FUTURE OF MEDICAL PROFESSION IN INDIA IN THE EYES OF A CHILD

Once there was a question in tenth standard examination, “What do you want to become in future and why, explain in detail?” What one student wrote would move even the strongest ones.

I do not know what I want to become in the future, but I surely know what I do not want to be, and I am writing on that. I do not want to become a doctor. This is due to number of reasons, which I am explaining below.

Since the time I was old enough to understand things, I have been hearing everywhere that doctors fleece their patients, that doctors are robbers. But whenever I was not well and required the services of a doctor, I never found it to be true. The doctor just examined me, asked a few questions, ordered a couple of tests and prescribed me medicines for some days. And I became well. This took place quite a number of times with me, and my friends also have the same experience. I fail to understand till now that why someone who takes away our pain and sickness is called a robber. If I too would have to hear the same things from the society, then I definitely do not want to be a doctor.

After going through a lot on this matter and collecting a lot of information, the facts I have come across prevent me from becoming a doctor, which I am writing down.

No other field in this country requires the amount of study and hard work required to become a doctor. There is fierce competition over a handful of seats after putting in a lot of hard work. It is indeed painful not to get knowledge even after such an uphill struggle. Most of the cities do not have medical colleges. A child has to stay away from his parents and leaves his home at a tender age of 17 years. The condition of hostels in medical colleges is more like stables meant for cattle. No fixed time to eat, no fixed time to eat. I am made aware that medical education in India is considered to be the hardest among the whole world. No way, I do not want to become a doctor.

I have also come to know that simply doing graduation in medical field is of no use. One only gets superficial knowledge, or in other words, gets sensitized, after putting in five to six years of his life. One cannot treat even his own family members properly, what to talk about treating patients. There is a rat race going on for post graduation seats, and post graduation in clinical subjects is considered superior. The society even refuses to acknowledge those who did their post graduation in non-clinical subjects as doctors. Why should I become a doctor when people would not recognize me as one?

After putting in ten years full of hardship, what does one get, just a degree? There is still no experience. One cannot be expected to treat patients straightaway. To gain some experience, one would have to work under a senior doctor for another 3-4 years, which makes up a total of 13-14 years before one can finally start earning. I can start earning way earlier by doing some other work and bring my life on track.

Following post graduation come the needs for a job. There is a dearth of government jobs. Nothing is possible without bribery. And even if one does get a job without bribing, he is sent to such a place where there is nothing in the name of resources. I had heard that there was a place called “Kaala paani (Black waters)” somewhere on an island far off from the country, but for a government doctor, most of the villages are Kaala paani. There is a just a site and nothing else. A rusty old building in the name of a Primary Health Care (PHC) centre, few resources like electricity, water, accommodation, medicines, operation theatres, instruments, and the list seems to continue till perpetuity. I have heard that in a government setup, things work at the discretion of the administration and not the doctor. No matter how much study one has done, how much hard work one has put in, only those medicines can be prescribed that are provided by the government, whose quality has also not been checked. If such medicines fail to present the required results or do some kind of harm to the patient, the doctor is to be blamed. In some instances the doctor has even been put behind bars.

Getting into private practice after post graduation is like hitting one’s own foot with an axe. There are ‘n’ numbers of laws and ‘n’ number of hands which seem to loot the doctors. I now understand that the society, calling doctors robbers, is itself robbing off the doctor and, to hide this fact, is putting the blame on this noble profession. Along with the daily hassles of life, a doctor also has to deal with various medical laws. Countless laws and acts like CPA/ CEA/ Nursing Home Act/ Biomedical Waste Act/ PCPNDT/ MTP/ Drug and Cosmetic Act are meant only for the medical fraternity. Add to these others that grapple the whole society, such as the Shop and Establishment Act/ Income Tax/ Motor Vehicle Act/ Property tax, among others. This is just too much to ask for, and the reason I do not want to become a doctor.

We keep on hearing cases in which a doctor has to pay a compensation amounting in crores. To add to these, doctors are not even allowed to raise their voice against the administration, like everybody else, if their demands are not being met. Does this mean that doctors are not a part of democracy, that too in the largest democracy of the world? Doctors are more like bonded laborers. Opting for medical profession in this country is like opting for slavery. It is like one has chosen a wrong path in his life. Doctors have dissimilar laws for them, like they are some social outcasts, a sinner, of no use to the society, every order is against them. That is why I do not want to become a doctor.

I think a new regulation is not too far off which would state that a doctor is not entitled to any salary. They are just there for the betterment of the society. They should not get up for any work, no matter how urgent it may be, while examining patients, neither to attend nature’s call, whether they are feeling thirsty, or even to relax or stretch a bit after a long day. What’s more, a doctor should not even be allowed to have food as he is not a human being. He is a robot, after all. Maybe a law is also passed that a doctor is not required to marry and settle down in life as it will cause a conflict in his responsibilities, and would result in a lack of interest while treating patients. Similarly, the government could also ban the doctor from procuring a decent house as he is supposed to be in the hospital, with his patients, round the clock. And to cater for the doctor’s hungry stomach, as he would be drawing no salary, he’d be given some bread with curd and vegetables two times a day, just like the mid-day meal for school children. This means that in coming times, a doctor might have to even live the life of a prison inmate. That is why I do not wish to become a doctor.

Today’s government, administration and judiciary are hell bent on downgrade the medical profession. Attacks from all the strata of the society probably illustrate the fact that the medical fraternity has no power of any sort. Media has the power of pen, judiciary has the power of law, administration has the power of force and society has the power of numbers. All these people tend to look down on the powerless and un-unified medical fraternity. What is the society’s motive behind this is beyond my reckoning. But after learning all this, I cannot see myself as a doctor.

The final outcome of a disease depends upon a number of factors, like the symptoms told by the patient, for how long did a patient wait before visiting the doctor or whether he visited some quack prior to showing up at the doctor’s, whether the patient even got himself investigated as per the doctor’s instructions or the investigations ordered by the doctor were precisely performed, whether the medicine dispensed by the chemist was of superior quality or did the patient even bother to take the medicines as prescribed, and whether the patient followed all the doctor’s instructions properly. If the patient is not cured then the doctor is held responsible, all other factors are negated. What is more, if the attendants of some patient become enraged, then God only save the poor soul. Doctors routinely get manhandled, leading to grievous injury, or even death. In a society where somebody else’s mistakes are planted over the doctor, I do not wish to become a doctor in such a scenario.

Doctors are more like a manual worker. Just like a daily wage laborer picks up his shovel, working continuously for 8-10 hours and then getting his remuneration, likewise if a doctor does not attend patients or perform a surgery for a day, he would get nothing. It is nothing like a business where the businessman, not even being in town, carries out his trade and keeps on accumulating profits. What I fail to understand is why the society keeps on calling a job equivalent to manual labor as a business. I feel that it is better to do some other job which involves money and power. Government officials, bureaucrats and politicians can earn lakhs through various means, with their one foot always abroad. Media persons have also made themselves so powerful these days. A person, with his bag, holding a camera or a microphone, calling himself media’s agent, can also acquire bungalows and gifts worth crores. Even the biggest and the richest doctors of the country do not anywhere near the likes of such people. So, whatever I might become, it is definitely not going to be a doctor.

Sir, with all due respect to you, I swear by God that I would never become a doctor, and neither would advise anybody to do the same. I might become a government official, or opt to open an STD/ PCO booth, or even a shop recharging mobile phones, BUT DEFINITELY NOT A DOCTOR.

PATIENT’S COMPLAINTS: A BLESSING IN DISGUISE

As a dedicated doctor, it is not always easy to hear criticism from patients. However, if a doctor changes his mind set so as to view complaints as free advice about how to make his medical practice the very best it can be, both his business as well as the patients would benefit.

Some of the most common patient complaints include that the doctor is not easily accessible, patients have to wait too long after coming in for an appointment, the doctor not giving enough time to the patient, the doctor not returning back the patient’s calls, or does not explain properly what is going on to with the patient.

In fact, the complaints of the patients can prove to be a lot beneficial for the doctor. A doctor should even encourage the patients to share their feedback, which includes both constructive complaints as well as compliments. In any case, a doctor would rather have patients come directly to him and/or his staff to discuss their concerns and proposed solutions, rather than bottling up their displeasure. If the patients do not vent out their displeasure and their concerns are not resolved, then in due course of time, they would end up either switching their doctor and/or bad-mouthing the doctor to potential patients.

If a patient is unhappy with the doctor or his services, the doctor should encourage him to tell what the problem is so that the doctor can try fixing it. While it is true that it is not possible to fix all problems as the doctor does not have unlimited resources of time, money, energy, and staff, the doctor can at least try to address the fixable points so that the patient is happier in the future.

The best complaints are the ones that are accompanied by possible solutions. Therefore, the doctor should always encourage his patients to propose a solution while they are telling the problem being faced by them. This increases the chances that the doctor would be able to do something productive to address the patient’s concern.

Quite a few times, doctors have to deal with patients who are unhappy with a previous doctor. When asked whether they discussed their dissatisfaction with that doctor, mostly the reply is in negative. Dissatisfied patients do not complain to their doctors, which is basic human nature. Patients are worried that if they complain, the doctor or his staff might get angry and would not provide them with good medical care. Also, patients often feel powerless and helpless in front of their doctors, thinking that the doctor would not pay heed to their issue and would ignore them. So they do not feel it worthwhile to complain. However, doctors would rather have happy, satisfied patients who recommend them to their family and friends than unhappy, disgruntled patients who leave the doctor’s practice and tell others about their dissatisfaction.

Patients with complaints should be encouraged to talk with the doctor and/or his staff about their concerns. This can be done through a scheduled phone call or in-person visit, a feedback form that could be dropped into a box designated for the same, or an email.

The doctor should be sure in developing in-person or online feedback forms that all the important aspects of the feedback are covered, viz. asking for complaints/criticism, proposed solutions, as well as compliments (as it is also important to know what one is doing right so that he can keep on doing the same).

The doctor should also be sure to follow up with patients who submit feedback to let them know that their opinions matter, and that the patients taking out their time to comment is appreciated. While not all the issues that patients complain about are valid or fixable, most of them are, and that’s where one should focus his attention. This would empower the patients and send them a message that their opinions matter.

By being responsive to a specific patient’s concerns, one is also likely to resolve issues that are troubling other patients who might not have spoken up, and would have an exponentially greater positive impact.

By working in collaboration with one’s patients, a doctor can build a stronger practice, thus creating a win-win situation for both himself as well as his patients.