This simple looking girl in her early twenties walks into my OPD with her parents. They all are dressed up typically worker/ lower middle class, just enough to avoid obviously torn clothes. Everything humble, barely touching middle class, but very well behaved. She starts telling her father’s complaints in perfect English, and as good as a medicine resident doctor would perform in exams, she relates proper history in the correct textbook format, with a polite comment about examination findings. Definitely better than some US / Canadian / European students I had known would present.
“Are you a Doctor?” my curiosity was awakened by the accuracy of her medical description.
“ Yes Sir, I passed out MBBS from BJ, now doing my compulsory Medical Officership, then will try for PG”.
A hot knife cut my heart.
She will start PG in mid-twenties. She will marry sometime then, have children, raise family while slogging as a doctor, while girls her age fully live their life, proud and rich being a doctor, in most of the developed world. This lady will continue to carry the country’s healthcare burden till some arrogant minister / govt. officer / local politician or general public gets her suspended for not delivering results expected by them: like saving their alcoholic / smoker / aged/ chronically diseased, drug-defaulting, multi-pathy medicating relative admitted at the last moment at midnight after their party is over.
Or else she will keep on begging / applying at multiple corporate set-ups for a decent salary and opportunity, where fresh degree holders from all other nonmedical streams who couldn’t get enough merit to get into professional courses will make her stand in a queue, ask her for different certificates and proofs of ability, and some perfume-suited insulting CEOs will ask her of possible income she can generate, and any “procedural gimmick advantages” she has over others.
Or her teachers will give her sermons on social service being service to God, it being her duty lifelong to serve poor and illiterate helpless patients like they had done, neglecting any of her own desires, especially that of a good life. Or her own richer / well settled colleagues who earned wealth from prior generations will tell her to “Chill and take things easy”.
Or some court will send her to jail for documentation mistakes. Or peel off her degree as if it was bought undeserved by money.
Or worse, some bollywood or other celeb with a devastating past and glycerine tears will preach her how a doctor should be a good human being, and never think about money having chosen this profession.
And like a girl at night in the streets of our country, nobody will protect her.
Among billion-some population, mostly poor and illiterate, of a disease-ridden country where everyone in government, police, business continues to get richer by the day, judiciary and lawyers take eternity to conclude cases while millions keep on paying both handsomely, the medical fraternity is pushed into hell by all of these : PG students are exploited under the “teaching-learning phase” excuse, then medical officer in remote villages as a “social binding duty” (which lawyers, judges, engineers, ministers, IAS, IPS, all others can skip) without proper salary / remuneration (all other classes above have multiple “helpers” and other benefits). And when one emerges from all this “Hell”, they are left out in open, without any insurance / health or retirement benefits / holidays/ loans/ any form of help from any source, but a compulsion by law to attend all emergencies they may encounter, anytime, anywhere, lifelong, with punishment for not attending that emergency.
Why not apply the same to all three: ministers, judges and police: that you must attend to any emergency (state, legal or criminal) immediately, anywhere, anytime, all your life, punishable if you do not immediately act accurately and produce correct results always (judged by public!)? Also, write in capital letters accurately everything that happens, and handover a copy immediately, without being provided a clerk for assistance? Also, let people decide the salaries for ministers, judges, lawyers etc all professions, based upon people’s satisfaction, just as in case of doctors. Then again, let people file cases when they are not happy with the outcome. Let doctors also participate in the decision making of such cases.
Doctors understand law and administration as much as government and legal systems understand complicated, critical, superspecialty & specialty medicine!!
It is ridiculous that people who have no idea of what hardwork goes into making of a doctor make laws about medical profession , and have the audacity to suspend doctors at their wish and whim. The IMA / Medical Councils must strongly stand by and defend doctors who face threats, suspensions, injustice and unfair treatment by all and sundry. This is their first duty.
If the govt. spends upon the making of a doctor, it is not obliging the doctor, it is doing this for the society whose poverty, illiteracy and ill-health is the govt.’s failure, not the doctor’s responsibility. The govt. should learn to respect the merit of its own best students, extraordinary talents who also have the heart of gold to serve humanity via their talent and hardwork. It should encourage their well being and provide for their basic needs without pretending to do them a favour. There is nothing more shameful than this: that thousands of “MADE IN INDIA” doctors leave the country every year never to return, while it is being urged that the world must “Make in India”. Indian doctors practicing in other countries earn name, fame and wealth far beyond possibilities in India. They are far more productive in clinical, academic and research areas than those who stay back to tolerate Gutkha /Paan-eating, Gold-laden, Abusive Corrupt Free-monger Tyrants directly or indirectly in power!
It is a big joke that while most of the doctors slog in rural / backward India to fill up the govt’s failures with their blood and sweat, govt encourages corporate cultures and business houses in medicare, and accredition bodies further make things glittery so as to earn more! As if the millions of doctors practicing in small villages / towns/ cities on their own, (each one of whom is no less than any Nobel-winner as they spend an entire lifetime serving the poor) are worthless without such accredition! Who handles the thousands of epidemics / vaccinations / tubectomies / mother-child care and emergencies at the rural / grassroot / PHC / RH level? Do they have any accreditions? Does any govt hospital qualify for any accredition? Then why this new accredition business has suddenly cropped up where the patient and doctor are both harassed while others including mediclaim companies earn crores? On top of this, while everyone acts harshly against individual doctors and suspends them at the drop of a hat, the medical bodies are magically and tragically silent about corporate hospitals owned by big business houses, quoting that there are NO RULES against them, and medical councils are not authorised to take action against these big set- ups. They can get away with false advertising , harassment of doctors and even medical negligence without being acted upon by any medical body in India!! How pathetic and mean!! So anyone with money can form a medical company and start open advertisement about diabetes, heart disease etc., while the medical bodies will act only agsinst individuals who do so.
Even the few rich doctors in our country earn less than a tenth of what they could if they had chosen to practice in a developed country. Still almost everyone doubts the intentions of most doctors.
Coming back to the lady doctor in my OPD, I told her that her father may require an MRI as stroke was suspected. She hesitated for a moment, then her father asked in a shaking voice “How much will it cost? We have one thousand rupees only.” As I begged our kind Radiologist for another free MRI (Which she granted as always!), I avoided eye contact with the embarrassed family.
If a young meritorious MBBS doctor passing out from a premium government medical college (indicating highest standards of medical education in India) has to beg for basic medical facilities, while not being able to properly provide for her own parents, not only us as a profession that has failed to stick together to deserve respect and financial security, but the government, administrative bodies, medical bodies should all be ashamed of the state of affairs of medicine as a profession in India.
It is high time we demand “IMS” (Indian Medical Services) as an autonomous body to develop and control the medical services in India.
After all, Resuscitation is our prime duty.
(c) Rajas Deshpande
Please feel free to share without editing and with credits.