DOCTORS: GODS OR SOMETHING ELSE?? (PART I)

There have been many reports about Eminent Doctors taking cuts / referral fees. There cannot be any justification. But if in a whole system based upon corruption, a whole society facing inflation, people expect only one of its components to be sane, it’s insane.

There is corruption in every aspect of every field including religion, law and judiciary, government, politics, police, press, military, film industry, and also medicine, as the doctor is a part of this very same society, not from any outside world. There indeed is corruption in many aspects of medical field, referring a patient, unnecessary lab tests, CT/MRI scans, surgeries, cross referrals, almost everything.

As in every field, there are few people who do it by choice. There are some who have to be a part of the system to survive in India, and some who refuse to be a part of it all, facing many other problems including a perpetually low income.

This is where some thought has to be put. Why would a person with highest of merit, hardest of hard work, and a tendency to help others want to become corrupt? Not by choice, at least. No one becomes a doctor for greed. Some people might attempt to do so, but these people drop out in the first six months or a year, as they are not dedicated to a hard life, and cannot endure medical education in India.

Every doctor wants to do good of his patient, and also live a decent life. After a life-long meritorious career, he is expected to toil in villages / rural areas without any rewards for it. Should he not want his kids to go to the best schools? Should he not want a decent lifestyle? Should one give up a lucrative career in the west and return to his homeland feeling patriotic, to just be told that in your own country you are doomed to a life of sacrifices just because the society expects so?

“Someone who wants money should not become a doctor” says an actor, who is seen doing all immoral things (from peeing openly in a garden for press in real life, to cruel crimes and revengeful murders in movies, all this while running a show to change India to an ideal country). Should not a doctor not want money for a decent life? Should he endure the humiliation of so many non-meritorious people from his class, living in luxury, because they chose not to be a doctor, while he chose the noble profession?

Listening day-in and day-out to patient’s problems, tears, cries, allegations, threats, and expectations, not ever having a peaceful sleep for a week at a stretch, not eating in time, not having enough time for family, a doctor also wants to earn well.

Doctors are fined hefty amounts for medical negligence. If a judge, policeman or a politician is wrong, and even when proven wrong, can get away with it easily. There is a general presumption that the negligent doctor’s intention was bad. Negligence is possible in all fields (bridges/ buildings/ food/ public transport), and can cost many lives. The doctor alone pays in crores for a life that he was attempting to save, while in all other cases the motive is profit, not saving a life.

Judges decide the amount of fine for the so-called negligence. Doctors save millions of lives, some through heroic and exceptional efforts, without thinking of rewards. If a young patient is saved, the doctor does not charge according to all the income the person can make all his remaining future. So this criterion for deciding fines is also not correct.

Highly specialized doctors in India are expected to be at par with their western counterparts. They often are, because half the world travels to India for medical advice.

But the Indian community is yet to awaken to the doctor’s fees. An average specialist in the developed world charges between an equivalent of 10,000 to 30,000 Indian rupees for the first consultation. Appointments are very difficult to get. They don’t work out of 8 am to 4 pm slots, except in emergencies (although there are some honorable exceptions). And yet they get so many benefits from the hospitals they work at, and also from the government. They see no free patients. Most doctors live in luxury in the western world.

Indian doctors, on an average, charge 200-1000 rupees for an OPD patient, and also see many free patients (almost 40-50%) everyday. They continuously have to be occupied with the patient’s health, relative’s expectations, their anger (they think that every patient must get well irrespective of his / her health status, with many holding the doctor responsible for their illness / failure to improve/ complications) and continuous suspicion (patients think doctors are out to loot, with every investigation with an intention to get more profit out of the patient). People want the best, but want to bargain, like buying vegetables. There is also a widespread belief that pharmaceutical companies are actually serving the doctors, and not the patients.

Google searchers think they know better medicine just because of what they recently read about a tiny drop in the ocean of medicine. They take up a lot of doctor’s time, but don’t want to pay for that additional time. The very relatives who shout at the doctor seldom know what medicines the patient is taking, as it is all supposed to be his responsibility. So many people come over and threaten, abuse and even manhandle the doctors, which is a routine nuisance in every casualty in India. There is no sensible director in Bollywood to have realized a doctor’s plight while working under threat in casualty. Everyone loves the populist “Doctor-threatening” hero.

The respect doctors get is divine, that respect and the satisfaction of doing something godly by saving lives, helping people live better lives alone keeps doctors from going on and not quitting the profession for better incomes. It is not that the doctors do not have the options of making more money, having used their talents elsewhere.

But that respect does not substitute for children’s fees, rents, electricity, travel, or any other expense. Almost all doctors and their family members end up paying almost full bills for themselves at the very hospitals that they work in. Everywhere a doctor goes, he pays the same money that any other citizen does. There isn’t a separate queue for a doctor anywhere in any office. There is no pension. There is no security. If a doctor is sick, his / her income is zero as long as he does not work: No one cares if he has treated hundreds for free. The respect does not substitute for the stress a doctor bears, of years of listening to and attending pain and tragedy, years of sleepless life, fasting days, lost precious time with dear ones.