President Address

 

Prof. Mahipal S. Sachdev, takes over as President, AIOS on 13th feb 2020 during 78th annual Conference at Gurugram

Respected Chief Guest Shri Amitabh Kant, Guest of Honour Shri Sudhir Singla, Prof. Harminder Dua, Prof. Chee Soon Phaik, other dignitaries on the Dias, my esteemed senior colleagues, brothers and sisters from the Ophthalmic community.

It is one of the most important days of my life today, as I stand here in front of you. It is not every day and for everyone to have the proud privilege of addressing the gathering of top ophthalmic minds in the country and abroad, including one’s mentors, colleagues and students. This honour that has been bestowed on me is wholly and completely due to the support, faith and encouragement I have received in abundance from each one of you. I thank you all for giving me this opportunity to put in my best for the ultimate glory of Indian Ophthalmology.

It is my proud privilege to welcome amongst us, the Chief Guest for today’s event, Mr Amitabh Kant, a career bureaucrat. Mr Amitabh Kant is an IAS officer of the 1980 batch. As of June 2019, he is the CEO of NITI Aayog. An alumni of Alliance Manchester Business School, Jawaharlal Nehru University, St Stephens College and Modern School; his passion for the upliftment of his cadre state, Kerala was instrumental in making it “God’s Own Country. “Make in India” and “Stand up India” initiatives would have lost their momentum, had it not been for his passion and zeal to achieve the impossible. With his expertise, experience and efficiency, he is the right torch-bearer as the present government moves towards the target of a 5 Trillion US dollar economy. He has been the catalyst for a lot of positive steps this government has taken towards promoting entrepreneurs, business and industry. It is only apt, that his presence here today should work as an elixir for us, as we at AIOS stand poised to step on the gas. On behalf of the All India Ophthalmological Society, I extend a warm welcome to Mr Amitabh Kant, and am sure his presence will leave us richer for ideas and strategy; at the same time giving us an opportunity to acquaint him with the challenges faced by the Ophthalmic Community in India.

I also welcome our Guest of Honour, the beloved leader of BJP and MLA from Gurugram Shri Sudhir Singla for being with us.

The best way to move forward is to get our bearings by looking at the past. The last couple of years have been filled with a lot of new initiatives, renewed vigor, consolidation of the old activities and innovative projects which were focused on maximum participation from the members of AIOS. It has been in no small measure due to the efforts of Dr Natarajan, that AIOS has made it a mission to screen all diabetics of India for Retinopathy through the use of Community Outreach, Artificial Intelligence and Mega camps. This unique initiative, with the help of the present government will take us miles ahead in eradicating preventable blindness from the face of this country. The last year saw us at AIOS holding a record number of webinars, CMEs and surgical skill enhancement capsules, with the idea that the physical location of an ophthalmologist in a remote area should not come in the way of learning and acquiring the latest skills and knowledge.

Last year also saw us making concerted efforts to make our voices heard in the corridors of power as regards the contentious issues plaguing the medical fraternity in general and the ophthalmic community in particular. This saw us challenging the applicability of the PNDT act on Ultrasonic Biometry Machines, the irrational rules of the insurance agencies in respect to health insurance packages or payouts and the complex issue of pricing of surgeries in various panels and government schemes. We also contested the harassment of ophthalmic community by GST officers in various states on the issue of laser vision correction surgeries.

But then this is just a pitstop. I will be failing in my duties, if I don’t lay out before you today, the path on which I see AIOS moving in the coming year.

Today, the medical care provider has become a convenient and populist target for any folly or shortcoming in the healthcare industry. A case of cluster endophthalmitis sees the ophthalmologist being taken to task, even if subsequent investigation proves beyond doubt that the fault lay in the irrigating fluid or some other factor, not in direct control of the treating ophthalmologist. This “shoot the messenger” mentality is further fanned by an overzealous media and individuals out for cheap and quick popularity. The impact it has on the healthcare provider not only results in personal turmoil for him, but also effects his treatment strategy, where the best interest of the patient is diluted by his apprehension about personal safety. We need to impress upon the appropriate authorities the need to have a logical, level headed approach to such events guided by principles of natural justice.

We at AIOS will repeatedly and continually approach all those who matter to make legal framework to safeguard the eyecare-provider from physical, financial and emotional distress, when the fault lies somewhere else. This would also include all efforts to insulate doctors from impulsive, violent and abusive behavior at the hands of the patients and relatives.

Closely related to this subject is the status and importance accorded to professional societies like AIOS by government agencies. AIOS is the ophthalmic society having the largest number of life members in the world and has members with rich, vast and varied clinical and administrative experience. It is not difficult to envisage the value addition which can be accrued by tapping this talent pool for formulating policies and regulation concerning ophthalmic practice. Unfortunately, till date such symbiotic initiatives have been few and far between. It will be our intention at AIOS to make the government of the day aware of the substantial benefit to the nation which can be gained by involving national professional societies in formulating policies.

Ophthalmic practice is unique from the other branches of medical practice, in being equipment intensive and fairly non-dependent on external investigative modalities like laboratory and radiological inputs. This has resulted in ophthalmology being largely practiced in a single specialty clinic or hospital. Irrespective of the size, most of the eyecare facilities are stand-alone, clean, focused day care facilities. This trend is not geographically limited to India, but can be seen in the practice patterns all across the world. Unfortunately, the present regulations do not have any special head under which rules for such day-care centres are formulated. These day-care centres are weighed in the same scale as multispecialty hospitals, resulting in lot of infructuous and illogical requirements being asked to be met by the regulatory authorities. The criteria of infrastructure status being accorded to healthcare facilities relies heavily on the number of in-patients, availability of emergency facilities and such parameters which unjustly exclude eye care centres from being eligible for funding and taxation benefits which accompany the label. This aberration needs rectification, and we at AIOS will ensure that the we make the right noises in the right offices, including that of our Chief Guest!!!!

We all daily keep hearing about the ease of doing business, and the way India is climbing the charts of this parameter vis-à-vis other countries. No doubt things are moving in the right direction in this respect, but a few sticky points need to be pondered over.

A medico, after finishing his education, (though a medico’s learning phase never ends), finds himself shackled by various bonds of rural service in sub-optimal facilities. Having done his bit for the country or community, which by the way, no other professional graduate like an engineer or lawyer passing out from the highly subsidized government colleges is required to do, he still finds his right to earn a decent living clamped by abysmally low financial payout. This is an indirect fallout of the squeeze applied on the rates of healthcare unilaterally decided by the agencies responsible. A survey by one of the most reputed audit agencies pegged the input cost of a cataract surgery by the currently practiced techniques at Rs 24,000. The rate being offered for a similar surgery under Ayushman Bharat is Rs 7500....

The rates of surgeries offered by government panels like CGHS, DGHS have not been revised at least for a decade. This pill is made even more bitter by the fact that the renumeration offered by health insurance agencies have seen a downward revision, which with the rising human resource and material costs is sounding the death knell for ophthalmic care in the country. You can’t realistically offer ridiculously low rates and ask for state-of-the-art care. This is making the practice of ophthalmology a daunting and unenviable proposition.

Looking inwards, we also have ambitious plans of strengthening our society, making it more effective, vibrant and productive. AIOS has an unmatched pool of human resource skills. More than many of our members are sought after faculty on international podia and are called to help in tackling complex cases. What is surprising is that despite being a society with a rich heritage, glorious past and an energetic present, we have not been able to garner eyeballs globally. Our international membership is one way to spread the good work of the society and stamp its relevance on the global stage.

Towards this end, we will initiate ways and means to encourage foreign ophthalmologists to become members of the society, increasing our international footprints.

Ophthalmology is rapidly moving towards super-specialization. These special branches of ophthalmology need to be supported by providing them the right environment to mature. We at AIOS plan to settle up specialty groups in coordination with the national sub-specialty associations to amalgamate and synchronize the efforts towards scientific advancement and growth.

AIOS in the coming year will also try to get a grip on the issue of accreditation. Though substantial progress has been made in this field in the past year by getting special parameters laid out for eye care organizations, much still needs to be done to get all on the same platform. We need to make the requirements more realistic, achievable and driven by practical realities rather than paper filling exercises.

A lot of our young ophthalmologists are taking the cue from the prevailing startup scenario in the country and venturing out to start their individual/ group practices after acquiring reasonable skills. Astute clinicians, these young friends sometimes lack in business acumen. We plan to set up an SOS cell (Support for Ophthalmology Startup) which will hand-hold these entrepreneurs through the whole process of setting up an eye care facility and be a meeting ground for the industry and the practitioner.

Along the same lines, every ophthalmic practice requires an HIMS to function. With increasing importance being placed on the record maintenance each passing day, having a standardized and robust ophthalmic practice management software becomes an essentiality. We at AIOS envisage developing an HMIS suited to ophthalmology practice and plan to make it available to AIOS members at a nominal per user charge. This will not only reduce the cost of procuring such software, but will also standardize record keeping, thus making transfer, exchange and collation of data easier and effective. As a consequence, this will be the first step in setting up a national ophthalmology database providing an accurate, exhaustive and one-stop solution for research and training.

On the anvil is a path breaking government resolution, expected to be enforced by April, which will remove the geographical restrictions placed on an ethics committee in respect to the projects it can approve. This will open the way for AIOS to have its own in-house ethics committee to review and approve ophthalmic research projects, thus giving a further impetus to research and clinical trials.

In our country we are blessed with the excellent quality of the best research minds and the abundant quantity of patient data at our disposal. With the easy availability of the ethics committee, I am sure our long-term goal of promoting research will be fulfilled.

Friends, our biggest strength is our unity, and numbers. This strength of numbers empowers us with the power to negotiate from a position of strength. These negotiation skills will be put to use in our dealings with Health Insurance Agencies for including all ophthalmologists in their eligibility for reimbursement and offering near uniform rates. This will also help us drive a hard bargain with the industry, forcing them to offer reasonable rates and effective after-sales service.

A penny saved is penny earned. These are hard times for eyecare facilities, with input costs rising, regulators tightening the noose and the financial renumeration dwindling. Make in India is something, which is the need of the hour. This indigenous production of material and consumables will help each ophthalmic setup save some funds, which will be critical in today’s scenario. We at AIOS will walk the extra mile to encourage industry, institutes and individuals in inventing and improvising by providing them with all the support required.

Friends, we, the office bearers at AIOS have set ambitious targets for the society. All of this will remain a dream and a fairy tale on paper, unless we all join hands and resolve to make this a success. It is my humble request to each one of you to help me take this wonderful organization of ours to its rightful place at the top. I am a firm believer of teams being bigger than an individual. Towards this end, I have made it a point to ensure my availability and easy accessibility in whatever post I have held in the past. The same would be my endeavor as President, AIOS. I would be honored to receive your inputs, feedback, suggestions and constructive criticism by phone, mail or any other medium, because this will make my job of doing my best for AIOS that much easier.

Before I conclude, I bow in reverence to the lord almighty, who has always been very kind to me. I would like to convey my gratitude to my colleagues in the AIOS OBSC specially Prof. Natrajan, Dr. Barun Nayak, Dr. Ajit Babu Majji, Dr. Lalit Verma, Dr. Namrata Sharma, Dr. Santosh Honavar, Dr. Rajesh Sinha, Governing Council, Managing Committee, the LOC , Haryana Ophthalmological Society, and all others who have worked tirelessly and relentlessly to make my being here possible today. The silent workers at the AIOS headquarters including Mr Kripal and Ms Rakhi need a special mention for their relentless pursuit in meeting deadlines. I am also indebted to my wife, Dr Alka and my family whose support was the backbone for my being able to dedicate myself single-mindedly to this cause. My second family, each and every member of team Centre for Sight; my special thanks to you for believing in me, and being my strength each and every day. Last but not the least, this journey would not have taken off, had it not been for my Alma Mater, R P Centre for Ophthalmic Sciences.

Once again, thank you all for giving me this responsibility.

Have a fabulous conference and may we progress, prosper and flourish together, making 2020 a year to remember at AIOS.


Prof. (Dr.) Mahipal S. Sachdev
President, AIOS 2020-2021.

Awarded Padamshree by President of India
President, All India Ophthalmological Society
Chairman, Medical Director & Senior Consultant Ophthalmology Centre For Sight Group of Eye Hospitals

president@aios.org