Cardiologists from India’s foremost medical institute, AIIMS, came together about a year ago to form SLIM – the Society for Less Investigative Medicine – and now it is becoming a national society. This is an initiative taken by the doctors to prevent over- diagnosis from irrelevant tests that have plagued the field of medicine for too long now.
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The movement imitates the change that has already being implemented in over 112 countries. ‘Choose Wisely’ of US is amongst other similar initiatives. SLIM wishes to make a list of symptoms that need not be tested and lay emphasis on facts like too much diagnosis is not just a waste of resources, but could also affect the patients adversely, while keeping the Indian context and problems in mind.
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When specifying the reasons for the over-diagnosis, Dr Samiran Nundy, chairman of the department of surgical gastroenterology and organ transplantation at Delhi’s Sir Ganga Ram Hospital said, “Though such doctors slip under the radar by justifying over-diagnosis as necessary for precise investigation, the reality of the matter is often different wherein the doctors over-prescribe to provide increased profits to the private hospitals to give incentives for the exponential salaries that they receive.”
The corruption in health care is more worrisome because of the developing state of India, where the country has scarce resources, enormous population and widespread poverty. This makes corruption all the more problematic because it is preventing even the providence of optimal basic health care to people, as resources are being spent mindlessly on testing that might not be required at all.
If this not reason enough, the doctors say that inappropriate practices of over-prescribing are very common in India, with unwarranted interventions and investigations and there are medical practitioners who are willing and motivated to stand against this, restoring the medical practice to what is necessary and relevant.
SLIM has seen renewed interest this past month as other countries saw a reinforcement towards the drive to practice rational medicine.
Dr. Reddy, president of the Public Health Foundation of India, says that growth in the health sector should focus on fixing and filling the gaps that the field has, and not to proliferate through maximum use of technology which is worthless and not required in most situations, which is where SLIM will come in. It is hoped by the society that the word of qualified doctors and their detailed reports and lists will dissuade such practices in the near future. SLIM has received support from doctors and non-medical practitioners alike.