Corruption Is where Heart Is – Dr. K. K. Aggarwal
New Delhi, 29 September: Dr. K. K. Aggarwal has been caring for hearts ever since he founded ‘Heart Care Foundation of India’ 28 years ago. That is why he minces no words when he says that corrupt practices are on in the treatment of hearts in Delhi and elsewhere in the country and patients need to be protected from such unconscionable doctors and health providers. His words assumes greater cutting edge as he is all set to lead Indian Medical Association (IMA) as its Secretary General for about two and half years subsequent on upcoming December.
In no-holds barred interview to Meditoall Editor-in-Chief Dhananjay in HCFI office at GK1, Dr. K. K. Aggarwal dropped a bombshell of sorts by saying point blank that there are some private hospitals which are giving targets to fulfill to doctors, leading in turn to unnecessary heart procedures. He says he will work to stamp out such doctors as are caught doing this by recommending them debarred from practice.
Dr. K.K. Aggarwal has been a crusader of sorts in spreading awareness about keeping heart fit and in fine fettle for over two decades through his MTNL perfect health Mela in Delhi every year (it is starting from 15 October) and other programs throughout the year. The icing on the cake is that this year he has created a fund named Sameer Malik HeartCare Foundation Fund to help those who cannot afford heart treatment. He claims that from now onwards no one in Delhi – NCR will die of heart disease for want of money.
Excerpts from Interview:
Allegations of unnecessary heart procedures for money have turned out real. As you are going to take up reigns of IMA, the largest body of doctors in the country, as its Secretary General from December, you would have to confront this question over and again. What is your take on this?
I am aware of such illicit practices in heart treatment. Yes, there are some hospitals which give targets of number of angioplasty or bypass to be done in a month. Naturally, it leads to procedures which are not at all needed. It is illegal and criminal.
In fact, there is much scope of corruption in the treatment of heart. Visit the site of CGHS and truth of corruption will come home to you. On the site the cost mentioned for drug eluting stent (medical device used in angioplasty to open the blocked artery) is Rs.25 thousand and that of bare (non- drug eluting) stent is Rs. 12 thousand. Even if stent has to be used for PM Narendra Modi, the cost of stent should be Rs 25,000 or 12000. Then how come stents are available at 60-70 thousand rupees? It clearly shows there is much scope of fleecing heart patients.
It is not only so in case of stent, scope of corruption is in every medical device. The rule in CGHS is to sell the stent to patient exactly at price at which it was bought from Stent Company. If you buy it in Rs. 20 thousand, it is wrong to sell it to patient at one lakh rupees. I would recommend that Medical councils should take very stern view of this and resort to debarring doctors caught in this act.
In the light of such allegations, there are murmurs of demand for audit of heart procedures. Do you think audit will help?
Audit of heart procedures is the need of the hour to stamp out such illicit practices. The hospitals themselves should do their own audit. CGHS and medical councils also should start audit of heart procedures so that black sheep even dread to think of doing procedures that are not indicated for patients.
Chest pain is one event that puts the patient at the mercy of doctor and hospital. How to know whether chest pain relates to heart?
If the chest pain lingers more than 30 seconds, it could be a heart event. The heart pain does not occur at a point in the chest, it pervades the whole chest. In case of having chest pain, instead of wasting time in thinking whether it relates to heart or not, the first thing that should be done is to chew a disprin tablet and go to the nearest hospital. Even if chest pain relates to heart, ECG can come normal till 6 hours. Eco should confirm whether the event relates to heart or not. Angiogram may also be needed.
What are other symptoms that should be taken seriously?
If age is 30 plus and the person is experiencing acidity for the first time in life or asthma attack occurs unwarranted, heart attack should be ruled out first. Chest pain is not the only symptom of heart attack. About 40 percent of those who get heart attack do not have chest pain. They only experience choking feeling, pressure on the chest, weakness, tiredness or even pain in stomach.
When blockage in the coronary arteries does become critical? There does not seem to be a consensus among doctor on this
It depends on the number of collaterals a person has. Collaterals are thinner branches from main arteries. These are natural bypass. Percent age of blockage and natural bypass taken together decides criticality of situation. That is why sometimes you do not need operation despite having 90 percentage blockages of coronary arteries and sometimes even 60 percent blockage can precipitate the need of intervention. Treadmill or stress echo test underlines whether a person needs operation despite blockage or not.
How to know what procedure one needs for the treatment of heart? Or they do not need them at all, mere medicine can treat him?
Out of 100 patients about thirty happen to be those who need bypass and angioplasty but only when all experts say they are needed. One third does not need any of them at all if all experts say so. One third will have to choose from all three. It depends which expert you are going to. If you go to an angioplasty expert, he will say stent is the answer. If you go to a heart surgeon, he will recommend bypass and the cardiologist will say he will treat you through medicines.