Hospitalizing patients under a team of doctors - Need for clearer protocols in India

March 28, 2024

A patient is usually treated under the care of a ‘principal doctor’. Clinical decisions and accountability rests upon him / her. There could be instances when the patient requires medical care from multi-disciplinary specialists / super-specialists, which could be termed as ‘group practice’.

State Medical Council, in this case, drew adverse inference on such ‘group practice’. Read the case to know what exactly happened.

Irrefutable Facts

The patient, suffering from pain in his back and both lower limbs consulted the senior surgeon. The doctor performed L5S1 Left Sciatica Microsurgery, assisted by other surgeons.

The patient continued to experience pain post-surgery, and despite repeated visits to the OPD, the patient did not get relief. He consulted the doctors at various other hospitals. Later in one of the hospitals, he was operated on for L4 L5 Discectomy, L4 L5 Laminectomy L5 S1 Foraminotomy, decompressed and Pedicle Screw and Rod fixation.

The patient sued the doctors and also filed a complaint before the State Medical Council which observed that the patient was not admitted under a whole team, the senior surgeon was mentioned as the responsible doctor. The Council had also observed that operating the patient in absence of a responsible surgeon was an unacceptable practice.

Doctor’s Plea

The senior surgeon stated that, being senior-most neurosurgeon of the hospital, he joined the surgery as soon as the patient was ready for it.

Court’s Observations

The court observed that disc desiccation from L3 – 4 to L5-S1 with bilateral foraminal stenosis at L5-S1 Microdiscectomy was the best possible treatment for such kind of disease.

Hence, the court did not hold the surgeons negligent.

Prevention Is Better Than Cure

Group practice is a relatively unknown concept in medical practice in India although it flourishes in developed nations. A group of doctors either from the same speciality or different specialities present themselves as a unit to the patient. There is no legal or ethical bar on group practice in India.

The only care that needs to be taken is to specifically inform the patient about this arrangement at the outset and take their assent, preferably in writing. Medical societies as well as the regulator (National Medical Commission) should prepare appropriate protocols in this regard.


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Source : Molla Sirajul Islam v/s Dr. L. N. Tripathi & Ors.