Medical Profession is in Dilemma

Medical Profession is in Dilemma

Medical man is no longer fountain of all medical wisdome, or repository of occult secrets. Internet has changed the status. Our role in medical landscape is fast changing, to be a guide for solving a health issue. 

Concordance (No decision about me without me) and cafetaria approach is fast coming up as a tool for shared decision making & to decrease medical conflicts.

Consumer movement is gaining strength. And rightly so. Health care consumees are also waking up BUT many a times cross their lakshman rekha. 

Material values are dictating corporate culture. High end medicare is cost intensive. Health care in general is also becoming costlier & is going beyond paying ability of majority. This is one of the major reasons for rural debt, mortgage of tangible assets and withered faces. 

We as society, ill afford facing reality. Expectations from health sector are high, while government views health care as non-prodoctive expenditure. Only 0.9% of GDP is spend on Health. This translates to merely eyewash medicare. Priorities are misplaced.

Patients are now impatient to see favourable results. 

Costly medical education for majority & dependance on costly medical equipments, has made this a high investment area, expecting proportionate returns.

Doctors are fast loosing their halo of moral armour, which used to be their protection shield. 

Media is more commercial and sold out to the rich and the mighty. They appear to sell their pen to the way there political mastets or else TRP dictates them. A honest journalist is found suffocate, while fighting for freedom of press.

We the doctors of this country are soft targets. We are intimidated, interfered, infringed and thrashed on duty. Our kiths and kins and even selves are kidnapped for ransom. Our hard earned money and property are ablazed and damaged......  The list of atrocities is long.

No surprise brain drain attracts doctors, for brain drain is better than brain in the drain. If not attended with sense of urgency, merit will stop coming to this profession. In fact it has already started. The quality of new medical graduates and post graduates is an area of darkness.

We need to identify various concerned cluster of issues, create teams to examin & analyse each of their aspects and spell out with effective action plan for positive change.

Just blaming social intolerance is not going to solve the problem.  I see, social intolerance to mount further, like in all other social sectors, to add insult to injury. 

A early wakeup call is necessary, before it is too late.

Quoting doctors

*Quitting Doctors: The New Phenomenon*

©️ Dr. Rajas Deshpande 

“I am reducing my practice now. I have already stopped admitting cases” one of my colleagues told me during the coffee break. I wasn’t surprised, as it was the fourth time this week some doctor had said that to me. 

He is an excellent physician, I know he has saved hundreds of lives. I understood him, despite the terrible thing he had just said. 

“It’s not the hard work. I passionately love solving medical cases, and feel inner happiness when a patient is cured or relieved of suffering. But I don’t feel the same affection and compassion now for the patient or relatives- because whatever good I may have done in the past, their assessment and behavior is always suspicious, screwing me for each word I say, cross examining every decision with their knowledge scales. It is not my job to teach everyone and bring them at par with all medical knowledge and wisdom. If I admit a patient, they start treating me as if they own me - like a slave- even if their breakfast is late they will start calling, write bitter messages or write complaints and expect written apologies- hardly acknowledging the importance of concentration and time limitations of doctors. Even when the patient comes back from deathbed, they tend to write negative reviews because the hospital couldn’t give them bill concessions to their satisfaction, or the insurance companies declined their case. One cannot expect respect now a days from anyone, but the disrespect is uncalled for- the tone of relatives, even when I try to save their patient, is like hidden threatening, disbelief and over expecting. After slogging for so many decades I don’t think I deserve this. I will now choose which cases I will treat, based upon whether they are well behaved or abusive.” 

“The threats of media defamation loom high, however hard working and honest a doctor has been. It’s all at the mercy of one dissatisfied relative or patient, without a chance to explain or sue them back. I don’t want it now. I haven’t slept well for decades. I have decided that I need good sleep, timely food and rest- exactly what I have advised thousands- to be able to function well”.

“Now, when arrogant, ill-behaved relatives approach me with goonish tendencies and language, when even the highly educated come with polished threats and higher expectations with bargaining attitude, I give the case a pass. I wish them well and refer them to the low cost centers which is their primary concern. I am not open for abuse or bargain “.

He was right. irrespective of what payments are offered, many responsible, experienced and highly qualified, skilled doctors have started to wind down their work to minimize the abuse they face. Treating admitted patients is a pleasure, but dealing with over expectant relatives who want daily explanations of everything without the ability to grasp things is now impossible. Everyone brought to the hospital may not get better in spite of best efforts. The moment something goes wrong, it is presumed to be the doctor’s fault or negligence, and right from litigation to violence, anything can happen. 

Fortunately, there are some trusting, well behaved patients and families, who understand the doctors’ limitations and time restrictions. There are emergencies where only the right decisions by the right person can save lives. For those we will always be available, as is our innate wont. 

*©️ Dr. Rajas Deshpande* 

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