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Ultrasound curbs row

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New Delhi, July 19: A Union government order that prohibits radiologists from offering ultrasound scans at more than two clinics has angered doctors who claim it will hurt the public, particularly the poor who visit low-volume, charitable clinics.

A body of radiologists has called on the government to reconsider the June 5 notification that asks radiologists to specify their working hours and prohibits them from performing ultrasound scans at more than two clinics in a single district.

The Union health ministry notification amends the rules governing an 18-year-old law that bans prenatal sex determination, which is believed to be driving female foeticide and contributing to India’s declining sex ratio.

“This notification appears to have been crafted without thinking about its impacts,” said Harsh Mahajan, president of the Indian Radiological and Imaging Association (IRIA), which has challenged the order in a court.

“Under the new rules, a radiologist who performs an ultrasound scan after his specified hours for a patient in emergency will face imprisonment,” Mahajan told The Telegraph.

The IRIA has said the move to restrict the number of clinics where a sonologist (a radiologist who performs ultrasonography) can practise to two will lead to a shortage of sonologists, which is likely to be experienced mainly by low-volume and charitable clinics.

“This is not going to affect large hospitals, but is likely to hit small nursing homes and charitable clinics where sonologists routinely visit to offer ultrasound scan services,” Mahajan said. “It’s mainly the poor who visit such clinics.”

IRIA members say the new rules will also hurt their livelihood.

“Radiologists who are just starting out take time to get fully occupied through a single clinic,” said Rajesh Kapur, IRIA president-elect. “Young radiologists need to go to three or more clinics to keep themselves occupied.”

A foetal medicine specialist who has been campaigning for years for stronger action against doctors involved in sex determination and female foeticide said the new rules would do little to curb these practices.

“This notification is just another arrow in the dark,” said Puneet Bedi, a foetal medicine specialist at the Apollo Indraprastha Hospital, New Delhi, who has for years campaigned for stricter enforcement of the law that bans sex determination.

The law demands a rigorous documentation process to record ultrasound scans performed on pregnant women in clinics across the country with opportunities for follow-ups and tracking of pregnancies that are terminated.

“There’s been no proper audit of records and no genuine attempt to curb female foeticide,” Bedi said. “But the radiology association is trying to protect its members’ interests — it’s mainly in peripheral clinics that rules are easily broken.”

India’s director-general of health services, Jagdish Prasad, said the government would “examine” the concerns expressed by radiologists. “I’ve asked my officials why this notification has been introduced,” Prasad said.

India’s 2011 population census had revealed the lowest child sex ratio in 50 years — the ratio of girls to boys up to six years of age had dropped to 914 girls for 1,000 boys in 2011 from 927 in the previous census of 2001.

A national committee set up under the law banning prenatal sex determination has conducted surprise inspections of ultrasound clinics in several states including Odisha, Maharashtra and Delhi over the past year, sealing some clinics that had violated rules.

The IRIA has also challenged another rule in the notification that requires clinics to register the doctors who will operate ultrasound machines a month in advance.

“Now if a radiologist abruptly leaves a clinic, and there is another who’s ready to join, the replacement radiologist will be able to perform ultrasound services only after one month,” said Kapur.

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About the Author:

Paul Khunkhun, serving Southern California since 1998. Paul is the owner of MDIS. He is a Board Certified Ultrasound Sonographer with RDCS and RVT credentialing. He is also pending ICAEL accreditation.

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