On the Jayant Patel issue

Don’t condemn ‘Indian’ doctors

There are few joys in life which can supersede that of finding a position in your dreamt and desired career. Becoming a doctor is one of the few privileged accomplishments which not only secures social status, but fulfils one’s underlying desire to alleviate suffering and serve humanity. The grief of falling from grace in one of life’s most treasured aspects is soul shattering. And that is what has happened to Jayant Patel, who has been repeatedly referred to as an “Indian” doctor in disgrace. This term has evoked an indignant response from the Australian Indian Medical Graduate Association (AIMGA), a large group of skilled, honourable and dedicated doctors from India.

Australia has been actively recruiting foreign trained doctors since the past 40 years. The process of medical registration in Australia is by no means lenient. Medical training in India, though somewhat variable through its hundreds of medical institutions, is generally considered comparable with world-class medical education, both at the graduate and postgraduate levels. A vast majority of Indian doctors have made easy, comfortable and acceptable transition into the Australian community of patients and professionals. Indian doctors are valued as competent clinicians, academics and researchers around the world, and Australia is no exception.

Dr Jayant Patel’s conviction must not reflect on the Indian system of medical education, training, culture or philosophy. It was a most unfortunate event for the doctor and his patients, which undoubtedly was unintentional. As professionals, we are citizens of the world without borders in providing selfless service. As much as Dr Patel must bear most of the responsibility for his neglect in the stringent review of the failure of his surgeries, the hospital must have maintained a peer review system to avoid continuing complications on the operated patients.

Dr Patel has submitted to the highest defeat and failure of his life, and will continue to pay the price for his unscrupulous professional competence. It is a mistake made by a doctor, and not an Indian doctor.

Dr Patel’s actions may seem catastrophic but in the precise field of human anatomy any inadvertent deviation can cause a catastrophe, further blurring objectivity.

The art of success is to remain vigilant with objective and realistic self-appraisal, and the courage to consult a colleague when in doubt. There will be unavoidable, unforeseen and unfortunate adverse outcomes of medical and surgical treatments in the future, and doctors of Indian descent who make up nearly a quarter of the medical workforce in Australia can not be excluded from it.

AIMGA will continue to promote good medicine, scrupulous professionalism, dedication and commitment to patients and towards the advancement of medical science in Australia.

AIMGA would like to emphasise that Dr Patel in his situation does not specifically represent India. As a professional, he is a doctor before he is an Indian.

Shailja Chaturvedi

Criminal, not civil?

Dr Jayant Patel has been sentenced to seven years in prison. This is the very first time that a doctor’s case was tried as a criminal matter, rather than a civil matter. It has caused a serious concern among the doctoring community in Australia and is going to have a serious impact on the way medicine is practised here.

We all know that Dr Patel was a USAtrained surgeon, although he was born in India and did his MBBS in India. Thankfully, this time the Australian media did not overemphasize him being an Indian too much.

Every doctor I have spoken with including myself, feel for what happened to patients in Bundaberg. This did not need to happen and indeed, it would not have happened if the ‘system’ in Queensland had worked effectively. Had the system been effective, Dr Patel would not have received unrestricted registration in the state. In the USA, he was required to seek a second opinion on cases like the ones he operated upon in Queensland, but not in Bundaberg.

If the system had worked, the complaints and concerns in Bundaberg hospital would have been acted upon, thus preventing harm to patients. Many of these problems will be taken care of by the new national registration for medical practitioners. AMA and other medical bodies have raised concerns about the implications of this judgement on the medical profession. The concerns are about doctors being forced to practise defensive medicine and second-guessing about the criminal consequences of what they do, day in and day out. This may lead to delays in providing treatments. Concerns have been raised about the insurance premium for doctors, with the follow-on effect on fees which doctors will have to charge.

The biggest concern is, however, the fact that Dr Patel was tried as a criminal case, rather than a civil case. It is hard to believe that he operated on patients with the intention of causing death. People can bring on incompetence and negligence, but I don’t think criminal motives can be entertained in regards to the operations he performed.

Even though the case was conducted in Brisbane, not Bundaberg, the saturated coverage in media over the last five years including branding him “Dr Death” has been such that everyone has heard about it. Did he get a fair trial is a question which is also being raised by many.

In Queensland and regional Australia, less than 25% of the doctors are trained overseas, and they provide great medical services. They are very concerned, as some of them have been abused or targeted by a small number of people who hold adverse views against overseas trained doctors and people of ethnic backgrounds.

Dr Jayant Patel’s case is bad news for these overseas trained (ethnic) doctors specifically, but it is also bad for the medical profession in general. Mistakes do happen in health services delivery and now we have this precedent of a criminal litigation. It is a bad news for regional Australia as doctors, many of them overseas trained, may not be willing to work there. One doesn’t have the same level of support and supervisory mechanisms in regional hospitals, as in teaching hospitals in metropolitan cities.

There is disquiet on this matter among doctors who will be keeping a close eye on the outcome of the appeal by Dr Patel’s defence team in the court of appeal.

Yadu Singh