#RTH-AGITATION- Rajasthan – Sadly doctors are fighting for their genuine rights and dignity against all. No one is with them – media, judiciary, Government and not even patients whom they have saved.
Aspiring doctors should know the reality and introspect- why they wish to be a doctors in such circumstances?
Smaller hospital and individual doctors’ clinics are backbone of the health care system in India. Their contribution towards public health can’t be ignored. Be it Covid care or treatment of daily ailments, they are actually helpful to the public and indispensable in real sense. Their contribution to society is huge especially in view of broken public health care system.
They provide health care near to public near their residential area at affordable cost. From an another angle, they generate employment to the workers as well as small businesses associated with their small hospitals.
In a populous country like India, strengthening these smaller hospital is a desirable step. To strengthen the health care, Government can actually do well to support these hospitals and achieve health care to all. Supporting them will require a fraction of resources, as compared to the money needed in case Govt has to provide to public itself.
It will be a short-sightedness of the Government policies, if instead of supporting them, Govt wishes to exploit their resources to give free health care to public.
But administrators and bureaucratic system has failed on both fronts. Neither they were able to develop a dependable health care system for public, nor they tried to support smaller health systems. What they tried to do was akin to the ancient story of ‘ the farmer and the Golden goose’. The Greedy farmer wanted all the golden eggs instantly without feeding the bird and therefore killed the duck. Government with its short-sighted bureaucracy is killing its golden health care and not realizing the real potential and benefits.
In the present day, ebbed from all sides, doctors need to earn back the dignity of profession and resist oppression. The phenomenon of oppression of doctors in the name of regulation is a global issue. The populist oppressive schemes in the misleading names like #RTH-Rajasthan (RIGHT TO HEALTH) are prevalent everywhere globally in some form or another. Doctors and nurses have been reduced to no more than moral and economical slaves either by industry or administrators, not infrequently pulled by legal bridle in their noses.
Acquiring kind of skill , the years of passionate, merciless, excruciating medical learning is placed at the disposal of administrators, who themselves have failed to develop a good health care system in real sense.
#NO-TO-RTH-AGITATION is a movement , the result of failure of Government to create public health system, but it has potential to fail the existing private doctors’ system as well. Smaller hospitals are already on verge of closure, will be forced to shut down. It carries the risk of extinction of neighbourhood friendly doctor and hospitals.
The basic problem is the intentions for the task of developing a good health care system. The agenda of administration is to control the health care workers rather than developing a good health care system for citizens.
What NO-TO-RTH-AGITATION is actually doing? It is a cry for survival of the smaller hospitals- not only for themselves but for Indian Health care system, if short-sighted bureaucracy can understand the real problem.
It is not easy to practice as doctor these days. Media full of doctors bashing, credibility crisis and regulators perpetually hounding doctors, who are forced to work under imposed medicolegal sword. There is no day that passes when system does not perpetuate negativity against medical profession. Doctors, ebbed from all sides, have lost the dignity and independence. Doctors and nurses have been reduced to no more than moral and economical slaves either by industry or administrators, not infrequently pulled by legal bridle in their noses.
The complex medical skill, the years of passionate, merciless excruciating medical learning is placed at the disposal of administrators, who themselves have already failed to develop a good health care system in real sense. Doctors have become soft targets for populist attention mongering and transforming social nuisance into messiah of the deprived by administrators -by sprouting the fraudulent generalities.
All the calculations that usually precede the enslavement of medicine, everything gets discussed by administrators and industry – except the well-being of the doctors and nurses.
Doctors have often wondered at the smugness with which administrators assert their right to enslave them, to control their work, to force their will, to violate their conscience, to stifle their mind. Irony is that while administrators do this, still they depend on the same doctors for saving lives -whose life they have throttled, who resent the treatment meted out to the health care workers.
In todays’ era there has been bullying of doctors by administrative systems, new unreasonable laws, which use pressure tactics on medical professionals to get their own way – no less than enslavement.
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.
Medical courses are comparatively lengthy and expensive study course and difficult training with slave like duties. “enslavement of doctors”.
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.
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.
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 treats them as cheats and dishonest. Their work is seen with suspicion and often criticised.
The fear and anxiety about the actual treatment, favourable and unfavourable prognosis of patient, keeps mind of a doctor occupied.
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.
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.
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.21 occupational risks to doctors and nurses
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.
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.
11. Physical assault, routine instances of verbal abuse and threat 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.
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: zero fee and fixed commission ads on television by lawyers in health systems are a common advertisement to harass doctors. 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 instigation of lawsuit against doctors is a major disadvantage for medical profession.
14. Overall, a complex scenario for doctors: There is increasing discontentment among 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.
In this era, a thought is gradually getting prevalent-‘Is choosing medical career or becoming a doctor is a mistake?
Evolution of Medical profession-Extinction of good doctors 