tag:blogger.com,1999:blog-17270152556147972832024-03-19T02:52:55.863-07:00MaxfaxGeorge Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.comBlogger49125tag:blogger.com,1999:blog-1727015255614797283.post-47133628502358679302023-05-13T20:27:00.001-07:002023-05-13T20:27:38.319-07:00An Open Letter to Shri M K Stalin, Chief Minister Of Tamilnadu<p> <span style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SFUIText"; font-size: 17pt;">Respected Sir,</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">My name is Dr George Paul. I am a practising Oral and Maxillofacial Surgeon in Salem, Tamilnadu. </span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">This is to bring to your notice that there maybe ineligible candidates for the post of VC of the prestigious TN Dr MGR Medical University, who have been short listed.</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">I wish to inform you through this open letter that I am acquainted with the case of Dr S M Balaji who has been interviewed. He is ineligible ( ab initio) for consideration on account of the fact that there is a criminal case pending against him. I am bringing this to your notice for two reasons</span></p><ol class="ol1" style="-webkit-text-size-adjust: auto;"><li class="li1" style="color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">I am a complainant and a petitioner in the case no. Crl OP 25521/2021 which was quashed but has now been recalled by a honourable judge of the Madras High Court and numbered as Crl MP no 17942/ 2022. </span></li><li class="li1" style="color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">Dr S M Balaji has been short listed and interviewed despite the objections raised by me to the Convenor Shri V K Subburaj on 8/ 05/2023 through e mail and speed post. </span></li></ol><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">The application form for VC requires a declaration that no criminal case should be pending against an applicant. There is clear violation by the candidate and the Committee which short listed him. I have withdrawn my candidature for VC before making this representation to avoid speculation as to the motive for my posting this letter. I have all the documentation to show the complete details of the case which involves criminal intimidation and criminal offences under the Information technology Act.</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">In fact Dr SM Balaji has admitted in Court on 23/12/2021 that his employee was made to write a defamatory and intimidating letter under a pseudonymous name in 2014, casting false aspersions on several eminent surgeons including me. In addition to this being a bar on his candidature, it is also a matter of moral depredation and such a candidate is clearly unsuitable for a responsible position in academia.</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">I wish to further express my sentiment, as a former teacher and present practitioner in TN, with a long relationship with the TN DrMGRMedical University since 1989, that the person selected to head the state university should be an accomplished teacher ( private or government) with experience in academic administration and should have an honest unblemished personal record of honesty, and should be free of any moral turpitude.</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">If one were to believe the newspapers and social media, it is clear that the decks have been cleared to appoint a pre- determined person. There may also be conflict of interest between members of search committee and the candidates.</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">I have been a long standing supporter of the welfare schemes of the Dravidian parties and the legacy left behind by the founding fathers of the state and others who followed them. TN has always stood up for social justice and welfare, particularly in the field of health. This is because of the excellent medical institutions and healthcare network laid down by several governments, including the DMK. </span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">It has also come to our notice that several eminent persons who studied and taught in Government Medical and Dental Colleges have been ignored in the selection process and don’t find a place in the short list prepared by the Search committee to be forwarded to the Governor and Chancellor of the University. This includes highly accomplished professors , administrators, Deans of Medical / Dental Colleges, Former and serving Directors of Medical Education and even serving Vice Chancellors in Deemed Universities. </span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">It is therefore surprising and out of place when private medical or dental practitioners are given charge of a University with more than 800 medical, dental, nursing, physiotherapy and other courses. The fact that some of them like Dr S M Balaji did not obtain their education through merit and actually took two attempts to pass his post graduate examinations is a reflection on their background. I do not know if there are others like him. He has never been a full time staff in any academic institution and whatever may have been shown as full time academic tenure in past or present applications is possibly fabricated. This is borne out by the fact that he has never been an internal or external examiner even once. Dr Balaji has also tried to do MBBS in a private Medical College, while working full time in his private dental clinic. He was forced to discontinue for want of attendance. </span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">It is therefore distressing to understand the compulsions that make a responsible government or search committee to even consider such a person despite his basic ineligibility on account of a pending criminal case.</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">It is still not too late and I hope that the Chief Minister and Governor will use their good office to ensure that an unsullied person with genuine academic credentials occupies this high office.</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">Thanking you</span></p><p class="p2" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px; min-height: 20.3px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;"></span><br /></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">Sincerely</span></p><p class="p2" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px; min-height: 20.3px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;"></span><br /></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">George Paul</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">F 72 Brindavan Road</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">Fairlands</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">Salem-636016, TN</span></p><p class="p2" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px; min-height: 20.3px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;"></span><br /></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">Cc: </span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Text"; font-size: 17px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIText"; font-size: 17pt;">Convenor Search Committee</span></p>George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com0tag:blogger.com,1999:blog-1727015255614797283.post-55537652615892812042020-10-08T21:18:00.001-07:002020-10-08T21:18:25.052-07:00The illegality of fixing minimum charges for medical services<p><br /></p><p class="p2" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px; min-height: 27.4px;"><span class="s1" style="font-family: ".SFUIDisplay-Bold"; font-size: 23pt; font-weight: bold;"></span></p><p class="p2" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px; min-height: 27.4px;"><span class="s1" style="font-family: ".SFUIDisplay-Bold"; font-size: 23pt; font-weight: bold;"></span><br /></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIDisplay-Bold"; font-size: 23pt; font-weight: bold;">Introduction:</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">Recently, several private medical and dental organisations have been attempting to fix minimum charges for services amongst their members. This has no doubt been fuelled by price wars in the practice arena. Most medical and dental professionals, despite cautions, are unaware that fixing minimum prices by organisations for its members is an illegal act as per the laws of the country. </span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">The minimum price fixing by organisations are being done on the pretext that the recently introduced Clinical Establishment Act requires all medical and dental practitioners to publicly display the charges for various treatments. What the private organisations do not realise is that the CEA was legislated not for the purpose of minimum charges but rather in the interest of transparency for the public who can make an informed choice on who to take treatment from based on their charges for service. </span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">The minimum charge fixation, in addition to being illegal, is also going to work against the interest of the members because those professionals who are not members of these associations are free to fix their own charges and can undercut them by declaring that they are willing to offer services at a lower cost. The associations do not realise that they are putting themselves at a disadvantage if the recommended cost is publicly announced. In fact even members of these associations, may in private, offer services at lower cost by citing the recommended fees. </span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">However, the bigger issue is that it violates established laws of the country and the associations are liable to enormous fines for cartelization ( forming groups to fix prices) under the Competition Law of 2002 enacted in Parliament in 2003.</span></p><p class="p2" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px; min-height: 27.4px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;"></span><br /></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIDisplay-Bold"; font-size: 23pt; font-weight: bold;">What does the law say?</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">The competition law in India was legislated in 2002 to replace the Monopolies and Restrictive Trade Policies Act ( MRTP) of 1969. (1)</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">This law gives overreaching powers to the Competition Council of India ( CCI) to impose exemplary fines for violation of these laws. The law was created in line with similar laws around the world like Anti Trust laws in USA which is enforced by the Federal Trade Commission or the Competition and Markets Act ( CMA) or the Competition Act of the UK and European Union respectively. (2)</span></p><p class="p2" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px; min-height: 27.4px;"><span class="s1" style="font-family: ".SFUIDisplay-Bold"; font-size: 23pt; font-weight: bold;"></span><br /></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIDisplay-Bold"; font-size: 23pt; font-weight: bold;">So what is Competition law in India?</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">The Competition Act, 2002, as amended by the Competition (Amendment) Act, 2007, follows the philosophy of modern competition laws. The Act prohibits anti-competitive agreements, abuse of dominant position by enterprises and regulates combinations which causes or likely to cause an appreciable adverse effect on competition within India.[3)</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">There are some features of this law which we must be familiar with. </span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIDisplay-Bold"; font-size: 23pt; font-weight: bold;">Cartelisation</span><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">: This refers to any group that forms into a cartel ( group) to fix prices or in any way impedes the process of competition. So let us see how cartels are defined in Indian law.</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIDisplay-Bold"; font-size: 23pt; font-weight: bold;">Cartel:</span><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">Cartel includes an association of producers, sellers, distributors, traders or service providers who, by agreement among themselves, limit control or attempt to control the production, distribution, sale or price of goods or provision of services (3)</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">This means that competition <span class="Apple-converted-space"> </span>should be a product of market forces and cannot be controlled by any group or organisation that forms into a cartel to fix minimum prices.</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIDisplay-Bold"; font-size: 23pt; font-weight: bold;">Predatory pricing:</span><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">Predatory pricing means the sale of goods or provision of services, at a price which is below the cost of production of the goods or provision of services, with a view to reduce competition or eliminate the competitors.(4)</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">This is the opposite of cartelisation. No person or group of persons can charge abnormally low prices to drive other competitors out of business. An example is telephone companies charging low prices, even at a loss, to eliminate others from competition.</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">There are several other commercial clauses but these two are most relevant to medical practice.</span></p><p class="p2" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px; min-height: 27.4px;"><span class="s1" style="font-family: ".SFUIDisplay-Bold"; font-size: 23pt; font-weight: bold;"></span><br /></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIDisplay-Bold"; font-size: 23pt; font-weight: bold;">Do doctors and other professionals come under this Act?</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;"> In India, like many other countries, medical service comes under the definition of contract for services ( under section 2 (1) ( 0) of the Consumer Protection Act) and are therefore commercial services as decided in the </span><span class="s3" style="font-family: ".SFUIDisplay-Italic"; font-size: 23pt; font-style: italic;">VP Shantha vs IMA and others.</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">In the USA, <span class="Apple-converted-space"> </span>‘It was generally assumed that professions, such as the practice of law or medicine, would be exempt from antitrust ( Competition Law) considerations. The 1975 U.S. Supreme Court ruling in </span><span class="s3" style="font-family: ".SFUIDisplay-Italic"; font-size: 23pt; font-style: italic;">Goldfarb v Virginia State Bar</span><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">would change that assumption’(5).</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">If and when any medical association tries to fix minimum prices, it will be a violation of Competition Law and the organisation fixing these prices can face enormous fines. </span></p><p class="p2" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px; min-height: 27.4px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;"></span><br /></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIDisplay-Bold"; font-size: 23pt; font-weight: bold;">Who can punish for violation?</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">Any complaint with the Competition Council of India (CCI) by any person affected by any violation can prefer a complaint to the competition council. This maybe a member of the organisation who is prevented from fixing his/her own charges or a person from the public who feels that the cost of service has been escalated by an association of professionals involved in cartelisation.</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">It is the duty of the Commission to eliminate practices having adverse effect on competition, promote and sustain competition, protect the interests of consumers and ensure freedom of trade in the markets of India.(6)</span></p><p class="p2" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px; min-height: 27.4px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;"></span><br /></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIDisplay-Bold"; font-size: 23pt; font-weight: bold;">What is the punishment for violation of Competition Act?</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">According to the Act the punishment for violation is as follows</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">If any person fails to comply with the orders or directions of the Commission shall be punishable with fine which may extend to ₹ 1 lakh for each day during which such non compliance occurs, subject to a maximum of ₹ 10 crore.</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">Further disregard can invite 3 Years imprisonment and upto ₹25 crores.(7)</span></p><p class="p2" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px; min-height: 27.4px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;"></span><br /></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s1" style="font-family: ".SFUIDisplay-Bold"; font-size: 23pt; font-weight: bold;">Conclusion</span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">Associations such as the Indian Medical Association and Indian Dental Association should refrain from forming into a group and fixing minimum prices, in the same way that Government agencies should stop fixing maximum prices. </span></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">There are at least three reasons why fixing minimum charges will work against the members of these organisations </span></p><ol class="ol1" style="-webkit-text-size-adjust: auto;"><li class="li1" style="color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">It is illegal and the associations are liable for penalty.</span></li><li class="li1" style="color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">Only 15% of dentists are members of the dental associations. Dentists who do not belong to the association will see an opportunity to undercut members of associations as they are not bound by their recommendations or dictates.</span></li><li class="li1" style="color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">Private teaching institutions have started paid clinics as income generating measures ( due to low demands for seats). They fall outside of these recommendations and members will lose patients to these institutions that deploy their paid staff who can earn more with lesser profit. </span></li></ol><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">It is high time that the matter is carefully thought out before making recommendations.</span></p><p class="p2" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px; min-height: 27.4px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;"></span><br /></p><p class="p1" style="-webkit-text-size-adjust: auto; color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">References</span></p><ol class="ol1" style="-webkit-text-size-adjust: auto;"><li class="li3" style="color: #e4af0a; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s4" style="color: #454545; font-family: ".SFUIDisplay"; font-size: 23pt;"><a href="https://en.m.wikipedia.org/wiki/The_Competition_Act,_2002"><span class="s5" style="color: #e4af0a; font-size: 23pt;">https://en.m.wikipedia.org/wiki/The_Competition_Act,_2002</span></a></span></li><li class="li3" style="color: #e4af0a; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s4" style="color: #454545; font-family: ".SFUIDisplay"; font-size: 23pt;"><a href="https://en.m.wikipedia.org/wiki/Competition_law"><span class="s5" style="color: #e4af0a; font-size: 23pt;">https://en.m.wikipedia.org/wiki/Competition_law</span></a></span></li><li class="li3" style="color: #e4af0a; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s4" style="color: #454545; font-family: ".SFUIDisplay"; font-size: 23pt;"><a href="http://indiankanoon.org/doc/1113485/"><span class="s5" style="color: #e4af0a; font-size: 23pt;">"Section 2(c) of Competition Act 2002"</span></a>. Indian Kanoon.</span></li><li class="li3" style="color: #e4af0a; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s4" style="color: #454545; font-family: ".SFUIDisplay"; font-size: 23pt;"><a href="https://web.archive.org/web/20120627063249/http://www.cci.gov.in/images/media/competition_act/act2002.pdf"><span class="s5" style="color: #e4af0a; font-size: 23pt;">The Competition Act – Act No. 12 of 2003"</span></a></span></li><li class="li3" style="color: #e4af0a; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s4" style="color: #454545; font-family: ".SFUIDisplay"; font-size: 23pt;"><a href="https://www.healio.com/orthopedics/business-of-orthopedics/news/print/orthopedics-today/%7Bb4d25dee-71a8-44ba-8006-b7089a8dc5a0%7D/physician-mergers-antitrust-law-are-often-complicated-for-individuals-groups"><span class="s5" style="color: #e4af0a; font-size: 23pt;">https://www.healio.com/orthopedics/business-of-orthopedics/news/print/orthopedics-today/%7Bb4d25dee-71a8-44ba-8006-b7089a8dc5a0%7D/physician-mergers-antitrust-law-are-often-complicated-for-individuals-groups</span></a></span></li><li class="li1" style="color: #454545; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;"><a href="http://www.cci.gov.in/about-cci"><span class="s5" style="color: #e4af0a; font-size: 23pt;">"About CCI | Competition Commission of India"</span></a>. </span><span class="s3" style="font-family: ".SFUIDisplay-Italic"; font-size: 23pt; font-style: italic;">www.cci.gov.in</span><span class="s2" style="font-family: ".SFUIDisplay"; font-size: 23pt;">. Retrieved 19 November 2015.</span></li><li class="li3" style="color: #e4af0a; font-family: ".SF UI Display"; font-size: 23px; font-stretch: normal; line-height: normal; margin: 0px;"><span class="s4" style="color: #454545; font-family: ".SFUIDisplay"; font-size: 23pt;"><a href="https://en.m.wikipedia.org/wiki/The_Competition_Act,_2002"><span class="s5" style="color: #e4af0a; font-size: 23pt;">https://en.m.wikipedia.org/wiki/The_Competition_Act,_2002</span></a></span></li></ol>George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com1tag:blogger.com,1999:blog-1727015255614797283.post-58113310101424647472020-07-07T01:38:00.000-07:002020-07-07T01:46:06.641-07:00An open letter to my professional colleagues<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div class="MsoNormal">
<span style="mso-spacerun: yes;"> </span>India has just
emerged as the third most affected country in the world. Covid 19 has a
remarkable recovery rate and the Government is doing a decent job of containing
the epidemic. Experts say the worst is yet to come and the soft underbelly of our
health system is likely to be exposed when our health infrastructure and our
already burdened doctors and nurses can no longer cope.<o:p></o:p></div>
<div class="MsoNormal">
It is time to bring in more manpower from allied health care
professions. I am not sure of<span style="mso-spacerun: yes;"> </span>the indigenous
systems whose concepts of therapeutics and <span style="mso-spacerun: yes;"> </span>pathology of diseases are quite different from
that of modern medicine. But professionals trained in dentistry and who have a
common pathway of training like physicians should certainly be mobilised. Amongst
them, maxillofacial surgeons, with extensive hospital and ICU familiarity can
certainly amplify the manpower requirements.<o:p></o:p></div>
<div class="MsoNormal">
Many cities are already reeling under the lack of medical personnel
to deal with the number of patients requiring critical care. Even hospitals
with adequate infrastructure are unable to function for want of man power. <o:p></o:p></div>
<div class="MsoNormal">
India has a serious anomaly where we have a deficient doctor
patient ratio for medical doctors whereas we have an enormous surplus of
dentists, due to poor manpower planning and business interests a decade and a
half ago. So here is our opportunity to deploy hospital based dental or
maxillofacial surgeons. <o:p></o:p></div>
<div class="MsoNormal">
In fact some cities have already called up eminent maxillofacial
surgeons and some like Dr Neelam Andrade, a maxillofacial surgeon and Dean of
Nair hospital has been appointed head of one of the biggest dedicated Covid
hospitals in the world in Mumbai.<span style="mso-spacerun: yes;"> </span>The
NESCO jumbo facility which has a projected capacity of 3000 units has 1171 fully
furnished beds with bedside oxygen, advanced monitoring and resuscitation
equipment. It also has an impeccable, 0 mortality. Dr Andrade, who also happens
to be a friend and professional colleague, directs the logistics of managing
the facility, from the control room and on the ground. This includes non-
contact triaging, computerized tracking and ensuring the safety of 62 doctors,
87 nurses and 103 ward boys and<span style="mso-spacerun: yes;"> </span>includes,
pulmonologists, intensive care physicians, dental and maxillofacial surgeons
and doctors from various other indigenous systems. We are proud of the
outstanding contribution of Dr Neelam, one of our fraternity, a dynamic woman
and a past president, who heads this operation.<o:p></o:p></div>
<div class="MsoNormal">
While Universities like RGUHS and some other universities
have given Interns, PGs and staff an option, we need greater mobilization. So
why are so few dental surgeons, particularly OMFS not deployed for COVID duty
at this crucial time? India currently has nearly 10-15000 registered OMFS with
dental background. The DCI has nearly 400,000 dentists registered in its
various state registers. <span style="mso-spacerun: yes;"> </span>Many young men
and women are enrolled for post -graduation while others are in private or
government practice. The government must seriously consider deploying them in
this emergency. The DCI must make a firm commitment in this time of need. The
majority of them are currently sitting at home, allowing their skills to be
wasted, waiting out the pandemic, while thousand are seriously sick around the
country. As a first step, the oral and maxillofacial surgeons who are trained
in administering intravenous drugs, monitoring vitals and capable of several
bedside procedures must be mobilised. Other dental surgeons, particularly
hospital based ones, can follow and contribute with their medical knowledge,
particularly if they are not engaged in active work. <o:p></o:p></div>
<div class="MsoNormal">
While several State governments have compulsorily enrolled
the services of their staff, many private dental institutions remain closed
with their staff safely ensconced in their homes delivering and listening to
webinars and online symposiums. <span style="mso-spacerun: yes;"> </span><o:p></o:p></div>
<div class="MsoNormal">
The Association of Oral and maxillofacial surgeons and the
Dental Council of India must encourage the members in private institutions and even
private practice to join the endeavour against Covid 19 by calling for volunteers
and even compulsorily deploying post graduates and junior staff of OMFS to be a
part of the war against the deadly pandemic. Apart from being a corporate responsibility
social responsibility, this will bring dignity and recognition to the profession
by standing shoulder to shoulder with our medical colleagues at this crucial juncture.
On the part of the government, there should be incentives in the form of
attractive remuneration, additional marks for NEET (for interns) and decent
food and living condition. <o:p></o:p></div>
<div class="MsoNormal">
Recognition for OMFS as an important surgical speciality has
to be earned by our actions, not by just claiming parity and privileges without
taking risks. I have volunteered. Have you?<o:p></o:p></div>
<div class="MsoNormal">
Dr George Paul<o:p></o:p></div>
<div class="MsoNormal">
Past Hon. Secretary, AOMSI<o:p></o:p></div>
<div class="MsoNormal">
Past President AOMSI <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<br /></div>
George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com10tag:blogger.com,1999:blog-1727015255614797283.post-19671341700021129852019-04-10T04:16:00.001-07:002019-04-10T04:16:26.140-07:00Should Doctors in India be allowed to advertise?<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div style="color: #454545; font-family: UICTFontTextStyleBody; font-size: 23px; text-decoration: -webkit-letterpress;">
<b><br /></b></div>
<div style="color: #454545; font-family: UICTFontTextStyleBody; font-size: 23px; text-decoration: -webkit-letterpress;">
<b>Introduction</b></div>
<div style="color: #454545; font-family: UICTFontTextStyleBody; font-size: 23px; text-decoration: -webkit-letterpress;">
This is a question that has been asked repeatedly amidst the recurring debate on the ethics of advertising. While many seniors strongly object to advertisements by doctors, a new young generation of medical professionals have been increasingly strident on the right to advertise about who they are, what their qualification is, their strengths, special skills etc. The new notion comes in the wake of several developments and questions about the medical professionals between 1980 and 2000. The argument in favour of doctors being allowed to advertise or provide information to the public have largely been fuelled by the following issues</div>
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1. The question of whether doctors are commercial service providers?</div>
<div style="color: #454545; font-family: UICTFontTextStyleBody; font-size: 23px; text-decoration: -webkit-letterpress;">
2. The existing pattern in countries like India, where large corporate hospitals advertise, whereas private practitioners are hauled up for doing so.</div>
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3. The increasing pressure from the public for a right to know as a principle of autonomy</div>
<div style="color: #454545; font-family: UICTFontTextStyleBody; font-size: 23px; text-decoration: -webkit-letterpress;">
4. Competition laws in many countries that have come down heavily on the monopolies by certain groups and the fundamental principle embedded in the law to allow equal competition.</div>
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<b><br /></b></div>
<div style="color: #454545; font-family: UICTFontTextStyleBody; font-size: 23px; text-decoration: -webkit-letterpress;">
<b>Historical perspectives and reason for change</b></div>
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All over the world, the code of ethics for doctor's have been changed to permit doctors to advertise in the public domain about their practice details. This comes from several legislations and amendments in the laws governing medical practice. In fact the Councils which implement Competition law ( also known as anti -trust laws ) have forced Medical statutory bodies and Medical/ Dental Associations to remove clauses against advertising in their respective code of ethics. This has been enforced through legislations in several countries including USA, UK, European Union, Australia, New Zealand etc starting in the early 1980s. Let us take an example of UK where the ethical guidelines were systematically dismantled in stages despite the opposition from the GMC/ GDC. It is a lesson that India should pay attention to.</div>
<div style="color: #454545; font-family: UICTFontTextStyleBody; font-size: 23px; text-decoration: -webkit-letterpress;">
Let us look at this excerpt, 'To consider the desirability of issuing a general warning notice to medical practitioners against the practices of canvassing and advertising or the purpose of procuring patients' (1). If these words sounds familiar, the chances are that you are practising as a health professional in India or one of the South Asian countries. The above advisory is a recommendation from the British Medical Association to the General Medical Council in 1905. The view that any kind of advertisement or marketing strategy is inconsistent with the practice of Medicine or Dentistry was widely held in England and most countries in the commonwealth till about 1983. While most developed countries have reviewed the code of ethics for those practising medicine, a few countries like India continue, as always, with the hangover of the colonial era. </div>
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After 1983, matters began to change in Great Britain when a series of consultative meetings between doctor's associations and public organisations resulted in a movement for major changes in the policy. Much of this was translated into a revised guideline published in 1986 which relaxed most of the restrictions on advertising by doctors. This was mostly due to the pressure from patient's groups like the Patient's Liaison group of the Royal College of General Practitioners (2) , that wanted more information about services available and also from some professional groups that felt that the GMC ( the statutory body) should play a role to 'lead the profession rather than simply reflect established opinion'(1).</div>
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Some further relaxations were made on the basis of an acceptance that it was easier to control the contents rather than preventing the dissemination of information per se. By 1987 the Government bodies started taking an interest in the matter through The Office of Fair Trading ( OFT) and thereafter asked the Monopolies and Merger Commission ( MMC) to investigate into the issue of restricting advertisement by the statutory bodies. The MMC took evidence from a variety of bodies representing both the professional and the public and published its recommendations in March 1986. (3) . Eventually three questions were raised</div>
<div style="color: #454545; font-family: UICTFontTextStyleBody; font-size: 23px; text-decoration: -webkit-letterpress;">
1. The use of promotional advertising technique</div>
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2. Canvassing or touting for patients</div>
<div style="color: #454545; font-family: UICTFontTextStyleBody; font-size: 23px; text-decoration: -webkit-letterpress;">
3. Making disparaging statements about fellow professionals</div>
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<br /></div>
<div style="color: #454545; font-family: UICTFontTextStyleBody; font-size: 23px; text-decoration: -webkit-letterpress;">
With regard to the first two issues, the questions was whether the restriction should be on the method of advertising or the contents of an advertisement. It was decided that the contents should be honest and factual. There was to be a relaxation of the manner in which information was provided. The difference between providing information to the public or patients and promoting oneself is a difficult call.</div>
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With regard to the third it was equivocal and therefore based on the situation. While it was necessary for doctors to bring to the attention of patients and authorities, evidence of gross negligence, it should not be used to benefit oneself. The lines are blurred. Today section 70 of Good Medical Practice in the UK has only this to say about advertising " When advertising your services, you must make sure the information you publish is factual and can be checked and does not exploit vulnerability or lack of knowledge."</div>
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At least 10 years prior to the UK relaxation, the USA had completely relaxed the restriction on advertisements by doctors as a result of the intervention of the the Federal Trade Commission ( equivalent to the MMC in U.K. And the Competition Council of India ). After <span style="background-color: rgba(255, 255, 255, 0);">the successful FTC suit in 1975 (<em>Goldfarb v Virginia State Bar</em>), the AMA removed all prohibitions to advertising, retaining only a weak restriction against false or misleading advertising(4). In fact, the FTC challenged the ethical restrictions imposed by the American Medical Association on the grounds of monopolies. Today doctors and dentists in USA can freely advertise provided it is factual. Breach of honesty is dealt with under tort and the statutes of the advertising regulatory authority.</span></div>
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<span style="background-color: rgba(255, 255, 255, 0);">This is the situation in other countries. The German medical statutory body called ARTZETAG, similarly withdrew all restrictions. From 2000, Doctors in Germany can publicise their formal education, experience, special diagnostic and therapeutic abilities etc on their practice signs, newspapers and the internet.(6). Other countries that expressly permit advertisements by physicians and dentists include Singapore (7), Australia and New Zealand (8)etc. In fact the Italian Medical and Dental Council was fined € 831,816 by the Italian Competition Agency ( ICA) in 2014 for imposing restrictions on advertisement by doctor's(9).</span></div>
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<span style="background-color: rgba(255, 255, 255, 0);">It is perhaps high time that the MCI and DCI restructure the code of ethics to permit fair competition for young doctors to be able to break the monopoly of the corporate establishments which indiscriminately violate the existing norms. The Competition Council of India can even initiate suo moto action against legislations and statutes that prohibit such marketing techniques based on archaic ethical principles handed over to us by the British, who themselves have amended their laws and regulation.</span></div>
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<span style="background-color: rgba(255, 255, 255, 0);"><b>Conclusion</b>: </span></div>
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<span style="background-color: rgba(255, 255, 255, 0);">It may therefore be concluded that the time is ripe for the statutory bodies to take a re look at the issue of advertising. There is likely to be legal or statutory imposition on the Medical and Dental Council if the competition Council of India takes cognisance of the fact that medical practice is a commercial service and it is monopolised by some sections, particularly the corporates. </span><span style="background-color: rgba(255, 255, 255, 0);">There is of course a danger of doctors going overboard using the relaxation. I would quote from the Indian Journal of Medical Ethics to point out the impact of strict restrictions being bad in morals. "Relying </span><span style="background-color: rgba(255, 255, 255, 0);">strictly on word-of mouth has some negative implications 1. It favors the already established doctors, “the gray beards”, against the new entrants to the field of medicine. This bias is entirely in keeping with the hierarchical nature of English society that gave us our system of medicine 2. Allowing other doctors to be gatekeepers to consultants has promoted fee splitting. A transparent well-publicized schedule of fees and services of a consultant may help put a stop to this practice."(10)</span></div>
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<b>References</b></div>
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1. Irvine DH, Journal of Medical Ethics, 1991,17, 35-40 ( General Medical Council. Minutes. Vol XL11: 138 London 1905)</div>
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2. Patient's Liaison Group of the Royal College of General Practitioners. Availability of Information for patients. Journal of the Royal College of General Practitioners 1984;34,269:672-673 ( also page 644)</div>
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3. Monopolies and Mergers Commission. Services of Medical Practitioners: A report on the supply of the services of registered Medical Practitioners in relation to restriction on advertising. London: HMSO, 1989. </div>
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4. <span style="background-color: rgba(255, 255, 255, 0);">Burnham J C. American medicine's golden age: what happened to it? In: Leavitt JW, Numbers R, eds. <span class="ref-journal">Sickness and health in America, readings in the history of medicine and public health</span>. Madison, W: University of Wisconsin Press 1985</span></div>
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<span style="background-color: rgba(255, 255, 255, 0);">5. </span><a href="http://www.gmc-uk.org/Good_medical_practice___English_1215.pdf_51527435.pdf">http://www.gmc-uk.org/Good_medical_practice___English_1215.pdf_51527435.pdf</a> </div>
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6.<a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)73346-8/abstract">http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)73346-8/abstract</a></div>
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7.<a href="http://www.healthprofessionals.gov.sg/content/dam/hprof/smc/docs/guidelines/2016%20SMC%20Handbook%20on%20Medical%20Ethics%20-%20(13Sep16).pdf">http://www.healthprofessionals.gov.sg/content/dam/hprof/smc/docs/guidelines/2016%20SMC%20Handbook%20on%20Medical%20Ethics%20-%20(13Sep16).pdf</a></div>
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8. http://www.medicalboard.gov.au/Codes-Guidelines-for-advertising-regulated-health-services.aspx </div>
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9. <a href="http://iar.agcm.it/article/viewFile/11063/10256">http://iar.agcm.it/article/viewFile/11063/10256</a></div>
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10. <a href="http://ijme.in/articles/ethics-of-professional-advertising/?galley=html">http://ijme.in/articles/ethics-of-professional-advertising/?galley=html</a></div>
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George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com2tag:blogger.com,1999:blog-1727015255614797283.post-16086981164127830952019-03-07T04:26:00.000-08:002019-03-07T04:26:19.205-08:00What is wrong with the the continuing education point system as a mandatory requirement for registration.<div dir="ltr" style="text-align: left;" trbidi="on">
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Let me be very clear. Continuing education is a necessity for professional upgradation and public safety. So when I ask "what is wrong..." it is immediately construed as being negative. No! But the system must be implemented in a rationale and beneficial manner causing the least inconvenience to those involved. The issues that require review include</div>
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1. The CME/ CDE is not a requirement for registration as a dentist according to the Dentist Act. While there is a gazetted regulation making it mandatory, it cannot be legally binding as the Dentist Act 1948 ( along with amendments) which lays down the criteria for registration as a dentist in India does not have such a requirement. If challenged in a court of law the Act will prevail over the regulation. Therefore the Act will need to be amended to make the CDE points binding.</div>
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2. The cost of earning CDE points is very high, at the present. To earn 20 points a year a person will need to spend an amount that is not affordable by a newly minted dentist, thousands of whom do not even have a job. Medical doctors need to earn only 30 hours in 5 years whereas dentists require 100 hours in 5 years ( the calculation of credit per educational hour is of course more stringent for medical doctors). The Dental Council of India or the State Dental Council should therefore offer free programmes to help practitioners, if it is to be made mandatory. At a time when webinars and online learning and even assessment is possible at a very minimal cost, the necessity to travel and attend costly programmes must be eliminated. Online attendance can even be monitored better. The current system of points for attendance at conferences is a farce with most attendees standing around in corridors and foyers when lectures are delivered to near empty halls. The Kerala state IDA has just announced a free state CDE in Oral Surgery. As one of the speakers, I have waived all reimbursements for travel and stay, which is normally extended for outstation lecturers. I am sure that several senior experts and teachers are willing to do so. If the IDA, a private association, can do it, then the Government statutory bodies should be able to do so with government subsidies. It is after all meant to provide public safety.</div>
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3. Some categories of professionals are exempt from continuing education. This seems to be scripted to benefit selected segments. Let me deal with each of these exemptions.</div>
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A. Section 8.1 says all dentists above 65 are exempt from CDE. I should be celebrating the exemption because I will be 65 in 5 years and therefore exempt when the first evaluation takes place. But no! If the principle of CDE is based on the ethics of being currently updated there is no rationale in exempting a 65 year old, unless he is not practising, in which case he has no need for those points anyway. How does a 65 year old become safe for practice without CDE when a 55 or 60 year old is deemed unsafe if not updated. It is purely arbitrary.</div>
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B. Section 8.2 exempts all MDS staff with 15 years experience and currently teaching post graduate students. This is quite ridiculous as the CDE points is for the sake of safe practice of dentistry. Not just one specialty. The exemption is acceptable if these professors are not practising, as in central or state government institutions which do not permit private practice ( e.g. AIIMS, JIPMER or states like Kerala Government etc). It is even applicable to specialists who only practice their specialty, which is difficult to determine in the absence of a specialty register. However it is unfair to exempt teaching dentists who practice general dentistry after their college commitments. Thousands do so and they mostly do general practice outside of their specialty. For example, how can a professor of oral pathology be provided exemption of CDE points when he/she does endodontics, orthodontics or oral surgery in his/ her private practice. The whole notion is facetious and poorly thought out.</div>
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C. Section 8.5 says that if one is 'seriously' sick, it is necessary to get a certificate from a Government doctor. It means if one has a CABG it is not enough to get it from your private cardiac surgeon or hospital. You need a certificate from a joint director of health service or some person.Why? Because Government doctors are honest!!!</div>
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There are several other issues. Can a person working abroad retain his/her registration. If so how? Are foreign CDE programmes accredited. What will happen if you don't fulfil the CDE point requirement? Will your registration be cancelled? Since one requires 20 points minimum a year, does it mean one can be considered as ineligible in the first year itself? How do you get your registration back? </div>
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Does the DCI need to go back to the drafting table?!!!</div>
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George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com6tag:blogger.com,1999:blog-1727015255614797283.post-2815118622754771932018-09-19T10:04:00.001-07:002018-09-19T10:04:55.290-07:00New CDE regulations- another avenue for institutions to make money??<div dir="ltr" style="text-align: left;" trbidi="on">
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<b><u>Continuing dental education- will be it another avenue for profiteering by institutions??</u></b></div>
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In 2007, the Dental Council of India came out with an ambitious but poorly drafted, half hearted and ambiguous attempt to make continuing education compulsory for practising dentistry. In 2011, a new regime, struck it down as non implementable due to several reasons. Five years later it has now emerged again as a rehashed version of the original regulation, by the same dispensation that struck down the earlier version.</div>
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There are two things that strike me.</div>
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1. Why is it that the already beleaguered and over produced specialty of dentistry alone require such compulsory updation as a pre requisite for renewal of registration when critical health bodies like MCI, AYUSH and other bodies have not imposed such compulsions?</div>
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2. Why has the onus of providing such updation been placed almost exclusively with Dental Colleges which have been variously described as ranging from very good to very bad. In other words, why are other private organisations and skill providers been excluded from accreditation?</div>
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Before anybody gets me wrong, let me explain that I am in full support of doctors and dentists being fully updated on advancement in their science as a matter of public safety and quality treatment. However, there are too many glaring holes in the structure of the current regulation, though most of us will concede that it is a significant improvement over the last attempt, a decade ago. My position on the matter is simple. Make learning a more open process where people can gain knowledge in less expensive ways provided by modern communication technology. We do not need another regulatory body breathing down the backs of the poor struggling dentist who has to reckon with one more 'bully' in the form of the state dental council. Here are some of the objections</div>
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1. The primary task of providing continuing education has been offered to the teaching institutions. Are we looking at a bail out package for Dental Colleges that are sinking for want of students taking up dentistry? Going by the new regulation, it seems that the statutory bodies are providing them with another opportunity to make money. It is completely presumptuous to think that teachers in dental colleges are better placed to provide skills and knowledge. On the other hand the need for continuing education and updation is precisely because many of the sub standard colleges have failed to provide good training in the first place.</div>
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2. Even more presumptuous is the fact that teachers do not need continuing education. They are exempt!! This could be true, if they were pure teachers who did not do private practice and their work is restricted to the dental colleges. Let me give you an example. How can a teacher in Oral Pathology, who neither sees nor treats dental patients in a dental college be allowed to practice dentistry after college hours without the mandated CDE points? Does teaching Oral Pathology give the person knowledge about Infection control, Ethics, Crown and Bridge preparation or Oral Surgery. Absolutely not!!! The only way that this major anomaly can be addressed is by preventing dental college staff from private practice or by making it compulsory for them to undergo CDE like every body else, if they wish to practice after their working hours.</div>
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3. By introducing a self assessment protocol we are giving too much of discretionary powers to the regulators. They can pick and choose their victims. Most of us see the enormous possibility of some of these powerful persons venting animosity by targeting those they have professional or personal rivalry with. If made compulsory, CDE as a compulsory requirement, should be used universally against all those who do not comply by a process of due diligence exercised by the regulatory bodies. Any attempt by regulators to exempt anybody from statutory action for non compliance, should be considered as a corrupt practice and criminal action should be initiated against the regulators. This is the only way to prevent selective harassment.</div>
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4. There is a discord in the rules for obtaining CDE points. It says one should have 100 points in 5 years but not less than 20 points in a single year. Going by this rule, a person who gets less than 20 points in the first year, already faces disqualification. Why wait for 5 years to take action? Another clause also says ' not more than 25 points in a year'. What will the DCI do? Punish those who learn more? We will ignore that as oversight or stupidity!!</div>
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5. The notification says it comes into effect immediately. Does this mean that a dentist cannot register on the 1st January 2019, if they do not have 20 points? Are all the oversight mechanisms in place or is it going to be arbitrary. Is my next CDE programme this weekend valid? Is the next National Conference of my specialty valid? Too many gaps, if you ask me.</div>
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There are several more vacuous discrepancies in this incomplete regulation. </div>
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My bottom line is that while the DCI has the powers to make sub ordinate legislations, it cannot legally refuse re -registration on the grounds of this new regulation. The Dentist Act only requires a recognised qualification and a prescribed fee for registration. In any conflict between the Act and regulation, the Act will prevail. I hope the DCI is prepared for litigation, unless they amend the Act and even then it cannot be used retrospectively. It cannot be used for those who are already registered.</div>
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The DCI should remove draconian consequences for not updating and encourage CDE as a positive way to remain relevant in the profession. In as much as that is concerned, I appreciate the provision in the new regulation for certifying those who achieve the recommended CDE points. That alone should be an incentive. Not punitive action!</div>
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George Paul</div>
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Oral and Maxillofacial Surgeon</div>
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Salem</div>
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George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com8tag:blogger.com,1999:blog-1727015255614797283.post-62380476752680082842018-08-05T20:11:00.000-07:002018-08-05T20:11:02.521-07:00An open letter to the Secretary of the Indian Dental Association<div dir="ltr" style="text-align: left;" trbidi="on">
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Dear Dr Dhoble,</div>
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First, let us affirm that this letter is not ad hominem and it should not be taken personally. At the end of our careers, we have no interest or ambitions to any post or privilege in IDA. But as members or past office bearers of the association we have deep concern about the way the Indian Dental Association ( IDA) is being run. We have brought this matter to your attention in a personal note and have not received a credible reply or explanation about several issues being raised. We also wish to assert that we are not being influenced by any group as is being perceived by some of your friends.</div>
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Therefore this open letter. While we acknowledge the fact that you have made the IDA into a gleaming corporate structure, we are also concerned about the meagre benefits the contributing dentist members around the country are getting out of their association. The matters of immediate concern are ( but not limited to)</div>
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1. The concentration of power in the hands of a few. The Hon. Secretary's post is a time bound one as per the constitution but we have seen just 2 secretaries in the last 36 years. By the end of the present term in 2022, the secretary would have served 20 years. The general body meetings for election of the HGS are somehow arranged to always be in the incumbent secretary's home city or at least state. This seems more than a coincidence as it has happened two times and we will not be surprised if it is scheduled again in Mumbai / Maharashtra in 2022 for the next election.</div>
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2. The IDA Head office is run like a corporate office at enormous cost to the association. We see from the balance sheet/ statement of accounts that the HO spends about ₹6-8 crores a year ( 4 previous year statements available to us). The rent for running the office and salaries run way beyond 1 crore each. In your communications you have claimed to have 80 employees. The annual electricity bill is ₹ 15 lakh , there are humongous expenses for travel in India and abroad amongst other things. This does not seem to be helping the contributing dentist from various parts of India in any meaningful manner. Today's offices, nationally and internationally, are run with paperless administration and e- governance. Major International Associations with larger memberships and handling greater logistics are run at far lower costs and manpower ( calculated on purchasing power parity). More over, this is not a permanent office and it is meant to be rotated from time to time. Can this kind of expenditure on resources be justified, particularly when the members do not even get a quality journal free of cost. What does a dentist shelling out ₹1400 a year in these hard times get for their contribution?</div>
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3. The sponsorships from toothpaste and other companies, received and disbursed through the HO, seems to be too centralised. Current government and statutory regulations frown on corporate sponsorships and the money received itself is questionable. Let us assume that it is a 'corporate social responsibility' ( CSR) and there fore justified because the profession and public has after all benefitted in some small ways by their schemes. However the centralised receipt and disbursement of these sponsorships call into question the manner in which the finances are being spread across the branches. If at all sponsorship as CSR can be received, the dentists are concerned about transparency and fairness in its distribution for conduct of continuing education or knowledge dissemination programmes. In fact the ethical conflicts raised by such sponsorships itself should be scrutinised.</div>
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3. A recent development suggests that the IDA is being turned into a professional service provider for a statutory body, namely the Maharashtra State Dental Council. This is being viewed sceptically by many members. We understand that the IDA is providing logistic and data management support to the Maharashtra Dental Council for a fee of ₹45,000 a month and ₹5 lakhs as development fees. We have reservations on this matter for 4 reasons</div>
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a. Whether the General Body of IDA was consulted before involving the IDA as a business service provider. Business outsourcing is not a function described in the IDA constitution.</div>
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b. Whether it is correct to use the services of employees of the IDA head office for business purposes as they have been employed ( at enormous cost) for administration of the association.</div>
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c. Whether the company Dentsoft, which developed the software, belongs to any office bearer of the IDA. </div>
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d. We understand that the Hon.secretary general of IDA is canvassing for the post of DCI member under 3 (a). Since the IDA secretary will have access to the data of the prospective voters for 3(a) in the State Dental Council elections, there seems to be a conflict of interest and an unfair advantage to the Secretary? This model will be misused across the country if we allow this to happen. </div>
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There are several other issues pertaining to the democratic running of the organisation. We strongly feel that the association would be better run by employing a highly qualified executive secretary ( as is done by several international associations) with adequate pay and perks rather than have a professional dental practitioner running the affairs of office as Hon. Secretary General with no pay. Alternately, the term of of the secretary should be limited to one term. The association should be run by a President and executives elected by the members for a fixed term and preferably in a centralised city where the real estate is not so high and the human resources are more rational. We need an association that can work towards the welfare of the dentists who are going through a rough patch, rather than build plush corporate offices and initiate programmes that have no impact on the practising dentist for whom the association was created in the first place.</div>
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As a beginning, I hope the members will strongly gather together and bring change in the constitution so that we can have a more democratic and decentralised organisation working towards the welfare of the dentist, his profession and the public. Despite the requirement that the constitution and amendments be circulated, there is no public access to it.</div>
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We do not want World Dental Shows and pomp. We need welfare for the members at a time when dentistry is going through some bad times. We need representation in the Clinical Establishment Act. We need social security and indemnity. We need free continuing education, not just in Mumbai but in the remotest parts of the country. Mostly, we need absolute transparency and free and fair elections.</div>
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We need change! It can only come with new and younger faces of a bright new generation. As a secretary, you can still make it happen and salvage your position by engineering change and passing on the baton after serving for 20 years. The gray beards must retire gracefully. </div>
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This letter in its authentic original format is available on the blog site www.maxfaxgp.blogspot.com . Any variation in its dissemination is not the responsibility of the authors. It is being published in the interest and welfare of the profession.</div>
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George Paul- Member IDA, past Hon. Gen. Secretary and President AOMSI, TN State Legal Cell Convenor</div>
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Viswanath V- past State IDA president, Kerala State and CC member.</div>
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Murali Venkataswamy- Member IDA, past TN State Legal Cell convenor.</div>
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George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com1tag:blogger.com,1999:blog-1727015255614797283.post-75715132008589814942018-05-07T02:42:00.001-07:002018-05-07T02:43:18.870-07:00SOCIAL MEDIA AND THE MEDICAL PROFESSION<div dir="ltr" style="text-align: left;" trbidi="on">
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There is a message circulating on the social media that is a cause of great concern and brings into focus the dark side of this new media phenomenon. I am trying to make a balanced statement on why the social media should not and cannot be used to settle personal scores between doctors and patients, especially when it can do unjustified harm to the reputation of the other.</div>
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The issue in question refers to the travails of a retired army officer living in coimbatore who claims to be the victim of medical negligence. The message expresses with angst his sufferings with an implant supported denture, done and redone, by two dentists in Coimbatore for which he spent a large some of money. I had the opportunity to see the letter written by the patient on several Whatsapp groups, expressing his angst. I also received a copy of an X-ray ostensibly of this patient's jaws. As a dentist who has been in Maxillofacial surgery for the last 36 years and as a qualified lawyer and ethicist I have a few comments to make. This does not purport to defend or vilify anybody.</div>
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1. I do not wish to comment on the treatment per se because I am not an implantologist although I have a working familiarity with the process. Implants are done by another specialist in our practice. However, I can say that the patient's claim about the cost is irrelevant. Implant dentures are costly fixtures and I am sure the patient was informed about the same. The number of implants and how it is engineered are purely technical details and can be justified based on the prevailing situation of bone and nature of prosthesis. There is no such thing as an exorbitant professional fee unless it is sprung on people without notice. That does not seem to be the case.</div>
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2. I fully empathise with the patient who is obviously frustrated because some of the teeth on the denture where constantly chipping off. If I had paid 6.5 lacs for a treatment, I too would be frustrated. I am close, in age, to the patient and can fully understand the despair one feels as we grow old with multiple medical problems. However, one cannot justify the act of using social media to name and blame the medical/ dental care giver based on personal opinions.</div>
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3. For the lay persons benefit, let me explain what an implant supported denture is. Implants are titanium devices that are planted surgically into bone. They can fail if improperly placed or if the bone condition is unfavourable or due to various other situations. These days, 95- 98% of implants do not fail. </div>
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This is followed by loading the implants with a functional denture after 3 to 6 months or sometimes even immediately. These dentures are fabricated in dental laboratories and the teeth on them is made of a costly material which is expected to bear normal bite forces.</div>
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4. <span style="background-color: rgba(255, 255, 255, 0);">Having seen the X Ray and CT scans, it is obvious that in this instance the implants have remained intact after 2 years. However, </span>the patient's teeth on the denture were supposedly getting chipped. It cannot be seen on a radiograph but it is a possibility. This can happen due to improper fabrication or by sub standard material used by the laboratory etc. Since the patient complains that it has occurred twice with two different dentists and labs it is unlikely to be due to the laboratory procedure. This can also happen if there are excessive forces acting on the dentures. These forces maybe due to para functional activity of jaws, due to movement disorders like Oro facial dyskinesia, bruxism ( night grinding) or simply hyper function. I cannot comment on what the cause for the chipping of teeth was or on the engineering principles that required the number of implants he had. This is because of my limited knowledge on the nuances of implantology and full mouth rehabilitation. However, I can comment on the line of action the patient chose to publicise this issue, either because of ignorance or despair or both.</div>
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5. If the patient assumed that there was negligence on the part of the dentist, he may well be right or wrong. That needs to be decided by experts on the direction of a legal or statutory authority and should be based on evidence based science. There are several provisions within the legal and statutory system to get relief and a due process of law to ascertain medical negligence. I, as the author of a book on medical law and having written several articles on the subject of medical negligence, feel strongly that the gentleman has used the social media as a tool to defame the dentist on the basis of his personal opinion. Medical negligence can only be decided based on evidence that a practitioner has caused injury by failing to meet the standards of care prescribed by evidence based medicine. The Supreme Court has repeatedly reiterated that mere dissatisfaction or the development of a complication does not constitute medical negligence. </div>
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6. Under these circumstances the decision to take the matter to the public without any technical input and premised purely on the basis of personal experience or dissatisfaction amounts to subverting the provisions of law pertaining to medical negligence. Directly putting up complaints on the social media drawing attention to the professional abilities of their doctors and imputing motives to their actions amounts to civil and criminal defamation. This is particularly so because the nature of the post appears to be ad hominem ( personal).</div>
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My comments are a reaction to an increasing tendency of people to express their angst and targeting medical professionals in a way that affects their profession and standing in society. To do so, if they are indeed found negligent by a court of law, is different from making unqualified judgment based on personal experiences. </div>
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The patient, in the above situation, can always go to court or approach the relevant statutory body to obtain relief. It must also be remembered that the doctor who has been vilified has the option of going to court for civil and criminal defamation against the patient for using the social media with the obvious intention of causing loss of face and reputation which the professional might have built up over several decades. This amounts to extra judicial vigilantism in the name of warning the public. </div>
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<span style="background-color: rgba(255, 255, 255, 0);">Both doctors and patients must act within their remit, realising that both have rights, duties and responsibilities.</span></div>
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<span style="background-color: rgba(255, 255, 255, 0);">George Paul</span></div>
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<span style="background-color: rgba(255, 255, 255, 0);">Oral and Maxillofacial Surgeon</span></div>
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<span style="background-color: rgba(255, 255, 255, 0);">Consultant in Medical Law and Ethics</span></div>
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George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com3tag:blogger.com,1999:blog-1727015255614797283.post-23838697317343919522018-04-20T09:05:00.000-07:002018-04-20T09:12:15.703-07:00Attention members of DCI<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="color: #454545; font-family: "uictfonttextstylebody"; font-size: 23px;">AN OPEN LETTER TO THE PRESIDENT AND EC MEMBERS OF THE EXECUTIVE COUNCIL OF THE DCI</span><br />
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Respected sirs and madams,</div>
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I happened to see a memo from the office of the DCI restricting the conduct of any kind of course not pre approved by the Dental Council of India ( No De-110(186)(complaint)-2018/457. This obviously sponsored notice, coming as it does at this point of time, seems to suggest that all programmes aimed at providing knowledge or refreshing skills must have the approval of the Dental Council of India. </div>
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Respected president and members, I beg to differ, like thousands of others, because the DCI has no such powers to curtail the improvement or renewal of knowledge and skills from qualified persons with or without the sanction of the DCI. The notice cites sections 10, 10A, 10B, 51 and 52 to make the fallacious argument that the DCI is the custodian of all clinical learning or updating. It has freely and wrongly interpreted the meaning of the term ' qualification' to mean competence or acquisition of knowledge and skills. I hope the statutory body had spent a little more time taking a legal and grammatical opinion before coming out with such an ambiguously framed memo hindering the fundamental right to learn and benefit society.</div>
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Sirs and madams, the heading of section 10 of the Dentist Act refers to registrable qualification. I am sure that you are aware that the medical and dental statutory bodies regulate only registrable degrees which indeed are qualifications. The prime registrable degree in dentistry is BDS . A registered dentist with a BDS is allowed to practice dentistry including all specialties depending on their interest, ability and training. The postgraduate qualification is only an additional or add on registration. Add on Registration for post graduation essentially permits one to become a teacher in a college approved or recognised by the DCI. It does not provide exclusivity of clinical practice in a specialty, as India ' DOES NOT HAVE' a separate specialty register.</div>
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In other words, the members of the statutory body must understand, that a qualified BDS graduate can do Endodontics, Oral surgery, periodontics or orthodontics according to his expertise which is achieved through experience, practice and skill enhancing programmes. Where they obtain these additional skills within the purview of dentistry is not the business of the DCI . This is made clear in the definition of 'recognised dental qualification' in chapter1 (j) which includes only 'qualification in the schedule'. In which part of the schedule are there references to refresher courses recognised by DCI, sir??? </div>
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Section 10(2) requires all these qualifications to be entered in the schedule. Which courses other than those offered by recognised dental colleges are included sirs? Are the courses conducted by IDA or Specialty associations part of the schedule? Does the DCI have powers and guidelines to include them? NO! Quoting section 51 and 52 in the aforesaid memorandum/ notice is at best a wrong interpretation and at worst an attempt to mislead. These sections only refer to practice of registered dentists and has nothing to do with acquisition of further skills and knowledge by them. </div>
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In fact the code of ethics regulation ( of which I was one of the draftees) encourages the acquisition of knowledge without conditions. It exhorts dentists to continuously upgrade skills in Chapter I, 3.2 and subsections. Nowhere does it say that imparting knowledge and giving a certificate of experience is unethical as implied in your notice.</div>
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Let me try to cite an example. Several hospitals provide Basic and Advanced life support training for a fee. The same with Trauma Life Support. Does the DCI have to whet every certificate programme in every hospital or institution in India and abroad to have a current training record in BLS, which you will agree is an essential part of safe practice. Skill renewal and enhancement can be provided in formal and informal settings with and without certification from a person with established skills. Dental practitioners get trained by other practitioners in the use of new techniques and materials. They attend courses conducted by industry pioneers and manufacturers of new devices and equipment. What has DCI to do with these?</div>
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Medical science has advanced only because of these courses which cannot be or has not been provided in teaching institutions during their limited course of study. In fact the need has arisen because many recognised dental colleges have not been able to provide the knowledge and skills as prescribed in the curriculum.</div>
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Sirs and madams, I request you to withdraw the memorandum which was issued in haste. If indeed the Dental Council wishes to bring in regulation for accreditation of providers of knowledge and skills, please create terms of reference, guidelines and make amendments to the constitution rather than issue fiats which retard the continuous enhancement of knowledge and skills by imposing unreasonable and unconstitutional bars on the dissemination of information.</div>
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Thanking you,</div>
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Your sincerely</div>
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George Paul</div>
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Reg No 10285 ( TNSDC)</div>
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Past President AOMSI</div>
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George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com4tag:blogger.com,1999:blog-1727015255614797283.post-75032005407278961542016-10-07T20:04:00.001-07:002016-10-07T20:21:39.394-07:00Sharon palliative centre- dignity in life<div dir="ltr" style="text-align: left;" trbidi="on">
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It has been said that "Death with dignity is better than life with humiliation". It is an affirmation of what most of us secretly hope for. In India, a dignified death is a difficult proposition. A TOI report says that of the 9 million deaths every year in India, nearly 6 million need some kind of palliative care. The fact that most do not have access to it, is altogether another matter.The same article throws up a shocking reality- 80% of the palliative care centres in India are situated in one state, Kerala ( with 3% of the nation's population). </div>
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Sharon Cancer Centre in Salem, TN, has just been renovated to serve as the largest palliative centre in our region. Most Doctors, over the years, have been obsessed with strategies and means of prolonging life without actually considering the quality of life. Palliative care focuses on providing care for the hopelessly sick by helping patients and family to cope with their physical pain and disability. While palliative care can sometimes be given along with their treatment, most patients admitted for end of life care will receive very little in the form of therapeutic interventions.</div>
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The staff at Sharon's palliative facility have been carefully chosen, keeping in mind the special needs of patients with advanced disease. The doctors, nurses, counsellors and social workers form a tight and empathetic group of specially trained personnel committed to making the life of terminally ill patients comfortable and dignified.</div>
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The premises have been carefully structured and planned keeping in mind the special needs of our patients. The verdant campus, situated in sylvan surroundings at the foothills of the Shevarayan hills, is a pleasant blend of natural beauty and functional efficiency. The buildings are disability friendly and well equipped to handle the unique needs of our special patients.</div>
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Sharon palliative centre was conceived as a non profit establishment committed to egalitarian principles that will not discriminate on the basis of type of diseases, social status, race, religion, language or ethnic background. </div>
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However in the absence of any external funding the management will strive to run it at a minimum fee to cover actual expenditure. A percentage of the beds will be reserved for indigent and extremely poor patients who will be screened by a select panel. Sharon palliative care currently provides clean and airy housing, bed and linen. Diet plans and pain medication is provided on an actual cost basis. Specially trained palliative nursing is covered in the base costs. Surgical or medical interventions are generally not curative and meant only for alleviating pain and discomfort through licensed narcotic medications and limited toilet or pain relieving surgeries. Special requirements including visits by external consultants can be obtained on request through the administration. Special needs like private rooms, air conditioning etc can be made available at cost price but all general services are charged on a flat affordable fee structure. We look forward to volunteers from the public, who can provide solace, comfort or mere companionship.</div>
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Sharon will also expand its services to include domiciliary care where nurses and social workers will make periodic visits to homes to counsel, advice and intervene for terminal patients needing home care. Placement of trained male or female nurses for continuous home care will eventually be rolled out later to meet in -house domiciliary care needs.</div>
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Those willing to offer their services on a voluntary basis are requested to contact Dr Karthik Rajaratinam <span style="background-color: rgba(255, 255, 255, 0);"><a href="tel:9894027274" x-apple-data-detectors-result="1" x-apple-data-detectors-type="telephone" x-apple-data-detectors="true">9894027274</a></span></div>
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IF YOU KNOW ANYBODY WHO NEEDS HOSPICE, PAIN OR PALLIATIVE CARE PLEASE CONTACT Dr Kartik Rajaratinam <span style="background-color: rgba(255, 255, 255, 0);"><a href="tel:9894027274" x-apple-data-detectors-result="2" x-apple-data-detectors-type="telephone" x-apple-data-detectors="true">9894027274</a></span></div>
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George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com5tag:blogger.com,1999:blog-1727015255614797283.post-89748801034558165212016-09-10T06:42:00.000-07:002016-09-10T06:55:07.154-07:00An open letter to the Hon. Minister for Health and Family Welfare - Shri J P Nadda<div dir="ltr" style="text-align: left;" trbidi="on">
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Sir,</div>
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This letter is a reflection of the angst that has preoccupied the minds of thousands of professionals in the field of dentistry. Over the last decade and a half, dentistry has suffered enormously at the hands of several persons who have been running the Dental Council of India and the Health Ministry. The profession has become a burden to thousands of young people who have chosen it, believing that it would give them a meaningful role in society and a means to a stable economic career. The unprecedented and totally unplanned increase in colleges and seats has caused an irreversible glut in the profession leaving hundreds of unemployed dentists and specialists. Many have abandoned the profession resulting in an unforgivable waste of human resources. All this was done to feed the business interests of certain persons who run private institutions as a pure business with the help of the statutory bodies- indeed an unholy nexus!</div>
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We appreciate the initiatives being taken by the government and the judiciary to revamp the medical statutory bodies. Dentistry is perhaps the worst. In this regard I wish to bring to your notice the fact that the Dental Council of India continues to be run through the agency of corrupt members, nepotism and poor governance. It is a sad reflection on the Health Ministry that despite numerous petitions pointing out the illegal membership of the President and several members, no action has been taken against them. The nomination of the President of DCI Dr Dibeyendu Mazumdar to is flawed ab initio as also that of several others. Despite overwhelming evidence produced by several persons and pending cases challenging such nominations, the health ministry has done little to correct the situation. Nothing short of disbanding the DCI and reconstituting it anew will solve the continuing problems faced by the profession. </div>
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Sir, there has to be </div>
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1. A complete moratorium on new dental colleges and increase of seats in under graduation and post graduation, because of the super saturation by poorly qualified dentists. </div>
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2. The quality of students entering and exiting the institutions have to be monitored through appropriate examinations in the interest of public safety.</div>
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3. The complete administration of the profession has to be revamped to remove illegal members and prevent concentration of power in the hands of a few. This has to start by sacking all the illegal members, starting with president. It is after all the Health Ministry that has been tasked with the job of constituting all the statutory bodies. It has to be their responsibility to dissolve and reconstitute when it becomes unbearable.</div>
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Looking forward to a speedy reaction from your ministry.</div>
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I remain</div>
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Sincerely</div>
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George Paul</div>
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George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com1tag:blogger.com,1999:blog-1727015255614797283.post-35297018590990627242016-08-25T20:55:00.000-07:002016-08-25T20:55:59.616-07:00A half ticket to Heaven!<div dir="ltr" style="text-align: left;" trbidi="on">
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<span lang="EN-US" style="background-color: rgba(255, 255, 255, 0);">The in-flight newspaper on the Kenyan Airways flight from Mumbai to Nairobi announced that hundreds of people were dying of malaria in the rift valley. The rift valley is endemic for rift valley fever and malaria which kill hundreds of humans and animals annually.</span><span lang="EN-US" style="background-color: rgba(255, 255, 255, 0);">I never imagined that malaria took its toll in such a dramatic way until I saw a child die in his mother’s lap. I had just landed at the mission Hospital in Kilimongogo, where I was to spend the next one-month as a volunteer dentist. A little boy with cerebral malaria lay on the lap of his mother, his eyes rolled up to reveal only the whites. He was delirious, muttering words and making incomprehensible noises. The mother sat mute and helpless as the young doctor examined the boy and drew blood. “Cerebral malaria” the doctor informed me “do you see it in your country?” The doctor was himself a refugee from Rwanda- A Tutsi, who fled massacre in his own country. “ I am sure there are cases” I replied “ I haven’t seen one though.” Later that evening he informed me that the child died and they were keeping the boy till morning so that the mother could take him back home- somewhere in the rift valley, I assumed. There was no public transportation. The hospital had just one ambulance and several people were dying. I wondered how the mother was going to deal with it. She was gone in the morning, carrying her dead son !</span><span lang="EN-US" style="background-color: rgba(255, 255, 255, 0);">This incident brought back memories of something that happened many years before that incident, in my hometown of Salem in India. A little boy with an ulcerated growth on his palate was referred to me from a village. As an Oral surgeon I often encountered these conditions. The father explained that he was an extremely poor sharecropper. They were unable to get any treatment at the government hospital and were referred to me by their village doctor. The growth was surgically removed under local anaesthesia and sent for a biopsy. The report was inconclusive. A couple of months later the same boy was brought to me again. The surgical site in his mouth had healed completely but he now had an ulcerated lesion on his leg, quite similar to the one he had in his mouth earlier. His leg was grossly swollen, as were his genitals. I had the boy admitted and asked for my friend Dr Ranjan David, a general surgeon, to see him. Despite Ranjan’s best efforts the boy died of septic shock a day later. We never found out what the problem was. The hospital was gracious enough to waive all the expenses except the drug bill. As the little boy was admitted in my care, I went over to complete the formalities. The boy’s father was extremely distraught. He was inconsolable and kept wondering how he was going to tell the boy’s mother in the village. I realized he did not have the money to pay the drug bills. We passed the hat around and collected some money to pay it off. I then asked him how he planned to take the dead boy home. His brother in law had enquired at the local taxi stand and was told that they charged a hefty sum to carry a dead body. Virtually no ambulances transported corpses those days, as there was a stigma on such vehicles. A couple of taxis parked around the general hospital did transport dead bodies, but they charged exorbitantly. He told me that he could not afford the transportation costs and that he would manage somehow. I watched helplessly as he thanked me and heaved the boy onto his shoulder and threw a cloth on to his head. He told me that he was going to take a one-hour bus ride to his village. When I asked him if the conductor would allow it, he answered simply “ I will say the boy is sleeping and take a half ticket for him.” The picture of a father carrying a dead child on his shoulder in a bus was imprinted indelibly in my mind and it comes up every time we consider the inequities in our health system.</span></div>
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George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com0tag:blogger.com,1999:blog-1727015255614797283.post-64777499105366553872016-06-23T05:14:00.001-07:002016-06-23T05:19:34.906-07:00Appointing a secretary- breaking the rules!<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="background-color: rgba(255, 255, 255, 0);">How the rules and regulations have been twisted to select a secretary to DCI.</span></div>
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<span style="background-color: rgba(255, 255, 255, 0);">As per the Dentist Act, section 8.1 ( quoted by the DCI in its office memo) it says ' the Council shall select a secretary'. It was decided that the secretary will be selected by a committee ( probably to give the impression of fairness). The 1956 regulation in Part IV section 47-51, clearly defines how a committee has to be selected. It says that ' The council at anytime shall, by adoption of a motion, appoint a committee........'</span></div>
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<span style="background-color: rgba(255, 255, 255, 0);">The key word is 'the Council'. In the preamble to the 1948 Act and the 1956 Regulation, 'The Council' is defined as ' The Dental Council of India, constituted under section 3 of the Dentists Act'. This means that the Council means all the members of the General Body ( GB). Therefore any act by the DCI requiring the Council to decide means that the decision has to be taken at a GB.</span></div>
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<span style="background-color: rgba(255, 255, 255, 0);">Now look at how the Secretary was selected. The DCI calls for a vacancy of secretary ( having thrown out the previous acting secretary because he was not co-operative) in the Employment news. The President/ EC appoints a committee. Now it is very important to understand that neither the President of DCI nor the EC is the 'Council'. I am reiterating again, that the Council means, all the members of DCI under section 3, which means the GB. Therefore 'the committee' should have been formed at the 134 th GB. It was not. It was constituted illegally by the President and the EC subsequently. They then went ahead with the interview despite objection from the Health Ministry ( letter reproduced). The selection was then ratified by the EC and the 135th GB. This is completely illegal as 'the Committee' consisting of the President, Vice President and a member are per se illegal because it was illegally constituted.</span></div>
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<span style="background-color: rgba(255, 255, 255, 0);">This same modus operandi has been used to grant favours to Dental Colleges, by sanctioning PG and increasing BDS and MDS seats without prior sanction of GB. The whole process, it appears, is a manipulation by the President and his close friends in the EC leaving the GB to be a silent spectator with no powers. The subsequent ratification is obviously just a joke!!</span></div>
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George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com0tag:blogger.com,1999:blog-1727015255614797283.post-64224497909453274772016-05-08T09:44:00.000-07:002016-05-08T09:44:40.624-07:00Everything you wanted to know about NEET but was afraid to ask!<div dir="ltr" style="text-align: left;" trbidi="on">
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<b><u>What will happen about admissions this year?</u></b></div>
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As per the Supreme Court directives, the following are almost certain . There will be two phases of NEET for MBBS/ BDS. One has already been completed on 1st May 2016 and the other will be held <a href="x-apple-data-detectors://2" x-apple-data-detectors-result="2" x-apple-data-detectors-type="calendar-event" x-apple-data-detectors="true">on 24 th July 2016</a>. All admissions to be completed by September. The Supreme Court clarified on 6th May 2016 that those who attempted the first phase ( AIPMT) on May 1st cannot attempt the 2nd phase. The Supreme Court also clarified on 5 th May that private institutions cannot conduct their own entrance tests. With regard to State Government Entrance tests, the Court is yet to give a ruling.</div>
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<b><u>My take: </u>it is a good beginning. The state government admissions, if permitted, is also acceptable since there was insufficient time. The stricture on private entrance test is a great boon for merit students and a very bad blow to those institutions, particularly DeemedUniversities that conducted fake tests, and believed that the party was for ever!!!</b></div>
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<b>I personally think it is unfair to not permit those who attempted in the first phase ( AIPMT) to not have a second try. It is unfortunate but not as bad as things were before. Those who attempted first time were serious students who prepared. Those who did not are unlikely to score much anyway. That is consolation for the former!!!</b><br />
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<b><u>2. What about PG admissions?</u></b></div>
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For this year there will be no change in PG admissions as per the Supreme Court. Those already admitted in private and Deemed Universities after paying huge capitations may have escaped by the skin of their teeth. The NEET will be imposed from next year.</div>
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<b><u>My take: </u>hundreds if not thousands of merit students have been disenfranchised by the system, hopefully for the last time. In many institutions crores of rupees were paid, seats booked and fake exams held. Hopefully it will not happen again.</b></div>
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<b><u>3. How will private institutions survive financially and make profits if the new policy is implemented?</u></b></div>
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Private institutions are not expected to make money. The Supreme Court has issued a clear directive in several cases that There can be no profiteering from higher education including medical education. They can levy a reasonable tuition fee based on actual expenses to be supervised by a High Court appointed Retired Judge and a chartered accountant to audit the expenses and income. Here is the relevant portion of the judgment</div>
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<span style="background-color: rgba(255, 255, 255, 0); text-align: justify;"><i>"The fee structure for each institute must be fixed keeping in mind the infrastructure and facilities available, the investments made, salaries paid to the teachers and staff, future plans for expansion and/or betterment of the institution etc. Of course there can be no profiteering and capitation fees cannot be charged. It thus needs to be emphasized that as per the majority judgment imparting of education is essentially charitable in nature. Thus the surplus/profit that can be generated must be only for the benefit/use of that educational institution. Profits/surplus cannot be diverted for any other use or purpose and cannot be used for personal gain or for any other business or enterprise." And also </i></span></div>
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<span style="background-color: rgba(255, 255, 255, 0); text-align: justify;"><i>"</i></span><span style="background-color: rgba(255, 255, 255, 0); text-align: justify;"><i>we direct that in order to give effect to the judgment in TMA PAI's case the respective State Governments concerned authority shall set up, in each State, a committee headed by a retired High Court judge who shall be nominated by the Chief Justice of that State. The other member, who shall be nominated by the Judge, should be a Chartered Accountant of repute..."</i></span><span style="background-color: rgba(255, 255, 255, 0); text-align: justify;"><i> </i></span><span style="background-color: rgba(255, 255, 255, 0); font-weight: bold; text-align: justify;"><i>Islamic Academy Of Education And ... vs State Of Karnataka And Others on 14 August, 2003</i></span></div>
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<span style="background-color: rgba(255, 255, 255, 0);"><i>Author: V N Khare</i></span></div>
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<i><span style="background-color: rgba(255, 255, 255, 0);">Bench: V. N. Cji, S. N. Variava, K. G. Balakrishnan, Arijit Pasayat, S.B. SinhA. </span><span style="background-color: rgba(255, 255, 255, 0);">CASE NO.:</span><span style="background-color: rgba(255, 255, 255, 0);">Writ Petition (civil) 350 of 1993</span></i></div>
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<b><u>My take: </u>private medical institutions run a multi multi crore business with support from politicians of every hue and enormous financial resources. They have been thumbing their noses at the judiciary, NGO's and most importantly to the people of India. The bench headed by Justice Anil Dave will put them in their places. Nobody asked these private institutions to run medical or dental colleges as business! If they wanted to make money there were so many avenues. They do not have to play with the quality of medical care and put the public at risk by admitting sub standard students. I must mention that there are several good private institutions that have served the profession well! They will not feel the pinch of this order as they have fulfilled a need by starting and running colleges without profiteering. The others who made business out of it will need to re think and still find a way to contribute! I only hope that it is not once again upstaged by money power and politics!!!! </b></div>
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<b><u>4. How will the government ensure that there is no 'exploitation' by the private institutions by taking capitation fee from the super rich and refuse deserving students?</u></b></div>
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The Supreme Court has ruled that the institutions must publicise their tuition fee ( endorsed by the committee mentioned above). If a merit student through NEET wishes to join at the stated fee, he/ she can apply with full knowledge of the fees quoted by the institution. If the candidate is bypassed by a person with a lower rank ( who probably paid under the table), the rank holder who is denied the seat can approach the government and punitive measures can be instituted against the principal/ admission officer.</div>
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This is reflected in a tabled star question in the Rajya Sabha by a member Vijay Jawaharlal Darda ( no 1092) on 3 rd May 2016 "<span style="background-color: rgba(255, 255, 255, 0);"><i>c) how Government proposes to stop prevalence of capitation fee in private medical colleges in flagrant violation of the law and the details thereof?"</i></span></div>
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<i>The answer by the Honourable Minister JP Nadha was</i></div>
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<tr><td colspan="3"><span style="text-align: justify; width: 633px;"><span style="color: rgba(0 , 0 , 0 , 0.7019607843137254); font-family: "uictfonttextstylebody";"><span style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0980392); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.301961); background-color: rgba(255, 255, 255, 0); font-size: 23px; line-height: normal;"><i>c): In case of Government medical colleges, the respective State Governments are responsible for fixation of fees. However, in the case of private unaided medical colleges, the fee structure is decided by the Committee set up by the respective State Government under the Chairmanship of a retired High Court Judge in pursuance of the directions of the Hon’ble Supreme Court of India. It is for the Committee to decide whether the fee proposed by an Institute is justified and the fee fixed by the Committee is binding on the Institute.</i></span></span></span></td></tr>
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<span style="background-color: rgba(255, 255, 255, 0);">To quote a leading article on this issue</span></div>
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<span style="background-color: rgba(255, 255, 255, 0);"><i>The bench characterised capitation fee as “nothing but a price for selling education” which amounts to commercialisation of education adversely affecting educational standards, characterising such institutions charging capitation fee as “teaching shops”. “The concept of teaching shops is contrary to the constitutional scheme and is wholly abhorrent to the Indian culture and heritage.”</i></span></div>
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<span style="background-color: rgba(255, 255, 255, 0);"><i>Thus, the notion which was first observed in Mohini Jain’s case, was upheld in the Unikrishnan’s case, in Father Thomas Shingare and others v. State of Maharashtra and others, the Pai foundation case, Islamic Academy of Education, Modern School v. Union of India, P.A. Inamdar and finally in Modern Dental College & Research Centre v. State of M.P in the following words:</i></span><br />
<span style="background-color: rgba(255, 255, 255, 0);"><i>“Capitation fee is prohibited, both to the State Government as well as the private institutions, vide Para 140 of Inamdar case….”</i></span><br />
<span style="background-color: rgba(255, 255, 255, 0);"><b><u>My Take: </u>capitation fee is illegal. It has been taken in flagrant violation and it has been exposed by the media several times, but no action has been taken. The fees have to be announced in advance as decided by the Committee referred to earlier, so that students can decide whether they can afford the fee. The fee is invariably never advertised and students who claim admission are often harassed at the time of admission, during the course and at times of examination. There has to be a clear announcement of tuition fees as submitted by the Institution to the designated Supreme Court mandated committee based on fee fixation. This is never done and it is up to the state governments/ UGC/ HRD Ministry to ensure that it is followed at the pain of punitive action. The state/ central government can show intent of justice for merit only if they take action against erring institutions!</b></span><br />
<span style="background-color: rgba(255, 255, 255, 0);"><b>5. What is a reasonable fee quoted by the private college?</b></span><br />
The fee for a medical dental admission is decided by the fee fixing committee based on the information submitted on the salaries of staff, patients treated and other expenses. No profit can be made by the management. A 10-15% extra fee per year to be used only for expansion is allowed. This needs to be reported through an auditor who calculates the actual expenses. The relevant Supreme Court paras are quoted above.<br />
<b>My Take: Deemed Universities and private medical colleges are supposed to be run only by private charitable trusts. These trusts appropriate money received by black money and distribute it amongst relatives, friends and even employees who have amassed great wealth despite the funds being held in Trust! Salaries to staff are often not paid on time while children of these trustees drive fancy cars and invest in real estate. Only a complete investigation can reveal where this money running into several thousand unaccounted crores was sourced and the necessary action taken against them through the CBI or other investigating agencies. Some of these are even going overseas! </b></div>
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<b><u>6. I have paid advance capitation fee on the promise of a seat. What do I do?</u></b></div>
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Go back to the institution and take back your money if you can! It was illegal to give money or for the institution to accept it in the first place. Prepare and write the NEET <a href="x-apple-data-detectors://8" x-apple-data-detectors-result="8" x-apple-data-detectors-type="calendar-event" x-apple-data-detectors="true">on July 24 th</a> and book a deserved place in a Medical/ Dental College of your choice. By paying money you are depriving another merit student of a seat. <a href="http://timesofindia.indiatimes.com/city/chennai/University-official-caught-asking-capitation-fee-let-off-hook/articleshow/38447520.cms" x-apple-data-detectors-result="9" x-apple-data-detectors-type="link" x-apple-data-detectors="true">http://timesofindia.indiatimes.com/city/chennai/University-official-caught-asking-capitation-fee-let-off-hook/articleshow/38447520.cms</a> .</div>
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It has happened several times!</div>
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<b><u>My Take: </u>being anti national is not related to chanting slogans alone. It comes from paying black money in cash for getting admissions which are against the laws of the land. It is a crime against a fellow Indian. Take a deep breath and allow merit to take its course. If there is a fee to be paid for private education, you must know what it is and take a decision accordingly. It is wrong to get an admission by paying more illegally to gain advantage over a more deserving person. It is not only morally wrong but it is also anti national!</b></div>
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I wish to state that there will be hiccups in the process. There are problems of language, syllabus etc. some may argue that everything was done in a haste. But this has been in the pipeline for several years. Prevaricating on a decision now will only give those who want to make a business proposition out of medical admissions will get another opportunity to hijack the whole process through a legal or legislative process. The opportunity to have a single window is, now! The small glitches can be sorted out by states improving their syllabus and trying to get as many regional languages as possible included in the entrance tests! Any postponement will only give academic businessmen a foot in the door to continue to make money selling medical seats. This is not good for the meritorious students and the public. Act now or never! </div>
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George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com1tag:blogger.com,1999:blog-1727015255614797283.post-89924378825917203092015-08-19T10:11:00.001-07:002015-08-20T05:06:32.686-07:00All the President's men- A Fairy Tale<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0980392); color: rgba(0, 0, 0, 0.701961); font-family: UICTFontTextStyleBody; font-size: 23px; text-decoration: -webkit-letterpress;">It is almost exactly 5 years since the Madras High Court ruled that the then President of DCI, Dr Anil Kohli's membership in DCI from Delhi was illegal. The then President of DCI resigned after his illegal membership in DCI was exposed through a Writ Petition filed by me. History now repeats itself. Dr Mazumdhar's nomination from a little known University in Jharkhand called Nilamber Pitamber University appears to be faulty just as the membership of 21 other members of the DCI ( for various other reasons). Here is the reason why Dr Mazumdhar is likely to be an illegal member.</span><br />
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1. To become member of the DCI under section 3(d) i.e Representative from University, one must be elected from amongst the Faculty of Dentistry of the University ( not teaching faculty).</div>
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2. While the Nilamber Pitamber University has an affiliated private dental college called Vananchal Dental College, it has no Faculty of Dentistry in the University. So the Nilamber Pitamber University cannot elect a member to DCI u/s 3(d).</div>
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3. Dr Mazumdar was made a honorary teaching faculty of Vananchal Dental College which is a private Dental College, in 2013 ( and it was kept a secret) despite he being a government servant of the Government of West Bengal. Either due to ignorance or by design the Nilamber Pitamber University has thought that being a member of the teaching staff of an affiliate dental college is the same as being a member of faculty of dentistry of a University. The two are quite different.</div>
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4. On May 31st 2015 Dr Mazumdhar who lost his membership to DCI from West Bengal ended up losing his Presidency of the DCI too, as they are co- terminus. He again stood for the post of president on June 11 th 2015 by claiming membership from Nilamber Pitamber University. He suddenly revealed his Hon. Professorship to claim membership under 3 (d). Based on this illegal membership he was elected by DCI members without opposition ( no one was allowed to oppose).</div>
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5. The question now is whether we have an illegal president Dr Mazumdhar and 21 members including the famous Ketan Desai in our statutory body. Dr Ketan Desai in fact found it convenient to enter DCI after being disallowed in the MCI. The reason why Dr Mazumdhar's Presidency is illegal is very simple. The Dentist Act does not allow membership from amongst faculty members of a private dental college ( which Dr Mazumdhar claims he is by honorary appointment). It only allows a person who is a member of a duly constituted faculty of Dentistry of a University who should thereafter be elected by a senate of the University. Nilamber Pitamber University by its own RTI admission does not have such a faculty with a fixed tenure and the election by senate was a farce. The member of an affiliated college's teaching faculty CANNOT be a legal member of DCI and therefore Dr Mazumdhar CANNOT be president of DCI.</div>
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His membership and election as President will hopefully be challenged.</div>
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George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com2tag:blogger.com,1999:blog-1727015255614797283.post-40394643928571511002015-03-11T06:12:00.000-07:002015-03-11T06:14:29.086-07:00Nirbhaya- The story of a nameless martyr!<div dir="ltr" style="text-align: left;" trbidi="on">
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It is impossible to not have moist eyes after viewing the
Chanel 4 BBC documentary ‘India’s Daughter’. <span style="mso-spacerun: yes;"> </span>The movie had the desired effect - a
sordid revulsion against the heinous things man is capable of! It is the
touching story of the young girl and her parents who suffered so that India
will be shocked into action. A story has different voices. I see the interview
with the rapist as part of a narrative that exposes the dark side of society-
not as a platform for justification. Unfortunately, a large section (mostly
males) have seen it as being anti national. Somewhere, we have missed the wood
for the trees!</div>
<div class="MsoNormal">
My daughter, who is the same age as the unfortunate victim
of the gruesome rape in 2012, called me up on the same day the documentary was
released to express her angst at the move to ban or restrict the showing of the
visual drama. As a woman and a lawyer my daughter should know better than those
who wish to hide the story of a young girl in a city- not different from her
background. At the end of the documentary, the father reveals with candor the
name of his daughter while the rest of the country still goes on with the
charade of a pseudonym that is meaningless to the family or her memory. Why are
the government and a segment of the media so concerned about the revelation of
her identity, when her own parents want to honor her life and death so that
others will not suffer? In fact this ostrich like attitude of our leaders and
our media is the reason why we cannot confront our demons. I purposefully said
‘our demons’ because, in one of the interviews in the documentary, Gopal
Subramaniam, the former Solicitor General, <span style="mso-spacerun: yes;"> </span>explains how the women who testified before
the Justice Verma commission said in unison that “the perpetrators are <b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%;">our</span></b> people”. This is the bitter truth. The justification of
Mukesh Singh, one of the rapists, can at best be the narrow vision of a closed
society that veils and mistreats its women in the name of ‘Indian Culture’. I can
see where that opinion is coming from- Ignorance, deprivation, poverty and a
system that objectifies women as commodities! What I cannot forgive is the
attitude of the defense lawyers. Granted, it was their duty to defend their
clients. But what they revealed to the camera is the twisted mind of a
patriarchal society that has reduced women to mere decorations. <span style="mso-spacerun: yes;"> </span>One of them called ML Sharma in almost poetic
cadence describes women with ‘flowery’ metaphors and predicts their fate on
their literal use- worshiped in the temple and crushed in a gutter! He
therefore prescribes a curfew of 6.30 PM for women to ensure that the men will
be ‘good’. His lawyer colleague A P Singh brazenly says on camera that he would
burn to death the female members of his family if they misbehaved. <span style="mso-spacerun: yes;"> </span>It is unfortunately the mindset of a large
number of our people including leaders and religious heads who have said it
without fear on our television channels before. It is important that these
devious opinions come out into the open- not hide them from the world in the
name of ‘Indian pride’. <span style="mso-spacerun: yes;"> </span>So, why are we
so scared to look at the blemishes on our social mirror? <span style="mso-spacerun: yes;"> </span>This documentary revelation should help us
understand the lurking dangers even within our so called educated class so that
we can protect our women. Closing our ears to the rabid voices of some of our
own, is not the answer.</div>
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I was shocked to hear Meenakshi Lekhi, BJP MP, on TV saying
that her concern was the ‘Image of India’. For a country that has a rape
happening every 20 minutes we are concerned about what others think about us,
not what we do to ourselves! That is the problem with a certain kind of
nationalism founded on pride and past glory and espoused by certain political
parties. The argument that this happens in other parts of the world is true,
but it is a tepid excuse to ban a documentary that delves into the heart of our
hypocrisy.</div>
<div class="MsoNormal">
The transparency of the Nuremberg trials in post war
Germany, exposed the genocide by the Nazi leadership. Herman Goering and Rudolf
Hess were given a chance justify their actions of killing a million Jews and
telecasted it to the world on news reels! It was important that the world knew
of such monsters. More importantly it was important that Germany knew what
happened to its citizens in that horrific period. Nobody was shamed in the
process! I hope this documentary does the same and……. Give her back her name!</div>
<div class="MsoNormal">
George Paul</div>
<div class="MsoNormal">
March 2015</div>
</div>
George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com9tag:blogger.com,1999:blog-1727015255614797283.post-62195181940098446002014-09-05T00:33:00.002-07:002014-09-05T00:34:27.206-07:00Do our Dental Teachers need protection?<div dir="ltr" style="text-align: left;" trbidi="on">
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These are trying times for teachers in dental colleges.
Before this column goes to press the right to personal liberty (Article 21 of
the constitution) of a highly respected dental teacher would have been decided
in a High Court. Until then he will remain under judicial custody for an
alleged crime of pulling up a student for indiscipline (1).<span style="mso-spacerun: yes;"> </span>Can the heads of institutions take criminal
responsibility for the unfortunate death of a student who commits suicide
because legitimate disciplinary action was taken against the person for
violation of the college rules? The tragic death of a young student is painful
but can a teacher take the rap for their emotional reaction to a legitimate
action? Several High Court and Supreme Court verdicts have laid down norms
against police harassment in these situations (2) (3) (4) (5). There are of
course instances of genuine <span style="mso-spacerun: yes;"> </span>harassment
and we will need to leave the matter to the Courts of Law to decide.</div>
<div class="MsoNormal">
Teachers in Dental Colleges are also facing an intense
crisis with job security. In many ways it is our own doing. In the last 15
years, particularly the decade between 2001 and 2010, has seen a proliferation
of dental colleges and increase in seats far beyond the manpower requirements
in the country. Some states like Karnataka, Kerala, Tamilnadu and Maharashtra
have a dentist to patient ratio which has caused enormous unemployment in the
profession. In the initial stages this proliferation of dental colleges <span style="mso-spacerun: yes;"> </span>was a huge bonanza for dental postgraduates
due to the teaching jobs in the market . I remember many teachers defended this
abnormal proliferation. <span style="mso-spacerun: yes;"> </span>Growth has a way
of subsuming its own existence by shifting demand and supply. These Colleges
soon turned out more post graduate dentists, who in turn returned to compete
for teaching jobs. The large number of unemployed teachers created through this
growth is now threatening the existence of the old teachers in a wage war of
plummeting salaries. Now private managements are happy to hire and fire at
will, offering pathetic salaries based on market demands. Post graduates cannot
find jobs in dental colleges, unless of course more dental colleges are started.
This is fortunately not going to happen! In Oral and Maxillofacial surgery, it
is predicted that by 2020, 80% of OMF surgeons will not have teaching jobs at
the rate at which post graduates are being churned out(6)</div>
<div class="MsoNormal">
The third major area of discomfort is for teachers in administration
as Deans and HODs. Many private managements have violated statutory provisions
related to entrance examinations, eligibility criteria and excess admissions
for monetary purposes (7). Heads of institutions sometimes have to face the
wrath of students affected by these decisions. In some instances the Principals
and HODs have also been subjected to enquiries by investigative agencies for
decisions taken by unscrupulous managements (8). The staff are usually fall
guys who have no option but to obey their paymasters!</div>
<div class="MsoNormal">
It is needless to say that in some extreme cases teachers
mutely accept non -payment of salaries for several months. This has caused
enormous financial and social strains in the job environment.</div>
<div class="MsoNormal">
The solution to this can only come through a broad
unionization of teaching faculty to protect their interests. The Dental Council
should also lay down service rules in the interest of teachers. A teacher’s
organization will have to:</div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l0 level1 lfo2; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span>To stand up for innocent teachers in the event
of unfair actions against them.</div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo2; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span>To protect the salaries of incumbent teachers by
creating a national salary structure for all levels of teaching staff and thus
prevent under payment of staff</div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo2; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span>To create service conditions that ensures job
security and prevent arbitrary firing of teachers on specious grounds</div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l0 level1 lfo2; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span>To ensure that payment and perks are received by
the staff in accordance with service conditions.</div>
<div class="MsoNormal">
In the absence of a system to protect the interests of
staff, dental college teachers may have to face an undignified future!</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
References:</div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><a href="http://www.udaipurtimes.com/dentists-protest-against-arrest-of-dr-bhagwan-das/">http://www.udaipurtimes.com/dentists-protest-against-arrest-of-dr-bhagwan-das/</a></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Ramesh Kumar Vs. State of Chattisgarh [2001(9)
SCC 618</div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span>S.S. Chheena Vs. Vijay Kumar Mahajan & Anr.
[(2010) 12 SCC 190]</div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto; mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-style: italic; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman";">State of Gujarat Vs. Sunilkumar Kanaiyalal Jain (1997 Crl.L.J.2014)</span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Chitresh Kumar Chopra v. State (Government of
NCT of Delhi),<br />
AIR 2010 SC 1446 </div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span>George Paul, The Future of Oral and
Maxillofacial Surgery, MSN Ginwalla Oration delivered at AOMSI National
Conference, Hyderabad November 2012</div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><a href="http://timesofindia.indiatimes.com/india/Tamil-Nadu-dental-colleges-flout-rules-admit-students-who-failed-entry-test/articleshow/39012566.cms">http://timesofindia.indiatimes.com/india/Tamil-Nadu-dental-colleges-flout-rules-admit-students-who-failed-entry-test/articleshow/39012566.cms</a></div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";">
</span></span></span>https://www.google.co.in/?gfe_rd=cr&ei=Rwb2U4fRGaXV8gf70oCIAw&gws_rd=ssl#q=RMDCH+CBI+enquiry+Annamalai+University</div>
</div>
George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com2tag:blogger.com,1999:blog-1727015255614797283.post-47717796796427208932014-06-25T23:06:00.000-07:002014-06-25T23:06:56.997-07:00Why was the BDS course duration increased in 2007?<div dir="ltr" style="text-align: left;" trbidi="on">
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<div class="MsoNormal">
Have you wondered why there is so much time taken up in the
electronic media about Delhi University’s Four Year Undergraduate Course (FYUC)?
<span style="mso-spacerun: yes;"> </span>The motives maybe dubbed as dubious if
the only reason was because the American Universities do so. I am not
suggesting that the DU’s decision was unfounded as I do not know if there were
other reasons, valid or not, <span style="mso-spacerun: yes;"> </span>behind the
move. I am only saying that mimicking ‘foreign’ Universities is not a great
idea because our needs and resources can be different.</div>
<div class="MsoNormal">
In 2007/2008 the Dental Council came along with a similar
hare brained idea. It was ridiculous because the unilateral decision by the Dental
Council to increase the course duration from a four to five year course was
justified on the same grounds- International standards. It could have been
justified if it was not done at the expense of the one year Internship. The
Internship in medical courses in India provide for ‘on patient’ training under
supervision. It also provides for some autonomy in decision making in the
bridge between being a student and an independent practitioner. In short the
decision to scrap internship and increase the duration of the course was in
complete variance with all the medical courses in India. <span style="mso-spacerun: yes;"> </span>The reasons for the increase of the course
duration from 4 years to 5 years was justified by the then DCI as</div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span>The Americans do not have internship</div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span>It provides more time for study</div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Training (Internship) is not necessary because
students are anyway exposed to patients during the course</div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Students will not attend internship!!!</div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Private managements will be financially
benefitted!!( The DCI secretary actually sent out a memo to that effect and it
is attached)</div>
<div class="MsoNormal">
The only acceptable reason to any rational person is the
last one- more money in tuition fees for the private managements. Several of
them did charge a 5 year fee for the course which was eventually decreased to
four years! More importantly the Colleges will not need to pay the compulsory
internship (which many of them still do not pay). A rough calculation for a
college with 100 seats charging 2 lakhs per year as fees would be 2 crores a
year. Add to this the benefit from not paying the compulsory stipend (which I
have fixed at a conservative Rs3000/ a month). The saving for private
managements would be a saving of approximately 36 lakhs a year. A financial
gain of approximately 2.5 crores a college is no small profit. This involved at
least 250 colleges (excluding the Government Colleges) in the country. Something
worthy to lobby for! You do the math and see how many crores would have accrued
to private managements each year! The question therefore is why did the DCI
make such a move and try to stifle the objections raised by several of us? The
move was staunchly promoted by the then President, Vice President and some
members- significantly a DCI member from Kerala who was in the fore-front of
its promotion. There are several reasons why we can pick holes in the rationale
of mimicking the US Universities. One of them is that the 4 year US dental
courses are done after a four year pre-med graduate degree. It is true that
there is no formal internship but the US has a statutory licensing examination
before they can practice in any state. Without any of these safe guards, just
scrapping internship would have been dangerous to the public. Imagine sending
college fresh graduates on to the general population. One senior DCI proponent
of the course who was also dean of a dental college said it would enable
American Dental Association accreditation. His college was trying for
accreditation. It is these kind of personal agendas that hijack our teaching
and training!!</div>
<div class="MsoNormal">
Fortunately, a new President was elected and the decision
was reversed without causing too much harm to the students. This could have
been done in DU too, with a little mediation and planning. Regarding what
happened in the DCI, nothing short of a full fledged investigation will reveal
the motives behind the attempted move by the previous President and his men.
Some skeletons may actually spill out of the ancient cupboard!!</div>
</div>
George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com1tag:blogger.com,1999:blog-1727015255614797283.post-27463936472078325952014-06-17T10:40:00.000-07:002014-06-17T10:40:11.175-07:00The Clinical Establishment Act- How will it affect the practising dentist<div dir="ltr" style="text-align: left;" trbidi="on">
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<div class="MsoNormal">
The Clinical Establishment Act 2010 became effective in Feb
2012 through an extraordinary gazette notification and is today applicable in 4
states with at least three more poised to adopt the same. There is no doubt
that this is a landmark legislation which very few people in the dental
profession noticed. One of the reasons is that, dentistry as an important
clinical branch of health care has been grossly under represented. The DCI has
represented the meeting of the national Council in two of its four meetings
through its secretary. The minutes of the meetings are available on the website
of the body ( 1). Scanning through the minutes it is surprising to see that
while all the branches have strongly voiced their opinions, dentistry has not
spoken out a single sentence (as per the recorded minutes). <span style="mso-spacerun: yes;"> </span>It must be said that the National Council has
made an exhaustive list of the regulations required for starting and running of
clinics. In fact the requirement for a dental clinic is rather well formatted.
It is divided into Dental Center for a single dentist practice and a Dental
Hospital for those with inpatient facility. The Dental Hospital requirements
are a little difficult to fulfill- at least for the new practitioner starting
in a metro city! Dr Anmol Kalha is the member from the Dental Profession and we
hope that dentistry is well spoken for. The State Council will be the
implementing authority through its district officers. The District registering
committee will be nominated by the Collector and will have three members
including a senior police officer and a representative from the profession. It
is at this level that one can expect problems if any for the practicing
dentist. The inspectors are nominated by the District authority.</div>
<div class="MsoNormal">
Since most of the States have yet to adopt the Act, it may
be some time before all dentists face the nuts and bolts of regulation. We
sincerely hope that it will not be a source of harassment for an already struggling
profession. On the other hand regulating practice may eliminate quackery to a
large extent. More importantly it will ensure safety for the public.</div>
<div class="MsoNormal">
I thought I will touch upon a few of the requirements and
comment on them so that eminent persons who will eventually represent us will
be able to get an idea about how laws are likely to affect the common dental
practitioner. I was recently told by someone that impossible guidelines like an
OPG in every clinic etc were suggested. On reading the clinical requirements,
it is clear that these were exaggerations. It is titled as Standard No CEA/
Dental Hospital-38 and 39 for Dental Hospitals and Dental Centers respectively.
This is unusual because the Code of Ethics Regulation prevents Dental Clinics
from being called Hospitals. That may change because the new code of Ethics is
almost ready as per information from the DCI.</div>
<div class="MsoNormal">
In any case the new requirements will cover all dental
clinics including single person run establishments and exceptions are only for
the armed forces. The format available on the website (2) is comprehensive and
covers all specialties. The norms for infection control, cleanliness and safety
(including bio and radiation safety) are quite rational and practical. However
there appears to be some need for pragmatism in the space requirements. It says
that for Dental Hospitals 30% of carpet area should be reception and
circulation. 30% of carpet area for one Chair is expected to be 6 sq meters of
carpet space (i.e 18x18= 324 Sq Ft). In addition 30% carpet area should be for
ancillary purposes including sterilization, toilet etc. This means that a
clinic should have a minimum of 1000 Sq Ft for one chair. For every extra chair
there must be an additional 60% or 600 Sq Ft. I will leave it to the reader to
decide if this is practical in a city like Mumbai. It does not say where the
patients will be admitted. On the other hand Dental Centers need only 60 Sq Ft
for a chair and 35 Sq feet for reception etc. The 60Sq ft will be a little
tight if a patient needs to be shifted after a syncope. I do not understand why
one needs 5 times more space around a chair in the hospital category! There are
several other small glitches including a number of inspections for bio safety,
lift safety, drug expiry etc. While I think it is necessary, I am not sure how
many dentists will be comfortable with buying Oxygen and other gases and all
monitoring systems and equipment. Another difficult task will be the employment
of ‘qualified’ assistance (diploma recognized by state dental council) and
providing minimum wages according to the labor laws. Some requirements like
waste disposal etc are definitely important. Some others may need tinkering.
Some other requirements may worry dentists and doctors. One is expected to put
a price list for procedures for patients to see and the rates are decided by
the competent authority, not the dentist. I am not sure if this will work for
health care.</div>
<div class="MsoNormal">
My biggest issue with the construct of the legislation is
the absence of the IDA inputs, whereas the IMA, Ayurveda, Unnani, Yoga and
Homeopathy associations (not just councils) are very well represented. How in
the world are they going to implement ground level regulation without technical
inputs from the dental profession- particularly practicing dentists!</div>
<div class="MsoNormal">
While you chew on that information, you can go to the very
informative website and troll through all the sections at<span style="mso-spacerun: yes;"> </span><a href="http://clinicalestablishments.nic.in/En/1066-national-council-members.aspx">http://clinicalestablishments.nic.in/En/1066-national-council-members.aspx</a>.</div>
<div class="MsoListParagraph" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><a href="http://clinicalestablishments.nic.in/En/1066-national-council-members.aspx">http://clinicalestablishments.nic.in/En/1066-national-council-members.aspx</a></div>
<span style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><a href="http://clinicalestablishments.nic.in/WriteReadData/449.pdf">http://clinicalestablishments.nic.in/WriteReadData/449.pdf</a>
</span></div>
George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com4tag:blogger.com,1999:blog-1727015255614797283.post-17052721147317597842014-06-12T04:46:00.000-07:002014-06-12T04:46:06.341-07:00Open Letter to the President and Members of DCI<div dir="ltr" style="text-align: left;" trbidi="on">
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<br />
<div class="MsoNormal">
Dear Sirs/ Madams,</div>
<div class="MsoNormal">
We are informed that the DCI is preparing to conduct its
General Body Meeting on Friday the 13th of June! As practicing dentists we have
several concerns. We have personally raised these issues in the past as well
and would like you to once again look into it.</div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span>Following our persistent objections the slew of
new dental colleges has thankfully ceased or at least decreased dramatically.
We however note with some alarm that a backdoor mechanism is in function. The
seats in the existing dental colleges are being increased. Several Dental
Colleges have applied for doubling of existing seats. I wonder if you realize
that the reason for asking for moratorium on new dental colleges was based on
the fact that there are too many dentists in ratio to population. By increasing
the seats in existing colleges, the problem persists. It might even be said
that this amounts to favoring existing dental colleges who benefit from this.
The Health Ministry and the recommending body (The DCI) must call for a
complete moratorium on the number of dentists graduating. The Dentist to
population ratio has already been highlighted and the increase of seats must be
based only on the manpower resources required. The State Governments, Central
Government and the DCI have completely ignored this issue in giving
‘essentiality’ and ‘No Objection’ certificates. This is true for Government and
Private Dental Colleges.</div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span>There must be a complete review of all dental
colleges by an independent body similar to the Anil Dev Singh Commission and a
complete weeding out of improperly functioning institutions must be effected.
In fact the Ministry of Health can undertake an exercise similar to the Flexner
Committee report in the early 1900’s in the USA where medical education was
rationalized and almost 50% of existing medical institutions were shut down or
merged. The existing DCI inspections are unlikely to fulfill such a drastic
exercise. Where is the Anil Dev Commission report (2004) by the way? An RTI by
one of us indicates the Health Ministry does not even posses a copy of it after
spending crores of rupees!!</div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span>We understand that several institutions are
scheduled for getting PG seats (new or increased). As per procedure the DCI has
to recommend the names of these institutions to the Health Ministry for them to
grant permission. However, we understand that the word ‘Council’ as defined in
Section 3 of the Dentist’s Act 1948 refers to all categories of members in the
General Body (GB) of the DCI. The powers and responsibilities of the EC are
mentioned in several sections of the DCI separately and distinctly from that of
the ‘Council’. They obviously cannot be interpreted as the same. <span style="mso-spacerun: yes;"> </span>We have learnt that the recommendations under
item no 8 of the agenda for this meeting seeks to approve new courses or seats
in various institutions. The recommendations for these institutions were sent
by the EC (not Council) to the Health ministry. <span style="mso-spacerun: yes;"> </span>Do the 5 or 6 persons in the EC represent the
will of the whole Council? The Health Ministry has apparently given permission
based on this questionable reference. The ratification by the GB therefore
appears to be a mere formality and is obviously ‘post facto’. We see a major
procedural lapse in this sequence. The GB ratification appears to be eyewash
and the whole exercise raises questions on the enormous powers being asserted
by the handful of persons in the EC. We request the DCI to rethink on the
recommendation particularly because there are institutions in this list who are
under investigation for precisely the same issue- grant of PG. How did they get
the permission now?</div>
<div class="MsoNormal">
We need greater transparency in the functioning of
regulatory bodies! The role of the GB has been reduced to a superfluous one. Justice
should not only be done, it should also be seen to be done!</div>
<div class="MsoNormal">
George Paul- Salem</div>
<div class="MsoNormal">
V. Viswanathan- Calicut</div>
<div class="MsoNormal">
Murali Venkataswami- Chennai</div>
<div class="MsoNormal">
Varghese Mani- Thrissur</div>
<div class="MsoNormal">
Raveendranath M- Kannur</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
CC- To Hon Minister of Health and Family Welfare</div>
</div>
George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com0tag:blogger.com,1999:blog-1727015255614797283.post-36441716341469742462014-06-01T23:01:00.001-07:002014-06-01T23:01:23.390-07:00An open Letter to Ms Smriti Irani- HRD Minister<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%;">Dear Ms Smriti Irani,</span></span><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%;"><br /></span></b></div>
<div class="MsoNormal">
Let me first congratulate you on your conferment as the
guardian of one of the most watched ministries in the new Government. No! I was
not rooting for the BJP. I was not cheering for any party for that matter. They
have all disappointed us for several decades- some more than others. I hope you
prove my skepticism wrong, at least as far as the HRD ministry is concerned. <span style="mso-spacerun: yes;"> </span>It was however a pleasant surprise when you
were named the HRD minister. Much noise has been made about your qualification
for the post. Degrees, in my opinion, are of no concern. You seem to have
enthusiasm. And in Ralph Waldo Emerson’s words <span style="mso-bidi-font-weight: bold;">“Nothing great was ever achieved without enthusiasm”. I think that alone
will suffice.</span></div>
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<span style="mso-bidi-font-weight: bold;">For several years I
have written about and petitioned the HRD department on the functioning of some
Deemed Universities in this country. To understand the angst of the student
community, one must go back into its history. The Radhakrisnan Commission
(1948) had mooted Deemed Universities as a means of making innovative higher
education available to meritorious students. Private sector participation was
sought as a means of corporate social responsibility- not profit making
ventures. Until the mid 90’s Deemed status was given to only the best
institutions. Suddenly, the flood gates opened and a slew of institutions were
accorded the ‘Deemed to be University’ status. The reason is obvious. The
objectives of Deemed Universities were turned on its head. The autonomy vested
in them became a means of cheating the system. Institutions, mostly medical and
engineering colleges, wanted greater autonomy in their admissions, to by- pass
the state merit quotas. The HRD ministries in those days were headed by highly
qualified professionals. It is surprising that they saw nothing amiss when
medical and engineering seats in some of these institutions were being
auctioned off for crores of rupees. It goes on unhindered. This is why many of
us feel that the HRD ministry does not need doctorates to head it. We need
honest persons who can empathize with the plight of disadvantaged meritorious
students who have been systematically sidelined in the last decade and a half.
Ms Irani, you may be in a position to do what your ‘highly educated’
predecessors failed to do!</span></div>
<div class="MsoNormal">
<span style="mso-bidi-font-weight: bold;">The decision to
grant Deemed Status in most of these institutions was not in keeping with the
established guidelines and norms which required that these institutions strive
for a policy ‘leading to excellence and innovations’. In fact the Deemed
University objectives specifically exclude routine courses like BA, MA, MBBS, BDS,B
Pharm etc. Clause 3.2 in the extraordinary gazette dated 21<sup>st</sup> May
2010 says that one of its objectives is “To engage in areas of specialization
with proven ability to make distinctive contributions to the University
Education system that is- academic engagement clearly distinguishable from that
of an ordinary nature that lead to conventional degrees in arts, science,
engineering, medicine, dentistry, pharmacy, management etc routinely offered by
conventional institutions.”</span></div>
<div class="MsoNormal">
<span style="mso-bidi-font-weight: bold;">Thankfully, the
Government has not sanctioned any new Universities after 2009. On the contrary,
in 2010, the Government moved the Supreme Court to withdraw the Deemed Status
from 44 Universities based on the recommendations of a high powered committee.
The fact that these Universities continue to brazenly admit students after
collecting huge capitation fees and conducting fake entrance examinations, is
an indication that there are powerful political forces behind them. The
Chancellors are often the owners of the institution. Vice- Chancellors are
often handpicked and appointed from within the family or close inner circles.</span></div>
<div class="MsoNormal">
<span style="mso-bidi-font-weight: bold;">The least that the
HRD Ministry and the UGC can do is to regulate and oversee the entrance and
exit examinations. <span style="mso-spacerun: yes;"> </span>In fact the first
step would be for the UGC to conduct a common entrance examination to ensure
merit at least for the Medical and Engineering courses (UG and PG) in all these
institutions. Deemed Universities certainly cannot claim exclusivity in the
award of routine MBBS, BDS, BE and their post graduate courses. The Supreme
Court, in several judgments has clearly stated that all professional and higher
education admissions should be governed by the triple test which is based on an
examination that is fair, transparent and non- exploitative. An entrance
examination can be fair, transparent and non-exploitative only if it can be
accessed by everyone and a rational fee structure for the course is clearly
announced in their admission brochure. Many authentic Deemed Universities
conform to these norms. They should have no objection to a common entrance
test. </span></div>
<div class="MsoNormal">
<span style="mso-bidi-font-weight: bold;">Ms Smriti Irani, as the
honourable minister for HRD, this should not be a tough act. It will vindicate
your claim that you should be judged by your actions and not your
qualification. You will also earn the everlasting respect from generations of
meritorious students for restoring their trust in the system.</span></div>
<div class="MsoNormal">
<span style="mso-bidi-font-weight: bold;">George Paul</span></div>
<div class="MsoNormal">
<span style="mso-bidi-font-weight: bold;">June 2nd 2014 </span></div>
<div class="MsoNormal">
<br /></div>
</div>
George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com1tag:blogger.com,1999:blog-1727015255614797283.post-26950334543495719542014-04-26T00:13:00.001-07:002014-04-26T00:13:43.317-07:00Twenty Seven Years of tolerance- a tribute to a loving wife! <div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">I was being very honest when I said
steamy. Anybody who has spent a summer in Salem will vouch for that. I
do not know why we had the wedding that punishing summer, when we could have
done it in salubrious Bangalore. But then there are some customs amongst the
Syrian Christians. Unfortunately Salem had no Syrian Christian Church and
naturally no priest. Unlike the Catholics, the average Syrian Christian goes through
the business of confessing to a priest only at the time of their wedding and if
lucky just before they die. With great reluctance I decided to confess my sins
of bachelorhood to an imported father (from Kerala), in a rented Church, on the
morning of the day. The priest was a merciful man. He asked me to just think of
all the sins I might have committed over the last 28 years and ask God for
forgiveness. Now! That can be a laborious process- recalling the indiscretions
of more than two decades. I did some rewinds and fast forwards on what I
perceived could be construed as sins by the Orthodox Syrian Church. Unlike
several other priests, he was not interested in the salacious details of my
adolescence- it saved me the blushes. And thus I was rendered ‘pure’ and
in a state of grace, ready to accept my communion and my new bride. At 40<sup>0</sup>
centigrade the normal 3 hour wedding service seemed like eternity. It was truly
an act of contrition for my bachelor days! If you were waiting to hear about my
first night, you will be surprised to know that we spent most of it looking for
my missing father in law in the Hotel we were staying in. He had crept into one
of the several rooms that were booked for the bride’s family and went to sleep-
while everybody searched high and low. My worried wife and I sat outside our
honeymoon suite awaiting news. They found him snoring in a room at
dawn!</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Bini spent the first two years of
our married life in Bangalore completing her studies and I taught and practiced
in Salem. We met over the weekends keeping alive a marriage that remained fresh
by virtue of distance. She later joined me in our practice and became my
father’s protégé and inheritor of his dental practice. I taught, traveled and limited
my clinical work to my specialty, maxillofacial surgery- which was convenient.
It has been a good 27 years with Bini. She took control of things. The loving
mother of our two wonderful girls. The new daughter to my parents. The purse
strings of our modest resources. Our cheer leader. My critic and conscience
keeper. Our occasional cook (thankfully!). The spiritual motivator who left me
to my own beliefs. Our social manager. Our accountant and fiscal planner. My
designated driver (after parties). Our public relations expert. Our holiday
planner and side seat driver. My confidant and hand holder. My writing censor.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">She allowed me my privileges. The TV
remote. The weekend binges. To call a spade a spade. To fight my battles.
To lick my own wounds without rubbing it in.</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">The shy and reticent Bangalore girl
who transformed into a street smart, multi-tasking small town house wife and
professional was exactly what the doctor ordered. She balanced life with
great grace, taking care to always make me feel like the boss. She became the
friend of my friends. She reformed me in the limited ways that wild guys can be
reformed. She has made my life a worthy one. She was always there for me
through good times and some bad patches. She is the love of my life. She is the
wind under my wings. </span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">She has approved this message!</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">George</span></div>
<div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">26<sup>th</sup> April, Wedding
Anniversary and day of marital recollections!</span></div>
<br /></div>
George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com2tag:blogger.com,1999:blog-1727015255614797283.post-64017918669140432272014-02-13T22:40:00.002-08:002014-02-13T22:40:29.454-08:00Science or Surgery- an unnecessary debate!<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">I recently encountered a raging
controversy on the semantics of a dentist's degree. Simply put, the question
was whether a 'master of science' degree should be considered inferior to a
'master of dental surgery'. To explain the background, one must understand that
in the USA, a master of science is designated with the acronym MS, whereas in
India ( and all commonwealth countries) the same is designated as MSc. For the
record I might add that MS in India generally refers to Master of Surgery and
by logic the MDS is called a Master of Dental Surgery. The case in question
refers to a gentleman with <span style="mso-spacerun: yes;"> </span>MS in
Orthodontics ( as it is referred to in the USA) is today being challenged by
one of his colleagues because he has a 'science' degree and not a 'surgery'
degree and therefore ineligible to call himself an Orthodontist. Orthodontics, strictly
speaking, is not a surgical persuasion. It is an important specialty that deals
with non surgical correction of dental and facial deformities. The
surgical corrections are done by another specialty. Notwithstanding any of
these, in India they are all designated as Master of Dental Surgery. For
instance Oral Medicine, Preventive Dentistry and Oral pathology (which are all obviously
non surgical specialties) are also designated as MDS. It is just a nomenclature
to which we have not appended much thought. It certainly does not matter too! All
specialties are important.<br />
To me, the whole controversy about the expansion of a degree ( MS or Msc)
appears puerile and immature because the course content and structure of
the syllabus are exactly the same and the regulatory body in India (DCI) has
clearly recognized the MS from the particular US University as being equivalent
to the MDS. So you can see that the bone of contention is in the expansion of
the acronym after the dentist's name!<br />
Science is perhaps the greatest persuasion in human endeavor and surgery is
just a part of this great ocean of collective knowledge. Then why do we
consider science to be somehow inferior to surgery. It is unfortunately an
uninformed world view that makes people clamor after a title that incorporates
the word 'surgeon', not realizing how limiting that term can be. I am a
Maxillofacial surgeon (a surgical specialty of dentistry) but I would feel more
pampered to be called a scientist rather than a surgeon. This is because it
would be an acknowledgement that my professional abilities extend beyond the
realm of purely using a knife to cure people. In fact until the last century,
surgeons were looked down upon because they achieved much less in health care
than the other health professionals. In fact even today the surgeons in the UK
are called 'Mr' and not 'Dr'. Have you ever wondered why the AIIMS is called
the All India Institute of Medical Sciences. Does the word ‘science’ seem
inferior for this institute? The same applies to NIMHANS and several other
national institutes of higher medical training.<br />
Surgery is just a small aspect of the higher calling of science which
encompasses a greater understanding and application of knowledge. We must
remember that to become a surgeon, one must first embrace science. Surgery is
just minuscule arm of the broader subject of science.</span></div>
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George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com3tag:blogger.com,1999:blog-1727015255614797283.post-49452496179655416702014-02-07T22:39:00.001-08:002014-02-07T22:39:10.867-08:00The many headed hydra called 'anonymity' !<div dir="ltr" style="text-align: left;" trbidi="on">
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Many of you must have heard of the arrest and incarceration
of a young man in Chennai, who works for a well known dentist and oral surgeon.
He was arrested for illegal use of cyber space under anonymity, to spread
canards and lies about several honorable professionals. His employer, a famous
dentist and accused number two in the FIR was given anticipatory bail after it was dismissed on a previous occasion.
The long arm of the law has finally caught up with the cowardly crime of
anonymous assault on the reputations of respected professionals. Having been
the subject of these cowardly mails by anonymous persons, I am supposed to feel
happy. Ironically, I feel no joy. Not even hate. There is however a pall of
sadness that engulfs me. I feel sorry for people who could have used their
publicity building abilities to do a great service for humanity. Instead they chose
to use their resources to disseminate hate, lies, vulgarity and petty schisms
in the hope of destroying the reputation of others. Letters under assumed names
and anonymous blogs have been created to defame people. Technology has been
twisted on its head to perpetuate hate and misdemeanor. Only a detailed
investigation will bring out the whole conspiracy and the people involved. The
authors of such venality may well find themselves wallowing in their own
machinations. It is a lesson for all of us. The trail has not ended and many
more are likely to feel the fall. I am also aware that my complaint to the
authorities may make me vulnerable to retribution. These are politically
powerful people- remember!</div>
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Dissent and righteousness are noble persuasions when one can
stand up and be counted for his/her views. However fallacious rumour mongering
and puerile lies under the veil of anonymity is a narrative of the deep seated
evils that plague human personality. Half truths are disingenuous attempts to
give life to a lie. Here I need to quote Criss Jami ( American philosopher and
lyrical poet) who said “Just because something isn't a lie does not mean that
it isn't deceptive. A liar knows that he is a liar, but one who speaks mere
portions of truth in order to deceive is a craftsman of destruction.” I can believe
that!</div>
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<span style="mso-spacerun: yes;"> </span>For the last couple
of years I have waited patiently to see the perpetrators of these lies, about
me and several others, to be exposed. I even thought I would be happy to see
the culprit being apprehended. But when it finally happened I feel remorse and
revulsion. The remorse is for the people who trusted the person- his family, his
friends and the professionals who work with him. The revulsion is reserved for
the person himself and those who colluded with him in systematic character assassination.
Choosing to defame and indulge in anonymous character assassination is a
reflection of a particularly dark personality. The singular feature of such
persons is cowardice. If folks do not have the courage to stand up and speak,
they should remain silent. It is a much more virtuous option.</div>
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Most importantly, we must all learn to shun anonymity when
we see it. Anonymous letters belong to the waste basket (in modern times to the
trash folder). I have been surprised by friends of mine who actually sought my
clarification about absurd allegations. If indeed there was any truth, why would
anybody want to be anonymous in revealing the same?<span style="mso-spacerun: yes;"> </span>We cannot ignore their crime. But we must
learn to ignore their scurrilous message. I cannot help quoting Criss Jami
again “The only thing more frustrating than slanderers is those foolish enough
to listen to them.” </div>
<div class="MsoNormal">
Peace!</div>
<div class="MsoNormal">
George Paul</div>
</div>
George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com2tag:blogger.com,1999:blog-1727015255614797283.post-89305581152938182782013-12-05T21:02:00.000-08:002013-12-06T04:12:09.506-08:00Bhuvaneswar, Puri and Konark- A Travel story<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<br /></div>
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This year I did something different at the National
Conference of my specialty. After several years, unburdened by official work, I
took half a day off to do some tourism. This was my first visit to </div>
<div class="MsoNormal">
Bhubaneswar, for that matter, Odissha. Kumar, Anjan, Sunil
and I did a quick visit to Puri and Konark, places I had only heard
about.</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgVNckMZKCFtnleRuHJz63eCrAtCUHnSwOho9XaYcjdpMEn4oJjRpIWKq4pC8mG1gImrq2Pm1VLlo19_wsynDyzhMWbBRQooP05bv6dA_saUGCMFy9fpEGjmJCMH5kcAj0JmFSpJg8ewQY/s1600/Jagannath+Temple.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="297" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgVNckMZKCFtnleRuHJz63eCrAtCUHnSwOho9XaYcjdpMEn4oJjRpIWKq4pC8mG1gImrq2Pm1VLlo19_wsynDyzhMWbBRQooP05bv6dA_saUGCMFy9fpEGjmJCMH5kcAj0JmFSpJg8ewQY/s320/Jagannath+Temple.jpg" width="320" /></a></div>
<b>Pic 1 (above) Picture of the Jaganath Temple (down loaded from Wikipedia as no photographs are allowed)</b><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg0_m3rWDFZ2NoUaDalGIqGTz1ufwejLhUC5n_ejby3wfpfnw85zaNYkYLtwTw_woODNPBrioZ38bjJtcfbS4zF3mIyVT0oKWDK77qvV0KsvQPj2fgwPlqK0gCOgA57lrrC8uFvZfkAf-U/s1600/Sthumba.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg0_m3rWDFZ2NoUaDalGIqGTz1ufwejLhUC5n_ejby3wfpfnw85zaNYkYLtwTw_woODNPBrioZ38bjJtcfbS4zF3mIyVT0oKWDK77qvV0KsvQPj2fgwPlqK0gCOgA57lrrC8uFvZfkAf-U/s320/Sthumba.jpg" width="240" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiXPOhmjpQRoDkH4B-bgXkYoPAyEm-RWeUvrJIPtwN6lzeu4kEgtQynvcmZXyh2MABOK9Hqe3phIkY3FSyhnqG3mNO0iFr2dUFNUAcrl7xjx2LtJ_H5HVvmDBFfztUG9MfsW_Ndp3v0Lgw/s1600/Khaja+for+sale.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="264" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiXPOhmjpQRoDkH4B-bgXkYoPAyEm-RWeUvrJIPtwN6lzeu4kEgtQynvcmZXyh2MABOK9Hqe3phIkY3FSyhnqG3mNO0iFr2dUFNUAcrl7xjx2LtJ_H5HVvmDBFfztUG9MfsW_Ndp3v0Lgw/s320/Khaja+for+sale.jpg" width="320" /></a></div>
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<b>Pic 2&3 The Sthumba in front of the temple with a section of the devotees outside and the sweet Khaja on Sale.</b><br />
<br />
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First, the Jaganath temple at Puri. It is of course famous
for the annual rath yatra when the three gigantic deities are paraded through
town. It commemorates the visit of the three deities to Gundicha Temple (their
aunt’s house). It would be impossible to visit the town during the event
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<span style="mso-spacerun: yes;"> </span>However, it is the
only time that non Hindus and foreigners (even if they are Hindus) can see the
deities. Since the visit to Mausi only takes place in July, I would have to
come another time to see the deities. In any case, at this time of the year
things were expected to be quieter and I went nevertheless. This small town
gave the English language a rather large, new word in the early 20th
century-Juggernaut. I can imagine a colonial Englishman with his sun toppee<span style="mso-spacerun: yes;"> </span>squinting up at the gigantic temple car on
its annual Rath and exclaiming under his breath “ Juggernaut..” (the
Englishman’s (mis)pronunciation for Jaganath) and thereby enriching the English
language with another word for ‘enormous’. I must admit that I went to Puri
with no hope of seeing the temple. As I said earlier it is one of those
exclusive temples that do not permit non-Hindus entry into its premises.
Was it worth the trouble then? Well! Yes and no!<br />
The panda (priest retained by my friends as guide and guardian angel) was kind
enough to find me a little shade in a sort of waiting room adjacent to the
temple. I would spend the better part of the next two hours watching the
immense devotion of hundreds of ordinary people seeking solutions to their
everyday problems. As a rather tolerant (and sympathetic agnostic) I was moved
by the ordinary person’s quest for peace and salvation. In the 'waiting room' I
had a few priests for company and they lounged around in various positions
on the floor. This included a big mustachioed giant of a man and a young lad,
both of whose legs were amputated. I suspect that they were not priests, but
had some other kind of privilege in the temple complex. The young chap kicked
of his artificial limbs (Jaipur foot, I believe), leaned it against a corner,
plugged in his ear phones connected to a mobile phone and spent the rest of the
morning humming a tune! </div>
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<br />
<br />
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<br />
<b>Pic 4 The waiting room (note the Jaipur foot in the</b><br />
<b> corner)</b><br />
<br />
<br />
<br />
<br />
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<![endif]--><span style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Sitting
on the steps and looking a tad incongruous in my jeans and tee shirt, I
decided to watch the milling crowd in front of the temple. It was an excellent
vantage point from which to watch the devotees arriving and ‘cleansing’
themselves with a sprinkle of water and a ‘wade’ through running water.
In addition to the devotees, there appeared to be several others with
some interest in the temple activities. Beggars and vendors were doing brisk
business in the full knowledge that devotion does loosen one's purse strings.
There were also persuasive priests selling their services. The system works
like this. New visitors retain a recommended panda (temple priest) to protect
them against other Pandas (also temple priests). If it sounds a little like a
protection racket, Well! It is a little aggressive. ‘Selling’ is a mild word.
They just point at themselves and inform you that they will be the ‘panda’ for
the day. If one is timid, he will spend the next few hours shelling out money
on one pretext or the other! Kumar and Anjan later told me that the
‘friendly’ panda priest, who came well recommended and at a price, was almost a
necessity because one can be pretty badly hassled by the resident priests
who rule the premises. The temple however also has its benevolent side. Free
food is prepared and given away to the devotees and also to the poor from a
large kitchen. The food is apparently prepared from 56 ingredients. The kitchen
is apparently a huge affair with hundreds of cooks and assistants who prepare
the food in earthen pots which are destroyed everyday (disposable and biodegradable).
Anjan, the inveterate foodie, had a glint in his eyes when he narrated these
facts and also the possible recipes that can be made from 56 ingredients.
It was lunch time, remember! I am not sure of the significance of the
magic number. Earlier, sitting on the steps, I viewed the heaps of a yellow,
fried, sugary snack that is sold all over the premises from small kiosks. This
is called khaja and is a popular snack, the recipe for which was personally
revealed by Lord Jaganath himself- the story goes! I had already tasted <span style="mso-spacerun: yes;"> </span>it the previous day. I remembered the
delightful quality of crispy sweetness that it had and <span style="mso-spacerun: yes;"> </span>was tempted to buy some. Seeing the flies (who
also obviously found the thing delightful), I chose to avoid the dangers lurking
beneath its sweet exterior. After about an hour the giant with the fiery mustache lay down for his siesta. The amputee had also dozed off lying on his
back. The other priests stepped out into the crowd and I saw one of them
imposing himself on some hapless devotee who was making a vain attempt to shake
him off. My ‘waiting room’ was now an island of peace in the otherwise intense
activity outside. One of the striking aspects of the crowd was the complete
absence of foreigners (as in Caucasian visitors) which is a common site at
these touristy temples. The reason obviously has to do with the restriction on
entry. And there were a fair number of bulls that wandered elegantly, unruffled
by the pandemonium around them, dropping off large patties of steaming fresh dung
that one had to watch out for- particularly when walking barefoot.</span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhB3npyE8u5v2mVQ2NFiXnqmSJjB21VBvCj9FondFvGcRE1XCmWiLMWsSNN7kLBwVvF7hVbVYQmBnOgU9Kulm6fjsbxzphBGWG2VXIw3UTSIFC5JGy9_9iclAhznTxdZldcBHpjWDNWc_w/s1600/Priests+Bulls+and+Vendors+on+the+Bada+Danda.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhB3npyE8u5v2mVQ2NFiXnqmSJjB21VBvCj9FondFvGcRE1XCmWiLMWsSNN7kLBwVvF7hVbVYQmBnOgU9Kulm6fjsbxzphBGWG2VXIw3UTSIFC5JGy9_9iclAhznTxdZldcBHpjWDNWc_w/s320/Priests+Bulls+and+Vendors+on+the+Bada+Danda.jpg" width="320" /></a></div>
<b><span style="font-family: "Calibri","sans-serif"; font-size: 11pt; line-height: 115%;">Pic 5. Priests, Bulls and Vendors on the Bada danda</span></b><br />
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<span style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">The
Jaganath temple is one of the four centres (Char Dham) of Hinduism,
specifically Vaishnavism. Its deities are Jaganath, Ramabhadra and Subhadra.
The present temple was built in the 11th century century CE by Ananda
Varma Chodaganga Dev which was again modified by Ananga Bhima Deva in the 12<sup>th</sup>
century CE. Like several temples in India it was ransacked by foreigners
including the Afghan emperors. I later found out that the temple not only
disallows non Hindus but also foreigners, even if they are Hindus. This
recently created a crisis when 3 Balinese who were Hindus ( 90% of Bali are
Hindus) were not allowed because they did not look like Hindus or perhaps one
needs to be born in India to be a Hindu. Remember, Sonia Gandhi has similar
problems! The temple eventually permitted them entry, we are told. The reason
is that the temple has traditionally been wary of foreigners, because they have
been on the receiving end of foreign vandalism. The Aruna Sthambha, a pillar at
the entrance represents the Charioteer of Lord Surya and was transplanted to
Puri from the Temple at Konark which we were going to see later. This pillar is
open for all to see!<br />
<br />
We drove out of the temple premises after collecting our footwear. One
can leave footwear, mobiles and cameras at the numerous kiosks specializing in
the 'custody' business. My friend’s cameras and mobiles however were in my safe
keeping- no fee paid! The sea of humanity parted to allow the car to pass. We
drove down the Bada Danda or great avenue which is also the traditional route
of the annual Rath Yatra, when viewing points in the buildings are sold for as much
as, take a deep breath, <span style="mso-spacerun: yes;"> </span>Rs2000 per head.
I must come back again sometime to see the rath yatra- perhaps the only way for
a non Hindu to see the deities!<br />
We were on our way to Konark. The drive from Puri to Konark was breathtakingly
beautiful. We drove through well laid out roads flanked by pristine beaches,
lagoons and mangroves. My friends, Kumar, Anjan and Sunil, who, having attained
some state of grace in the rough and tumble of Puri, decided that we needed a
little more spiritual reinforcement. I agreed. We stopped at a beach side beer
parlour and got ourselves fortified. Anjan eyed a couple of fried crabs
lying in a basket and with great reluctance tore his eyes away, having decided
that it would not be a good idea to eat the stuff. <span style="mso-spacerun: yes;"> </span></span><br />
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<br />
<b><span style="font-family: "Calibri","sans-serif"; font-size: 11pt; line-height: 115%;">Pic 5.The famous Konark Wheel and the 'Famous Four' </span></b><br />
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<b><span style="font-family: "Calibri","sans-serif"; font-size: 11pt; line-height: 115%;">Pic 6. View of the Konark Structure</span></b><br />
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<![endif]--><span style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">We
drove on to Konark which is indeed touristy in the real sense. The beach side
tourist centre had numerous shops selling souvenirs and other sundries. There
were also several guides offering their services. We selected a rather ancient
looking gentleman who clearly had a serious respiratory problem. He informed us
in breathless anxiety that he spoke English. Well! He did speak English in a
telegraphic sort of way and conveyed to us the history of Konark in about three
and a half sentences- between wheezes. I regretted not having googled about
Konark before coming. The temple itself, built in the 13th century BCE to the
Sun God (Surya), is an imposing piece of architecture in sand stone/ rock. I
later learnt that it was built by Narasimha Deva of the Eastern Ganga Dynasty.
The structure (no more an active temple) is meant to represent a grand, albeit
stationary, chariot. The Charioteer, remember was transferred out to the Temple
at Puri! The structure faces east to receive the first of the rising sun's
rays. The numerous wheels of the emblematic chariot can be seen at regular
intervals. The Konark palace (it is not an active temple any more) is a UNESCO
heritage site. It is surprising that the intricate carvings have survived the
onslaught of the sea winds laden with sand. We saw restoration work in
progress. It was a good sign that someone was paying attention to our cultural
heritage after all. “No cement!” said the guide, revealingly. Obviously!
Portland cement is after all a new building material, I thought. There is so
much of harmony and symmetry in the structures.</span><br />
<span style="font-family: "Calibri","sans-serif"; font-size: 11pt; line-height: 115%;"> </span><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjC-j1aalqijAB1BdMcW3NF0ltNC7q06OpVu6TuGzciABEJKkcidsniow9igcWZaQi6KBhDS98vKHfogW2N1zONNz33er8WNdtzOMCGr7nM2jfiOQJ5Vxk1hKs05tGDFM0SdxNvFkqTsZ4/s1600/Konark+Kumar+Pole+dance.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjC-j1aalqijAB1BdMcW3NF0ltNC7q06OpVu6TuGzciABEJKkcidsniow9igcWZaQi6KBhDS98vKHfogW2N1zONNz33er8WNdtzOMCGr7nM2jfiOQJ5Vxk1hKs05tGDFM0SdxNvFkqTsZ4/s320/Konark+Kumar+Pole+dance.jpg" width="320" /><b style="color: black;">Pic 7 Kumar doing a pole dance</b></a><br />
<br />
<br />
<span style="font-family: "Calibri","sans-serif"; font-size: 11pt; line-height: 115%;"> The Konark temple is an elegant
architectural wonder whose significance was both spiritual and political.
Our guide’s attempt to explain the details of the architecture in English
was quite incomprehensible. He could very well have talked to me in Oriya. As
we went around the temple the gentleman suddenly became animated. He found a
glorious new vocabulary and enthusiasm which was lacking until that point of
time. He looked around and in a conspiring tone drew our attention to
intricate details of the carvings. He then burst into what we might call
inappropriate language that included words we do not use in civil discussions.
Only when we saw the depictions did it become clear that he was giving a
running commentary on the remarkable poses etched brilliantly on the rock face.
It detailed the numerous possibilities between a man and a woman, a woman and a
woman and some raunchy details of a ‘ménage a trois’ and more (if you know what
I mean). Our guide, for the first time found vocabulary, which I thought he lacked.
In fact, I thought his breathless excitement might kill him. “Very nice time”
he finally wheezed as though recalling the salacious times which were never
going to come back. Kumar celebrated the viewings by doing an impromptu pole
dance on the railings around the structure. Anjan tried but failed! I sort of
agreed that this Sun God was a fun God after all! We rushed back just in time
to have the three guys dropped off at the airport. It was an amazing drive with
the sky lit up in dazzling orange by the setting sun. A fitting tribute to
Surya who will rise again with a certainty that we cannot aspire for in our
lives!</span><br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjC-j1aalqijAB1BdMcW3NF0ltNC7q06OpVu6TuGzciABEJKkcidsniow9igcWZaQi6KBhDS98vKHfogW2N1zONNz33er8WNdtzOMCGr7nM2jfiOQJ5Vxk1hKs05tGDFM0SdxNvFkqTsZ4/s1600/Konark+Kumar+Pole+dance.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><br /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhEXkjk1bLIm9NHm1B-QECcMkfQKa2uWbaroqBpRwMbZYobqTyEj4z1RvxfDtIEC9qVh4r_j2oRBJyTqKGpmTtNn5BKGIJl8QGSIfe4GBrMubhWu9nnbX8z4VJZ_wFA0dD5B-4j6cGGolY/s1600/Anjan+with+the+erotic+carvings.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhEXkjk1bLIm9NHm1B-QECcMkfQKa2uWbaroqBpRwMbZYobqTyEj4z1RvxfDtIEC9qVh4r_j2oRBJyTqKGpmTtNn5BKGIJl8QGSIfe4GBrMubhWu9nnbX8z4VJZ_wFA0dD5B-4j6cGGolY/s320/Anjan+with+the+erotic+carvings.jpg" width="320" /></a></div>
<b>Pic 8- Anjan trying to do a pole dance (check out the background)</b><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh48MpCi39F0ocTnM3LqSr2Ar5L6rTKZYSN79rj4jcmQDG7qxj6ECZ1G22JhsUs5d6wM05uUIiMwrfExtp0QvEFNpkcL328Bdv_v3guOMvKZUGMg7bNKoB2SvrLpA-I-m-pzdw2d4sKe78/s1600/With+our+Interpreter.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh48MpCi39F0ocTnM3LqSr2Ar5L6rTKZYSN79rj4jcmQDG7qxj6ECZ1G22JhsUs5d6wM05uUIiMwrfExtp0QvEFNpkcL328Bdv_v3guOMvKZUGMg7bNKoB2SvrLpA-I-m-pzdw2d4sKe78/s320/With+our+Interpreter.jpg" width="320" /></a></div>
<br />
<b>Pic 9-With our Interpreter of 'dreams' </b><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg7TzurbjedEyithJTxNui4kkRru7sTFwv_6FE27nigJKQ982UWUmZlKwVGuSVrCLMrAOVNrSKNXQeeOIwGWcYc3KEoFdlGCTh2IAZilaNFR8S2n6kTMjbsiaYihoZkDABGSxODH5terxE/s1600/Evening+drive+to+Bhuvaneswar.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg7TzurbjedEyithJTxNui4kkRru7sTFwv_6FE27nigJKQ982UWUmZlKwVGuSVrCLMrAOVNrSKNXQeeOIwGWcYc3KEoFdlGCTh2IAZilaNFR8S2n6kTMjbsiaYihoZkDABGSxODH5terxE/s320/Evening+drive+to+Bhuvaneswar.jpg" width="320" /></a></div>
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<b><span style="font-family: "Calibri","sans-serif"; font-size: 11pt; line-height: 115%;">Pic 10- The setting sun- adieu to Surya. Driving back!</span></b><br />
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<span style="font-family: "Calibri","sans-serif"; font-size: 11pt; line-height: 115%;">George with Anjan, Kumar and Sanjay. November 24th 2013</span></div>
George Paulhttp://www.blogger.com/profile/14356367967150501249noreply@blogger.com4