists in TN are in govt. service. Ban will restrict access to the remaining 40% - again increasing the cost. (among the 40% - 10 % are in corporate sector)
3. 70% among the rurally practicing (baring the bigger towns) doctors, are govt. doctors. Ban will increase the suffering of the poor rural public.
4. Already doctors are reluctant to join service in interior PHCs and difficult terrains. Ban will aggravate this situation.
5. Above all – ban will force all the talented hands to leave the govt. service. Almost all super specialist and other specialists with good private practice will quit service. The quality of govt. institutions will go down.

Is the argument that banning Private Practice will raise the concentration of doctors to serve the public?

No. the earnestness and serving nature is individualized. Except a few, almost all doctors work with passion and sincerity. But the exorbitant load of patients – mask it and the stress shows off.

Even the UNIVERSITY GRANTS COMMISSION since this year has liberalized and has permitted all the college teachers to take up “Private Consultancy Assignments” – vide the UGC – Pay Review Committee Report of 2008. It justifies saying that such assignments will help community to augment their educational quality.

Is it possible that awarding UGC scales, increase the duty timings in DME side?

No. The UGC permits 10 weeks vacation to the teachers. Vacation to certain npn-clinical departments possible. Already they work on par with other college teachers.

In the clinical side, vacation is not possible. So, titrating the 10 weeks vacation and the 24 hours stay duties; the existing timings is already more than the stipulate 30 hours a week norms of UGC.

State Secretary

TIPS AND DIRECTIONS ON TNGDA AGITATIONS:

TIPS AND DIRECTIONS ON TNGDA AGITATIONS:

FROM 30.6.2009: PROPOSED INDEFINITE BOYCOTT OF PROGRAMMES

DONT’S

• Not to organize or attend VKT camps
• No disability or any other medical camps
• No meetings to be attended or conducted (including PHC review meetings)
• No trainings – as trainer or trainee
• No classes – clinicals, theory, lab, exams, CME, all academic activities for UG/ PG students, medical officers, nurses or any categories (including HIV lectures etc)
• No MCI inspection – either in their or on deputation
• No medical board
• No VIP duty
• No medical/ health check-ups
• No medical certificates/ physical fitness/ age certificate/ wound certificates/ PM certificates

DO’s

• All VKT MOs to attend work @ their parent institution.
• FW camps and elective surgeries will be done.

ON 6.7.2009 : ONE DAY STATE WIDE TOKEN STRIKE

DON’T’S

ALL INSTITUTIONS (EXCEPT Dist HQ and Medical College hospitals):-

• All work in these institutions will be stopped.
• All professors, directors, associate professors, assistant professors, tutors, assistant surgeon, sr. assistant surgeons , civil surgeons, Sr civil surgeons, medical officers , ARMOs – these cadres working in PHCs, ESI dispensaries, taluk and non-taluk hospitals, medical colleges and attached hospitals, other dispensaries, deputation duties in social welfare dept, school health, ICDS, Jail etc will join strike.
• Doctors working (including hospital heads) to simply abstain and switch off their mobiles from 7 am on 6.7.2009 to 7am on 7.7.2009.
• INCLUDES ALL SCS (including Chief MO of taluk, non taluk, ESI dispensaries)
• Includes 10a1 doctors in CEmONC, PHCs, GH, Mobile doctors and those in clinical, non clinical and non-teaching departments of medical colleges.

AT DISTRICT HQ HOSPITALS: -

• Life Saving services only will be provided.
• No AR entries (except for life threatening cases and mass casualties)
• No post mortems
• No OPD
• No ward rounds
• No deliveries
• No elective surgeries

DO’S

• Life saving services in District HQ Hospitals will be maintained by 1 general duty doctor and 1 OG doctor (preferably active members) and an office bearer to actively advise and support them.
• They will not sign attendance register but write case sheets and AR entry to cases whose life is in danger.
• They will attend cases in the wards/ labour ward / ICU (choose wards/ examination rooms away from casualty / OPD)
• AVOID ATTEND CASES IN CASUALTY
• Write notes to all death or serious cases.

AT MEDICAL COLLEGE HOSPITALS: -

• Life saving services only will be provided.
• No AR entries (except for life threatening cases and mass casualties)
• No post mortems
• No OPD
• No ward rounds
• No deliveries
• No elective surgeries

DO’S

• Life saving services will be maintained by 1 DAP, 1 DAS, 1 DAA, 1 DAPP, 1 DAOA (preferably active members) and an office bearer to actively advise and support them. (Call for DANS or DATS only in imminent cases that too after CT Brain or CT chest)
• They will not sign attendance register but write case sheets and AR entry to cases whose life is in danger.
• They will attend cases in the wards/ labour ward / ICU (choose wards/ examination rooms away from casualty / OPD)
• AVOID ATTENDING CASES IN CASUALTY
• Write notes to all death or serious cases.

Office bearers to personally meet administrative cadres like DDHS, RMOs, Superintendent, JDHS, RAMO (ESI) to cooperate in the strike. The point that all of them are the immediate beneficiaries as their pay and pension will double should be emphasised.

Any doubt feel free to contact State Secretary or State President 94431 30399.

UNITY IS STRENGTH.

State Secretary

Resignation letter

To
The Director and Appointing Authority,
Medical Education\ Medical and Rural Health Services\ Public Health and PM,Chennai.
From
Dr
______________________
______________________________________
______________________________________
Sir,

As resolved by the Tamil Nadu Govt. Doctors Association to press our only demand of implementing the “Special Doctors Promotion Scheme” till the doctors reach the 36100-67000 scale as recommended by the 6^th Central Pay Commission, I willingly herewith offer to resign my post forthwith. I am forced to take this decision in view of the poor promotion opportunities, poor pay scales and heavy work load and poor infrastructure.

In case if the demands are NOT met, please accept my resignations. But still I hope that our Honourable Chief Minister Dr Kalaignar will accept the TNGDA demand and in such case I would withdraw this resignation letter and rededicate myself to the service of the poor and the state.

Thanking you,

Yours faithfully,

Date:

Station:

Participation letter

Participation letter

To
The Director and Appointing Authority,
Medical Education\ Medical and Rural Health Services\ Public Health and PM, Chennai.
From
Dr
______________________
______________________________________
______________________________________
Sir,

As resolved by the Tamil Nadu Govt. Doctors Association to press our only demand of implementing the “Special Doctors Promotion Scheme” till the doctors reach the 36100-67000 scale as recommended by the 6^th Central Pay Commission, I willingly join all the agitation of TNGDA – including the proposed strike. I also state that I am frustrated to work in view of the poor promotion opportunities, poor pay scales and heavy work load and poor infrastructure.

I hope that our Honourable Chief Minister Dr Kalaignar will accept the TNGDA demand and in such case I would be happily rededicate myself to the service of the poor and the state.

Thanking you,

Yours faithfully,

Date:

Station: ( )

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one point demand of the Tamil Nadu Government Doctors Association

Details of the one point demand of the Tamil Nadu Government Doctors Association:

Demand:

• Implementation of the exclusive Pay scales and Career Progression opportunities to doctors in govt. service – central govt. based on the V and VI Central Pay Commission.

Details of the demand:

• Extended DACP is periodical promotion in 4^th year, 9^th year, 13^th year and 20^th year in the scales of 15600+GP 5400, 15600+GP 6700, 37400+GP 8700 and 37400+GP 10000 respectively.

This extended DACP is the demand of the association.

• By this the association requests special promotion scheme in the following scale and period.

Service Details	Demanded scale of Pay
Entry	15600-39100 +GP 5400
At 4th year	15600-39100 +GP 6600
At 9th year	15600-39100 +GP 7600
At 13th year	37400-67000 +GP 8700
At 20th year	37400-67000 +GP 10000

• This is applicable to all the medical doctors, whether belonging to organized services or holding isolated posts.

In addition to the above Pay Scales and career advancements the other parts of the demand are

• Special allowances for special duties (for other duties not in central govt. service) – given in our earlier detailed representation. Like - Treatment Allowance, PHC Allowance, Multi speciality Allowance, Risk Allowance etc
• Voluntary Retirement from Service (as in central health service)

Dynamic Assured Career Progression (DACP) - genesis and course:

• This is a special promotion scheme first suggested by the V Pay Central Pay Commission Report. The Central Govt. implemented this scheme since 1.1.1996 to all different streams of doctors up to the scale of 14300-18300. So since 1996 the central doctors were getting promotions at 4^th year, ninth year and 13^th year in the scales of 10000, 12000 and 14300 respectively.

• The VI Central Pay Commission: also suggested to continue DACP to all categories of medical officers including isolated posts of medical officers. (Vide Page 193 and para 3.6.7 of the Central Pay Commission Report)

• The Central Govt. after accepting the recommendations, decided to further extend the DACP to one scale more – promotion at 20^th year upto the scale of 37400-67000 GP 10000. [vide the Gazette – Ministry of Finance (Department of Expenditure) New Delhi, dated 29^th August 2008; Resolution No. 1/1/2008-IC. para 12 ]

• So, finally the central doctors are given promotions in 4^th year, 9^th year, 13^th year and 20^th year in the scales of 15600-39100 GP 6600, 15600-39100 GP 7600, 37400-67000 GP 8700 and 37400-67000 GP 10000.

• V and VI PC Report justified this special scheme to doctors stating: - “DACP is extended to doctors as their basic qualification is of longer duration and the doctors hence, have less number of total services. This cannot be extended to any other government servants.”

Urgent Executive Committee Meeting resolutions

TAMILNADU GOVERNMENT DOCTORS’ ASSOCIATION
Recognised by the Govt. of Tamilnadu vide Public Department G.O. Ms No. 1980 dated 7.10.1969
STATE PRESIDENT Dr.S.Kanagasababathy Thanjavur		STATE SECRETARY Dr K.Senthil Madurai
	STATE TREASURERs
Dr K.Jeyakumar Vellore		Dr P.Prakash Karat Ramanathapuram
State Office: 208, DAS Quarters, Govt. Rajaji Hospital, Madurai

14^th June 2009

Urgent Executive Committee Meeting resolutions

The Urgent Executive Committee Meeting of the TamilNadu Government Doctors’ Association was held at Madurai on 14^th June 2009.

The Executive Committee members from all over the state attended the meeting. The Pay Commission implementation in Tamilnadu without correcting the existing anomalies for the government doctors was discussed in detail.

All the members uniformly expressed that it is a betrayal of our cadres after assurances from our Honourable Health Minister in the floor of the assembly.

In spite of the just issue and steps to highlight it in a democratic way, the response from the govt. is very disappointing. The association is forced to go in for agitations to press the demands.

After elaborate discussion the following resolutions were passed unanimously.

• The association appeals to the Honourable Chief Minister Dr Kalaignar to kindly consider our following one point demand favourably.

Our Demand:

Implementing the VI Central Pay Commission recommendations for doctors in Tamilnadu.

• In order to press our demand
1. it has been decided to hold a one day token fast by the state EC members at Chennai on 23^rd June 2009.
2. To boycott the following programmes without affecting the patient service indefinitely from 30^th June 2009: Varumun Kappom Thittam, Other camps, meetings , training programme, MCI inspections, medical board, VIP convoy duty, students classes, practicals and all other academic activities.

If the demands are not met by the govt., the association has resolved to go for one day token strike on 6^th July 2009. Emergency and life saving services will be maintained.

• Each district to convene an urgent GB Meeting and get their members ready for implementing the State EC resolutions and issue press releases.
• Not giving option to new pay till the demands were met. All members will continue to get the old pay.
• The association has resolved to convene an urgent EC Meeting on 12^th July 2009 to decide on the “Indefinite Strike” and further course of action.

(State Secretary) (State President)

97877 27213 94431 30399

Events in July

DENTAL
Famedent 2009 - 23rd July to 26th July, Pragati Maidan, New Delhi
MANAGEMENT
Act 2009 - 17th July to 19th July, Chennai, Tamil Nadu
2^nd National Symposium on Reproductive Medicine – 17th July to 19th July, Hotel Green Park, Chennai, Tamil Nadu
Health GIS 2009 – 24th July to 26th July, Hyderabad, A.P

Medicall 2009 - 31 july to 02 August, Chennai Trade Center, Tamil Nadu
NEUROLOGY
Spine 2009 – 17th July to 19th July, Hotel Kodai International, Kodaikanal, Dindigul, Tamil Nadu
RADIOLOGY / IMAGING
Brace 2009 – 10th July to 12th July, Chennai, Tamil Nadu
UROLOGY
Szusicon 2009 – 11th July to 12th July, JN Medical College, Belgaum, Karnataka

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Tamilnadu Govt Doctor's pay hike

TN sixth pay commission has given doctors nothing but a poorer service condition and treated as bonded labourers.

Ä There is nothing in relation with sixth central pay commission in this except entry scale of 8000-275-13500 ie 15600-39100 with grade pay of 5400.

o Successive scale never exist in central pay bands.

o Senior civil surgeons and Associate professors are the most affected.

o Equality prevails in the sense that entry and highest promotion (which all doctors achieve ) are kept in the same pay band.

o Dynamic Assured Carrier Progression schem ie time bound promotion given in 5th and 6th central pay commission is not even mentioned.

Ä Inspite of shortage of teaching faculties in all new medical colleges more than 50 to 75% in certain departments and colleges, no effort taken to retain qualified doctors and no incentives for rare specialities and higher specialties.

o Even though Tamil nadu is best in india in terms of health indicators ( as Govt claims) doctors are treated like bonded labourers by denying VRS and petty pay hike.

o This is not comparable to what is given in central pay commisiion yet they call it 6th pay commission.

o Giving an Msc, MBBS. MD/MS, and Mch/DM the same 15600-39100+5400 is some thing a gross anomaly existing no where in our country.

o Forgetting and ignoring CAG report ( Comptroller and Auditor General of Govt of India) deteriorating quality of medical education particularly in nonclinical side, shortage of teaching faculty in all new colleges does not even bother the concerned authorities in TN pay commossion.

Ä By giving this lesser pay, no person would ever come to nonclinical departments after finishing PG.

o A Govt department is cheating the MCI, another govt regulating authority, for ever to get recognition of Govt colleges by giving false posting orders with out making any effort to retain and recruit necessary taeching faculty.

o Permanent teaching faculty number has not been issued in this state only to facilitate showing same faculty in more than one medical college in the name of giving more medical seats to state.

Ä Virtually they are creating under trained doctors for the society by not having adequate teaching faculty.

o By not addressing the issue of shortage of specialised doctors in DMS and DPH side for OG and Anaesthesia , they are training MBBS doctors.

o If salary is not on par with atleast adjascent states( IF NOT ON PAR WITH CENTRAL GOVT), our medical education would not improve and we dont get specialised doctors in DMs or DPH apart from service quota PGs.

o If a trained MBBS doctor gives anaesthesia or conducts ceasarian section some complication arises would any court would accept or any public would accept if they come to know doctor is only trained but not qualified to give anaesthesia and do surgery. or any official involved in finalising this stategy of training MBBS doctors for anaesthesia or surgery would ever under go any procedure by these doctors for their family members.

o Because they go to only corporate hospitals, not even to esteemed govt colleges like chennai govt General hospital.

o It is only poor man who comes to our GH/PHC for treatment.

Ä Unless we, doctors fight for our better service condition no body would do.

Ä This is in the best interest of us and our society to have best medical education and best medical service by qualified specialised doctors by giving pay hike on par with either central govt or southern states.

Ä By giving poorer pay hike, Govt is encouraging speciality doctors to go join private institutions and encouraging private practice of those already in service and also encourages corruption.

Ä No govt doctor is happy to serve full years in service.

Ä If allowed, most of experienced and senior doctors of various specialties would leave service but state govt is not allowing VRS.

Ä Are we bonded labourers to be denied of fundamental right of VRS and compulsory service in under paid poor salary?.

If not now never ever we would get dignified salary in this state.
--

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Government Medical College Hospital inspected

http://www.hindu.com/2009/06/07/stories/2009060754380300.htm

Government Medical College Hospital inspected

Staff Reporter

For installation of linear accelerator radiotherapy equipment

— Photo: N. Rajesh 

assessment: An expert team at the Government Medical College Hospital in Tuticorin on Saturday.

Tuticorin: A team consisting of doctors led by Palanivel, Senior Regional Director, Health Services, visited the Government Medical College Hospital, Tuticorin, on Saturday, as part of preliminary inspection.

The team held discussions with J. Ravi Shankar, Dean of the hospital, on installation of a modern linear accelerator radiotherapy equipment at the hospital to facilitate radiation treatment for cancer patients without any side effects.

Installation of the equipment would obviate the need for patients to go to hospitals in other cities thus saving time and money.

Infrastructure

The team also made an assessment of the infrastructure facilities at the hospital with regard to sanction of Central government funds under National Cancer Control Programme to establish and strengthen an exclusive Oncology wing to cater to the needs of cancer patients.

Team members

M. Balu David, Director, Government Aringar Anna Memorial Cancer Hospital and Research Institute, Regional Cancer Centre, Kancheepuram, and P.G. Jayaprakash, Additional Director, Regional Cancer Centre, Thiruvananthapuram were among the team members.

The faculty members in the Department of Radiotherapy, including V. Viswanathan, Lalitha Ramasubramaniam and J. Silas, among others, were present.

Question bank CD for orthopaedic surgeons

We would be grateful if any of the viewers can give us the following information

1. Whether this CD is for Free or is there a price attached
2. Whether the concerned persons are ready to host the matter in a web site
3. Contact Information of the Surgeons

You can post the reply in the comments below or SMS 98421 11725

From http://www.hindu.com/2009/06/07/stories/2009060750040200.htm

Question bank CD for orthopaedic surgeons

Special Correspondent

---

“Question bank will help students perform better in examinations”

---

CHENNAI: A compact disc (CD) containing a bank of questions for orthopaedic surgeons was released at a function held at the Government Royapettah Hospital (GRH) here.

The question bank was prepared by the members of the Madras Orthopaedic Society, in which eminent orthopaedics in the city are members.

“Usually in orthopaedic studies postgraduate students had to get books from former students. But having a question bank will help the students to perform better in examinations,” said P. Selvaraj, a member of the Society.

“We have collected questions from various universities across the globe,” he added.

The question bank is divided into chapters. For example, traumatology and orthopaedics in rehabilitation, all of which are important for a surgeon, forms a separate chapter.

There are also sub-classifications for fractures of each region of the body, such as fracture of the spine or the hand.

The CD was the brainchild of the hospital’s Orthopaedics Department head N.O. Samson and was released at the meeting on Thursday by hospital superintendent K. Rajendran.

Members of the society said that the CD will also help teachers.

“Orthopaedics examinations are difficult to clear and only 30 per cent pass,” Dr. Selvaraj said.

pay structure

dear doctors,
we have not got the scale of pay and other allowances as promised.we shall stand united to correct the pay anomalies.

Tamil Nadu Sixth Pay Commission - Government Orders

• G.O of Finance Dept - Recommendations of the Official Committee on Pay
• G.O of Finance Dept - Recommendations of the Official Committee on Allowances
• G.O of Finance Dept - Recommendations of the Official Committee on Travelling Allowance
• G.O of Finance Dept - Recommendations of the Official Committee on Pension

Events in June

RADIOLOGY /IMAGING
CME on Vascular Malformations and Hands on Workshop on Interventional Radiology - 13th June to 14th, Coimbatore, Tamil Nadu
MANAGEMENT
Medicon2009 - 24th June to 28th June, Kasturba Medical College, Mangalore, Dakshina Kannada, Karnataka
MEDICAL RESEARCH
Mecor2009 - 31st May to 6th June, Chennai, Tamil Nadu
SURGERY
International Conference cum live Operative Workshop on Advanced Laparoscopy - 4th June to 6th June, Sheri Kashmir International Convention Complex, Srinagar, J&K