Refusing emergency?

Can a single specialty doctor running clinic single handed refuse night emergency due to acute medical illness to himself or due to severe physical and mental exhaustion?

A single specialty center cannot pick and choose emergency. If you are a gynaecologist and if you write on your board “24 hour emergency” meaning only “Obstetrics emergency” will be handled then it will not be acceptable if you turn away a cardiac emergency or a RSA. You should clearly display on your board and letterhead that services in this facility are available within working hours only and no emergency services are available. You may even give the phone / address of nearest facility with emergency services. That said it is better to lock your entrance after duty hours because if patient enters your premises in an emergency and you do not handle it or fail to provide first aid and patient dies then you will be liable. For this reason it is no longer beneficial to live and work in same premises unless you are willing to provide proper 24 hour emergency services with staff and ambulance etc. The CEA is very clear on this issue and for the same reason it is not advisable that you book your flight tickets as “Dr”…..Once identified as a doctor you are expected to serve and not providing “services” is a punishable offence

There are so many loopholes in the problem stated-

1) A single specialty clinic is not supposed to run 24X7X365 with a ‘Single Doctor’ and therefore, essentially, cannot be an ‘Emergency’ clinic. If the clinic claims to provide ‘Emergency’ services, then, by Law, there should be team of Doctors and a duty-roster.

2) A Single specialty clinic, usually, operates in the convenient ‘Working Hours’ which is clearly mentioned in the Sign board and during that hour, if an ‘Unrelated’ emergency arrives, the Doctor is only supposed to provide the ‘First Aid’ services and refer the case to suitable hospital (As per guideline of the Hon’ble SCI)

3) Even in cases of the concerned specialty, if it is a ‘New Case’ arriving at the ungodly hour of the midnight, then the Doctor can do the same thing as mentioned in point-2

4) Only in those cases where the patient is ‘Under treatment’ of the concerned specialist in that clinic, the Doctor has an onus to attend him/her as do the needful treating the patient as his ‘Consumer’

5) No Doctor is expected to provide services when he himself is sick or exhausted, because in that case, he may not only jeopardize his own safety but the patient’s as well. This is an accepted norms by Law. But, these ‘Limitations’ should be clearly mentioned in the ‘Sign-board’/ Documents/ Prescriptions of that clinic that the -Doctor is only available from such & such hours.

6) A single Doctor clinic is expected to have a ‘Referral chain’ established, because it is not logically possible for any Doctor to deal with all sorts of emergencies single-handed and there are ‘Medico’s platform’ for networking and mutual help.. take the advantage of being connected with your fraternity.

7) The problem stated seems as good as – “Storming into the house of a local Doctor, dragging him up from his sick bed in the un-Godly hour of Midnight to attend an awkward Emergency at the gun-point because of his only ‘Crime’ that he is a Doctor and ‘Runs a specialty clinic’ in the locality”– probably that is not the general situation in India. We are all anxious about the ‘increasing violence’ against the Medical personnel. But, on that pretext, we should not exaggerate the ‘situation’ because in that case, Doctors in India will all become ‘Psycho’ patients suffering from persistent ‘Delusion of Persecution’ and ‘Nightmare’ !

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