Who should treat a child with disability – a Therapist/Spl Educator or a General Practitioner ??

Dear Friends,

Greetings from ADITI!

In our work with parents and children with disabilities, especially children with neurological impairments, learning and intellectual disabilities, infants at risk & pre-term babies,  we have found numerous examples where we felt that had the Doctor who first attended the child immediatley referred the case to us or a rehabilitation professional, the child could have got timely early intervention and improved his functional skills  to a great deal!

 Sorry to say but feedback from most of the parents and NGOs reveals that the General Practitioners keep the infants with disability under their treatment, even when surgical intervention was not needed – knowing well that the prescribing medicines and tonics are not the solution and the situation needs immediate intervention of a Therapist/Special Educator. This is an unethical practice of general practitioners who are unequipped to handle such cases and at the same time they do not want to loose the patients due to monetary considerations thereby playing with the lives of such children!

Also, after the creation of Rehabilitaiton Council of India which prepares competent rehabilitation professionals to provide right intervention in disability rehabilitation, the general practitioners registered under Medical Council of India (MCI) and not trained in rehabilitation under RCI, should refrain from trying to waste those precious & crucial early months and years of such children at risk /with disabilities and immediately refer them to the appropriate rehabilitation specialist/centre.

Any such doctor who continues with such unethical practice can be taken to task under relevant provisions of the MCI which has been amply stated by the Court of Chief Commissioner vide its oder dated 15 May 2008. Congratulations to the Chief Commissioner -Disabilities for such a constructive Order! Those who need the circular, please click on the link: https://developmentaltherapists.files.wordpress.com/2009/01/ccpds-circular-to-medical-council-of-india.pdf or visit Resources Section of the Blog.

 Therefore, we at ADITI fully support the New Notification of the Medical Council of India that such cases should not be handled by MBBS doctors /general practitioners and they should restrict their role to treatment of diseases and illnesses only.

We further want to make it clear that merely the fear that patients/parents will go to quacks is no sufficient reason of continuance of General Practitioners treating disabilities without any training and experience in rehabilitation! Also any such rehabiliation training of doctors/gemeral practitioners should be conducted under the aegis of RCI and not by IMA or MCI! 

The proper solution will be that  Developmental /Paediatric  and other Therapists and Special educators should be mandorily included in the Structure of PHCs at Taluka Level, in District Hospitals, in Government Schools through State Notification.  An integrated approach of rehabilitation and treatment can only bring desired results for Rehabilitation is a team effort.

We are pleased that MCI has taken such constructive steps through this notification and acknowledged the role of RCI and Rehab professionals on its rolls. However they should not have waited for an Order from the Court of Chief Commissioner- Disabilities on the issue. We would be further pleased to see that MCI sufficiently publicize this notification to all its members through appropriate mechanisms too!

We call up the Union Government and respective State Governments to include rehabilitation professionals in the basic structures of PHCs, Schools & District Hospitals and create and link hospitals to the District Resource Centres on Rehabiliation like DDRC. Please don’t reduced such cells merely to a Aids and Appliances Distributing Cell!

You may like to read  the Newspaper report on the New MCI notification on the issue which we at ADITI certainly welcome it  as a very constructive step ahead:

Subhash Chandra Vashishth,

For Association of Developmental Therapists of India

09811125521, developmentaltherapists@gmail.com

Can a general practitioner treat kids with disabilities?
22 Jan 2009, 0511 hrs IST, Umesh Isalkar, TNN

PUNE: The city’s medical fraternity is divided on a general practitioner’s right to treat children with disabilities. In its recent notification, the Medical Council of India (MCI) has made it clear that doctors not trained in rehabilitation of disabled, should restrict treatment only to medical illnesses and diseases.

Calling it a “superfluous move lacking in practical approach”, senior orthopaedic surgeon K H Sancheti said, “Around 60 to 7o per cent children live in villages where there are no specialists. If a qualified medical practitioner, who is an MBBS, is barred from treating disabilities at village and taluka level, the cases will eventually be diverted to quacks. And this will only worsen the situation.”

In cities, disability-related cases are diverted to a specialist as a general practitioner is not willing to treat it as the outcome in such cases is less likely as compared to efforts put in, said Sancheti who has conducted over 300 camps for treating disabled children at village and taluka level.

In a sharp contrast to this, state president of Indian Medical Association (IMA) Devendra Shirole called it a welcome move. “It is often seen that general practitioner treat disabilities even when medical or surgical interventions are not required. In the process, the most critical period is lost which is important to train and rehabilitate the child with disability,” Shirole said. He said the move will put a curb on such practices and rehabilitation of a disabled will be expedited. Moreover, there is need to generate awareness among people and doctors about the move, he added.

“The IMA will try to conduct courses in rehabilitation for doctors working in peripheral areas of the city. This will prevent the flow of patients to quacks,” said Avinash Bhondwe, president of the city chapter of IMA.