By Dr Kamal Mahawar
Medical profession in India is in a state of free fall. Practitioners of what was once a noble profession are today behaving like any other business and making as much money as possible from the ailing is the new mantra. However, medical professionals are not alone in this moral decline, and they are merely following the prevalent trends of the society.
In contemporary Indian society, honesty and strength of character are not treated with respect, these attributes once used to command. Today, money, irrespective of how earned, gets you respect, and without it, no matter how good or upright you are, you’ll struggle to get it. Earning money is everyone top priority. Doctors are no exception.
There is nothing wrong as long as money earned is a fair reward for one’s efforts. The problem starts when what patients are willing to pay doctors, as a fair reward does not match doctors’ expectations. There are two aspects of this problem. First is that of the patient perception. India is a poor country with limited insurance penetration. Majority of India’s population can barely manage food, shelter, clothing, and education. There is no provision for health expenditure in the family’s budget and is often enough to push them into poverty. Even those who can afford medical care treat it as a non-essential commodity. People who can spend thousands on a social meal will often use all tactics to avoid paying doctors’ genuine consultation fees. Of course, why should they pay for an opinion in a society where majority of the population have their opinion on health issues and will also share with you freely! Moreover gone are the days when patients treated doctors as gods and gave them their due respect. Today’s paying patient demands attention and if the outcome is not his/her favors/he will not hesitate to beat doctor up or hurl abuses at him/her.
The second problem, of course, is that of doctors’ expectations. We live in as a society where money is everything and little else matters. It shouldn’t surprise anyone if doctors wish the same. No amount of money is enough for doctors who wish to compete with business tycoons who set up the biggest of the hospital chains and wish to own a fleet of fancy cars and number of farmhouses.
Doctor-patient relationship in India is almost completely breaking down. Instances of unethical and incompetent practices are becoming common. Patients have lost all respect for doctors and doctors in turn have reciprocated by distancing themselves emotionally and concentrating on the monetary aspect of the relationship. Medicine can be a rewarding profession when a patient pays doctors with gratitude, but many contemporary doctors have yet to experience this feeling. For this feeling, doctors used to work for very low wages and sometimes even put their health at risk. Not too long ago this was commonplace in Indian medical profession. This has now changed. Patients don’t pay with gratitude anymore; they pay with money.
The emotional fulfillment that one got a little bit of gratitude cannot be obtained from even lakhs of Rupees. However, many doctors simply don’t understand this and seek to obtain missing professional satisfaction by trying to earn more and more money. This is an unending cycle with counterproductive results.
What we need is a series of trust-building measures to rebuild a healthy doctor-patient relationship in India and nudge practitioners of medicine towards their not too old noble foundations. Government, Medical Council of India (as the regulator), and bodies like Indian Medical Association all have their part to play. Doctors need to start practicing medicine ethically and competently in return for a fair wage. At the same time, patients need to appreciate the effort and sacrifice that goes in the making of a doctor. The doctor should get emotional and material fulfillment out of the profession. Patients also need to realize that medicine is not an exact science and sometimes despite the best attempt, outcome may not be in our favour. Even the best of the surgeons sometimes have complications, and that does not mean a personal failing on the part of the surgeon or doctor. Above all, society at large will only get honest and noble doctors when it starts respecting honesty and nobility and not wealth and power.
In contemporary Indian society honest are considered “impractical” and looked down upon for their failure to amass wealth or power. As long as the society as a whole doesn’t learn to dig deeper and ask the right questions on what it takes to acquire wealth, someone will try to get rich by whichever means it takes. Doctors too come from the same society and cannot be an exception.
Dr Kamal Mahawar a leading obesity specialist and senior consultant in bariatric and metabolic surgery with Indraprastha Apollo Hospital, New Delhi.