National Doctors Day was celebrated in India on 1st July in memory of the iconic Bharat Ratna Dr Bidhan Chandra Roy, India’s first Union Health Minister, whose birth and death centenary fall on that day. In those days doctors were revered, and a doctor was generally assigned the Health Ministry to guide the civil administration. Over the years administration of healthcare, across the world, moved away from professionals from the medical field to people remotely connected to the profession, be it at the government level or at the hospital level. Most hospital chains are administered by engineers, who have degrees in business administration or finance, while the government health ministries are run by administrators with a background in arts, commerce or engineering.
Over the last few decades, doctors have become workers with little control over patient care. The empathy and the compassion of the profession thus vanished, and the status of doctors took a tumble in the society. Doctors were gradually pushed to being service providers, and patients started getting treated as business commodities. The sacred profession was relegated to a mundane job to earn a livelihood. The noble intent of healing the sick humankind made way for a professional seeking to ensure consumer satisfaction and make money.
Today, the doctor is rated by professional marketing agencies by yardsticks least related to curing disease. Doctors are rated for how they behave, to the time they spend with the patient, etc. with the treatment of illness treated as an unimportant data point. Meanwhile, hospitals are assessed by these agencies by parameters which were meant for hospitality industry rather than by parameters defining patient care. All big hospitals have marketing departments, and they use agencies to promote themselves rather than attracting patients with their outcomes and efficient management.
Governments look at hospitals with a hawk’s eye and audit their revenue parameters. People with no concept of running hospitals or healthcare sit on committees to develop healthcare polity. Politicians with medical background run environment and tourism ministries and those with no exposure to medicine run the health ministry. Medical governance in the government is by professional administrators, ably assisted by doctors who were misfits in the medical profession and manipulated their way to ‘Babudom’ in the ministry.
The medical profession today is perhaps the most unhappy profession. Senior doctors are looking for alternatives while junior ones are looking for the elusive dream job. A dream of excelling in the sphere has become an illusion as all that’s on offer is suspicion and abuse of the patients and a crumbling healthcare system. The disillusionment about the profession’s future is so widespread that the selection grades for admission to medical colleges are getting lower by the year despite the education board’s results climbing up every year. The days of the medical profession running in families are over as progeny of doctors do not want to take up the vocation, even though the country doesn’t have enough doctors.
The ridiculous package rates of medical therapeutics, in the about to be announced ‘Rashtriya Swasthya Bima Yojana’ scheme, has dampened the spirits of the profession further. On the other hand, the common man is convinced that such a scheme is the need of the day, as doctors are looting them. The scheme has unfortunately been conceived and framed by the ‘management gurus of the Niti Aayog’ who live in ‘Wonderland’ and not the real world.
Healthcare is the cheapest in India, and the cost of treating various ailments is one-third to one-tenth that in the western world. Our planners decided to put a clamp down on the ‘expensive’ medical care in our country to make it accessible to the common man. The tariffs proposed are one-third to one-fifth of the current tariffs in the country. Just imagine what quality treatment the poor patients will get in the future. Some prophecies for the coming times are that we will return back to the days of reused and sub-standard devices; supposedly ‘generic’ drugs (which may or may not work as quality and patent control is non-existent in the country); dirty hospitals with no air-conditioning (as hospitals will cut down expenditure on maintenance); scanty number of paramedical staff and doctors (as hospitals will not be able to afford the wage bills); refurbished or old diagnostic infrastructure (as there will be no budget for modernization) and poorly maintained operation theaters (which will gift you postoperative infections).
The thoughts of a modest yet useful healthcare system of the country breaking down are making the doctors unhappy. The doctors are not greedy professionals, as painted by the media and politicians, but proud professionals with a humane touch. Doctors definitely desire a reasonable earning, like other equivalent professionals. Doctors are not leeches sucking blood but healers. They are not Gods nor are they born with a gift of a healing touch. Doctors are humans alleviating the suffering of fellow humans with their acquired skills. These acquired skills may have deficiencies as achieving perfection isn’t easy.
- The writer is Director, Department of Anesthesia, Max Superspeciality Hospital, New Delhi. His views are personal. He can be contacted at: mukulanjali@gmail.com
