Category: extinct good doctors

Unfair prejudice against doctors distressing : shortage of docs and still delivering best, but punished and assaulted


Shortage of docs ails AIIMS emergency only one technician each for ventilator, ECG (link)

http://timesofindia.indiatimes.com/city/delhi/shortage-of-docs-ails-aiims-emergency/articleshow/58831115.cms

Times of India yesterday carried a news article which highlighted the problem of shortage of doctors and trained staff in AIIMS hospital emergency.  The number of doctors  available are less than half of those required. And if this is the scenario in a premier Institute, it does not need an Einstein brain to figure out how the problem at other places in remote areas would be.

Everybody desires to have themselves treated within few minutes of their arrival in a hospital to the best of standards, but there are many obstacles to it in the form of large patient overload and shortage of doctors. Despite shortage of staff, each and every doctor tries his best to see as many patients as possible while sacrificing his own personal life. In any civilized society, this kind of work should bring in appreciation and respect for those who deliver. But for some strange reason, possibly due to vicious campaign against doctors by media and even celebrities, the respect and appreciation for this profession is sadly lacking. Possibly it is due to inadequate root cause analysis of the real issues. News items like these will probably help public realize the problems doctors face.

Despite working in such conditions, they are still abused, assaulted, beaten and taken to court for reasons, which are not justifiable in a civilized society. With all such problems and heavy hearts, this wonderful community still continues doing their noble work day and night to give each patient the best possible treatment within a reasonable time frame.  As compared to other professions the amount of work is more and appreciation much less.

Let’s take an example of courts where people spend lot of money and time and their cases still drag on for years. Crores of cases are pending in courts and thousands die without getting justice in their life time.  In contrast, even if there is shortage of doctors, relief to uncountable patients is provided and the quality of work is much better than other professions. As nature of work of this saviour is very high in moral hierarchy as compared to any other profession, it is time our society realized about the constraints doctors face before blaming them for the loss of optimal health care provision. Surely society owes much more to this wonderful community, but sadly this realization is unlikely in present era.

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Ray of hope for doctors :Honourable President and Delhi high court show concern about violence against doctors


At last, Delhi high court has expressed concern  over growing instances of attacks on doctors by irate patients. It also identified lack of adequate number of medical experts in government hospitals, as a possible cause. It also made a note of  government’s  failure to increase the number of doctors despite multifold increase in patient load. And the next date for hearing is fixed for 10 days later, on 29th May.

Our Honourable President Mr Pranab Mukherjee too, has disapproved of the violence against doctors, thus giving hope to  doctors that their fundamental right  of safe working environment may be restored in near future.

Although good working conditions still remain a distant dream for doctors but this raises hope of getting atleast a safer environment which is absolute  necessary for a doctor to practise.

Although points raised by courts are well known and basic but are very important to begin with. But still until now, none of the government authorities had extended help to the doctor’s community. Isn’t it ironical that in 21st century, when sky is the limit for advances in majority of the professions, the most educated and a hard working community of the country is fighting for its basic and fundamental right of a safer workplace? It is just unthinkable that doctors still have to struggle for their basic  right in present era.

 

Honourable President Mr Pranab Mukherjee too, has disapproved of the violence against doctors(link)

Attacks on doctors by relatives of patients unacceptable: President Pranab Mukherjee

Delhi high court has expressed concern  over growing instances of attacks on doctors by irate patients.(Link)

http://timesofindia.indiatimes.com/city/delhi/hc-seeks-report-on-docs-safety/articleshow/58504721.cms

 

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Real story of a female doctor assault : Routine affair for uncivilized society


Few words here can’t describe the plight of a female doctor, who was brutally assaulted by a mob at her residence, for no fault of hers. This incidence happened few months back, about 200 KM away from Delhi.

It was an evening time and a boy had an accident with a bus. He was brought to a community health center.  Female medical officer who had her residence inside the hospital in staff quarters examined the patient and found that he was already dead. She explained the situation to the family members with due sensitivity, did all the paper work and returned to her residence in about an hour. Mob kept on gathering and after half an hour, they barged into the house of the lady medical officer.

They dragged her by hair in front of her teenage daughter. Mob started assaulting her with fists and legs along with a rod. Her daughter cried and shouted for help.   Mob even tried to set her on fire. This brutal and devilish assault continued till neighbours from other staff quarters saved her with great difficulty and took her away. Mob continued rampage in her house and hospital, trying to break everything.

She sustained severe head injuries and was admitted in a hospital for about ten days. What was her fault and why mob did this to her? Is being a doctor and working in remote area her fault? Everybody knew that the reason for death of the boy was what happened outside the hospital.  There was an errant bus driver, who was responsible.  Then why was she made a punching bag for venting out emotions of the bereaved relatives. Nothing and really nothing can justify this barbaric act. Emotions should not be allowed to take such a demonic form. This is simply jungle raj, goonism and  expression of a most  uncivilized kind of society, which simply cannot be excused by any sort of reasoning. The incident was protested by the professional bodies as is the routine and after few day things normalized for everybody else except that terrorised family. The said lady medical officer took posting elsewhere and as is usual, nothing much happened to the accused.

Woman doctor assault : Era worse than MAHABHARATA for female doctors

There was again same silence and little concern shown by our media, courts, prominent people, celebrities, human right commission, woman right activists and women commission. This again brings forth the hypocrisy of these people and organizations, who otherwise cry about woman rights and empowerment.  Whenever a female is assaulted, there is an outrage but the same support is not extended to a female if she is a doctor. Such bestiality should create havoc in minds of civilized people but this apathy to such incidents clearly indicates otherwise. Have we become so uncivilised that an incident such as this just remains as a small news item in a local paper? Can’t we see that such incidents are harbinger of many more in future? It is important to realise that this is the time to unify and condemn such episodes vehemently and prominently so that the miscreants realise that they cannot get away with it.

Beti bachao Beti padhao vs Violence against female doctors

Violence against female doctors: Silence of human and  woman right commissions

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Generic vs. branded medicine: Doctor’s stake : just stringent check on quality of medicine.


Doctors should have no issues to what Honourable Prime Minister Mr Narender Modi himself has spoken, for putting in place a legal frame work to ensure that doctors prescribe only generic drugs. This practice can be easily followed if apprehensions about quality of medicines are allayed.

There have always been concerns regarding quality of generic drugs sold under various trade names since the control over their quality is not foolproof. Implementation has to come along with stringent laws regarding drug testing and quality assurance, otherwise it may be dangerous to patients and in turn to doctors, in the present scenario.

   Generic drug are low cost version of a formulation that should ideally be equivalent to a branded product as far as its production quality, dosage, strength, route of administration and efficacy is concerned. Most generic products are allowed to enter the market only after expiry of the patent protection duration granted to the drug’s original developer.

   Branded drugs are expensive and there is a huge price variation between different branded drugs containing same molecule which is inexplicable. How can doctors interpret the price variation which can be sometimes many times for the different brands of same molecule. Is this price variation because of some difference in efficacy? How to interpret this much price gap and how to keep track of newer names launched at lower prices? Doctors do not manufacture drugs nor are they responsible for printed high retail prices variation in drug prices. I feel the biggest problem is the lack of documentation on efficacy of different brands of same molecule, which if done could guide the doctor. Some regulatory agency needs to be responsible for guiding doctors and patients regarding relationship of quality of drugs and prices. Therefore it is actually not correct to hold doctors responsible for these cost variations.

Huge price variation:  But all said and done, none of the arguments can explain the huge price variation for the different brand of same molecule. This malpractice of pharmaceutical industry has gone on for years without any check and this needs a solution which cannot be found at the door of doctors alone.

The quality control mechanism need to be strengthened and made more stringent. Before using a generic drug, the doctor or patient has to be well assured about  consistent quality of various drugs of same molecule and their pharmacological properties and also the fact that they have been manufactured using the standard practices  and meet the quality controls as per the regulations laid down. Concerned agency should check, verify and certify each and every drug.

 Bioavailability equivalence: There has to be a stringent legal mechanism to guarantee the bio equivalency of the compound for the drug made available in the market. Even a bioequivalent drug can fail efficacy test because of factors like heat, humidity and stability issues. There should be a strict quality control with best manufacturing and packing practices followed for generic and branded medicines alike.

Quality assurance of every drug is a patient’s right and a doctor’s too. They both have a right to know about relationship of quality, efficacy and price. It is of paramount importance to the patient who is ultimately    the consumer.

 Doctors can be victim of this anomaly in a bigger way: They can be in big trouble if quality of the drug prescribed by them is lacking in its quality and efficacy. Major adverse effects and even deaths have been reported due to poor quality of drugs or contaminated drugs. For example deaths in a sterilization camp in Chhattisgarh (FIR 11.11.14) have been attributed to use of contaminated drugs. Think of the plight and suffering of the doctor who was then portrayed as a criminal. He was lucky that court ultimately found out about the poor quality drugs as the cause. But in a day to day routine practice, it is very difficult even to think of such possibilities and prove it and consequently doctor has to suffer the blame of being negligent. Most of the time, it is taken as incompetency and failure of the doctor while the actual problem lies with the drug. If a doctor makes a correct diagnosis and advises medicines correctly but the patient still does not get well, it is the doctor who is blamed for the lack of improvement. Sometimes, if patient does not get well or if a life is lost, doctor may be abused, assaulted or dragged to court. Consequently most doctors try to play safe and prescribe drugs of pharmaceutical companies of sound background. So doctor’s concern should be to ensure and demand strict quality control of medicines because it has a real bearing on the ultimate practice of the doctor. It is really unfortunate that for the lack of poor regulatory mechanisms and greed of pharmacy industry, doctors suffer.

 Doctors just need stringent quality control, law and mechanisms to guarantee effective medicine be it generic or branded. 

It is not a problem to a doctor whether patient gets a generic or branded medicine, as long as it is effective.  Nor does it concern them whether a drug company or chemist make 100% or 1000% of profit out of medicine. The latter should be regulated by government agencies.

It needs a sincere effort by the Government to maintain stringent quality of drugs so as to ensure that both generic as well as branded drugs have same quality and efficacy. The recent initiative by our prime minister can usher in a new era and can be path breaking if strict measure are in place for quality control and standard manufacturing practices are followed.

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NEET implementation vital and will decide quality of doctors in future


NEET, the common test for MBBS admission all over nation, is perceived as most basic step  towards uniformity of medical education. It is a welcome single most important step to transform the medical education. But its effective implementation is extremely vital for it to be successful and that is possible only if government takes strong measures to implement it in a true spirit. NEET can reform medical education, weed out corruption and in turn can radically transform healthcare. This new system should allow fair play, transparency and should set an example for promotion of merit in other arenas too. But it needs to be seen how NEET is finally implemented. It will be very unfortunate if it is diluted for any reason and merit becomes another casualty in accommodating other priorities, rather than having best doctors. It  is a now or never situation for the country to pick up best brains of country for  training as prospective doctors , decided purely on basis of merit.  By diluting the merit criterion, not only do less deserving people get ahead of deserving ones, but it breaks the faith and enthusiasm of the best and deserving people in the system, thereby generating a negativism in the whole system. Failure to implement NEET effectively and strictly should be interpreted as government’s inability to control vested interests in the system.

Enthusiasm and the zeal is what we need here in medical care. With the shortage of thousands of doctors, and our infant and maternal mortality rates matching sub-Saharan countries, it is not only the number of doctors which matters. The most important factor, I think, will be quality and enthusiasm of the people who are working for the system.

Besides Infant and maternal mortality rates, innumerable diseases like tuberculosis, heart and respiratory, cancer, neurological and mental ailments, accident and trauma etc need work on war footing.  But the medical system has to be built on the touchstone of merit and enthusiasm for a greater impact. Merely creating number of doctors is not the solution. The need of the hour is more but pure meaning on pure merit. If that does not happen sufferers will be poor genuine aspiring doctors and casualty will be medical profession and ultimately health system and its users.

Let merit not be made a casualty of the system. The ball is now in government’s court and they should ensure that NEET is implemented in its true spirit, to fulfil the dream for which it was envisioned and introduced which is to bring medical care in India to its most cherished peak.

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Nurses and Doctors, Altruistic professions not cherished in present era


Children from affluent, educated families are nowadays shunning from taking up professions like nurses and doctors. These professions, which at work naturally help others, are high in moral hierarchy. And the society and people are always benefitted by these altruistic professions but sadly these professions are no longer cherished and respected nor well paid. Although we are discussing here professions like that of a doctor and nurse which are involved with life and death, but other altruistic professions are also not much treasured. These include other noble professions like that of  soldier, teacher, scientist, fire-fighter etc. This emphasises a peculiar thought process of society wherein  only professions which earn handsome money are more respected. If we analyse and  compare different professions , we’ll realise that people in these noble professions are paid far less amount of money.   What does one pay to a doctor for saving one’s life  ( few hundred rupees/dollars)  or to a soldier, who is ready to  sacrifice his life for safety of fellow countrymen. Obviously the fact that these professionals are not much respected generally , neither well paid makes them less coveted by people as  career option. This highlights the misplaced priority and hypocrisy of society in present era.

Here we are discussing about the real hands that help. I am discussing about the doctor and nurses, who are awake at odd times, give a hand, really treats and saves life in real time(not as a investor in health). I am talking about a soldier in combat situation who really is fighting in a life and death situation.

A doctor  saves life and relieves pain while doing duty. Even a junior doctor while doing  duties deals with emergencies and saves uncountable people or relieves their pain. whatever  he is paid, it is no match to the amount and quality of work that he does. There are lot of problems and risk involved to doctors which I have already discussed before in “ doctor is a soldier” and “ doctor a wonderful global community”.

A nurse while doing duty, comforts the patient and  helps in all the work doctor does. It is really a skilled and hard  job. The sole purpose of their job is to benefit the patient and alleviate his suffering. There are only a few civilized societies in the world, where nurses get their due respect. But it is painful to see the how these comfort providers are taken as guaranteed and treated shabbily most of the time. Few lucky ones get decent placements but most are forced to do an underpaid thankless job.

These professions  make a living out of their noble work but money paid to them is not commensurate to the work, responsibility, accountability, risk involved to the provider and benefit they provide to other person and society. The money a doctor receives in lieu of saving a life is less than what people spend on a single good meal in restaurant. Reason for that is these altruistic professions are not monetized in a way other professions are. But strangely these professionals do not get rightful respect also and less treasured.

It will be interesting to note how many of our prominent leaders, actors and stars, elite and affluent society people, judges encourage their children to  become actual doctors and nurses . But they are ever proactive in sloganeering and blaming doctors for all malaise.

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Advantages Disadvantages of being doctor. pros cons of medical profession

Advantages Disadvantages of being doctor. pros cons of medical profession

Advantages of being a doctor, Good points of being a doctor:

In ideal situations, it is a great profession to be in.  Children strive hard to become doctors either because they idolize someone or were inspired by some doctor or were guided by their parents to become doctors.  Some favourable features of this profession, to my mind, include:

  1. Noble profession-One of the main reason of choosing this profession is the gratification achieved on treating a human being. Relieving a patient of his agony or bringing back a patient from brink of death gives immense satisfaction and this cannot be matched by any other profession.
  1. Decent earnings-In the process doctors usually make average to decent living. Most doctors actually earn a decent enough income. But it is quite variable depending upon city, country and specialization.  Those willing to work extra hours by sacrificing their family and personal life can earn more.
  1. Respectful profession– The moment a person comes to know that you are a doctor, a respect for the person is generated. Some patients, when cured, even start equating you with divinity.
  1. Working conditions– In most of the developed countries around the world, the working conditions are good. But these vary according to country, state, city and hospital (government or private) where one works.
  1. Continuous learning- A doctor is learning something new everyday. There is continuous mental stimulation which keeps the doctors mentally agile. 
  1. Independent profession- A doctor can be independent in his profession on his own. He doesn’t always have to work in a set-up and can have his own practice. There is no retirement age in such setup and he can continue working till he remains fit. Rather the more senior a doctor is, the more experienced he is in handling complex medical cases.
  1. Social profession- This profession entails active interaction with public and society. Hence the doctor learns many social aspects of life unlike other professions which involve deskwork only.
  1. Preventive and Social responsibility– The doctor can be instrumental in changing certain aspects and taboos which are ingrained in society. For example doctor can highlight the effects of smoking or talk against certain habits like open defecation to all sections of society. And he is someone who is heard and followed by his patients.
  1. Asset to family and friends-A doctor in a family is a real asset. He not only treats his patients but also gives preventive advice to his family and friends. There must be many of you who first turn to a doctor in relation first, for an informal advice, before consulting the specialist.
  1. Healer of mankind- All said and done, medicine remains the only profession that alleviates pain, heals and cures the mankind. The credit of increased longevity with much better quality of life goes solely to the advances in medical arena and research done by doctors and scientists. Without doctors, the human race would have long back become extinct due to epidemics and infections. 

These advantages and good points of being doctor are in IDEAL CONDITIONS, gradually dwindling  and disadvantages are increasing every day.

Disadvantages of being a doctor, Drawbacks of Medical profession: 

Choosing medical career  or being a medical professional  a disadvantage to doctor in comparison to other professions?

In the present circumstances, when doctors themselves are doubtful about the advice for choosing medical career, some are naïve enough to spend millions on securing an expensive medical college seat.  Problems faced by doctors are not only innumerable but are also so exceedingly complex that they are difficult to be analysed. Doctors feel so disgusted   about the entire system that they do not encourage their children to take up this profession which until now was one of the coveted ones, there must be something going terribly wrong with the profession.

  1. Medical courses are comparatively lengthy and expansive study course and difficult training with slave like duties. “enslavement of doctors”.
  2. Uncertain future for aspiring doctors at time of training: Nowadays, doing just MBBS is not enough and it is important to specialize. Because of lesser seats in post-graduation, poor regulation of medical education, uneven criteria, ultimately very few people get the branch and college of their choice.  They have to just flow with system ultimately.

3.Hostile environment for doctors to begin: Suddenly young and bright children complete  training and find themselves working in a hostile environment, at the receiving end of public wrath, law, media for reasons they can’t fathom. They face continuous negative publicity, poor infrastructure and preoccupied negative beliefs of society.

  1. Difficult start of career:After a difficult time at medical college, an unsettled family life and with no money, these brilliant doctors begin their struggle. Even before they start earning a penny, the society already has its preconceived notions because of negative media publicity and half treats them as cheats and dishonest. Their work is seen with suspicion and often criticised.
  2. The fear and anxiety about the actual treatment, favourable and unfavourable prognosis of patient, keeps mind of a doctor occupied.
  3. Blamed for all malaise: The society gets biased because of the   media reports and some celebrity talking glib against medical profession. The blame for inept medical system, administrative failure and complexity of medical industry is conveniently loaded on doctors. These lead to formation of generalised sentiment against all doctors and are then unfortunately blamed for all the malaise in the entire healthcare system.
  4. Personal and family life suffers: Large number of patients with lesser number of doctors is a cause of difficult working circumstances, and the frequent odd hour duties have a very negative impact on the family and personal life of the doctor.
  5. Risk doctoring himself: Repeated exposure to infected patients in addition to long work hours without proper meals make them prone to certain health hazards, like infections which commonly include   tuberculosis and other bacterial and viral illnesses. Radiologists get radiation exposure. Because of difficult working conditions, some doctors are prone to depression, anxiety and may start on substance abuse.
  6. Unrealistic expectations of society:  Every patient is not salvageable but commonly the relatives do not accept this reality. Pressure is mounted on doctor to do more while alleging that he is not working properly. Allegations of incompetency and negligence are quite common in such circumstances. These painful discussions can go to any extent and a single such relative every day is enough to spoil the mood for the day.
  7. Retrospective analysis of doctor’s every action continues all the life. It could be by  patients and relatives every day  in the form of  “ Why this was not done before?”Everyday irritating discussions, arguments, complaints, disagreements add to further pain and discontentment, in case the patient is not improving. Or it could be by courts and so many regulatory bodies. If unfortunately there is a lawsuit against a doctor, he will be wasting all his time with lawyers and courts, which will takes years to sort out.

The decision taken in emergency will be questioned  and  in retrospect they may not turn out to be the best one, but later retrospective analysis along with wisdom of hindsight with luxury of time, may be labelled as wrong if a fault-finding approach is used. This along with general sentiment and sympathy with sufferer makes medical profession a sitting duck for lawsuit and punishments. Even if the doctor is proved to be not guilty, his harassment and tarnishing of reputation would be full and almost permanent.

  1. Physical assault,routine instances of verbal abuse andthreat are common for no fault of theirs. Many become punching bags for the inept medical system and invisible medical industry. Recently, even female doctors have not been spared by mobs. Silence of prominent  people, celebrities and society icons on this issue is a pointer towards increasing uncivilized mind-set of society.
  2. Medical industry may be rich but not the doctors: The belief that doctor’s is a rich community is not correct. Although decent or average earnings may be there, but earnings of most doctors is still not commiserate with their hard work viz-a-viz other professions. Doctors who also work like investor, a manager or collaborate with industry may be richer. But definitely most of doctors who are just doing medical care are not really rich.
  3. Windfall profits for lawyers and law industry at the cost of doctors is a disadvantage for medical profession: I have seen zero fee and fixed commission ads on television by lawyers in health systems in certain developed countries. They lure patients to file law suits and promise them hefty reimbursements. There is no dearth of such   relatives, lawyers who are ready to try their luck, sometimes in vengeance and sometimes for lure of money received in compensations.  This encouragement and instigations of lawsuit against doctors is a  major disadvantage for medical profession.

14.Overall, a complex scenario for doctors: There is increasing discontentment amongst doctors because of this complex and punishing system. They are bound by so many factors that they finally end up at the receiving end all the time. They are under Hippocratic oath and therefore expected to work with very high morality, goodwill and kindness for the sufferings of mankind and dying patients.  They are also supposed to maintain meticulous documentation and also supposed to work under norms of  medical industry. They are supposed to see large number of patients with fewer staff and nursing support while still giving excellent care in these circumstances. And if these were not enough, the fear of courts and medico-legal cases, verbal threats, abuses, and physical assaults and show of distrust by patient and relatives further makes working difficult. Additionally there may be bullying by certain administrative systems at places, who use pressure tactics to get their own way.

 

25 FACTORS- WHY MEDICAL TREATMENT  ARE EXPENSIVE

REEL HEROES VS REAL HEROES

21 occupational risk of being a doctor or nurse

expensive medical college seat: is it worth

182

Violence at medical college Mujaffarpur Bihar(SKMCH): Revulsion, root cause analysis and early action need of the hour


This is yet another incidence of violence involving doctors and medical college. Such incidents have become increasingly too frequent even though everyone knows that it is our medical system which is not streamlined and is at fault. Such  repugnant incidents must  be universally condemned by one and all since they are against  the rules of  civilisation and are legally and morally incorrect. If the government, courts and human rights commission do not act swiftly against such incidents, soon the medical fraternity would be demoralised. This will further dampen the enthusiasm and morale of medical community and doctors. Doctors are blamed unnecessarily mainly due to involvement of touts and certain non medical people which are not under any regulation, and are invisible to the patient. Doctors have to fight a double battle instead of focussing solely on treatment of patient.

Most painful aspect of the problem is that society, media and courts no longer feel revulsion for such acts.  Such devastating events to medical profession are passed off casually. A new thought process of “such incidences do happen” is taking shape in mind of society. I want to emphasize again that the long term repercussions of neglecting these incidents will be heavy and if the root cause is not treated, it will surely kill the medical profession.

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Doctor’s assault at Saroj hospital Delhi: Kalyug for doctors ?


Possibly society does not need qualified doctors anymore.  The way physical assaults are increasing and no apparent government actions to stop these assaults, Doctors are sitting ducks for punishments, lawsuits and assaults.  With continuous instigation going on from prominent people and celebrities, doctors have become punching bags in place of inept medical system and invisible medical industry.  Government, human right commission  and courts have maintained silence on these issues.

Such incidents are likely to deter children from taking up this profession. How can we expect bright children to take up this profession if such episodes keep recurring?   Real KALYUG for medical fraternity.

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Choosing medical career or being a medical professional a disadvantage to doctor in comparison to other professions?


Problems faced by doctors are not only innumerable but are also so exceedingly complex and diverse that they are difficult to be analysed. It is common to listen doctors discussing these problems whenever one of these crop up. If so many doctors feel so disgusted about the entire system that they do not encourage their children to take up this profession which until now was one of the coveted ones, there must be something going terribly wrong with the profession. The challenges in this profession are too many and difficult to analyse.
  1.     Medical courses are Comparatively lengthy and expansive study course and difficult training with slave like duties: that I have discussed in one of my previous article on “enslavement of doctors”.
  2. Uncertain future for aspiring doctors at time of training: Nowadays, doing just MBBS is not enough and it is important to specialise. Because of lesser seats in post graduation, poor regulation of medical education, uneven criteria, ultimately very few people get the branch and college of their choice. They have to just flow with system ultimately.
 3. Hostile environment for doctors to begin: Suddenly young, meritorious and bright children who came out of training find themselves working in a hostile environment, at the receiving end of public wrath, law, media for reasons they can’t fathom. They face continuous negative publicity, poor infrastructure and prejudiced  beliefs of society.

4. Difficult start of career of doctors: After a difficult time at medical college, an unsettled family life and with no money, these brilliant doctors begin their struggle. Even before they start earning a penny, the society already has its preconceived notions because of negative media publicity and half treats them as cheats and dishonest. Their work is seen with suspicion and often criticised.
5.The fear and anxiety about the actual treatment, favourable and unfavourable prognosis of patient, keeps mind of a doctor occupied.
6. Doctors are blamed for all malaise: The society gets biased because of the media reports and some celebrity talking glib without proper understanding of inept medical system , administrative failure and complexity of medical industry.  These lead to formation of generalised sentiment against all doctors and are then unfortunately blamed for all the malaise in the entire healthcare system.
7.Doctor’s personal and family life suffers: Large number of patients with lesser number of doctors is a cause of difficult working circumstances, and the frequent odd hour duties have a very negative impact on the family and personal life of the doctor.
8.Risk to doctor himself:     Repeated exposure to infected patients in addition to long work hours without proper meals make them prone to certain health hazards, like infections which commonly include tuberculosis and other bacterial and viral illnesses. Radiologists and interventionalists get radiation exposure. Because of difficult working conditions, some doctors are prone to depression, anxiety and may start on substance abuse.
9.Unrealistic expectations of society: Every patient is not salvageable but commonly the relatives do not accept this reality. Pressure is mounted on doctor to do more while alleging that he is not working properly. Allegations of incompetency and negligence are quite common in such circumstances. These painful discussions can go to any extent and a single such relative  is enough to spoil the mood for the day.

10.Retrospective analysis of doctor’s every action continues all the life-It could be by patients and relatives every day in the form of “ Why this was not done before” ? Everyday irritating discussions, arguments, complaints, disagreements add to further pain and discontentment, in case the patient is not improving. Or it could be by courts and so many regulatory bodies. Unfortunately, if there is a lawsuit against a doctor, he will be wasting all his time with lawyers and courts, which will takes years to sort out.
In these court cases, the doctor is at disadvantage since his decision which is now being questioned was taken at that time in good faith using all his wisdom. The decision in retrospect may not turn out to be the best one, but later retrospective analysis along with wisdom of hindsight over many years, may label it as faulty if a fault-finding approach is used. This along with general sentiment and sympathy with sufferer makes medical profession a sitting duck for punishments and lawsuits. Even if the doctor is proved to be not guilty, his harassment and tarnishing of reputation will be full and almost permanent. No doctor has time to pursue such things all the time. Even if such events don’t happen to everyone, the very fear of such possible scenarios and their possible complications always lurks in the back of their mind.
11. Physical assault , routine instances of verbal abuse and threat  happen for no fault of theirs. Many become punching bags for the inept medical system and invisible medical industry. The threat of physical assault is quite real as well. Recently, even female doctors have not been spared by mobs. Silence of prominent social people, celebrities and society icons on this issue is a pointer towards increasingly uncivilized mindset of society.
12. Medical industry may be rich but not the doctors: The belief that doctor’s is a rich community, is not correct. Although decent or average earnings may be there, but earnings of most doctors is still not commiserate with their hard work viz-a-viz other professions. Doctors who also work like investor, a manager or collaborate with industry may be richer. But definitely most of doctors who are just doing medical care are not really rich.
13. Windfall profits for lawyers and law industry at the cost of doctors is a disadvantage for medical profession: I have seen zero fee and fixed commission ads on television by lawyers in health systems in certain developed countries. They lure patients to file law suits and promise them hefty reimbursements. There is no dearth of such relatives, lawyers who are ready to try their luck, sometimes in vengeance and sometimes for lure of money received in compensations. This encouragement and instigations of lawsuit against doctors is a major disadvantage for medical profession.

14.Overall, a complex scenario for doctors: There is increasing discontentment amongst doctors because of this complex and punishing system. They are bound by so many factors that they finally end up at the receiving end all the time. They are under Hippocratic oath and therefore expected to work with very high morality, goodwill and kindness for the sufferings of mankind and dying patients. They are also supposed to maintain meticulous documentation and also supposed to work under norms of medical industry. They are supposed to see disproportionately large number of patients with fewer staff and nursing support while still giving excellent care in these circumstances. And if these were not enough, the fear of courts and medico-legal cases, verbal threats, abuses, and physical assaults and show of distrust by patient and relatives further makes working difficult. Additionally there may be bullying by certain administrative systems at places, who use pressure tactics to get their own way.

With so many adversaries, the situation is like sailing a small boat in a tornado.
At present, with this mindset, the losers are the doctors and medical profession. But the society should be able to foresee its overall loss in the long run if these practices continue.

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