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The healing touch

Tuesday, July 03, 2018

On the occasion of National Doctor’s Day, members of the fraternity speak out about the current state of the profession

On July 1, India celebrated National Doctor’s Day to mark the birth and death anniversary of Dr. Bidhan Chandra Roy (1882-1962). Dr Roy was a physician, political leader, philanthropist, educationist and social worker and was also the second Chief Minister of West Bengal. In February 1961, Dr. Roy was awarded the Bharat Ratna, India's highest civilian honour. He was instrumental in founding the  Indian Medical Association in 1928 and also in the establishment of Medical Council of India (MCI).

A great deal has changed in the medical profession since Dr. Roy’s time. For one thing, the medical advances have been stupendous. Besides, with the rise of the Internet, and ‘Dr. Google’ on call all the time, more people tend to self-medicate, often acting on half-baked or incomplete information.

We asked a few doctors what they had to say about the current state of the profession in India. One question was about the shortage of doctors and how this number could be increased; according to the Indian Journal of Public Health in 2017, India will need 2.07 million more doctors by 2030. We also asked them if doctors today get the respect they deserve and, in this age of specialists, whatever happened to the good old General Physician (GP).

Here are some responses.

DR BISWANATH GOUDA

Consulting Laparoscopic Gastro-Intestinal Surgeon attached to Somaiya Superspeciality, Global Hospital, Nanavati Superspeciality and Holy Family Hospital

The government needs to spend more than 1% of its Gross Domestic Product (GDP) in the healthcare sector and start building more infrastructure and public teaching hospitals to bridge the gap. It needs to regulate the private medical colleges so that more students with the right aptitude and attitude to become doctors are possible. Two to three years compulsory service in rural or interior places where there is a dearth of doctors should be done after completing a course. We should also stop migration of doctors for a minimum of 10 years after graduation, especially those who avail government/public funds to get a medical degree.

As for whether doctors receive the respect they deserve… sometimes, doctors in the big cities are somewhat blemished due to rampant unethical practices in some places, the drive to meet targets and financial goals very soon and quick expectations by patients as they are all ‘Google-educated’. Still most doctors in India are going strong and doing great work and helping society. A few reports are causing negativity among the majority due to easy access of social media and other marketing tools.

One has to understand a doctor is also a human being first, has a family and his responsibility to attend to... doctors don't just live on air and water. Neither do they get any subsidy from the government like bureaucrats or politicians. Doctors have bills to pay so they will strive hard to make a living from their skills and education.

Regarding general physicians, this is the age of instant gratification. Every patient wants to get the best treatment and at the fastest possible time. These days, they first get themselves checked on the Internet and then come to doctors. They are demanding at times. Hence the good old GPs have become more defensive and don't want to take risks any more. Also in the earlier days, the family doctor used to spend time in counselling and knowing more about the family and its issues. Now it's just become more professional and very objective. The big hospitals spend more in advertising and marketing and this has made an impression in common minds; they go to such hospitals even for a common cold or fever. The old GPs are struggling to stay afloat in practice—and it's a dangerous sign for the community as the healthcare cost will just rise exponentially if this happens.

DR PRAVIN BANODKAR

Consultant Dermatologist, SRCC Children's Hospital

The shortage of doctors is due to the monetary benefits not being provided to them, and the lack of infrastructure facilities everywhere. 

One of the main causes is the poor health budget spending by the government. If one contributes more capital to each and every corner of the country the newer doctors and facilities will reach all citizens. The medical education fees are also a big deterrent.

As for the respect given to doctors today, doctors in India and even all over the world, do not get the respect they deserve due to the commercialisation of medical practice.

The entry of the target-based approach of clinics, nursing homes and hospitals is damaging the scenario and hence tends to sway the mindset to being money-making machines.This target-based approach should end and should be replaced by a government-funded capital flow where all doctors are given a salary depending on their degrees and specialities to work in hospitals.

The health budget spending by the government should be increased, which is one of the lowest globally. This should be the first step!

This is the era of super-speciality and big hospitals as tertiary care gives a more holistic comprehensive approach to treatment strategies.

Multidisciplinary care is the need of the hour due to patients’ changed lifestyles and stress-related triggers of pathogenesis. This is a good thing for healthcare.

PROF DR HEMANT GUPTA

Consulting physician and cardiologist, professor and unit head, Department of Medicine, Grant Medical College and Sir JJ Group of Hospitals, and Consultant, Somaiya Multispeciality Hospital

The government is making efforts to increase the doctor-patient ratio and the number of undergraduate and post graduate seats have been doubled now from this year.

Doctors in India do not receive the same respect now; it is declining, and compared to the West, they are not at all adequately paid.

The era of the family physician is dying with the advent of the new super specialty and big hospitals. This is not good at all as earlier, the family physician knew all about the patient and the person’s surroundings; it was more like a family. Now it is a mess as the liver is managed by one person, the kidney by someone else, the heart by a third person and the brain has become a khichadi! No captain takes care of all the organs together.

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