ANNUAL CONFERENCE OF KGMOA-2012 AT CALICUT

Respected president KGMOA, Chief Guest and other dignitaries on and off the Dias, KGMOA members and their family

First of all I place on record my deep sense of gratitude to the office bearers of KGMOA for inviting me to deliver the key note address. I congratulate you on arranging such a grand function.

Ever since I was invited I am worried about the content of my talk. Even today I am doubtful of my role. As a person working in another health stream for over 25 years, I can only submit my observations.

We know that heath sector in Kerala has advanced so much during the last decade or so. This is evident both in medical education as well as in health service. Be it in infrastructure, patient care, service benefits etc. But how well all these have percolated to the public at grass root level is still a question mark. Perception of the common man on health scenario is different. Their expectations are always high. We are no where near to that. And often we see the reactions of these.

The two branches of Health Dept namely Medical Education and Health Service are not working complimentarily. That is one huge problem we face. All the district hospitals where there is no proximity to med college are working like a huge establishment. But in districts where there is a medical college the district hospital is not developed like that. We both blame each other. Truth is entirely different. We never thought of complimenting each other.

Here we have to think of referral system. But what I see is that both at Medical Education level and Health Service level this is being opposed. Nobody come with a solid proposal or approach it with sincerity. The reason is not known to me.

I feel that we should bring the family practice to the forefront. If there is a referral system we can do this. The primary care level can concentrate on family practice. This will give us an opportunity to prepare the disease registry across the state. This will help us to plan the approach both at preventive and treatment aspects. Secondary level should be empowered to deliver the standard of care they are expected to. Tertiary level should be the teaching institution for treatment of patients referred from secondary level, teaching and research. The present load should be released from Medical colleges.

There is a growing concern that the public health activities are not taken seriously now. Once three tiers Local Self Government came many of the PHC were put under gramma panchayath or block panchayath. What happened after that I don,t know. But it is alleged that immunization, sanitation etc are not properly cared for. Every year we are getting new epidemics and thousands of people are affected. This creates a heavy burden on health system. But no concrete solution is being developed. There should be comprehensive approach, a combined act where medical college can also contribute to conduct field study and look for solutions. Field work in the health sector should be revived.

Another problem is the shortage of staff in the rural areas. Whatever steps the Govt. is taking we have problem in getting people to work at periphery. The latest is the CRS. I talked to many interns regarding this. They are not enthusiastic in pursuing CRS. One problem is our attitude to bonded labour. Most important is many of them do not understand the importance of working in rural areas. We are always promoting a specialized practice and our children are also not different.

It is important that we should create a cadre for rural service. They should be offered better incentives including a PG seat. Most important is that the system should recognize their service for future incentives too, that is giving them placement of their choice. In that case we can abolish CRS and only those who are interested will come for rural service.

I am sure that there are some positive initiatives in this line. There is a plan to start family medicine specialty in Medical colleges to give training in that line. Govt also is considering the system of cadre development during MBBS itself as practiced in AFMC. Initial discussions are started on developing the referral system in health sector. Only thing is that our approach also should be proactive and we should be able to give positive feed back on all hot issues in health sector in our state. We only can improve it. I thing KGMOA the largest service organization of doctors in the state can take initiatives in this line.

Thank you

Inaugural address-Diagnostics &Surgicals Dealers Association-Annual meet

Corporate social responsibility means taking proactive steps to help others, rather than just make money. In this era of Social Innovation, businesses can do many things by investing in local communities, improving labor practices, greening supply chains, and generally giving back. Businesses are beginning to be in the business of doing social good as well. Many companies shift to incorporate environmental, social, and welfare-based themes into business plans and products, and look to increase both profit and human development.

As surgical firms your first responsibility is to the doctors, nurses and patients, to mothers and fathers and all others who use your products and services. In meeting their needs everything you do must be of high quality. You must constantly strive to reduce the  costs in order to maintain reasonable prices. Customers' orders must be serviced promptly and accurately. The suppliers and distributors must have an opportunity to make a fair profit. You are responsible to the employees, the men and women who work with you throughout the world. Everyone must be considered as an individual. We must respect their dignity and recognize their merit. They must have a sense of security in their jobs, and must provide competent management, and their actions must be just and ethical. We are responsible to the communities in which we live and work and to the world community as well. We must be good citizens--support good works and charities. We must encourage civic improvements and better health and education. We must maintain in good order the property we are privileged to use, protecting the environment and natural resources. Business must make a sound profit. We must experiment with new ideas. Research must be carried on, innovative programs developed and mistakes paid for. New equipment must be purchased, new facilities provided and new products launched. Reserves must be created to provide for adverse times.

To quote an example Johnson & Johnson started in 1800s as a small unit producing dressing materials. Through hard work they could reach a level that today they are the leaders in manufacturing surgical equipments, sterilizing products, cosmetics and baby products. In their growth they had to face unethical competition which they survived. 7 patients died of taking Tylenol and they had to with draw the whole stock. Not only money but the reputation also was at stake. Later this was found to be a tampering at retail level. Sale of the competitive products went up and it was proved to be an unethical competition. Such things should be avoided.

Many firms now use the amount for charities to give kick backs. This is another unethical way of making money. This creates a nexus between corporate, doctors and paramedics. This practice definitely exploits the poor patients.

Dear friends in corporate sector you are permitted to make profit, but a portion of it should be given back to the society we represent. More over profit making path should be clean and ethical.

DR C RAVINDRAN,28/01/2012