Category: choosing medical careers

Doctor’s predicament: How to treat prejudiced minds of patients?


“Medical negligence” is the word in the air. Routine complications of treatment, poor prognosis of severe diseases and death of sick patients are blown out of proportion and projected as negligence of doctors. All these insinuations are creating fear in the minds of gullible masses, who do not have any idea about the complexity of medical profession and treatment of diseases.

Thing have become so difficult that it will become difficult to treat even simple diseases in future. Non acceptance of natural progression of disease or genuine complications of surgeries by a patients has created fear among doctors. This is due to vicious campaign by media and has done irreversible damage to doctor patient relationship.

Instead of trying to improve the health care system as a whole, focus has settled on blaming the doctor only. Less number of doctors, poor health care system and insufficient resources are nowhere in focus.

Being a doctor is a tough journey. Nature of work that provides relief to human beings, while sacrificing his own personal life should be respected by civilized society. But sadly, doctors are projected in a bad light due to vicious campaign by media and celebrities. The due respect and appreciation is sadly lacking. This kind of malicious allegation against a profession community has created a sense of mistrust against the doctors in the mind of patients. Situation has become so bad that a patient, while interacting with his doctor, is not trusting the correct advice and decisions taken by a doctor in good faith. Patient will question the advice and most of the time delay his own treatment. Not uncommonly the treatment is delayed and crucial time is wasted for unnecessary reasons.

Hostile environment, risk to doctor himself, unrealistic expectations of society, retrospective analysis, physical and verbal assaults, medical industry and medico–legal issues have created a complex environment for doctors.

Although doctors have learnt to live with this pain of mistrust thrust upon them and they are suffering. But it does not require an Einstein brain to anticipate that who will be suffering ultimately due to this kind of mistrust. Society seems to be going to self destructive mode. At present, doctors and patients both are sufferers. May be media and celebrities will earn some money and fame by creating and propagating this mistrust.

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‘A doctor who always operated on ear, irrespective of problem’: Role of media in Fortis and Max hospital Delhi incidents


        During my  days as medical student, we laughed at a story wherein a doctor always operated on patient’s  ear for all their ailments. Whatever may be the problem in the body, it was only the ear which received the cut always.  Similar treatment is being given to doctors by media.  Now-a days, for every progression of the disease and for genuine poor prognosis or death of the patient, media  is prompt to start the  blame game of doctor- doctor. Media even does not try to verify the facts. The real medical issues in treatment of these cases are still not emphasized by media, like whether these cases were salvageable or not.  For example why so many preventable disease like dengue, malaria happen every year   to thousands of people every year and are still progressing?  Take the case of foetus at 22 weeks…… how many have survived in India or in  the  world? In this case and that of  the complicated dengue case, the survival chances were quite dismal, even in developed world medicine.  Inability of media people to analyze the difficulty on scientific parameters, unwillingness of people to accept the real poor prognosis and political class to flow with populist opinion has done irreparable damage to medical profession. Just a blame game and the word ‘negligence’ are in the air.

    Outcome in these cases is not uncommon or unanticipated by any yardstick in the world. But no one is concerned about that. And in the end, what are the losses?

    Discouraged medical fraternity, low morale of doctors, and talk of leaving this profession have become smaller issues and do not affect anybody in media or Government. 

   But larger issues remain: how to prevent thousands of death due to poor control of communicable and preventable diseases. Proper delivery of health care will not improve by playing the blame game on doctor.  Media bashing of doctors may divert attention from the real issues and  media people   will earn money and fame. Doctors will be punished  as a result of  populist revenge.  But this approach of media is not going to save patients or provide better health care to masses in future.

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Silence of lords is a death sentence to the medical profession:#Doctor’s assaults


 

      Every one when sick, always seeks help of a doctor and invariably help is provided. But strangely, when a doctor needs help, there is no one. Even those people, whose life had been saved, have not returned the favor.  A   strange phenomenon has happened in few years of accusing the doctors for all the ills in society and holding them responsible, without even looking at the root cause.  Everyone has found an easy scapegoat to blame.   Human rights of medical community has been grossly violated by physical assaults. More painful is to see the authorities  who are  supposed to take action have maintained a silence in all these years about this issue.  There has been countless incidences, recent being in Kalyan and Jaipur.

 

If this trend is not checked in an effective manner, it will be difficult to even treat a single patient in coming times. The way media and prominent people have put all doctors in bad light, it seems that a normal and good advice is also not taken in a correct perspective. Even patients do not understand, that this advice is for the  their betterment only.  It is because of prejudiced minds against doctors. Our films and film stars have shown in films that it is okay to assault and bully the doctor to get treatment  in an effort  to impress the gullible masses and make some money. They may be successful in making some money, but by creating mistrust they have put the lives of gullible people on risk. The media should have a more sensible approach and do some basic research before highlighting sensational news against doctors, hospitals and healthcare professionals.

Just imagine, what that gynecologist did to the patient to  earn a slap, for no reason. In this  manner, forget about serious patients and surgeries, doctors will be afraid to do even routine surgeries as well. Here the situation is that even before surgery, doctor was slapped. Imagine, if a complication happens during or after surgery, doctor would have been killed. But strangely our government, human right commissions, police and courts have behaved as if they do not exist to help the doctor, but they expect the doctor to help everyone. This kind of inaction and  silence of  authorities is appalling.

       Obviously good doctors will try to shun the system. Government, human right commissions, police and courts, media have done their contribution to kill a profession, which was of great help to them.  I am sure we are civilized and wisened up enough to recognize these flaws in the society and have some corrective measures before it is too late………….too late to change the perceptions which will settle in the young impressionable minds of the children who till now think of it as their dream career. Otherwise no brilliant child would ever like to enter this profession out of their fear. Nor the parents would like their children to be working for uncivilized society.  The government needs to enact reasonable laws to use  healthcare systems,  to the best interest of people  instead of  unfairly victimize the doctors, just to impress the gullible masses.

It is not a doctor, which was assaulted. Silence of lords is a death sentence to the medical  profession as a whole. One person may realize the folly, but if we wait for realization to come to  whole civilization, it may be too late.

Again I will request the people to introspect, who rue the scarcity of good doctors “ do they deserve to have good doctors?”

 

 

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Aberrant Evolution of medical profession: will it help the patient?


With advances in medical science, simultaneously there has been aberrant evolution of medical profession, education, regulation and medical industry. By provoking controversy about doctors for varied reasons, medical industry and law has been positioned between the doctor and  patient and  taken a center stage in health care. Till now, doctor patient interaction was the central point of the health industry, a core around which medical industry revolved. But now   this interaction, treatment and  almost everything is controlled by industry and regulated in some manner. There have been technical advancements to promote better treatment and diagnosis but these, at the same time, increase the cost of treatment, involvement of industry and hence dependence on investors.

 There has been advancements, but are they in right direction?

Discouragement  of medical fraternity:  The adage “To err is human” probably does not apply to the doctors anymore. Doctors are definitely regarded different from rest of the humans and are not supposed to have privileges that other persons of humankind are guaranteed. Hence they are harassed often for any adverse clinical outcome even though it may be because of poor prognosis of patient. They work under continuous fear and stress and are punished for each small or big error.

Commercial evolution of medical education: medical student are now forced to pay exorbitant fee with lower standards of education.  

Evolution in medico legal  procedures:  extensive and complex communication, technical advancements and legal interactions has taken a toll on the doctors. But more importantly, how that has improved the patient care or  doctor patient relationship? I feel, it has created fear in mind of doctors and deterioration of doctor patient relationship.

 Evlution of Doctor patient relationship and Trust :In all the complexity, trust between doctor patient has taken a hit. A good paternistic relationship, now has been converted to more of a legal one. Trust has been replaced by  mutual fear.

Evolution of Complex medical regulation and documentation: There has been overzealous regulation of medical profession. Time and resouces which should have been utilized for treatment of patients,  has to be used for complex documentation.

Evolution of media and social media: Painful retrospective analysis of work of doctor by media, courts and public contuse. Decisions which doctors has to take in moments are analysed retrospectively by everyone with wisdom of hindsight over years, without understanding complexities involved.

Evolution of Insurance sector: increasing cost of treatment and  medicolegal component has made both patients and doctors paying to insurance companies.

            This kind of aberrant evolution of medical profession has increased the problems of doctors and patients and it is not helping anyone. Ultimately it will help everyone except doctor and patient. Ultimately discourage the excellence in medical care.

 

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Medical Regulation and Medical Community of Ancient Rome


Medical community

Medical services of the late Roman Republic and early Roman Empire were mainly imports from the civilization of Ancient Greece, and then through Greeks enslaved during the Roman conquest of Greece. Greek knowledge imparted to Roman citizens visiting or being educated in Greece.  A perusal of the names of Roman physicians will show that the majority are wholly or partly Greek and that many of the physicians were of servile origin.

The servility stigma came from the accident of a more medically advanced society being conquered by a lesser. One of the cultural ironies of these circumstances is that free men sometimes found themselves in service to the enslaved professional or dignitary, or the power of the state was entrusted to foreigners who had been conquered in battle and were technically slaves. In Greek society, physicians tended to be regarded as noble.

Public medicine

The medical art in early Rome was the responsibility of the pater familias, or patriarch. The importation of the Aesculapium established medicine in the public domain. There is no record of fees being collected for a stay at one of them, at Rome or elsewhere.  individuals vowed to perform certain actions or contribute a certain amount if certain events happened, some of which were healings. Such a system amounts to gradated contributions by income, as the contributor could only vow what he could provide. The building of a temple and its facilities on the other hand was the responsibility of the magistrates. The funds came from the state treasury or from taxes.

Private medicine  A second signal act marked the start of sponsorship of private medicine by the state as well. In the year 219 BCE, a vulnerarius, or surgeon, Archagathus, visited Rome from the Peloponnesus and was asked to stay. The state conferred citizenship on him and purchased him a taberna, or shop, near the compitium Acilii (a crossroads), which became the first officina medica.

The doctor necessarily had many assistants. Some prepared and vended medicines and tended the herb garden. These numbers, of course, are at best proportional to the true populations, which were many times greater.

Roman doctors of any stature combed the population for persons in any social setting who had an interest in and ability for practicing medicine. On the one hand the doctor used their services unremittingly. On the other they were treated like members of the family; i.e., they came to stay with the doctor and when they left they were themselves doctors. The best doctors were the former apprentices of the Aesculapia, who, in effect, served residencies there.

 

The practice of medicine

The physician

The next step was to secure the cura of a medicus. If the patient was too sick to move one sent for a clinicus, who went to the clinum or couch of the patient.

That the poor paid a minimal fee for the visit of a medicus is indicated by a wisecrack in Plautus. It was less than a nummus. Many anecdotes exist of doctors negotiating fees with wealthy patients and refusing to prescribe a remedy if agreement was not reached. The fees charged were on a sliding scale according to assets. The physicians of the rich were themselves rich. For example, Antonius Musa treated Augustus’ nervous symptoms with cold baths and drugs. He was not only set free but he became Augustus’ physician. He received a salary of 300,000 sesterces. There is no evidence that he was other than a private physician; that is, he was not working for the Roman government.

Legal responsibility Doctors were generally exempt from prosecution for their mistakes. Some writers complain of legal murder. However, holding the powerful up to exorbitant fees ran the risk of retaliation. Pliny reports  that the emperor Claudius fined a physician, Alcon, 180 million sesterces and exiled him to Gaul. By chance a law existed at Rome, the Lex Aquilia  passed about 286 BCE, which allowed the owners of slaves and animals to seek remedies for damage to their property, either malicious or negligent. Litigants used this law to proceed against the negligence of medici, such as the performance of an operation on a slave by an untrained surgeon resulting in death or other damage.

Social position While encouraging and supporting the public and private practice of medicine, the Roman government tended to suppress organizations of medici in society. The constitution provided for the formation of occupational collegia, or guilds. The consuls and the emperors treated these ambivalently. Sometimes they were permitted; more often they were made illegal and were suppressed. The medici formed collegia, which had their own centers, the Scholae Medicorum, but they never amounted to a significant social force. They were regarded as subversive along with all the other collegia.Doctors were nevertheless influential. They liked to write. Compared to the number of books written, not many have survived; for example, Tiberius Claudius Menecrates composed 150 medical works, of which only a few fragments remain. Some that did remain almost in entirety are the works of Galen, Celsus, Hippocrates and the herbal expert, Pedanius Dioscorides who wrote the 5-volume De Materia Medica.

Military medical corps

Republican

 The state of the military medical corps before Augustus is unclear. Corpsmen certainly existed at least for the administration of first aid and were enlisted soldiers rather than civilians. The commander of the legion was held responsible for removing the wounded from the field and insuring that they got sufficient care and time to recover. He could quarter troops in private domiciles if he thought necessary.

Imperial  

The army of the early empire was sharply and qualitatively different. If military careers were now possible, so were careers for military specialists, such as medici. Under Augustus for the first time occupational names of officers and functions began to appear in inscriptions. The term medici ordinarii in the inscriptions must refer to the lowest ranking military physicians. No doctor was in any sense “ordinary”. They were to be feared and respected. During his reign, Augustus finally conferred the dignitas equestris, or social rank of knight, on all physicians, public or private. They were then full citizens and could wear the rings of knights. In the army there was at least one other rank of physician, the medicus duplicarius, “medic at double pay”, and, as the legion had milites sesquiplicarii, “soldiers at 1.5 pay”, perhaps the medics had that pay grade as well.

Practice

Medical corps in battle worked on the battlefield bandaging soldiers. From the aid station the wounded went by horse-drawn ambulance to other locations, ultimately to the camp hospitals in the area. There they were seen by the medici vulnerarii, or surgeons, the main type of military doctor. They were given a bed in the hospital if they needed it and one was available. The larger hospitals could administer 400-500 beds.A base hospital was quadrangular with barracks-like wards surrounding a central courtyard. On the outside of the quadrangle were private rooms for the patients. Although unacquainted with bacteria, Roman medical doctors knew about contagion and did their best to prevent it. Rooms were isolated, running water carried the waste away, and the drinking and washing water was tapped up the slope from the latrines.Within the hospital were operating rooms, kitchens, baths, a dispensary, latrines, a mortuary and herb gardens, as doctors relied heavily on herbs for drugs.. They operated or otherwise treated with scalpels, hooks, levers, drills, probes, forceps, catheters and arrow-extractors on patients anesthetized with morphine. Instruments were boiled before use. Wounds were washed in vinegar and stitched. Broken bones were placed in traction. There is, however, evidence of wider concerns. A vaginal speculum suggests gynecology was practiced, and an anal speculum implies knowledge that the size and condition of internal organs accessible through the orifices was an indication of health. They could extract eye cataracts with a special needle. Operating room amphitheaters indicate that medical education was ongoing. Many have proposed that the knowledge and practices of the medici were not exceeded until the 20th century CE.

Regulation of medicine

By the late empire the state had taken more of a hand in regulating medicine. The law codes of the 4th century CE, such as the Codex Theodosianus, paint a picture of a medical system enforced by the laws and the state apparatus. At the top was the equivalent of a surgeon general of the empire. He was by law a noble, a dux (duke) or a vicarius (vicar) of the emperor. He held the title of comes archiatorum, “count of the chief healers.” The Greek word iatros, “healer”, was higher-status than the Latin medicus.Under the comes were a number of officials called the archiatri, or more popularly the protomedici, supra medicos, domini medicorum or superpositi medicorum. They were paid by the state. It was their function to supervise all the medici in their districts; i.e., they were the chief medical examiners. Their families were exempt from taxes. They could not be prosecuted nor could troops be quartered in their homes.The archiatri were divided into two groups:

Archiatri sancti palatii, who were palace physicians

Archiatri populares. They were required to provide for the poor; presumably, the more prosperous still provided for themselves.

The archiatri settled all medical disputes. Rome had 14 of them; the number in other communities varied from 5 to 10 depending on the population.

 

 

 

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21 occupational Risks to doctors and nurses, while performing their duties


Doctor save the patient, but save yourself also.

Working of a doctor and nurses is not free from risk to themselves. The risk is generally underestimated, although it often involves major  risk  to life and may be frightening. Problem is that  majority of people, society and governing bodies  and even doctors themselves do not perceive or acknowledge it many times  the risks seriously.  But since  these risks are increasing exponentially everyday, because of changing scenario, they should be known to students, who want to take medicine as a profession. They need to take an informed decision. There are lesser set procedures, lack of awareness, not protective equipment or supportive society, governance and  laws, at most of  the places globally, and  doctors continue to work  in danger zones. These risks can be of varied types. Contracting the diseases is just one of them.

Even when doctors and nurses contact the diseases, there may or may not be proper support for further treatment, compensation and rehabilitation. Most of the time, they  have to fend for themselves. Because quite many of them , in government and private sector work on adhoc basis, temporary posts and on contract. Doctors  may have following risks, readers can add, if I have missed few:

Occupational health hazards

1.Tuberculosis: Common among health care  workers

2.Hepatitis B, Hepatitis C

3.HIV

  1. Influenza, Swine flu and other viruses of similar type.

5.Chicken pox

6.Rabies

7.Patients some times comes with unknown viral illnesses, which can not be tested. At the time, when treatment is going on, even diagnosis is not known. Doctor can contract these bacteria or viruses. There can be many more.

Risks related to stress and overwork

8.Depression, suicide, hopelessness

  1. Burnout.

10.Restricted social life

11.prone to alcohol/ drug abuse/ drug exposure.

Stress of balancing Family life: Kind of work and night duties effect family life very adversely. 12. Specially  female doctors. Completing  family will effect their careers, most of time.

13.High rates of divorces

14.Stress related diseases

15.Life style diseases: mainly sedentary work and long hours of working, makes them prone to life style diseases like ischemic heart disease , hypertension etc.

16.Exposure to radiations: specially in radiology and oncology. female doctors are more affected.

17.Lack of exposure to sunlight: effects bones , deficiency of vit D and predisposes to depression

  1.   Risk of catching resistant infections and sometimes there is risk that they carry these deadly bacteria to their homes. So their family members and children are at risk.
  2.   Risk of  working in disaster area and transport of sick , floods, earthquakes. Accidents of    ambulances .
  3.   Change in natural bio flora  of doctors and nurses. It is replaced by hospital bio flora. If they get infection, it is difficult to treat.
  4.  Risks because of legal problems and violent patients:  adds to stress Patients may not have favourable prognosis. But it is common for doctors to be blamed  even for naturally poor prognosis of the  disease. Legal trouble adds to further stress.

    –verbal abuse and threatening is very common. So spoiled mood unnecessarily.

– fear of  physical   assault can really harm doctors and family members.

– excessive and unilateral regulation puts doctors at the receiving end of the discontent.

Worst part is that our systems are not defined to prevent, treat or compensate or even acknowledge for these big disasters, if it happens to healers. These problems are not known to students, when they decide to take medicine, nor they are taught in medical school. Most of the time they have to fend for themselves, if problems occur.

Administrators and regulators refrain to study data that would establish and quantify the occupational hazards of being a doctor and nurses. Some of these hazards may be known, but there is no comprehensive analysis of workplace risk for physicians and nurses, like those that have been done for other professions. As physicians, we have a sense of the risk, and yet we remain engaged, continuing to care for our patients as we know  “these things” happen. Perhaps society prefers to remain blissfully ignorant of the sacrifice and risk their doctors take on, comforted by the fantasy of the serene  hospital. Perhaps we  all despise to let reality and data shatter the illusion.

Everyday globally, the doctors and the nurses  greet the new day and return to their work of taking care of their patients, knowing well the risk  involved.

Maybe it is time that we are little more aware  and acknowledge that even doing everything in best manner and honestly , we are in a  conflict zone and  we are all in harm’s way. Just be careful and be mindful that  doctors, nurses, and healthcare workers,  may get  sickened, injured, disabled, or can be dragged to court or harassed even  as they care for their patients in best manner.

Doctor save the patient, but save yourself also.

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NEET Scams: Is unfair selection at medical college seat, root cause for poor health system?


A famous axiom “as you sow so shall you reap “  has an application to health system. As NEET has been implemented and there has been some effort to find out information about  admissions to medical colleges, at least tip of the  iceberg is getting visible.  More you know or read the news items about NEET, more one is convinced that industry  selling medical college seats has been quite powerful and practically every technique to sell seats is prevalent to by pass the merit and deny seat to deserving candidates. These meritorious children, who are denied seats could have been   good doctors and   real custodian for the health of people.  But  if for some reason, business prevails and government fails to prevent this cruel and corrupt selling of medical seats,  an Einstein brain is not required to  guess the whole malaise prevalent in health system.  Foundation  of  medical system is suffused with sand rather than touch stone of merit. It is the business and fraud which is rampant.

Astronomical fee of medical colleges  without proper facilities and medical education can be born only by investors and not good candidates.   It is the people and society, who will be the real sufferers in future. Therefore resentment to such system should come from the society. If every one is happy by the arrangement , then one has to introspect, whether they really deserve  kind of  doctors, they wish.

 

Following may be MEAGER TIP OF THE  ICEBERG

 

Sitting, retired HC judges under scanner for MBBS admissions scam http://timesofindia.indiatimes.com/india/sitting-retired-hc-judges-under-scanner-for-mbbs-admission-scam/articleshow/60772522.cms

As medical education hit by scams, planned reforms remain in backburner

http://timesofindia.indiatimes.com/india/as-medical-education-hit-by-scams-planned-reforms-remain-in-backburner/articleshow/60787796.cms

How NEET high scorers, pvt institutes colluded to make a quick buck | HT Special

http://www.hindustantimes.com/education/some-neet-top-scorers-blocked-seats-that-were-later-sold-to-low-rank-holders-by-pvt-institutes/story-UgVXOeOZ5xgIAWkRj3s6fO.html

 

 

 

 

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Medical college education: NEET cut off variation: any moral questions by society, celebrities and media?


Going by selection of candidates as doctors, If given a choice, by whom  a patient will like to get treated? A candidate who scored 20 % marks or a person getting 60% or 80%  marks.   NEET eligibility getting lower and  a  candidate getting around 20 % of marks  may be able to secure a degree to treat patients.  What will be the deciding factor? The criteria as to why a person with 60%  marks will  not be given a seat and with 20% marks will be able to secure. It will depend upon, whether  a student  is able to pay the exorbitant fee or not. Present system and mechanism of admission permit and accept such huge  variation! That strange equation is acceptable in lieu of money paid!

In this whole process, who will be the sufferer?

– Is it only the  meritorious  and honest candidate. children who has worked hard are going to lose faith in system, besides irreversible damage to career.

– the people and society, who wish for best doctors.

– in general, honesty and hard work and merit is a causality.

– But in the long run candidate, who purchase degrees with money  may also suffer. As in the times of consumerism and risk associated with less desirable medical services. Candidates may themselves be at risk. Rich candidates may be capable of becoming health investors and health managers by money power, so as to evade  the increasing litigation. But  those from average family backgrounds ,who practice as doctors, will  be at some risk in today’s  difficult environment   for doctors.

 Exit  exams from these paid colleges  need to be better regulated. These colleges are minting money for distributing degrees. Likely is that, ultimately  most of the  students will pass and try to recover  their investments.

Infrastructure ,  number of teachers and investment on training is unlikely to be uniform in such colleges.   It is a matter of speculation, how much facilities a student gets, specially at a time uncertainty  about uniformity of medical education is a matter of great debate. It is also doubtful that money charged  from students as fee, is spent on medical education of the aspiring doctors.

      National exit exam may solve uniformity issues to some extent, but like NEET, its correct  implementation is a big   uncertainty itself.  Doctors have to listen comments about quality of doctors everyday. Rather than doctors themselves, it is the system to select them  needs improvement, which permit and accepts such huge variation in marks and fee.  Someone will definitely ponder, why one should not get best available candidate as doctor?  

 

 

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Expensive medical college seat:Is it worth it.


 

At a time when students, parents and even doctors are uncertain whether opting for medical college along with the vulnerability and risk associated with   becoming a doctor is worth it or not, some are naive enough to pay millions as fee for medical education and for securing a seat of MBBS. The noble intentions of NEET were to minimize wastage of seats due to multiple admission procedures running concurrently and to do away with the variable criteria for selection used for admissions. But this time there has been unregulated steep increase in fees of private medical colleges. 

(http://timesofindia.indiatimes.com/home/education/news/under-new-rules-less-than-50-private-mbbs-seats-filled/articleshow/60200421.cms).

Isn’t it surprising  that a coveted course, with more than a million  students vying for it, ends up with vacant seats especially in private colleges?  The answer is not difficult to guess. There has been a huge increase in fees by private colleges, which along with disillusionment about medical profession has lead to change in mind of candidates.

It is ironical that the medical profession is regulated, but medical business or medical education is not.  Such business of producing doctors based on their paying capacity should be clearly trounced for the benefit of public. Foundations of healthcare should be on touchstone of merit, ethics and character and not based on business deals. Therefore meritorious students, especially from average backgrounds, who opt to become doctors feel cheated when they pay massive fee to buy a seat. It is an insult to the very virtue of merit which should have been the sole criteria for these admissions.

Truth  cannot remain hidden for long.  It is to be realized that getting into medical college is a minuscule component of the process of becoming a good doctor.  Once they opt for this profession, the real tough and prolonged battle begins. Quite a few successful candidates may eventually feel that the money spent and the hard work may not be worth it especially those candidates who may have invested in heavy fees or bought a seat in medical colleges with hefty amount. Some of them, who invested millions for becoming doctors, will be even probably unable to recover their investments. The students with strong financial backgrounds may be more benefited as they can become investors or health managers. But for others, it could be a dream turning into a nightmare.

Those who invest heavily for getting medical education would eventually try  to recover their money after securing a degree. This definitely clouds their judgement in any future decisions that they make as doctor. On the other hand, meritorious students may not be able to get a seat. These will eventually have an impact not only on the quality of doctors but also on their attitude towards this profession.

The government should regulate these fees and also ensure that if a heavy fee is charged, then it should be spent on medical education of students only. It  should not take a form of just any another money minting industry to be used for other purposes.

The foundation of  medical education should not be based on principles of business but should be on pure merit alone. There is a need for uniformity,  proper infrastructure and regulated standards for these heavily priced medical colleges. There is a need to set up quality medical colleges instead of launching lot of inferior institutions every year who just work for minting money rather providing good doctors to the society. Our society needs good doctors, selected on the basis of merit and their medical education has to be cheap and good. If the society continues to accept such below par practices, it has to introspect, whether it actually deserves to get good doctors.

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Future medicine is beyond human limits: robots as doctor, till then human docs with robot like activity:


 

         The adage “To err is human” probably does not apply to the doctors. Doctors are definitely regarded different from rest of the humans and are not supposed to have privileges that other persons of humankind are guaranteed. Hence they are harassed often for any adverse clinical outcome even though it may be because of poor prognosis of patient. They work under continuous fear and stress and are punished for each small or big error. Then what are they? Modern slaves or human docs with robot like activity?

With advances in medical science, simultaneously there has been aberrant evolution of medical profession, education, regulation and medical industry. By provoking controversy about doctors for varied reasons, medical industry and law has intruded between the doctor patient relationship to take a centrestage in health care. Till now, doctor patient interaction was the central point of the health industry, a core around which medical industry revolved. Except this interaction, rest almost everything is controlled by industry.  If this interaction too is replaced by robotic machines, the control of medical industry over business of health will be almost complete. With the evolution of robotic technology and artificial intelligence, the dream of industry to have full control over health care business has become a realistic possibility.  There have been technical advancements to promote better treatment and diagnosis but these, at the same time, increase the cost of treatment and involvement and hence dependence on investors and industry. Complexity of medical science, industry, legalities and medical regulation has been multiplying everyday beyond human limits for doctors, at least in some specialties. Long years of training, Dealing and working with all complexities of medical system, all time retrospective analysis of their work by patients and lawyers, complex documentations, social media mudslinging, extensive and complex communication, technical advancements and legal interactions has taken a toll on the doctors and they are gradually ceasing to be normal human beings. They are slowly being converted to humans with robot like activity.

Also there is a thought whether doctors can be replaced by robots, completely or partly. Such talk of having machines is not without basis as all the stakeholders are feeling the need for a drastic change to have better and better medical care .

 

Future of medical profession: Robots as doctor:

  1. Usually doctors have to carry huge burden of expectation of society and patient. People want quick and effective treatment, without human faults, with an up-to-date medical knowledge delivered within moments. Unrealistic expectations are getting beyond human limits and these can be fulfilled only by robots.
  2. Since well trained doctors are lesser in number, they are expected to deliver a curative treatment with excellent accuracy with perfect documentation even when load of patients is extraordinarily high.
  3. Even in presence of extraordinary work load and difficult circumstances, doctor are supposed to maintain perfect documentation to save himself. Because later, any case can be subjected to legal scrutiny in future. Lawyers and courts will analyze retrospectively for years, with wisdom of hindsight and luxury of time, to find the faults and may punish the savior.
  4. Nobody wants to die. Even somebody with severe disease, with poor prognosis, have tendency to blame doctors for his illness, if he has contacted    Such incidences occurring too frequently cause feeling of hurt to doctors. Verbal and physical assaults is a routine. Robots will be immune to such painful thoughts and will not be affected mentally and continue to work perfectly in such circumstances.
  1. Training to be a Doctors are expensive and takes years. It takes painful long years and time. Human life span is limited. Therefore training a doctor and paying him life long, a bad business idea for industry and society. That is reason of unwillingness to pay even the rightful to the doctors. Robots will be a onetime investment. Life is one and span is less. Studies and gaining experience takes away good part of doctor’s life.  People from strong financial backgrounds avoid becoming doctors. Although they may opt for becoming health managers or investors.
  1. Human limitations, like tiredness, mood variation, feeling hurt, family issues, failure to apologize always in all situations (especially if doctor is not at fault), diagnostic  bias, limited knowledge   are various human factors with doctors, which are undesirable  for being a doctor and can be rectified easily with Robots.
  1. Available medical information is like a sea, that cannot be held in a hand. However brilliant doctor may be, he will know fraction of available knowledge. The moment we pass our exams, we start becoming out of date.
  2. Human bias always plays a role, because medical science is far from complete. Moreover rapid change in technology makes all knowledge and experience of a doctor redundant. Robots can be easily updated.

 Present medicine: human docs with Robot like activity:

As humans, doctors can make errors, get demoralized or dragged to courts or subjected to verbal or physical abuse, their mood and enthusiasm may be spoiled and may make more errors in other patients as well.  But they have to continue to perform as due to nature of their work does not allow them to have time to cool their mind. Repeated incidents make doctors immune to such mudslinging. Their reaction to these insults and distressing situations becomes blunt and reactions are subdued like that of a Robot.  Doctors themselves are slowly being converted to Robots like creatures.

  • Doctors do not react to unjustified verbal assaults of a patient, same as machine do.
  • They do not get demoralized easily because of moral assassination by media, calling them thieves, thugs and dacoits, even doing most helpful job in the entire society, saving lives. Now there is no reaction from doctors, when an uncommon or single stray incidence of adverse kind is used to portray all doctors in same light. This unwavering sanity looks like as if there have no apperception to perception of such poignant thoughts, same as Robots.
  • Many of them tirelessly work day and night without rest and food, along with verbal and physical assaults, accomplish arduous tasks like a machine.
  • Medicine is very complex and far from complete, still the precision executed by this wonderful community is no less than great machine “robot”. They executing all theory, practical and experience, application with in a trice. There personal emotions get a machine like toughness. They look like tough ship in such tornado, like a tough machine with no human weakness.
  • There is many things going in a doctor’s life, on professional and personal front. For example, care of sick, difficult family communication, perfect documentation, complaints, ongoing, court cases, declaring deaths, data maintenance, treatment and prevention of infections, nosocomial infections, medico legal suits, iatrogenic complications or simply genuine poor prognostic patients, unforeseen complications, unnecessary mudslinging by media and social media along with newer advances to cope with. There can be personal and own family issues as well. For a simple human being, it is difficult to accomplish all this complexities   immaculately and at the same time, while handling the ongoing patient load.
  • Doctors continue to work unaffected by continuous retrospective analysis and afflictive comments from practically every side, patients, administration and courts. All of them acquire wisdom off hindsight and have luxury of time to make an analysis.

 

Present and Future of medical profession:

Robots will be immune from errors and mood swings, tiredness and human limitations, hurt feelings, (will apologize always even if it is not their fault). And therefore legalities in the profession will be minimized.  No breach of protocol is possible. No questions or room for mistrust. Robots can do duties all seven days a week and 365 days a year. Public, Governments and medical industry will be happy. With Artificial intelligence and rapid advancement in robotics, doctors will have very little role in medical industry. Best part is that, it will be a onetime investment.

 

          Minor disadvantage:  Only things Robots lack human touch and feelings and will not be going extra mile for patient as compared to human doctors. Robots will just complete protocols. But with time, these   qualities will not be required anymore. There will be no humans to blame for the suffering of diseased, or to vent anger at. No human scapegoat will be there for physical or legal revenge. But till the time human doctors are   completely replaced by machine robots, ordinary mortals have to fill in and they will be human Docs with robots like activity (HUDOROLA).

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