By: Dr. Upsham Goel, M.S. F.M.R.F., Chief Consulting Editor-ICN
Medicine is among the most complex of sciences, and no wonder, among all sciences, carries with it the longest training among all professional courses.
Despite this, in India, every other person, who is not a doctor makes all the decisions with regard to medical policies, while the doctors are just handed down dictates by the powers that be.
This archaic approach has resulted in such a sad state of affairs that, if a child dies in a hospital from injuries following an accident, then the entire blame is put on the shoulders of the doctors – no matter how hard they may have tried to save the child.
No one blames the parents for allowing their child to drive without helmets, nor the cops who should have checked fitness for driving before granting the licence, nor the municipal authorities for making the most dangerous roads, nor the town planners who did not bother to envisage the high rate of accidents which would be caused with such dense traffic conditions. Ironically, the fact is, that the above reasons are the cause for India having the highest rate of road traffic accidents in the world, and yet, the only person who actually made the effort to save the child – the doctor, gets all the blame.
Fallacious policies, complete absence of answerability of concerned authorities, and an apathetic attitude of the administration is causing a slow but progressive decline in healthcare delivery.
The Judiciary, without any knowledge of healthcare and without studying the ground realities decided that healthcare should fall in the purview of “consumer” protection.
If a patient is a consumer, then the revered profession is nothing but a service provider – not unlike a plumber or electrician. If so, the doctors would pick up those simple to treat, low risk cases. Why bother with a case where they know for sure that there is a 50:50 or even lesser chance of survival of a patient?
Now please, for Gods sake don’t start harping on the “Morality” issues – Either you are a patient seeking the help of a doctor who will work hard to save a dying person, or you are a consumer just paying for, and getting services as per the convenience of the service provider – the society has to decide, and it can’t keep changing its stance as per its own convenience from time to time.
And the ill effects of years of unplanned policies have now begun to show – to the general public that is. The doctors saw it coming decades back, but who is listening to them?
Now, more than ever before, fewer and fewer hospitals offer emergency or critical care services, despite being better equipped than ever before. Fewer are handling complicated cases which are known to have higher mortality or even morbidity. Paediatric cases are being returned due to much higher risks they inherently carry.
In 2015, during the dengue outbreak, a heart rending story of a family came in the papers – their child went critical after suffering from dengue. They ran from pillar to post, going to different hospitals, trying to get their child admitted, but by the time they got him admitted, it was too late. The child died, and the parents later committed suicide. This incidence can be seen on the web. The point is, except for blaming the hospitals which were already overflowing with dengue patients, what measures have the successive governments taken to bring the mosquito menace under control? To put it simply – Absolutely nothing. As long as they have doctors to pass on the blame to, why would they bother? But, their time is ticking out, as the Good Samaritan doctors are becoming a fast vanishing breed.
And why wouldn’t they be – they pay several Crores to become doctors from private colleges owned by ministers where education standards aren’t anywhere near what would be considered as ideal. Why were these colleges allowed to thrive in the first place? Why didn’t the governments see that a 1.3 billion population will need a lot more doctors? Why does India continue to spend a miserly sum of its GDP on healthcare, while throwing away trillions in name of subsidies to an ever growing monster sized population?
Sadly, though there is still time to retrieve lost ground, but is anyone listening?
There has now arisen an urgent need to revamp this archaic system, with a separate cadre for healthcare. Otherwise, one ineffective policy will follow another till the whole sector itself goes into demise.
Corrections need to be made right from admission process, to graduate training, through Post Graduate seats allocation, availability & training.
Then, getting the government healthcare out of the clutches of the current administrative frame work, and allocating it its own cadre.
Incentivising creation of healthcare facilities at every level.
Incentivising public healthcare programs.
Incentivising skill development in Medical, Paramedical and Research Scientists.
Rationalising “consumerism” and capping compensation.
Minimising extraneous administrative work, to maximise doctors’ work efficiency.
On each of the above I could write many pages on the detailed framework and planning.
But, as always, the question remains “Is there anybody out there?”