WHO
IS A DOCTOR? ; WHAT IS A HEALTH CARE?
………… THE TRUTHS AND FACTS; THE GOOD AND BAD.
THE REALITY …
Who is a doctor? The question is really tough
to ask in this ever growing, fast developing society. Doctors and medical
profession are once considered noble and pure. Does the same thinking and
belief exist now? What is the reason for this change?
Is it again an unanswerable question too!!
Before going in any deeper into the talks and
discussion I would like to say here that I am a doctor, a radiologist by
profession and I am a full time social worker by passion. So I think I have
full rights and qualification to speak about this issue. I am not going to
speak on any particular side or rather going to blame anyone. I will just share
with you the things I faced and learnt and those certain things that have
worried me. The ultimate decision is yours to make.
THE STRIVE…….
Let’s have a look at the life of every
doctor before we get blame at them …… To become a
doctor one goes through immense hardship. Any profession is difficult but I
would say medical profession is one step ahead. Though the younger minds today
are gaining a freedom of choice and opinion in choosing their career, still
majority of the system has not changed. Majority of the parents dream their
children to become doctors. And if or if not the child dreams to be so, by the
virtue of their parents’ perseverance they tend to take it their dream. Any top
ranker in the school is pushed into medical profession or rather he or she
chooses engineering from a top college so that he can settle fast.
OK, now the parents dream but they
fail to dream or rather fail to instill the thoughts of a doctor who will serve
the society into their children …now here starts the problem.
Now what you call as
service? ………… does servicing means you do something without accepting money?
Or does servicing means you
work with NGOS like “Medical san frontiers” and work in Somalia or Pakistan?
Or does servicing means
merely doing your job correctly and without any negligence?
To understand doctors you really have to be
one. Today doctors are blamed invariably. Hospitals private and government are
blamed invariably!
WHY IS THIS?
First let’s go into the life of student who
strives hard out to become a doctor. The top students from school go into
medical profession; there they strive for five and half years to pass out as
doctors. Five and half years may extend with 6 months or one year for some or
many; as the pass percentage is also kept high usually.
“Wow now that after all hardship he is a
doctor “…………..wait the real test is yet to come!!
GONE ARE THOSE DAYS…….
Gone are those days of general practitioners, family doctors who will attend patients at homes gives you tablets
and tends to cure 80 percent of the patients themselves. Today medical field is
vastly advanced and so are the diseases! In the past thirty years we are
diagnosing conditions and syndromes which were not known previously and we are
treating the same.
The average life expectancy at early 1900s in
India is just 20 -30. Today that is somewhere near 60-70. The major reason for
same is advancement in medical field. Today there are so many specialist and
super specialist narrowing down to every organ in your body. If I start naming
the ‘ ologists’ it will least a take page
long!
There is a high chance that for a
fever you have, which if has not subsided for more than a week you will be
attended by least four doctors! Yes it is true.
So now the student who strive out to become
doctors, now strives further to study post graduation and to specialize
himself. To get into it requires hardship training and to pass out of it is
another big hurdle to cross. This now is another 3 years of study. Does it stop here? No most of the post
graduates now specialize further with one or two years for super
specialization.
So that super specialty doctor you see sitting
and speaking to you in a language you never can understand has toiled himself for 10 years in studying after school
and this might be added with the years he puts in to get into these.
A doctor completes his curriculum and starts
his profession in proper by28-30 years. By this time most of his peers in other
field would have settled off with marriage and kids even.
SO WHAT?
So what is an easy tender question to
ask but a difficult daunting one to answer.
Many doctors prefer private practice; in fact
all doctors do private practices! Doctors striving out after 10 years of
training will be paid somewhere like 38,000 in government hospitals to start
with. So, even doctors working in
government hospitals will do private practice.
What happens today in the field of medicine
and medical profession is an ugly unethical business. Yeah it is true!
Medical field and medical profession has
turned into medical business. It has become a health care sector. And remember
this, it is not the doctors that run and hold the major share of this business.
The major share is now held by businessmen and politicians.
THE ROOTS AND POTENTIAL
CAPABILITY IS VAST AND MANY ARE INVESTING IN IT.
There are medical colleges which trains your
doctors, hospitals which treats you, there are pharmaceutical company which
provides you drugs, there are biomedical engineering services, there are
industries to produce surgical equipments.
Everything has to be produced – transplants,
screws, CT machines, x ray film, syringe, needle, everything and all this has
to be sold. There are manufactures, buyers and vendors and even stock exchange
and MARKETING in it …………and that is why; it is a business.
WELL IN THIS BUSINESS IS
THERE EQUALITY?
How do you expect that? If you expect that you
are really out of your mind! There never can be equality in anything - even in
a wardrobe or food.
Then how can be there equality here? The level of
care, the quality of care might vary so much depending on the amount you are
capable to pay.
An operation to deliver your baby can be done
at free of cost in government hospitals or by paying up to 50,000 rupees. Now
those which get 50,000 from you obviously provide you with a five star hotel
kind of treatment. There is inequality in everything a simple drug can be
bought under various trade names from 5 rupees to 50 rupees. A simple test can
be done from 1000 rupees to 10000 rupees.
It simply means one thing –
if you have money you can live long………………… yeah that’s truth!
SO HOW DO DOCTORS CONTRIBUTE
IN THIS UNETHICAL BUSINESS?
So let’s see the ugly note and ugly
end or to where doctors have been pushed.
Negligence is a different issue and money
making mentality is a different issue. No doctor would want to lose his
patient. But then there are some
un-tolerable things that happen.
For instance let’s start from government
hospitals; not many of us or any of us would prefer going to a government
hospital…why? Not because the doctors there are not good. It is about the level of care. Many of the
best doctors still exist in government hospitals only. But the truth is many of
them won’t dedicate themselves totally to it.
In any government hospital any normal surgery without emergency will
take 5 – 2weeks to happen. But if you go outside to a private hospital it can
be done immediately and that to by the same doctor who will operate you 2 weeks
later in a government hospital.
Many surgeons use district government hospitals
as patient pulling to the private setups. Now this I speak of only of the district
government hospitals; other sub-centers and primary hospitals doesn’t have a
doctor in it by majority.
Now, here come the private hospitals
which practice in an entire different way. These hospitals run mainly on MARKETING and HR and PR are the major
part of their business. They pull cases from doctors in rural areas and suburbs
and as they refer cases they are paid referral cuts (Now let’s come to this
referral cuts a little later)
The ambulances which you get in under
emergency will be bribed too and the ambulance drivers will take you that
hospital where the driver cut is more!!
NOW TAKE AT LOOK AT THIS
YOU MARKET, GET REFERRAL
CUTS/GIVE REFERRAL CUTS/ BRIBE AMBULANCE DRIVERS/PULL CASES FROM GH…………..AND
THEN?
You go to a doctor, he/she suspects something asks
for blood tests, a CT or MRI done means its logical. When he/she recommends a
particular lab or scan center that means there is referral cuts to him/her from
there.
Any lab or scan center does this. A MRI will
cost you 6000 in trichy and upto 10,000 in Mumbai. Out of this nearly half, say
2500 out of 6000 goes as referral doctors fee………….!!!!!!!!!!!!!!!!!!!!!!!!
A good concerned doctor should avoid this
referral fee. Not all doctors do so.
Scan
centers go beyond extent – some leading centers in Tamilnadu run by businessman
pay lakhs in advance to doctors in rural areas so that they refer cases to
these centers frequently ( doctors of homeopathy, ayurveda, sida are all
include in this)
IS THAT IT?
WAIT IT IS NOT OVER
YET….!!!!!!
The major hub in business is in ‘Pharma
industry’ and in ‘surgicals’. These are fields where fixed rate are not set. All
drugs are to be produced under strict guidelines – if so any tablet which
contains the same drug should be equal. But the cost is not so. A simple tablet
called ‘Paracetomol’ which you
commonly take when you have fever can be bought from 2 rupees to ten rupees, if this is so then imagine the cost of
other major drugs.
I will tell you this story here so
that you can imagine more.
We were conducting a medical camp basically
for children in a rural area while we were students. We went out to buy
medicines for this and approached a medical shop. We asked for ‘Albendazole’ tablet. And the pharmacist told us that the cost for
each tablet is 6 rupees. Then we told the reason we are buying the tablet for
and we told we will need 200 of those. Finally we bought the tablets for 2
rupees each from the same shop.
CAN YOU UNDERSTAND THIS?
This subtle difference of 4 rupees might not be an issue for us. BUT WHEN IT COMES TO A LIFE SAVING
EMERGENCY DRUG ???????????
Now that’s just an example……………….
When you buy any surgical items or drugs the
production cost will be around just twenty percent of what you pay. The rest is
in marketing, doctors cuts, the vendor and dealer cuts and profits for company.
Do you know how much marketing goes in
to this. Pharma companies will send representatives to doctors they will offer
gifts, foreign trips, flight tickets and almost anything. All that doctors have to
do is write their brand name.
CAN IT EVER CHANGE?
Basically the first reason is the change in
people’s attitude. Today people are willing to pay more. No one will go to a
center where they treat you for less cost. The
general belief is if you pay more you are treated well. If you eat more tablets
then you are getting better fast. This is utilized and made cash off by the new
growing health care industries.
The second and most important is a poor
government governing us. They have no real purpose on anything. Health sector
should be dramatically systemized and regularized.
Pay doctors high in government hospital,
develop all government hospitals to top level. Completely abandon privatization
of health sector. All doctors must be in government sector. They should be paid
good and should be posted in their areas of interest or their native places.
Put a separate budget for health sector.
Revise everything. Revise state taxes and get more taxes according to the tax
payer capability and instead give subsidiaries in everything including health
sector. Government’s hospitals can function at free of cost for below poverty
line people and can function at nominal cost for affordable patients.
Regularize all pharmaceutical companies. A
drug must be sold only at a particular price and not more. Invest more in
research and give hope for research. All this can happen only if some serious
measures are taken.
THE GENERAL AWARENESS IS VERY POOR ON
THIS ISSUE. WE MUST UNDERSTAND THE SERIOUSNESS AND SHOULD COME OUT AND DEMAND
FOR A REGULARIZATION.
SO WHAT YOU CAN DO?
The next time a doctor writes you medicine ask
him to write drug name and not trade name- never get a prescription with a trade name. Now if you do so there is high
chance on the pharma shop giving whatever medicine they feel like giving you and
which is costlier – in-fact demand for the cheapest available medicine in that
particular drug; remember trade name
doesn’t matter, it is only the drug that matters.
Then never go to private scan centers or labs
– go to medical college hospitals or to government hospital scan centers. It
will take time sometimes but if it is not an emergency then you can really do
it.
Understand doctors and health care
industries.
The most important thing you have to do is
come out and fight. We should demand our rights. Out of all these issues the
one who is affected most is the poor –health care to him is still not properly
reached but disease and disease and the disease process reaches him fast.
If it has to change and if all should
be treated with equality then we should come and fight for same. If and if only health care system is
regularized then and then only health care can be provided excellently and efficiently.
BUT AMIDST OF ALL THIS
REMEMBER THIS – PREVENTION IS BETTER THAN
CURE.
Eat healthy –plenty of
fruits, green vegetables, drink plenty of boiled water, eat less munches and
crunches. Avoid smoking, and tea.
Sleep healthy – don’t run
for money and don’t concentrate too much on money making. Learn to love and
live. Live with passion and live healthy. Keep your mind and body clean. Do
meditation and exercise and do some kind of physical activity every day.
Help others a lot and shed your selfishness
IF YOU DO ALL THIS, YOU WILL NEVER NEED
A DOCTOR AND YOU CAN LIVE A PEACEFUL, MEANINGFUL LIFE.
IF NOT RUN, RUN AND RUN AND FINALLY
DIE BY PAYING ALL THAT YOU HAVE EARNED INTO HEALTH CARE BUSINESS.
"DEMAND THE CHANGE
…………………..BE THAT CHANGE"
