Consumer Protection Act and its relevance to the Homoeopath
NATIONAL JOURNAL OF HOMOEOPATHY 1995 Sep / Oct Vol IV No 5.
Asrani C H.

In 1985, late Shri Rajiv Gandhi and his council of Ministers decided to promulgate an act to safeguard the interests of the Consumers, who were always at the receiving end and had no platform to complain and expect to be heard. Who could expect to fight Multinationals who were just about to make an entry in to the country? In 1986 the Consumer Protection Act became a law.

In 1989, the Kerala Consumer Dispute Redressal Commission held that Medical Services rendered for payment were services within the purview of CPA, a view affirmed by the National Commission headed by Justice Balakrishna Eradi. Subsequently Madras high court in 1991 ruled that they were not. In 1993 Indian Medical Association (an apex body of Allopathic practitioners) filed an appeal before Supreme court against the National Commissions ruling and were pretty confident that the ruling would be in their favour.

The Apex courts decision upholding the National Commissions ruling has resulted in widespread panic. Now is the time for all the Qualified practitioners, of whichever discipline, to take a serious look at the CPA and decide the course of action. Action pertaining to medical practice and not how to fight the Judiciary, as we must accept the fact that CPA is here to stay.

Have we ever given a serious thought as to why the Judiciary feels medical practice should be brought under the purview of CPA? We need it because our profession totally lacks accountability. Think of the scenario fifty years back. A doctor was not only a healer, he was a friend, philosopher and guide of the entire family. He was virtually like God, his was always the last word. He was not used to being questioned. He never had to justify his actions. He never liked to explain why a particular disease had taken longer to treat or as to why a certain patient could not be saved. They were obeyed instantaneously, whether on the issue of the daughters marriage, an investigation to be done or a specialist to be consulted. This total lack of accountability gave birth to a new breed of practitioner, the QUACK. Just calling yourself a Doctor was enough. No one was bothered to check your qualification or the degree certificate. Quackery first began in villages and spread slowly to the urban setup, with mushrooming of slums. With an abundance of Alternative medical sciences available in the country eg. Homoeopathy. Ayurveda, Unani and so on, the so called Desi Dava took firm roots. Because everyone proclaimed that Desi Dava has no side effects, almost everyone could practice it.

Gradually, with urbanisation, an increasing awareness and concern about health and the run for money, that trust was replaced by suspicion. Doctors were taken aback. How come, all of a sudden his actions, were being questioned? He, after all, was the savour of mankind. You see, he actually believed he was second to God. He just could not accept it. Increasing cost of medical care, coupled with fear of morbidity made patients seek second opinions and directly to Specialists and super-specialists. Doctors converted this to a God sent opportunity to make that extra buck. This set up the tidal wave of references, cross references, needless investigations, that scourge of medical practice-the kick back or the CUT. It was not long before this became more of a rule than an exception. This total lack of Accountability, virtually no respect for the patient and his condition, reckless medical practice which was dictated more by ulterior motives than patient care was what brought medical practice under CPA.

But why are we over-reacting in this way? We were already liable for legal action in Civil courts and Criminal courts, what saved us till now was the state of Judiciary. It used to take almost 10-15 yrs for a judgement and rewards were not worthy of that long await. CPA is just a way of quick redressal of patients grievances and the rewards are far better, anything from Rs. 2 lakh to Rs. 10 lakhs.

What does CPA actually means? It says that any deficiency in services rendered or any act of negligence (act of commission or omission) gives a right of action to the patient. What is the Courts definition of Negligence? It says "A person who holds himself out ready to give medical advice and treatment implied undertakes that he is possessed of skill and knowledge for the purpose. This person, when consulted by a patient owes him certain duties, namely a duty of care on deciding whether to take the case, what treatment to give or in the administration of that treatment. A breach of any of those duties gives a right of action for negligence to the patient".

How does this apply to the Homoeopath? Certain prevalent tendencies have to be curbed.

1. It is good to have faith in the system of medicine you practice, but it should not be blind faith. Every system has its limitations, so does Homoeopathy. But there is a tendency among Homoeopaths to take on my case right from Congenital anomalies to malignancy and promise the sky or guarantee a cure. You may take any case you want but it is your duty to understand the seriousness of the situation and it is obligatory on your part to give a clear picture to the patient as to his chances has of recovery.
2. You are taught almost the entire spectrum of medicine, except Pharmacology, as a part of your curriculum. You are therefore expected to advise necessary investigations and not to miss or overlook emergency situations. If you are treating a case of cough of about one months duration and fail to order an X-ray and thus miss out Tuberculosis it can be taken negligence (or act of omission.) Failure to diagnose or refer a case of Myocardial Infarction to a proper center can also make you liable for action.
3. Establish such channels of communication with the patient that he feels he is being told everything. Explain to him his ailment in simple, easy to follow language so that he develops faith in you. Also explain to him why this particular condition will take long to treat.
4. If you feel you are taking a calculated risk, it is better than either the patient or a close relative is taken into confidence.
5. All the world over, every Physician, every Specialist, every Superspecialist knows his limitations. It is about time that Homoeopaths also accept this and start referring patient to senior colleagues. never-say-die attitude is most certainly commendable but in todays troubled waters can be detrimental to the image of the practitioner.
6. Most important tool to make ourselves worthy for our patients is Continuing Medical Education or CME as it is popularly called. Medical science is changing virtually every day. Newer diseases, newer modalities of investigations and treatment are being discovered. If we do not keep abreast of all this knowledge, how can we expect to guide our patients properly. All of us should spend at least 5-6 hrs per week for Journals, clinical meetings and Seminars. Practitioners in smaller cities should make their own groups for interaction.
7. We have a duty to disclose immediately to the patient if an injury or unwanted action has been caused to him-her by our inadvertence. We should also start accepting Aggravations as a part and parcel of treatment. Fraudulent concealment of facts violates the trusting relationship between patient and the doctor.

Our fear that CPA will increase fraudulent cases to harass and blackmail us is not true. Out of 100 cases that are brought to Consumer courts, about 85-90 are never processed, as they lack substance or logic. Also Consumer courts are authorised to penalise fraudulent claims and award compensation to the Doctor.

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