Medical career in India

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ll India produces 67000 MBBS every year, 20000 Foreign Medical Graduates come to India every year. Even if only 16% clear the Foreign Medical Graduates exam that still makes the number of qualified and licensed MBBS doctors produced yearly at 70200. Government which is the largest employer has 1750 vacancies every year for MBBS to work in Primary Health Centres. About similar number are employed yearly by various Government agencies like railways, ESI, PSUs, army and other institutions. This leaves 66700 MBBS doctors looking for jobs every year.

Some of them will join post graduation, but even with the increased number of seats still about 35000 MBBS doctors yearly who are unemployed. Since the number of PG seats was limited to about half the current strength upto 2 years ago there is a backlog of previous years which adds to this number which is visible in the 1 lac MBBS doctors appearing for NEET PG entrance exam every year. These 35000 plus the backlog do join some private hospitals as resident doctors for a few months to few years but this is not a career option.

There is no career in being a resident doctor however good in clinical skills you may be. It is not as if it is a permanent job with regular pay scale and yearly increments and stock options. Ultimately after some time you are expected to move on. This is where a problem arises. Those who are left without a post graduation , have tried multiple attempts to crack the NEET PG, done residents job for 3 years or so and are not beneficiaries of any reservation so have not got any Government Job, are the ones who are most vulnerable. Already about 27 -28 years of age and expected by their families and friends to be “settled” they are adrift with no sense of direction.

Some try to go abroad to seek greener pastures. Setting up a practice is easier said than done. To set up a GP practice in a city is no longer a financially viable option for them. Costs are prohibitive in cities and the GP space in suburbs, small towns and villages is firmly occupied by entrenched Government approved quacks and crosspaths. To do in Rome as Romans do , the MBBS in a village would have to resort to the tricks and fraudulent actions of those around them to survive in the quagmire, but then that is not practice of medicine. Many youngsters leave the profession to join IT firms doing medical transcription, others join pharma industry, some try for civil services others opt for management career.

The super specialist culture deeply prevalent in India today encourages treatment of organs rather than the human body. The role of MBBS in clinical practice has been gradually but surely emasculated to the level that a catheterization is to be done by a urologist and an ECG by a cardiologist. We are moving from superspecialities to super super specialities. A DM Gastroenterology today needs a further fellowship to perform EUS and so also POEM and other specialized procedures. In this environment role of MBBS in clinical practice today is that of a glorified clerk and plebotomist. The turf war among specialists has lead to a situation where despite being a graduate in medicine and surgery the MBBS can neither practice medicine nor surgery, obstetrics, ENT, Eye or any other field which today is defined as a speciality. Unfortunately our courts have contributed their might to creating this mess. ll

Stay positive. Trust God

Excellent 👌 

The little boy came from school on Saturday and told his father, my teacher has given us home-work to Hug 10 people and tell them - "*Be patient, trust life and I Love you*".

The Dad said - "OK, we will go to the Mall tomorrow morning and do it".

The child woke up all spirited up in the morning, got ready. Went to his Dad and said - "lets go!!"

The father said - "there is Heavy rainfall, I fear nobody might be there".

The Child still insisted. So the Father drove in the horrible rainy weather to the Mall.

They stood in the mall for 1 hour, and the little boy hugged 9 people.

His father then said - "now lets go, its raining heavily and we shouldn't get stuck!"

Sad the son went along with his father's orders. 

As they where driving past, the child pointed at a random house said - "please dad, just 1 person is remaining, I will go to that house and complete my homework"!

The father smiled and pulled the car over.

The child went to the door and began to ring the bell and pound the door strongly with his knuckles. He kept waiting. Finally the door was opened gently.

A lady came out with a very sad look and gently asked:

"What can I do for you, son?

With radiant eyes and a bright smile the child said:

"Ma'am my teacher has told to Hug 10 people and tell them - "Be patient, trust life and I Love you".

I have hugged 9. May I hug you and pass the message to you. 

The Lady embraced him, and started crying profusely.

On seeing that the Boy's father came out of the car. He went to the lady and asked - "Any problem madam?"

She composed herself, took them inside, gave them a cup of tea and then told his father -

"My husband died a while ago leaving me totally alone in this world. Today morning the loneliness took over me. Since morning I have been thinking that this is the end of the road for me.

Then I took a chair and a rope to my bedroom and decided to end my life. As I was seeing the world for one last time, I begged for forgiveness to GOD and then heard this knock. I thought to leave it as nobody comes to visit me.

But When I opened the door, I couldn't believe what my eyes saw this little child.

 And when he said , "*Be patient, trust life and I Love you*".

I knew it was a message from God.

Suddenly I realized I don't want to die anymore, and have decided to make something productive of my life.

*REMEMBER - Give positive thoughts to people.*

*Tell them you stand by them.*

*And even if nothing, just listen to them.*

You could be the medium that saves a life.!

6 small stories

6 छोटी-छोटी  कहानियाँ:
        
                ( 1 )

एक बार गाँव वालों ने यह निर्णय लिया कि बारिश के लिए ईश्वर से प्रार्थना करेंगे, प्रार्थना के दिन सभी गाँव वाले एक जगह एकत्रित हुए  परन्तु एक बालक अपने साथ छाता भी लेकर आया.

इसे कहते हैं *आस्था*

                ( 2 )

जब आप एक बच्चे को हवा में उछालते हैं तो वह हँसता है  क्यों कि वह जानता है कि आप उसे पकड़ लेंगे.

इसे कहते हैं *विश्वास*

                ( 3 )

प्रत्येक रात्रि को जब हम सोने के लिए जाते हैं तब इस बात की कोई गारण्टी नहीं होती कि सुबह तक हम जीवित रहेंगे भी या नहीं फिर भी हम घड़ी  में अलार्म लगाकर सोते हैं.

इसे कहते हैं *आशा*
    

                 ( 4 )

हमें भविष्य के बारे में कोई जानकारी नहीं है फिर भी हम आने वाले कल के लिए बड़ी बड़ी योजनाएं बनाते हैं.

इसे कहते हैं *आत्मविश्वास*

                ( 5 )

हम देख रहे हैं कि दुनिया कठिनाइयों से जूझ रही है फिर भी हम शादी करते हैं.

इसे कहते हैं *प्यार*
    
                  
                   ( 6 )

एक 60 साल की उम्र वाले व्यक्ति की शर्ट पर एक शानदार वाक्य लिखा था "मेरी उम्र 60 साल नहीं है, मैं तो केवल 16 साल का हूँ , 44 साल के अनुभव के साथ".

इसे कहते हैं *नज़रिया*
 

💐 *जीवन खूबसूरत है,*
*इसे  जी भर के  जियें*💐

Hope it improves. Sad but this happens everywhere in the world in corporate sector in every field.

Why private hospitals make you buy costly drugs? 

HIGHLIGHTS
Private hospitals often buy medicines and devices in bulk at huge discounts and sell them to patients at the marked maximum retail price
Sale of drugs and devices account for huge profit for private hospitals
Patients are not allowed to buy anything from outside the hospital, ostensibly to ensure quality
Private hospitals are making a killing by buying medicines and devices in bulk at huge discounts and selling them to patients at the marked maximum retail price — accounting for huge profits. Patients, as a captive market, have little choice but to bear the inflated costs.
Take the example of Shalini Pahwa, diagnosed with multiple myeloma, a kind of cancer. She was given an injection, Novartis's Zometa, that costs Rs 15,200 per shot, every three to four weeks for over two years in a top private hospital in Gurgaon. On a work trip to Bangalore, she got the injection at a hospital there for just Rs 4,000. When she confronted the Gurgaon hospital about this huge cost difference, it readily offered her a cheaper option — Cipla's Zoldria for Rs 2,800.
"Why didn't they tell me earlier of the cheaper option? Why do I have to bargain like in a mandi? Now I go to a different hospital and get the same injection, Zoldonat, manufactured by Natco, for just Rs 800 and I feel just fine," says Pahwa.
A haematologist, who didn't wish to be named, explains the more expensive choices thus: "Some doctors feel safer giving the medicine of the originator company as they feel there will be better quality control. And some people feel if it's cheap it can't be good enough. But generics, especially by good companies, are as good as originator drugs. It's better to give patients a choice."
But quality issues may not be the only reason why a hospital chooses to push the more expensive option. Zometa is sold to stockists for just Rs 13,000, according to an industry insider. At that rate, the hospital would make a profit of Rs 2,200. Clearly, the Rs 2,800 injection could not yield that huge a margin.
Take the case of a broad-spectrum antibiotic, meropenem, used particularly in ICUs for patients with serious infections. Cipla's brand Merocrit is sold for Rs 2,965 per gram by a top hospital. The adult dose is about 1-2g every eight hours for about 10 days. That's about Rs 90,000 to Rs 1.8 lakh on just one antibiotic. Merocrit is sold to hospitals for anything between Rs 700-900 per gram. So the hospital makes anything between Rs 70,000 and Rs 1.4 lakh on just one patient by pocketing the discount.
Interestingly, other brands of meropenem are much cheaper in many not-so-high-end hospitals. "The MRP per gram of meropenem manufactured by Zuventus is Rs 698 and by Lupin, Rs 988. The hospital buying price for the Lupin brand Merotrol is Rs 600. When the patient is charged the MRP, the hospital makes Rs 400 per gram or Rs 12,000 to Rs 24,000 per patient over 10 days on one antibiotic even in a not-so-expensive hospital," explains a veteran doctor who wishes to remain anonymous.
It's not just medicines, hospitals charge MRP on every consumable — from syringes and catheters to bandages and diapers — though they buy them
at huge discounts. To protect this revenue stream, patients are not allowed to buy anything from outside the hospital, ostensibly to ensure quality.
"We give hugely discounted rates. It is not our fault that hospitals choose not to pass on the discount to patients," argues a company's sales official who didn't wish to be named.
However, that leaves one question unanswered — why hospital MRPs are so much higher than actual selling prices? Doctors point out that the huge MRP enables companies to attract hospitals with the prospect of high margins. "Pharmaceuticals or devices and diagnostics are two major revenue earners for any private hospital. Besides, as a private venture, we also have to ensure healthy profits for the investors or owners," points out a hospital administrator.
Public hospitals, in contrast, can not only get drugs and devices at even steeper discounts — the government buys in bulk — they have no compulsion either to earn ever higher profit margins. Yet, the failure of governments to boost public health infrastructure in keeping with rising demand has pushed patients to the private sector. And for many, this means impoverishment.

Comments:  I am myself a victim when a interventional cardiologist in a reputed  hospital in gurgaon prescribed me a blood thinner following angioplasty. The medicine manufactured by lilly was close to 90Rs a tab. The same molecule manufacturered by Ranbaxy was selling @ close to meagre  Rs 10 per tab.:a huge difference of 9 times. I was shocked that even doctors are not spared what to say of general public oblivious of marketing complexity.

Compiled by 

Arun shah

Sent from my Samsung device

Professionalism

*Shiv Khera, a renowned author and management trainer writes about his experience in Singapore*

*"Six years ago in Singapore I gave a taxi driver a business card to take me to a particular address.*

*At the last point he circled round the building. His meter read 11$, but he took only 10.*

*I said Henry, your meter reads 11$ how come you are taking only 10.*

*He said Sir, I am a taxi driver, I am supposed to be bringing you straight to the destination. Since I did not know the last spot, I had to circle around the building. Had I brought you straight here, the meter would have read 10$.*

*Why should you be paying for my ignorance ?*

*He said Sir, legally, I can claim 11$ but Honestly and ethically I am entitled to only 10.*

*He further added that Singapore is a tourist destination and many people come here for three or four days. After clearing the immigrations and customs, the first experience is always with the taxi driver and if that is not good, the balance three to four days are not pleasant either.*

*He said Sir I am not a taxi driver, I am the Ambassador of Singapore without a diplomatic passport.*

*In my opinion he probably did not go to school beyond the 8th grade, but to me he was a professional. To me his behavior reflected pride in performance and character.*

*That day I learnt that one needs more than professional qualification to be a professional.*

*In one line be a "Professional with a human touch and Values " that makes all the more difference.*

*Knowledge, skill, money, education, all comes later. First comes Human Values, Honesty and Integrity.*

*Professionalism:*
*It’s NOT the job you DO,*
*It’s HOW you DO the job.”*

Ray of hope

All the rays of the Sun are covered by clouds.
Then only we have a hope for strongly needed rains.
Isn't it same in the life?     
Cheers......