Re: The ART Counsellors should be allowed to practise independently

[Guest guest]

Re: The ART Counsellors should be allowed to practise independently

(Combined posting)

Re: /message/8975

(1) One wrong does not justify doing another. Both will lead to

fleecing of patients. Rajesh Sood

(2) The attitude reflected in the open letter is questionable.

(3) MO's of ART centers calling HIV patients to their homes should

be sacked with immediate effect. Dr. Rakesh Bharti

(4) We are missing the opportunity to use HIV to improve the health

care system. Dr. Ajith

___________________________

(1) One wrong does not justify doing another. Both will lead to

fleecing of patients

Rajesh Sood

One wrong does not justify doing another. Both will lead to fleecing

of patients-

There is great need of counselling services in each filed of health

care from psychiatry, to marriage counselling, lifestyle modification

and so on. The opening of chain of counselling clinics would be

desirable as the govt sector does not cater to this need yet apart

from HIV.

But counsellors or doctors who wish to engage in private practice,

should not take up government jobs and let other people take the job.

Rajesh Sood

Centre for Health Promotion,

PO BOX 17, GPO Palampur, HP.

E-mail: drrksood@...

_______________________

(2) The attitude reflected in the open letter is questionable

The issues/grievances highlighted by Mr. Jaikumar on behalf of the

ART counsellors need to be recognised. The counsellors are

postgraduates with good experience in the field of psychotherapy and

patients acknowledge their services. Therefore the authorities need

to look for better remuneration package considering the new economic

situation.

However, the approach/attitude reflected in the open letter is

questionable and objectionable. Since doctors are doing wrong things,

we too are eligible/allowed to do such things!!! That is not a

good/positive approach. Counsellors who support very many

people to develop a positive attitude should not develop a negative

attitude.

If doctors are doing wrong through private practice and canvassing

ART clients to private clinics, the counsellors & development workers

are supposed to oppose the same and make sure that the poor patients

are getting justice.

Instead of that counsellors who are supposed to help the patient to

correct himself/herself also advocating/ arguing to get permission to

do wrong things! Kalikalavybhavam!!

e-mail: <josemkottarathil39@...>

_________________________

(3) MO's of ART centers calling HIV patients to their homes should

be sacked with immediate effect.

Dr. Rakesh Bharti "

Surprise surprise -I am astonished to read that counsellors are

equally qualified as MO's manning ART centers. May I ask these so

called equally qualified people why could not they make it to the

Medical schools. And if wanna allow these guys to practice then what

is wrong in bachelors of other parties to practice allopathy.

Moreover the MO's of ART centers calling HIV patients to their homes

should be sacked with immediate effect. Only people with dedication

and those practising with heart should be selected for programmes

like HIV eradication.

Mr. Jaikumar should also be asked to specify the complaint against

the MO in particular and the case must be investigated further so

that no other MO can dare ask poor patients to visit their private

clinics.

Rakesh Bharti

Dr.Rakesh Bharti,

Bharti Derma Care and Research center,

27-D,Sant Avenue,The Mall,

Amritsar143001,Punjab INDIA

Email-rakesh.bharti1@...

9814044213 / 01832277822 /01832278522

______________________________

(4) We are missing the opportunity to use HIV to improve the health

care system

Dr. Ajith

Mr. Jayakumar is raising interesting argument. But, i think it is

main streaming in reverse direction. I would argue for ART medical

officers stop diverting their patients to private clinics than ART

counsellors taking the patients to private practice.

But remember many of us divert our private HIV patients to ART

centers just because there is quality comprehensive care and better

adherence levels in our ART clinics than private clinics.

I was expecting this kind of response but sorry to see this happening

in reality. We are missing the opportunity to use HIV to improve the

health care system. I am sadden by it.

Dr Ajith

Trichur

e-mail: <ajisudha@...>

[Guest guest]

The ART Counsellors should be allowed to practise independently

(Combined posting -2)

Re: /message/8979

(1) NACO has acted on some specific complaints received about doctors

calling patients to their residence for treatment. Dr B B Rewari

(2) Please clarify. Vethu

(3) Try to get it endorsed at every state level. Shyamala ASHOK

(4) What's the next step then? Bernard Allan

____________________________

(1) NACO has acted on some specific complaints received about doctors

calling patients to their residence for treatment. Dr B B Rewari

I also agree that this should not be permitted under any

circumstances. This will dilute the quality of counseling and care

offered at ART centers and shall not be permitted by NACO. In fact

NACO has acted on some specific complaints received about doctors

calling patients to their residence for treatment.

One wrong does not justify doing another wrong

Dr B.B.Rewari MD,FICP,FIACM,FIMSA,FGSI

Sr.Physician,Dr RML Hospital & National Programme Officer (ART)

National AIDS Control Organistion, 6th Floor, Chandralok Building,

36, Janpath, New Delhi-110001

Tel; 011-43616677,23731954(O), Mobile ; 91-9811267610

Fax : 011-23731746

e-mail: drbbrewari@...

______________________________

(2) Please clarify

Vethu

Mr. Jailkumar must clarify, what you mean to convey by saying " The

counselors are equally qualified as the ART Medical Officers " ,

Please clarify the forum about your views of what is your plans for

your PLHA care.

Vethu

" kumar mohan " vethu@...

__________________________

(3) Try to get it endorsed at every state level.

Shyamala ASHOK

Mr. Jaikumar's question is valid and correct but make sure if all

counselors have a related and valid educational background with the

required experience and probably work out a strategy with your ART

doctors to practice at thier clinics attached.

That would be the smart way to do it. More over you can negotiate

with NACO and try to get it endorsed at every state level.

Regards

shyamala ashok

e-mail: <aabinand@...

_____________________

(4) What's the next step then?

Bernard Allan

Its an interesting discussion and the question is " to be or not to be "

Who is big and who is small... can doctor who is allowed private

practice take care of quality counselling, or can s/he deal with the

issues like adherence, follow-up, psychological support without the

help of a trained counsellor? Similarly a counsellor cannot take up

the job of the doctor and both are equally important.

So if doctors are allowed private practice and respected for their

qualification and profession then why not equally a counsellor should

be? Whose interest is being hampered? - is it some power-freak?

We all are certainly aware that it is mostly ART Centre Doctors that

are not just asking better-off positive people to see them at their

private clinic but they are also misleading the clients by saying

that the government supplied drugs are not so effective.

I am sure Positive networks are aware of it... If you wish to

confirm, please visit ART Centres in Lucknow, Varanasi and Allahabad.

What's the next step then?

Regards

Bernard

e-mail: <bernardallan2000@...>

[Guest guest]

Dear Forum,

 

Re: http://health. groups.. com/group/ / message/8979

The issues raised here are unfortunate but true. In my past 25 yrs of

experience, the private practitioners ( GPs and Consultants) do not tell the

total truth.

The availability of DOT and ART centres and the enormous achievement it has done

for the poorst and deserving is never properly explained by the doctors. So huge

population of TB and HIV patients keeps paying unaffordable fees of these

doctors who do not have enough time to counsel the patients about adherence,

nutrition, psych-social problems the victims and the families face. So many

victims default because they had never expected the huge economic burden keeps

mounting due to the chronic nature of the diseases.

 

Maximum number of private doctors fall in the above catagory. So often, I have

heard my newly registered patients saying " I did not know that it is not all

that difficult to get free medicines from ART/ DOT centres. My doctor told me

that by the time you will be actually provided with the 'so called free

medicines', you will any way be on your death bed as these government doctors

will keep calling you multiple times, will never give you the medicines right

away " .

 

Obviously the victim and his relatives who even if know about such centres are

diverted to thier own clinics. How can anyone curb such things? I tell all such

victims that " now you have ran out of money, your doctor also has ran out out of

his luck of making money (though he would get fresh pray soon!)

Dr. Divya Mithel,

JCC, Kalamboli

e-mail: <d_mithel@...>

[Guest guest]

Dear FORUM,

Re: Dr. Divya's posting on " ART Counsellors should be allowed to practise

independently@?

Re: http://health. groups.. com/group/ / message/8979

I think the point is not good govt docs vs bad private practioners or vice

versa-there are all type of doctors in both settings and let us not deviate from

the point of discussion.

If you can count n number of " bad " practioners someone else like me can count n

number of " bad " govt doctors working in ARt centers.

The point of discussion is whether or not to allow Counselors to practice, the

point is whether or not to allow ART center docs to practice the point is

whether it is ethical for anyone to divert patients from free centers to their

own Private set upi think this is what is the crux.

Am I wrong?

Bharti

Dr.Rakesh Bharti,

Bharti Derma Care and Research center,

27-D,Sant Avenue, The Mall,

Amritsar143001,Punjab INDIA

Email-rakesh.bharti1@...

9814044213  / 01832277822 /01832278522

[Guest guest]

Dear All,

Re: /message/8979

Ultimate point is how to develop and sustain an effective health care system and

sustain it.

 

But this discussion started on a comment from Mr D Jayakumar suggesting

ART councillors  should be allowed to do private practice which can be discussed

further. But unfortunately the excuse was that some ART medical officers are

fleecing patients.(i dont know if he want councellors also should be allowed to

fleece them-- I dont think he meant it)

I don't think we are going to reach anywhere. This discussion on the private

practice is going on in the country and (even outside) for last many years.

Private practice has some advantages for those who can afford it but as far as

ART is concerned, there are  very few centers in India other than

government/naco supported ART centers which has good infrastructure and 

adequate staff to provide quality care, adherence intervention and linkages. The

HIV care modal being developed by NACO should be sustained and duplicated in

other sectors of health. I believe it is an example to show that government

agencies can be effective.

But if we miss this opportunity and allow the staff--wether it is MO or

counselor or Data entry operator , we are going to show how easily a government

owned system can decay.

I hope that is now we are aiming at.

Dr Ajith

Trichur

--

Dr Ajithkumar.K

Asst Professor In Dermatology and Veneriology

Medical collge Chest Hospital

MG Kav,Trichur, Kerala ,India

Ph 04872333322 (res)

9447226012

e-mail: <ajisudha@...>