Category: pros cons of medical profession

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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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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Enslavement of Doctors, Nurses and medical profession: specially junior doctors equivalent to modern day slaves?


When I was doing house job, once I had to do continuous 72 hours duty because there was no other house surgeon. I had to leave the ward without rounds which hadn’t started on time that day. And I was marked absent and had to apologise for leaving without rounds!!! Amongst many queries in my mind came the question “ Am I an animal?” but I guess even animals have better rights. Courts and animal right lovers show their concern for them all the time. Then “Who am I?” I was forced to think………some species who is being treated worse than animals. My seniors told me “You are a “doctor” and have to work like this only”.
Can this happen the same way with someone in any other profession? That too a profession wherein a young brilliant child, after 10-15 years of most tough studies ,exams, difficult training throughout the golden years of his youth, starts earning pittance. And in a job that also requires doing duties day and night, sometimes for 24 to 48 hours at a stretch without proper meals and sleep. Most of the hospitals don’t even ensure tea and food on these duties for doctors .But these young hardworking people do it gladly and enthusiastically, doing a most noble work saving innumerable lives or relieving countless people of their pain. No rights have ever been defined for these young brilliant children.
This great work is not even acknowledged in any way. These duties are merely systematic exploitation of doctors because of:
– sometimes in the name of Hippocratic oath,
– sometimes in the name of morality
– because of the kindness in their hearts
– in the name of suffering and dying patients
– in name of shortage of doctors and staff.
– for fear of courts and medico-legal cases
– for fear of assaults since the number of doctors is less per patient.
– by some administrative systems who use pressure tactics and sometimes
bullying to get work done
– by similar widely prevalent culture in most hospitals
– for sake of their career and higher degrees
for sake of employment
– in the name of training , and in many more ways.
And these innocent, brilliant and enthusiastic young doctor with stars in their eyes, go on doing it for years along with never ending studies. There is no count of hours, no money or compensation in most of healthcare systems of world for these inhuman duties, exploited young energy and lives. And then comes the most painful part when they do not get the due respect in the society. Their selfless hard work goes unnoticed and unappreciated most of the time. Most people take this slave like working as guaranteed and do not feel it as any injustice to these young doctors. These brilliant children while on duty, may be verbally abused, routinely threatened, assaulted or dragged to courts for trivial issues and that too for no faults of theirs. They just become punching bags for the inept healthcare system and invisible medical industry though lives saved by these young men are uncountable and people relieved of pain and agony innumerable.
Though some western countries of European union and NHS medical systems have realized the inhuman duties and are now following a fixed hours duty schedule, but still most of countries and health systems have kept their eyes closed regarding these slave like duty hours and poor work conditions.
I have enumerated just a few of the problems and the actual burden on the doctor is substantially more and that is further compounded by the behaviour of the society. All these factors put together threaten the very core of the healthcare system, the doctors, who are then not able to work to their full efficiency.
I wonder if this is perceived as normal and routine then what else does slavery constitute ?

nurses and doctors, altruistic professions not treasured in present era

fading charm of medical profession

choosing medical profession a disadvantage  to doctors and nurses

 

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Doctor is a soldier : fights the enemy within human body.


I have used this analogy since the situation is similar in certain aspects (life and death situation involving human beings, a war footing effort). When there is a disease, doctor will have to find out the attacking ailment and then find a way to combat that. In emergency situations, it is usually a life and death situation. This battle may involve different kinds of armours ( medicines) and techniques( surgeries and interventions). However unlike a soldier, a doctor while treating an emergency case has many distractions like fear of abuse, assault, legal lawsuit, compelling detailed documentation to save himself, veiled and open threats of implied force (physical, verbal or legal) every day, while the battle(treatment) is going on. With all these distractions, he still has to fight and win in situations where life and death are just moments apart
Though most of doctors learn to fight, with all these distractions, with their increasing experience and wisdom but these do dampen their fighting spirit and enthusiasm. It is ironic that both the patient and attendants, though desirous of positive outcome for the patient and winning the battle against disease, act counterproductively. Although the doctor tries to do his best almost every time, in certain cases, the patient is not able to win the battle. This could be because of any reason like a genuinely difficult situation or an action or decision taken , which later turned out to be not so good in that particular patient. Such cases are usually followed by some sort of assault (physical, verbal or legal)by patient’s attendants. This is akin to weakening your own army. In a battle, when the fighting becomes more risky and fierce ,the soldier is compelled to choose between his ownself versus those for whom he is fighting and this leads to a defensive approach to his fight. Similarly the doctor if exposed to repetitive threats to his own self, will have to become defensive and that surely will affect his treatment.

Just a thought: Imagine a soldier during a war preparing a detailed documentation of his decision making and the reasons for the same so that in case of failure, his actions could be analysed by courts and lawyers over years to find out the errors with aim to punish.

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Doctor’s wonderful global community- A reasonable and civilized society would always be indebted to doctors


When death stalks someone, be it in a day or at midnight ,or if anyone is in life threatening emergency of any type, when one starts having chest pain with sinking sensation or severe breathlessness that gives a sensation of suffocation, or a sudden unconsciousness that gives a feeling of impending death, just imagine whom one thinks of or rushes to. The only person working at most odd times at that dreadful moment, a Samaritan, whose mere presence and touch of hand gives one a sense of comfort and reassurance, is a doctor. The person who helps you always incessantly, in any corner of world at that time is the doctor. At these times he is the man who is looked upon to do a miracle. And most of the times miracle does happen. He is not concerned with one’s caste, race, religion, colour or political affiliations. You may not know him, neither would he have known you before this time. Still he will not hesitate to help one at odd hours late into night to treat the emergency. Thousands of patients in this whole world are relieved of their pain, agony and disease every minute by this hard working and wonderful community of doctors. Lives of a good number of patients out of these are routinely saved. This process happens every minute, day in and day out, all over the world. Even if one pays something in private setups for such services, sense of indebtedness still should prevail for saving a life and for timely help in a reasonable thinking and civilized society, as the money paid to the Samaritan for this great act is usually even less than what someone pays for a decent dinner in restaurant. But it is not about the money, it is about how the society perceives this act. It depends on one’s outlook whether he sees it as a noble Samaritan act or as that of a worker in a hospital which is taken for granted.

And if someone is not satisfied unto one’s uphill and unrealistic expectations, can one just go ahead and assault the saviour or drag him to court or vent his one sided version to media which is ever ready for one sided stories? The interpretation depends upon the reasonable thinking of our so called civilised society, which includes celebrities (revered for any possible reason), leaders and prominent figures. Recently, female doctors have been assaulted by mobs and these celebrities, who have sometimes fanned unholy sentiments against doctors, have not uttered a word. This reflects actual hypocrisy of these celebrities and society as a whole who project doctors in bad light unnecessarily. And although this affects the medical profession in a very negative manner , it is ultimately detrimental to patients only (I will explain that in my later article).

But definitely all these actions with which society and celebrities treat their saviours reflects upon the perceptions of the society and whether it is civilized enough to recognize and respect the good work done by a saviour community.

doctor is a soldier, fights enemy with in human body

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Doctor (including women doctors)assault: Silence of courts, human right commission, commission for woman rights is appalling:


  Human rights of doctor community have been grossly violated by physical assaults. It is painful to see that the authorities that are supposed to take action have maintained a silence all these years about this issue.

Even courts who have vehemently raised concerns about cruelty against dogs have shown no concern about issue of cruelty against docs (doctors).

Despite reports of assault against female doctors,  commission for rights of women have maintained an inexplicable silence till now.

What is role of human rights commission, if rights of a hard working community like doctors are violated and what is it supposed to do? I really fail to understand what else will it take to shake them out of their stupor ?

 If the courts, the commission for women’s rights, and the human rights commission are maintaining silence, is it because the rights of doctors were never clearly defined and outlined.  The duties of a doctor have always been enumerated but the rights have never been discussed. Isn’t it time that we discuss this important question  “What are the rights of a doctor?”

Beti bachao beti padhao vs female doctor assault

woman doctor assault: era worse than MAHABHARATA for female doctors

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