Even Government Doctors are not writing prescriptions by Chemical name, why ?
DAYA SAGAR
Not so encouraging fate of affairs concerning Jan Aushadi Scheme -2008 conceived by Lt Ram Vilas Paswan, the then Union Minister for Fertilizers & Chemicals, for uprooting the unfair trade practices of marking the medicines with exorbitantly inflated MRPs and selling the same with the help of ‘prescription writers’ even after naming that as Pradhan Mantri Bhartiye Jan Aushadi Pariyojna and Narendra Modi himself almost promoting the Pariyojna like a ‘brand ambassador” in 2022 even when under the Prime Minister Pariyojna the medicines can be provided at rates as low as 15 to 20 % of the many medicines that the prescription writers are found prescribing by ‘Brand’ names where as the medicines marked with fair & genuine prices under the do not have been able to take hold of even 5 % of the total trade of allopathic drugs through PMJAKs outlets of PMBI even after 14 years over rides the worth that Pharmaceuticals & Medical Devices Bureau of India – PMBI (earlier known as Bureau Pharma PSUs of India)- Department of Pharmaceuticals, Government of India has been trying feed through the success stories to Government of India.
The government doctors could do a lot to save the patients / their families from the unfair burden of the ‘profiteering and unfair’ trade practices like breaking the ‘prescription writer’ and drug seller racket, but even they are not doing that , why?
Civil society can work for strengthening the Prime Minister efforts by providing the real feedbacks from the ground. The comparative number of PMJAKs and the medical shops selling branded medicines even in cities like Jammu / Srinagar well speaks of the status on ground.
A few months back I had to purchase Roxithromycin 150mg Tablet and asked for Roxivista 150MG Tab (Roxithromycin 150 mg ) from a drug store in Jammu but the man on the counter regretted non availability and instead he offered me ROXID 150mg Tab manufactured by Alembic Pharmaceuticals Ltd with MRP 134.50/- 10 Tab strip. Since the MRP of Roxid 150mg appeared almost double the MRP of ROXIVISTA 150 Mg Tab (Roxithromycin 150 Mg ) i.e Rs.68.62 I hesitated to accepted his offer and in response he said brand asked for by me was not kept by since that was of a ‘local company ‘ . And when I told him that Cadila Pharmaceuticals Ltd was not a ‘local’ company the salesman simply said “sir, we keep what doctors in general prescribe”. What should be the genuine MRP for that drug could be well seen from the MRP with what it appeared in the pricelist of Jan Aushadi – Roxithromycin 150 mg film coated Tablets IP 10’s Rs,22.32 { it has to be noted here that the Jan Aushadi drugs that mostly cover the allopathic drugs that do not come under the patent rights of any particular drug manufacturer ( like of what are included in the National List of Essential drugs 2011 with revisions) are not marked with low MRP due to some subsidy from the government }.
The questions that are worth raising before a Health Minister/ Administration are (i) why even the majority of the government doctors do not prescribe even brands like ROXIVISTA 150 mg costing just Rs.6.86 /tab as against prescribing ROXID 150MG costing Rs.13.45 / tab what to talk of prescribing the same drug by Chemical Name / Generic name as Roxithromycin 150 mg could be got for just Rs,2.2 per Tab (ii) why did the vendor call even a company like ‘Cadila’ a local manufacturer, (iii) why has not the (PM) Jan Aushadi Pariyojna has not visibly taken off commercially even after 14 years of its launch (2008) inspite of its MRPs being genuine/ reasonably low?.
Ideally in areas like UT of J&K inspite of Doctors being government employees , they were and are allowed to do private practice outside during office hours so that the suffering people do get some local care and the serving doctor also gets some compensation for the services rendered. It was for the reasons of health related emergencies and social cause that the government doctors were allowed to render consultancy services before/after their official working hours and also accept some ‘honorarium’ / fee from the beneficiary .
The permission for private practice was given to Government doctors not to increase the income but was simply to make available emergency attention / consultation in the near vicinity at odd hours wherever possible. For such clinical consultations a doctor could at the maximum put a 10cm x 40cm name plate at his/her house but these days one could easily find large boards like a Kariyana shop on the house / private clinic of a government doctor. But the way even the commercialization of relaxations given in the shape of permission for private practice to government has grown need has emerged for withdrawing the service relaxations. Some government doctors have even invested in installation of equipment / laboratories with fully commercial intentions.
Most of the government doctors are these days doing nearly a ‘full time’ private enterprise under the garb of permission for private practice. The interaction between the sellers of medicines & utilities and the practicing doctors have almost shaped into trade relations .The custom of inflated prescription writing have started badly inflicting the family economy of common patients. In a way the social cause behind allowing government doctors private practice has been totally overshadowed by the commercial enterprising interests of doctors.
In the earlier times the provision for private practice was drafted for the benefit of the common man keeping in view the level/ quantum of available professional health services but now it is being alleged that it has started harming the common cause.
Health services in Private sector have also grown, private practitioners’ number has also grown, number of retired doctors is also reasonably high now , people do appreciate that services of doctors in institutions like AIIMS and PGI are much more dedicated to medical ethics since there doctors are not allowed private practice. More so no such relaxations have been allowed to other professionals in government service like engineers, accountants who too can increase their income by working off time.
It is not out of place to also mention here where the doctors in government service are not allowed private practice so they are given non practicing allowance. It may be a news for a rational thinkers that doctors in Army are also given non practicing allowance, how funny !!! Not only that a close look will reveal that in Medical College Jammu / Srinagar some doctors are given non practicing allowance who belong to a stream where in general no patient would like to go for private treatment to them.
Not only that even doctors in armed forces are given non practicing allowance, how strange!
So, in case the greater public cause is not being served with the relaxation given to doctors , rather some damage too is being alleged and permission to government doctors for private practice is to increase their income then why not allow private practice to all other employees with the government?
(The author is a Sr Journalist and a social activist dayasagr45@yahoo.com).