Plight of of a a common Indian Doctor.

Letter to a beloved Teacher:
(c) Rajas Deshpande

Respected sir,

Yourself and most other teachers are my Gods, I am what I am largely because of teachers like you, and cannot argue with your opinions.

Like any normal man, I wanted Porsches and Ferraris, a bungalow by the beach, a calm and quiet life of creativity, research, writing, and solving scientific mysteries, use whatever piddly talent God has given me to better human life, help orphans and end hunger by using my mind and earnings. However I got stuck into this greed-cage of social respect for being a good doctor, sold all these dreams for a life full of troubles for wanting to do honest good to people. And the respect? It came mixed with suspicion, threats, and an expectation of free / low cost availability 24/7 for everyone.

I cannot match your experience or sacrifice levels sir. You have created thousands of good doctors working in a government medical college for 35 years for basic salaries. I also know there are many doctors who work far harder than myself, are as ethical, and do more for the society than I want to.

But the fact remains that this cannot be taken for granted for the next generations. To be specific, I will not want my children to become doctors in India and spend a perpetually middle class life of loans, sacrifices, hate, suspicion, stress, threats and violence and pseudo-respect while having to keep their merit, hardwork and ethics above the rest of the society, much of which is corrupt, selfish, mannerless and deceitful.

I am not fighting for myself, but for the innumerable talented medical students who I see leaving India every year never to return. Because not everyone is wired for the simple life of a saint. If this does not stop, our country and its people will not have the best doctors, it will just keep on telling how 44 % of US doctors are Indian.

As for the example you quoted of a man who kept on walking to get maximum land and died of that greed instead of being satisfied with the land he already had, Sir I died the day that I realised my country does not care if I stay or leave, nor do my patients for whom I returned. My walk is not for any land, I do not really have any material wishes left, my purpose in life is to get maximum and best care for the poorest of the poor in India, while ALSO ensuring dignity and good life for the next generations of doctors.

I also fail to understand sir why people think “Good earning” contrasts with “Good MediCare”… why cannot both be feasible in a country which can send satellites to Mars, which has its students heading “Microsoft”, Royal Society, and many other world class institutions, a country which has multiple crores for so many “Pseudosocial” projects… Why is a doctor earning good by his merit and hardwork “Bad” as against a doctor who is not as good, but charges less fees and lives in poverty??

I cannot argue with everyone sir, but am sure India has enough intellectuals (even in media) who will agree that whatever the golden past was, most specialised good doctors will not stay in India without good pay and future generations will still feel shamelessly proud of their ministers, PMs, CMs, and sport stars, filmstars , rich, idols going to US and Germany to get treated under Indian doctors working there. I am not proud of it.

Secondly Sir, when I was thrown out of a large corporate hospital in Pune for refusing to compromise with patient care, I requested help from all medical bodies and health ministers, seniors in my field etc., but got no replies. After obtaining best Neurology training available anywhere in the world, I was roaming nearly 12 hospitals every day in Pune (2008-2009) for two years, to survive with two kids. NOBODY HELPED, except a classmate who lent money and a senior Neurologist Dr. Pradeep Divate who lent moral support, advising me not to leave India.. More of a hurt, NOBODY cared.
(c) Dr. Rajas Deshpande

My choices were to leave India, to leave kids or to compromise on principles. I offered to work at the govt run BJMC, Sassoon hospital (Dr. Anand Malick will testify), but was refused by govt because they had visiting (not fulltime) Neurologists, and new applicants cannot be over 35 years age. This is the age where most specialists get time and experience o be able to start teaching! So if you want to contribute free in a govt hospital as a superspecialist, you must apply before age 35 and can then continue beyond age 75! There are so many successful, good superspecialists who want to contribute to teaching and patient care in govt medical colleges and hospitals (which will also increase the number of PG seats), but the sad apathy of govts has always made things difficult and humiliating for them!

Sir let me also mention this to highlight the issue for patient benefit: you have given the example of two wheeler vs four wheeler, saying that four wheeler is greed when one can use two wheeler. in the 80s, two wheeler was what four wheeler is now. Then again, there may have been saints who even thought of your 2-wheelers and a bungalow as luxury and greed even then, which were basic needs for you. Wanting to live a good life according to the standards of one’s times cannot be called greed. Sir, you will agree that patients travel from rural areas to urban, and go to big cities for better medical care..why? : Probably if someone had started “making profit” for obtaining better medical facilities in smaller places earlier, the people there would have benefitted with it. Critical patients from rural areas have to travel to cities for hours, to get basic investigations like CT scans, MRI scans and specialist opinions. Why cannot the government provide this in all rural areas? Why must the medical superspecialist travel to rural areas as duty while the highcourts and parliaments have to be in the metropolitan cities? Unless there is affluence enough to develop it, how are the rural areas going to get better medical care?.. So the “profit making” I speak of is not for the doctor, but for investment for better medicare in future. Even Mahatma Gandhi agreed with the concept of profit, and now the courts have labelled our profession as “business” where patient is labelled a client.
(c) Dr. Rajas Deshpande

And in this era of human rights where even basic laoburers are supposed to not work for more than 48 hours a week, with one compulsory weekly holiday, how many doctors working for the govt / corporate set ups get this basic benefit? What is the fault of doctor’s parents and children that they must live / grow up in rural areas which have poor access, electricity, education and standards? Why should it be the doctors who bear the brunt of failures of public health and infrastructure developments?

A few bad eggs in this profession have been projected by the govt, media and society itself as the face of this noble profession, without realising what harm is caused to the country by doing so. More of a pain, the ministers, corporate bosses and insurance companies who exploit the services of topmost medical talents in the country roam around in the newest of the luxury cars, buy lands beyond imagination, and on top of this get accolades from governments for social service in the field of medicine!!! What a joke!!!!!

Let me assure you that I have personally tried not to let greed get the better of me: and also make you aware of the fact that 20 years in practice, I am still paying home instalments for a 3BHK apartment outside city, my current car is 8 years old, my bank balance has never exceeded 2 lacs till date, I look after (as single parent) two kids who go to regular college / schools, beyond fountain pens have no luxury items (I hope we are beyond the age of calling computers/ ipads luxuries), not a single piece of art / painting / costly wares etc at my home. I don’t drink or smoke. I have not travelled to ANY foreign country in last 5 years and have refused to take grants from any pharma, . I have never given cut for someone referring patients, never asked for it.

I work 12 hours a day, teach 2-3 medical / paramedical batches without charging anything for teaching or time, sleep 6 hours or less when not disturbed by calls / emergencies etc. As said earlier, no patient has ever gone back from my OPD for lack of money (except when it was a rich patient taking advantage of this), and in IPD I have had many free admissions, sometimes have paid from my pocket for poor patients.

I also aid donations of rich patients for an orphanage at Sassoon hospital. The @ 25 batches of students I taught till now will testify how much I have insisted on giving the best care to the patient, and to never think about money.

Please let me know what amongst my thoughts is correctable, so I can change accordingly.

I hope I will be able to justify your expectations of a good student sir!

(c) Dr. Rajas Deshpande

Please share unedited with credits.

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