Vision & Road Map of IMA: Health Care for All

IMA is the collective consciousness of the medical professionals
practicing modern system of medicine and is represented by over 3 lakh doctors directly through its members spread over 30 State Branches and 17 Local Branches and through FOMA (Federation of Medical Associations of India) to the rest of the medical professionals in the country. Through the World Medical Association (WMA),IMA is linked to 112 International Medical Associations.

Our guiding philosophy is ‘IMA 1 Voice’. IMA speaks as ‘one’ for the best interests of the medical community and gives it a global platform.

The principles defining IMA policies are:

The main objective of IMA is to provide affordable, available,accessible and accountable quality and safe health care to the public through its members in a stress free environment. Currently, we spend less than 1.2%of the GDP on health care and we are placed at 180th position out of 192 countries on this. The National Health policy 2017 has proposed a potentially achievable target of raising public health expenditure to 2.5% of the GDP in a time bound manner. But, even this proposed increased is not enough. To provide universal health care, we need 5% GDP funding by the central and state governments.

Compared to the previous year, the Union budget for the year 2017-18 shows an increase of 23% in the allocation for healthcare. Since it accounts for just 1.3% of GDP,it shows the hollowness of this apparent increase.

One of the objectives of IMA is to concentrate on primary, preventive and primordial care. 

In this regard IMA has launched many campaigns like:

Sun To Lo based on the concept of “Listen,Listen and Listen ”because good listening is key to mental health counseling.

Koi Dekh to Nahi Raha: Doctors are brand ambassadors of health and have a responsibility to uphold the honor and dignity of the profession.

Koi Sun To Nahi Raha to build and strengthen doctor-patient relationship based on Patientdoctor confidentiality

Baar Baar Pucho to remind every doctor to ask a patient at every visit about mood, depression, alcohol use, smoking habits, drug abuse,and sexual needs and preferences.

Puchna Mat Bhulo to promote“mandatory required request’, in which every medical professional is required to ask legal heirs for donation of eyes (in case of death)and organs (in case of brain death).

Woh to Theek Hai par Mara Kyon: Audit every preventable death.

Katwayega to nahi is the IMA campaign against mosquito control to prevent mosquito borne diseases like dengue, chikungunya, malaria.Ask before visiting a place “Is your place free of mosquitoes?”

Main hoon na i.e. Always be there for your patient to help and support the patient in managing his illness.

IMA also promotes soft skills in doctors and has devised an acronym ‘ALERT’ as a check list for doctors to improve their soft skills.

• – Acknowledge & Ask. When the patient enters your office,greet him/her by name. Ask about his problems, why did he feel the need to come to you
• – Listen to your patients without interrupting them.
• – Explain the diagnosis, the proposed line of treatment,duration of treatment etc. to your patients.
• – Revise & Review your instructions or the information given with the patient to make sure that they have been understood correctly
• – Thank you: Say thank you to the patient. He has trusted you with his health needs.

IMA is also incorporating social determinants of health in providing medical care. IMA provides avenues to patients from every segment of the society in getting cost effective treatment within their reach and within the same environment where he is living. IMA Project Jiska Koi Nahi Uska IMA guides patients in the right direction if they cannot afford treatment.

Today, IMA is fighting with the government for ‘one drug – one price – one company’ policy so that cost of 80% of medicines can be reduced. Today 80% cost of health care is on account of medicines and investigations. The govt. allows one company to market a generic drug under three names (generic-generic, trade generic and branded-generic)and also at differential prices, but is forcing the doctors to write only cheaper drugs.

IMA works hand in hand with the central and state governments in achieving its objectives via profession and community-friendly policies. IMA is also committed to working closely with all National Health Programs alongside the government.

The private sector provides 80% of health care in the country today, while only 20% is by govt. sector. But, the private sector is not being acknowledged for the same.

• – One of the objectives of the National Health Policy 2017 is to ‘Align the growth of private health care sector with public health goals’: Influence the operation and growth of the private health care sector and medical technologies to ensure alignment with public health goals and enable private sector contribution to making health care systems more effective, efficient, rational,safe, affordable and ethical(2.3.3). IMA is for providing all services to people which are not within the reach of state government. This can be subsidized by IMA members and reimbursement by state government.

• – The National Health Policy 2017 advocates incentivizing the private sector to encourage participation of private sector, through inter alia (i) reimbursement/ fees  (ii) preferential treatment to collaborating private hospitals/institutes for CGHS empanelment and in proposed strategic purchase by Government, subject to other requirements being met (iii) Non-financial incentives like recognition/acknowledgement/ felicitation and skill upgradation to the private sector hospitals/ practitioners for providing public health services and for partnering with the Government of India/State Governments in health care delivery and (iv) through preferential purchase by Government health facilities from domestic manufacturers,subject to quality standards being met.

IMA is for the profession. IMA is committed to solving the major issues confronting the fraternity because this will strengthen the profession and will benefit the community.

• – IMA is not against accountability but is against the people taking the law in their hands. IMA wants single window accountability for the same. A doctor cannot be tried simultaneously in Medical Council of India (MCI), state medical council, consumer court, human rights court,police complaint under Indian Penal court, and under special acts for the same complaint.IMA also wants Single Window Registration for any health care facility. Today, doctors are required to obtain more than 50 clearances to open any medical establishment. Also,how can we justify getting multiple registrations to get the license to practice?
• – IMA wants 100% PG seats so that every doctor who does MBBS is ensured a PG Seats and those seats where Indian doctor opts out can be given to foreigners.
  

  “Woh to theek hai, par
  mara kyon” is a major IMA
  campaign with the objective
  of preventing avoidable
  illnesses and deaths
  through strategic planning,
  awareness campaigns and
  mutual collaboration with
  concerned authorities.

• – Medical profession is not a business; it is not a commercial profession and all doctors provide reasonable subsidy to their patients, for which they are entitled for noncommercial rates for water, electric and property and other amenities.

• – IMA is for professional autonomy of doctors and for the doctor to be able to decide their drug, investigation and line of management based onpatient-centric medicine.
• – IMA supports rationalization of clinical practice. “Jaroorat Bhi Hai Kya?” is a campaign of IMA to promote rational use of drugs, especially antibiotics and/or rational ordering of investigations and hospitalizations. This will help check the widely prevalent problem of antibiotic resistance. IMA slogans in this regard are – “Think before you Ink”, “Use wisely and not widely”.
• – IMA is committed to achieving the 17 sustainable development goals and targets as defined by the United Nations. IMA has shifted its focus from disease to wellness.

IMA respects Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH)systems of medicine but is against Ayush doctors being allowed to prescribe drugs of modern system of medicine. The govt. should promote them in their respective fields and not mix the pathies.

IMA wants that the number of preventable deaths in the country should be reduced to zero.Preventable deaths should be unacceptable. To this end, IMA recommends that every preventable death should be audited to find out the cause of death, so that another such incident is prevented by timely action. “Woh to theek hai, par mara kyon” is a major IMA campaign with the objective of preventing these avoidable illnesses and deaths through strategic planning, awareness campaigns and mutual collaboration with concerned authorities.

IMA wants the concept of equality, equality and justice and for that IMA wants uniform age of retirement, uniform infrastructure,uniform hours of duty, uniform pay scale etc.

IMA is for competence-based training and not theoretical-based training. IMA also opposes NEXT,another 3-hour MCQ exam for an MBBS graduate, who has gone through 36 examinations in 3 dimensions to get his degree, to obtain license to practice. IMA is against repeated multiple theoretic exam to show their updated knowledge status.

IMA promotes the concept of one health,which incorporates human,animal, plant and environmental health (air, water, earth) under one roof. One Health recognizes that the health of people is connected to the health of animals and the environment.

IMA is committed to achieving government goals: Making India defaecation-free by 2030,Eradicating hepatitis C by 2030 and hepatitis B by 2050, Mercury free medical establishment by 2020, Eliminating measles and Controlling rubella/congenital rubella syndrome (CRS) by 2020.

“Aao School Chalen” is a project dedicated to hygiene, vector control, and cardiac first aid (CPR).

IMA is proposing all health days to be observed every month instead of being annual events. Starting with the Blood Donation Day, IMA is proposing to mark the ‘1st day of every month’ as “IMA Blood Donation Day” starting from the Doctors Day on 1st July this year.

IMA supports rationalization
of clinical practice.
“Jaroorat Bhi Hai Kya?”
is a campaign of IMA to
promote rational use of
drugs, especially antibiotics
and/or rational ordering
of investigations and
hospitalizations.
This will help check the
widely prevalent problem of
antibiotic resistance. IMA
slogans in this regard are –
“Think before you Ink”,
“Use wisely and not widely”.
IMA is committed to
achieving the 17 sustainable
development goals and targets
as defined by the United
Nations. IMA has shifted
its focus from disease
to wellness.

IMA has pledged to transform India to a “Blood Donation Surplus” country from a “Blood Donation Deficient” country. IMA has undertaken a herculean task of collecting more than one lakh blood component units on 1st July on the occasion of the Doctor’s Day. All blood donation camps should be “voluntary donation” “non-remunerated” an d “Only components”.

Shh Shh Shh…..Baat Nahi Karo: Hospitals should be Silence Zones In an effort to control noise pollution within the hospitals, IMA will launch ‘Silent Hour’in medical establishments every day, when everyone should not talk or speak very softly to minimize noise.Hospitals need to be silence zones as also areas up to 100 m around them. Permissible noise limits in Silence zone are 50 dB in day time (6am to 10 pm) and 40 dB in night time (10 pm to 6am).

Forget me Not is the IMA campaign for the elderly population enabling them to lead a healthy and productive life with dignity.Doctors need to be trained to take care of the special needs of the older people.

IMA advocates a common lifestyle pattern for lifestyle disorders in all systems of medicine to prevent all lifestyle disorders or NCDs share common lifestyle-related modifiable risk factors.

IMA advocates universal warning signals instead of defining warning signals for each disease condition separately“Never ignore a symptom which is unusual (different than usual), unexplained or occurring for the first time in life”. They may be red flags to consult a doctor as soon as possible.

Write NLEM drugs: IMA recommends that its members should write NLEM drugs, instead of prescribing expensive non NLEM drugs to those who cannot afford them. But, this does not mean that drugs not included in the NLEM are non-inferior drugs. If you prescribe a non-NLEM and more expensive drug, explain to the patient why you are doing so.