A young woman decides to have her first delivery to be conducted in the hospital where her husband, was working as doctor. The progress of delivery was slow. The patient as well as her husband requested the gynecologist to go for caesarean delivery, but it was not done. Uterine contractions had weakened and the birth was ensured with forced extraction of the baby! The baby had a poor sucking reflex and diagnosed as having cerebral palsy due to trauma sustained during prolonged duration of birth process. The baby expired after about 12 weeks. The family of the patient has filed a suit in for criminal negligence on the part of treating doctor. Was it an error of judgment or outright negligence? Not long ago any sick or injured person will feel safe as soon as he came close to the healer. Similarly the healer will wear an aura of nobility or Godliness while attending any patient. They had complete faith in each other and felt secure in each others’ company. Why there is a paradigm shift? Why there is a need to save the patients from doctors’ unethical and corrupt moves and why doctors are clamoring for protection from onslaughts from patients or their kin? Doctors need to take a moment to question why the medical profession has plunged from being the guardian of people’s health to demanding protection from the people.
Doctors are agitating all over the country to protest increasing instances of violence against doctors, the growing number of cases of criminal prosecution against doctors, the imposition of NMC and other bills to regulate hospitals and nursing homes, and the “trampling” of the prescription rights of doctors consequent to the government’s diktat to use generic medication. Why there is rising anger, both in the community and amongst policymakers, which leads to the kinds of actions the profession is concerned about? Why does the government implement policies, including disbanding the Medical Council of India, which has been denounced by the courts for its failure to regulate medical education and practice, which seemingly reduce the dignity and autonomy of the profession? Transparency International had published a report based on a survey of 5,000 Indians, which identified corruption in the health service as having the most impact on the people of this country, second only to the police. In a recent panel discussion on NDTV moderated by Prannoy on the topic ‘healers or predators’ it was alleged that Kickbacks for unnecessary clinical tests or referrals, an irrational use of medical procedures and surgeries for commercial gain, illegal payments from corporations in return for prescribing their over-priced products, and bribes for obtaining health care services are common. It was also said that despite serious criminal acts by doctors they are hardly punished. Samiran Nundy, a Delhi-based senior gastrointestinal surgeon who authored a book with the same title as mentioned above and one of the panelists blamed faulty medical education as one of the causes of unethical doctors. One of the studies told. “His findings support long-standing suspicions that for many private colleges in the country, medical education is just a business.” A four-month-long probe by Reuters found that since 2010, “at least 69 Indian medical colleges and teaching hospitals have been accused of such transgressions or other significant failings, including rigging entrance exams or accepting bribes to admit students,” and that “one out of every six of the country’s 398 medical schools has been accused of cheating, according to Indian government records and court filings.” In a country with the world’s heaviest health burden, and highest rates of death from treatable diseases like diarrhea, tuberculosis, and pneumonia, corruption at medical schools is an extremely pressing issue. Whether or not India tops in corruption in healthcare and medical treatment may be a matter of opinion, but hype against medical profession is in full swing! The discussion succeeded in painting all doctors with a black ink, though the fact remains that most doctors wish and try that their patients recover from ailments and only a small percentage may be greedy to overcharge. Some black sheep are there to soil the noble profession, but much less than other professions. It is believed that healthcare in most countries is viewed as a key strategy to enable people to rise out of poverty; healthcare in India is the leading cause of impoverishment, they opine. If doctors wish to redeem the situation and wish to regain their reputation as the noble profession and be trusted by our people, they will need to radically re-imagine the way of practicing medicine, to become genuine guardians of the health of Indians.
To do this, they will need to restate their commitment to preventive health, and champion the use of affordable and ethical treatments through a universal health care system. They will need to actively cooperate with the government as it implements its progressive National Health Policy, and become an indispensable partner of the movement that is so urgently needed to repair our broken health care system. Why doctors are opposing Modicare, which has been designed to help 50 crore people is an enigma! They should be advocating for and celebrating efforts to reduce health care costs. They should stand in solidarity with our people to hold the government and the private sector accountable when they fall short of their responsibilities. When the government insists on our using generic medicines, instead of viewing this as an intrusion into the privileged relationship they enjoy with their patients, they should demand action to assure the quality of these medicines and ensure that the cheapest generic drugs are sold by chemists — they should welcome the government’s initiatives to strengthen the oversight of medical education and their own clinical practice, for they have miserably failed to do so themselves.