“Get Out, Doctor! You Are Finished!”© Dr. Rajas Deshpande
“Doctor, it’s this way or highway. We have many from your specialty in the waiting list. Do you accept to go by our policies or do you want to resign? Mind well, if you disagree, we will see to it that your name is blacklisted in every hospital in this city”.
As Dr. Sumeet stood there thinking, one of the administrative doctors, always a first class bottom licker, commented “These days doctors are like W*****, throw money at them and you get them to do anything you want”.
One junior doctor, still hot blooded, walked away. Dr. Sumeet asked that medical superintendent to mind his language. There was no reply. The bosses had really enjoyed the comparison, and while eating their pistachios at the hands of their secretaries, laughed aloud.
Dr. Sumeet felt devastated in that super luxury office, among the administrative officers and his own senior doctors from that hospital. He had returned from Germany a year ago, and joined this corporate hospital that was recruiting specialists. They had also offered him a decent salary, and accepted his condition that no patient will be sent back from his OPD for lack of money. © Dr. Rajas Deshpande
However, he had had to face a lot of jealousy and hatred from his senior doctors as he was looked upon as a competition. This is extremely common in India, and however stifled, a major truth. But no one ever stood against the bosses of corporate hospitals, so they had to accept his appointment.
The same corporate also owned other industries, namely Gold, Cement, Cloth, Petroleum etc. They were a “closed” community, all in the administration belonged to a particular caste. This hospital was another of their ‘profit oriented investment’, and did really well as most of the public can easily be fooled by the words “Free, Concession, Accreditation, World Class etc”. Medical illiterates (read general public) are really taken for a ride by healthcare advertisements of corporate hospitals.
Few months after Dr. Sumeet joined the hospital, the CEO changed, and another “extremely loyal invertebrate profitmaker insider” came in as the new CEO. From prehistoric period, he was considered as the best pet of that corporate family. The new CEO started by applying all the labour and profit criteria of cement industry to this hospital. If anyone argued, his famous dialogue was “If Sirjee (the owner of the corporate) wants, he will make the sun rise from the west. You are not aware that his reach is beyond the highest in India”. Anyone who uttered a word against any policy was isolated, humiliated and finally thrown off. Various allegations and ‘proofs’were easily furnished by a dedicated ‘execution panel’.
The new CEO changed the conditions that were accepted when Dr. Sumeet had joined. He was now given a target that his patients have to increase by 25 percent every six months, so should his tests, surgical referrals, etc. Free cases were cancelled. Many doctors spoke in private about this, but no one wanted to lose their job, as it is very difficult to get attachments in multispecialty hospitals. © Dr. Rajas Deshpande
As Dr. Sumeet had argued, he was given this ultimatum. He appealed to the senior doctors in that room, most of them looked away. Some told him they had always warned him not to be ‘over-smart’.
“I will reply in three days” said Dr. Sumeet and left the room.
He had nowhere to go. He had shifted his family to this new city and his children were already adjusted in their school. He had chosen this city after long deliberation, and had recently bought a flat with a loan, so he needed a stable income. His parents were teachers, he did not have the kind of money required to make his own hospital. All his friends had one answer: “Adjust “. He decided to plead once more to the management, to allow him to provide free consultation to really poor patients, and to continue a contract not based upon income generation. © Dr. Rajas Deshpande
Next morning, as he entered the hospital, one of the servants (being from the inner caste, his title was ‘General Manager’) came to see him with a huge grin upon his face. “The CEO sahab has asked you to empty your belongings by afternoon. This office is given to another doctor”.
He went to the CEO, who refused to see him.
The same medical superintendent came out.
“Doc we do not require your services any more. Get out, You are finished” he said.
“Why?” asked Dr. Sumeet. “I want an explanation”.
“We have many reasons. You do not fall in line with our policies. You are insubordinate. Also, some staff say you are having an affair with another doctor in the hospital. We also had a complaint about you yesterday from a patient”. © Dr. Rajas Deshpande
The complaint was obviously custom-made, and there was no way to argue about the affair allegation. Medical staff working together in an extremely orthodox country has to face those allegations very commonly. How such allegations disqualified him as a doctor was beyond him.
There was no argument now. He was escorted by security team out of the hospital, in full view of many specialist doctors (his friends), patients (treated by him), and others, but no one had a word to say. After he came out of the campus, one doctor friend accompanied him home silently.
He wrote to many senior doctors. There were no replies. He wrote to the medical councils. There was no reply. One senior member of the medical council told him in confidence: “ All the Medical Council rules are only for doctors. Medical councils in India have zero control over private hospitals, especially corporate hospitals”. IMA and other doctor’s bodies are clueless and directionless about the open exploitation, humiliation and destruction of doctor’s careers, especially new-coming specialists. In a country devoid of specialists, it is paradoxical that so many specialists are continually fired / thrown off / made to leave corporate hospitals which take advantage of the competition among doctors. Sadly, the doctor community, with too many self-proclaimed geniuses, has failed to unite and protect itself from this corporate onslaught. It is pathetic to see some greedy doctors competing to see each other down. © Dr. Rajas Deshpande
His practice was super-specialised and required a multispecialty set up with inpatients. There are very few government set ups in India like those. The rules, conditions in most govt. hospitals are idiotic, age-old, and the payments are laughably low. Also, the govt institutes are mostly headed by you know whos.There are indeed some charity super-specialty set ups, but most are religion / cult / faith based.
Dr. Sumeet decided to work it out his way. The corporate hospital which fired him made sure that his name was defamed in every possible way, they left a many pronged negative feedback everywhere. © Dr. Rajas Deshpande. There is no remuneration for the career murders of the intellectuals in every field in India, caused by two-faced systems run by invisible hands.
Gradually, he picked up, losing years of his career. He found out a hospital that respected his wishes to treat the poor free, and did not insist on numbers.
The complete ignorant and irresponsible stance of senior doctors when someone wrongs the junior doctors, the complete lack of any control over the policies of corporate hospitals by any medical council or governments, and the impotent stance by many a doctor’s organisations has spread the healthcare-toxic corporate medical culture all over India.
Doctors should at least make directories and online lists (maybe anonymous to begin with) of hospitals which force doctors to accept malpractices, or do not respect terms of agreement and sack doctors without any mistake. These should also be reported to the medical councils. Any hospital sacking any doctor should have to send an explanation to the Govt., medical council and IMA for the reason of dismissal, and the doctor should also be able to explain his / her side of the story. Hospitals which “use and throw” doctors as per wish, without reason or logical explanation must be brought to the book. © Dr. Rajas Deshpande
Most corporates have excellent backup and protection from the government, and all they will do is to shift the blame on the doctors’ fees, hiding from the patient, media and society the umpteen other profiting headings that the patient thinks are benefit to the doctors. This is a tough war.
Another joke is that while the educational qualification and training of any doctor is strictly scrutinised by medical councils and media, the qualifications of those who own hospitals, run them are completely neglected. No wonder illiterate politicians, “Business Class” corporate houses and CEOs bully doctors into practicing policies which are often against the best practice principles of healthcare.
Very few non-medical CEOs actually have a good knowledge of medical ethics and principles, agree to logical arguments.© Dr. Rajas Deshpande
The media and society who advise umpteen things and expect a lot from the doctors never stand up for a good doctor. Everyone who has met one bad doctor cries all his / her life about all doctors. As if there were no bad apples in their field! The ‘hyper idealistic’ population expects that the entire healthcare comes under the heading of ‘charity practices’., unwilling to spend upon their own health. If malpractices and backdoor incomes are to go, the public should realise that the actual fees will increase.
Governments will always make populist, ultra-short term policies in healthcare, without involving the brainy specialists in practice. If the Medical Council or IMA do not take a firm stand, any doctor who takes a stand against existing corporates / medical malpractices will be orphaned by his / her own community, often boycott, and categorically defamed: until their career is destroyed or they leave the country.
Many Dr. Sumeets are actually suffering this right now in India, with no respite.
Doctors must also realise that this war will never be won fighting alone. If the subsequent generations are to get better quality healthcare, we should start by identifying the problems first.
An easier, nay, wiser option for every super-specialist is to leave India.
© Dr. Rajas Deshpande
PS: The “Chamcha Doctors” who line up with the corporates to compromise in healthcare principles must do some soul searching. Earning profits is not a crime, compromising medical principles is. A real “Doctor” will never do so.
Dedicated to the thousands of young medical specialists who are right now suffering this hell.