It was the best of times. It was the worst of times said Charles Dickens in the Tale of Two cities. No parabola is more apt in describing the medical profession today. While the profession is leapfrogging into the future with Artificial Intelligence and robotics the foundation of modern medicine is being mercilessly shaken from within and without.
The foremost priority and responsibility is to ensure the identity and integrity of modern medicine as we know today. Concerted efforts to dilute and eliminate modern medicine have been made. All systems are verticals contributing to the history of medicine. Any attempt to mix the systems of medicine has to be resisted. The purity of modern medicine is non-negotiable. What happened to Chinese Traditional Medicine by mixing is there for everyone to see. Modern medicine is robust science. Dilution will be catastrophic. The corollary would be the loss of employability of our young medical graduates.
Every single law enacted after independence impacting the medical profession has an element of injustice to doctors. Starting from criminalisation of medical negligence to legislations like PCPNDT and POCSO laws require to be desanitised of their prejudice. Laws with the goal of eradicating social evils have unfortunately been used to target the profession as a whole. There cannot be a medical solution for social maladies.
In a new low, alleged and perceived medical negligence is being used to close down institutions under the Clinical Establishment Act. The draconian effects that this law has unleashed on small and medium hospitals will be a historic case study of future.
The industrialisation of Health Care, redesignation of patient as a consumer and reducing the doctor to a provider coupled with the withdrawal of Governments from Healthcare with the share of the Governments hovering perpetually around 1.1 % of GDP are the root causes of violence against doctors. Violence in hospitals is a national shame and cannot be justified in any civilisation.
Relentless increase in the number of medical colleges and the high cost of medical education are raising concerns about the quality and the profile of the medical graduates. It is important to take affirmative actions to ensure that the medical profession remains a slice of the community we live in representing all the socioeconomic stratifications.
All India seats in the Government medical colleges should be left to the respective States. Abolition of the of NRI seats could be a beginning of the reforms in medical education. If these seats could be offered in open quota this would bring down the migration of our children for medical education in less than desired settings in foreign countries.
The nation needs to ponder whether the coaching industry that NEET has brought in is the best model to select our doctors and specialists. There is an inherent injustice built in the elitist NEET – Coaching industry system. Cosmetic changes in the exam system will not do. We need to shake it up to chart a new path. It is time for a national dialogue and consensus. This is an opportunity and challenge. The disruption that happened to the PG NEET can be justified only if the Government brings in a total revamping of the system of everything on the table: NEET UG, NEET PG and NExT. Nothing less.
Suicides amongst doctors and medical students fail to raise anyone’s conscience. The inappropriate work load and the exploitation of young interns and doctors require remedial action. Unemployment amongst fresh MBBS graduates is a reality. The oft repeated lie that India has shortage of doctors has to be contested. The stagnation of employment opportunities in Government sector several years on row and ad hoc appointments on temporary basis are an admission of systemic collapse.
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There is a crying need to increase the number of Medical Officers in the Government sector several folds as per the increase in the population. Justice should be done by recruitment on permanent cadre through a transparent process.
Chaining by bonds is nothing but slavery. Why single out medical students to remain slaves in an incompetent system? What is it that is different in other streams that exempts them from this slavery? Judicial sanction and complicity for slavery of medical graduates should be withdrawn.
Across the country Doctor entrepreneurs opening new clinics and hospitals are an endangered species. While extending MSME benefits to this sector is in the right direction much more needs to be done for the startups of doctors venturing to set up hospitals. Such a middle sector is an asset. Doctors running hospitals as part of their medical practice is unique and is a buffer of solace to the people.
Health insurance is a failed model and a mirage. The missing middle concept of NITI Aayog is a let down. Missing middle is not a business opportunity.
Well intentioned Ayushman Bharat PM JAY should be re envisioned by restricting it to strategic purchase from private sector on the basis of scientific costing. Direct Benefit Transfer to the patient removing all middlemen could be our tool to Universal Healthcare. Large Public Health measures need to be sensitive to the space of clinicians and the privacy of the patients. Confidentiality and patient data security are being compromised.
While we the medical profession get vocal about the injustices there is an important blind spot. Doctors are accountable to the fall in values. Consumerist culture and Corporatisation have had their toll. Doctors owe it to the nation to sanitise the medical profession of these unacceptable practices. Unless they are capable of doing this the silent majority of doctors upholding the ethics and etiquette of the profession will be short changed. Nothing short of a Renaissance will suffice.
India’s 706 medical colleges enabling 1,08,915 fine MBBS medical graduates every year is an asset and opportunity. India will not only be the Hospital to the world, our fine medical graduates are competent to be a Global Doctor. Time has come to actively facilitate our doctors to be deployed all over the world.
We are a young nation and medicine is an ancient profession. Doctors are not only nation builders they are also the conscience keepers of the Human civilisation. The Burden of legacy and expectations is heavy on their shoulders. Doctors should rededicate themselves to redeem the glory of the medical profession. They should overcome the frustrations and helplessness by patience and sophistication.
