White Paper of a Doctor’s Dilemma
© Dr. Rajas Deshpande
“Sir, I come from a family of doctors, who have always practised high values in Medicine. There was always this burning desire in me to do good. I felt that the country needs young doctors who are willing to work hard. but somewhere something inside me has changed. Now, with the on-going assaults against doctors, this clinical establishment act in West Bengal and in general the distrust and anger the public has against doctors, it has suppressed my older self. So much so, that I’m considering going to the USA now, even if that means doing residency all over again. I see my batch-mates and friends who went to USA after MBBS, really happy, earning well, enjoying holidays with friends and family. I do not envy the work part, I will always choose a day in the Operation Theatre rather than at the movies or hiking.. just that slowly my main motive for becoming who I am today is fading away.”
What a heartfelt question, a dilemma not only haunting me, but many doctors, especially from the younger generations, who started out to do something good for the country, have been dynamic, brilliant and hard-working, and now want to leave India!
Dear Dr. S,
Firstly, yes, the times have changed. Doesn’t the first page of most standard textbooks teach us: “Medicine is an Ever Changing Science”, now we must add the external scenario to this. We must change accordingly. Add laws, add medically inept judiciary, add media, add too many impractical conditions of practice where among the two sides involved in a profession, only one is legally answerable. I should write a prescription not of the best medicine I know, but of the cheapest one. In the face of lost faith and partial law, no relationship can be very cordial. Nor can any empathy be forced for a patient who suspects the doctor of wrong intention or inadequate skills. © Dr. Rajas Deshpande
Given the increasing number of Google empowered pseudo-literates and even genuine illiterates who are now questioning every medicine prescribed, every test advised, not because of curiosity but in an obvious visible distrust, it is becoming increasingly difficult to keep patience with practice. The combination of a western/ over-legalised medical service with a free-monger society, where instead of education, science, research and health, the taxpayer is happy paying for corruption in almost every sphere, lifelong deluxe travel, food and living expenses of everyone who has been elected even once to almost any civic body, no one wants to think logically about why there is healthcare failure in such a huge country that generates such high taxes.
Recently a headline about “Doctors prescribing costly medicines” hit the media. Why doesn’t the government make available free / cheap healthcare for everyone? Make all medicines free at all government hospitals. Why expect those who invest decades in making a medical career and then practicing under loans to keep on working with minimum incomes? Why aren’t there any laws against the corporate hospitals? Why don’t the same politicos speak about some of the capitation fees institutes that generate trillions, and also allow the quality of the medical education to be compromised? I wish the prime minister also says some day that we will make all medical education free for all merit holders, because the country needs more doctors. Why make it difficult at both ends for the doctors? © Dr. Rajas Deshpande
I can also be a high handed hypocrite and advise you the humbug: that a doctor is a social servant, that a doctor must only choose to live the life of a saint and never think about earning or a decent / luxurious life, that the society needs you etc. We live in a society where while searching for a groom, every father’s first question (if not the bride’s) is “How much does he earn?”. The stupid thought that a doctor should not earn a profit for his talent and hard work is redundant. If the society needs good doctors, it must also learn how to remunerate and treat them. It should also learn not to generalise that every doctor is corrupt. It should be intelligent enough to know that medical care can neither be free nor can be entirely based on charity or profitless structure. © Dr. Rajas Deshpande
But our society is far away from understanding this. The “High” of hate and criticism drives mobs berserk in the land of logicless thinking, and we Indians lead this game. To be opinionated by media and illiterate politicos and speak without studying is the sign of a degrading time. © Dr. Rajas Deshpande
My dear friend, I will be honest with you. Ten years ago, I strongly felt I should return to India and serve people. I doubt it now. I have urged hundreds of students to return to India after their higher medical education in the west. Now when some doctor is beaten up, killed or tried by media before law, I don’t feel justified to urge anyone to stay here.
You have only one life, and living it fully, enjoying health and peace of mind, joys of living is also your duty to yourself and your family. Are you inclined to do social work without recognition, with allegations and trials, in a society that refuses to respect a good doctor? Are you inclined to let a “Social change in the attitude of public over decades” take effect, by which time your career / life will be almost over? Are you ready to be tried by the media, taunted by the court even before being proven guilty, and punished by those in power, not because you are wrong, but merely to please people? Are you prepared for a scenario that even if you do 50 years of cleanest practice and save thousands of lives, when you are blasted all over the media for your first mistake, not a single patient will stand up and say”This is a good doctor”? If so, stay in India, this country really needs very good and honest doctors, even though it cannot respect or trust any. © Dr. Rajas Deshpande
In this country without a healthcare vision for the future, this is indeed a sinking ship, with opportunistic invasions not only from various unrecognised pathies, but with a society that is increasingly destroying the possibility of good healthcare for all in future, in its quest for free, and cheap, under the threat of violence.
If you want peace for yourself while doing good to the society and earning well at the same time, choose a developed and civilised country: at least payments are better, you get time for yourself, the law looks at both sides, and politicos can be questioned. You can also fund some health charity in India from your earnings there. Last but not the least, no F. B. will raise a hand upon a doctor, and still will be justified by law, media or government.
© Dr. Rajas Deshpande
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