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Doctors live in melancholy and despair, why?

Doctors live in melancholy and despair, why?

Only 6 percent of doctors are happy with their jobs, they commit suicide at twice the rate of the general population. Most would not recommend the practice of medicine to their children. Why? Doctors are gagged by various laws, feel low self esteem because of low wages and discrimination at all levels and feel insecure, discontent and scared about the future. Chosen out of the most brilliant as students, tough and expensive entrance to medical colleges, long and arduous journey during graduation and thereafter, poor job opportunities, hostile work environment, plethora of laws to threaten their medical registration and fear of losing lifelong earnings are only some of the stumbling blocks to ward off future aspirants and give up their chosen profession. While most doctors try to do their best for their patients, despite the heavy odds, some black sheep do exist as a matter of exception. Why the reputation of the doctors is being sullied as a class? Lamented one doctor, ‘I get too little respect from patients, physician colleagues, and administrators, despite good clinical judgment, hard work, and compassion for my patients. Working up patients in the clinic these days involves shotguning multiple unnecessary tests (many get MRI/ CT!) despite the fact that we know they don’t need them, and being aware of the wastefulness of it all really sucks the love out of what you do. This is either because of defensive medicine practice or directive by corporate honchos. I feel like a pawn in a moneymaking game for hospital administrators. There are so many other ways I could have made my living and been more fulfilled. The sad part is we chose medicine because we thought it was worthwhile and noble, but from what I have seen in my short career, it is a charade. I find myself watching and talking to doctors across two generations and various specialties these days. And increasingly, that sense of despair and disillusionment is writ large in their words’.

The growing discontent has serious consequences for patients. One is a looming shortage of doctors in primary care, which has most dissatisfied practitioners. But interest in primary care is at an all-time low. Perhaps the most serious downside, however, is that unhappy doctors make for unhappy patients. Patients today are increasingly disenchanted with a medical system that is often indifferent to their needs. People used to talk about “my doctor.” Now patient call every payment made to a doctor as loot. How the doctors will feel with this label! Many doctors feel ashamed even in disclosing their identity as medical doctors. How can we reverse the disillusionment that is so widespread in the medical profession? There are many measures of success in medicine: income, of course, but also creating attachments with patients, making a difference in their lives and providing good care while managing limited resources. We also need to replace the current fee-for-service system with payment methods such as bundled payment, in which doctors on a case are paid a lump sum to divide among themselves, or pay for performance, which offers incentives for good health outcomes. We need systems that don’t simply reward high-volume care but also help restore the humanism in doctor-patient relationships that have been weakened by business considerations, corporate directives and third-party intrusions.

Training period is dull and monotonous; practice period is full of hazards!

Walking out of the home at 7 AM and returning home at 10 PM just to fall into bed and then wake up again at 5 in the morning to restart the cycle- trainee wondered what the point of it all was. He was losing touch with her loved ones and had become a zombie, lost between the politics within the hospital and a total lack of social life. All this for a handsome salary of 50,000/- a month. There would be a pot of gold at the end of the rainbow! Not really!! Do not be a sentimental fool and get blackmailed by the medical system to go work like he did… because nobody cares for your service at the end of the day. You face copra  i  e consumer protection act of 1986, the same applied to petty goods sellers, but alleged deficiency in service to take away life time earnings in case of a doctor and say about 10% of the amount spent in case of a shopkeeper. The bonus for the doctor can be assault on his person or property for which the criminals escape without any punishment.  The Indian Medical Association confirmed in May 2015 that over 75% of the doctors in India have faced some form of violence at the patient’s hands in India. The recent verdict in the Joseph Eye Hospital case brought the reality of the Indian mindset home to many doctors. Handing down verdicts of imprisonment to 3 doctors for the loss of vision of 66 patients following an eye surgery in a free camp,
Then you have PNDT-alleged sex determination can take you to jail instantly. The abortion laws find a doctor as guilty suo moto, with no fault of the perpetrators of crime. Earlier Supreme Court observed that a doctor cannot refuse to treat a patient, even if he is not competent to handle such a case at any hour of day or night, but does not give any immunity in case the outcome is not favorable to the patient.  The latest clinical establishment act of 2010 has taken away the fundamental freedom of doctors, selectively. You have no rights of earning or regulating your work hours or right to get retired-unlike government service. Inspectors will make your life hell now, if you had any dream left of leading a life of free citizen. A recent gag order by MCI has taken away doctors’ right to protest, even if you have grave grievances. Were you doctors looking for such a weird life, when you planned your career? While allegations of unethical practices are abundant, the fact remains that most doctors can just make their both ends meet even when in their 40s or 50s, the loot included-while many techies earn a package of 40-50 lacs when in their 20s-still called mere employees with fixed income! Not 1% doctors get such packages even at their retirements why?                   DR.R.Kumar formerly from PGI, convener SPEAK

 

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