Sunday, January 29, 2023
HomeOpinionIndia’s overworked doctors are trashed by all —patients, corporates & even PM...

India’s overworked doctors are trashed by all —patients, corporates & even PM Modi

The human resource shortage and lack of regulation in India's hospitals is mind-boggling, leaving doctors to face the ire.

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As over 700 doctors resign and more go on strike in Mamata Banerjee’s West Bengal and other cities join in solidarity to protest patient attacks, I recall a conversation with a friend of mine who runs a small 100-bed hospital in one of India’s largest cities. Every now and then, his float glass façade is shattered. Without a frown, he replaces the same, with new float glass. Having seen this happen a few times, I asked him the silly question – why don’t you replace the glass with an iron grill? Wryly smiling he explained his crafty solution to a unique problem. Each time a patient died, the irate attendants would gather, encouraged by a local politician, and throw stones at his facade. The cathartic sound of shattering glass would douse all anger and with a sense of achievement, the bereaved patients leave and the hapless doctors heave a sigh of relief.

The vilification of doctors starts right at the top. Prime Minister Narendra Modi, in London last year, upset the entire doctor community by declaring that there is an unholy nexus between doctors and pharmaceutical majors. He went on to also state that doctors hoodwink anxious patients by selling them expensive stents. These comments by someone as senior as Modi further vitiated an atmosphere where doctors and not the corporate owners of tertiary care hospitals found themselves facing the music as irate patients across the country vented their fury on whoever they could see in front of them.

Also read:There is a law to protect doctors from assault but this is why it doesn’t work

The problem with both the health and the education sector in India is a deep asymmetry of information. While customers buying consumer goods know enough about products or have several alternatives to choose from, students and patients are clueless and must depend on the ethics and values of their providers of service. This asymmetry and stray examples of abuse of this power have led to a wide sweeping generalisation on the moral turpitude within the health sector.

The prime minister’s statement was adding fuel to the fire that had been burning since a highly publicised case of one major hospital charging Rs 16 lakh for a dengue patient who had died amidst claims of gross overbilling.

The strike by doctors in Kolkata that has now spread to many states brings up some very serious issues regarding the health sector in the country. The issue once again highlights the abysmal lack of clinical standards and a huge deficit in terms of human resources in state-run hospitals. The Clinical Establishments Act 2010 that was passed more than a decade ago has not been implemented in any state. Hospital associations have successfully ensured that the law is not implemented as according to them it is far too draconian, both by way of the penalties imposed and the price caps that it imposes. As a result, there is a widespread feeling that hospitals, particularly those run by corporate interests overcharge customers, even as they run on subsidised land made available by city planners and municipalities.

Doctors, on their part, complain that they are often underpaid even as they work round the clock given huge shortages of manpower, face angry customers and are abandoned by their owners and their management when things go sour. Unlike in other countries, our doctors are not covered by comprehensive insurance policies that protect them against legal action and against malpractice suits. Hospital managements complain that this kind of wanton vilification forces them to spend heavily on security, often hiring armed guards who must tackle mobs on a rampage. The police, which now runs an Omnipolis helpline in cities like Hyderabad, charges hospitals heavily for providing assistance during such emergencies.

Also read: Doctors blame staff shortage & poor infrastructure, not angry relatives for attacks on them

Nineteen states, including West Bengal, have passed the Protection Of Medicare Service Persons And Medicare Service Institutions (Prevention Of Violence And Damage To Property) Act that protects doctors. But enforcement is poor because the Act is not tagged to the Indian Penal Code (IPC) and the Code of Criminal Procedure (CrPC).

The situation is dire indeed. A much-quoted Lancet study shows that our doctor shortages are mind-boggling. There is much regional variation — there is one government hospital bed for every 614 people in Goa while there is only one for every 8,789 people in Bihar. Six out of 10 hospitals in our poor states do not provide intensive care and a fourth of them have abysmal sanitation and drainage facilities. The government’s flagship program Ayushman Bharat suffers from this gross undersupply of doctors even as it increases demand substantially. Till these concerns are addressed we will continue to have the kind of unfortunate flare-ups we are seeing in Kolkata.

The author is a professor of Health Economics at the MCRHRDI, formerly with the Gates Foundation.

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  1. Let’s keep it a security issue for medical professionals. Work ethics and general integrity issues are common to all professions and work places. We all belong to the same country.

  2. How to divert attention from mamta’s antics and the fact that peacefuls and minority appeasement led to this tomfoolery. The print and it’s mullah try to help the blame on Modi. The unfair and illegal aggression of patients towards doctors doesn’t absolve the latter. Instead of taking about the blatant minority appeasement by Mamta, the print is raking up the unrelated issue of stent regulation. Or maybe the print finds 500 to 600% mark up in the prices of stents and implants justified.

  3. When did Modi talk bad about doctors? And why such headlines, with one sided biased report. Cheap journalism. Finally, I went and checked the author and there I realize the pain and burning happening somewhere, just because he is M.

  4. I’m alone medical member in Delhi in d line of judiciary after leaving my medical profession of Allopathy over 20years and over ten years as a medical Advocate in Criminal n Consumer Courts before joining as member judge.
    I had lots of tension in my life when I was serving in my noble profession, but after leaving my medical (MBBS) field, never felt humiliation or any type of insulting behavior by any one.
    I will advise my medical fellow to come in legal fraternity n then see d difference. In coming days, medical profession will b more degraded right from politicians. Now it’s good that our Central health minister is a doctor n ENT specialist, but how far he will continue n help allopathy, is a point of issue.
    At d end, I will advise medical fraternity to be unite n have strong medical defence for surviving for livelihood. Gd luck.
    Dr. P N Tiwari MBBS, LLM, Member Judge, Del. M. 9990353185.

  5. Have Modi’s name in the headline for no reason– guaranteed to get you thousands of views.

    Cheap, sensational, gutter level journalism. It stinks. Totally disgusted.

  6. This writer’s ignorance is baffling.

    Walk into any of the thousands of doctors clinics and “nursing homes” and get a dose in person of totally unnecessary tests and the lengths to which most doctors go to promote the products of those from whom they get commission — not what they feel is the best option available.

  7. Doctors are in short supply and overworked in many countries. They are also working in active battle zones. But no one harms them. Through out history, every culture has respected and revered healers and doctors. Even animals are grateful for life saving aid; and yet Indians, who are universally considered amongst the most docile and mild mannered people, have taken to attacking doctors.
    Surely, some examination of the way doctors conduct themselves in the discharge of their professional duties towards their patients, specially in govt hospitals and clinics, is warranted to get to the heart of the matter.
    For me, the death or suffering of a human being due to a doctor’s refusal to attend to him because he’s on strike, is abhorrent to all human values; let alone the hippocratic oath.
    In a society where doctors and teachers start praying to the goddess Lakshmi (instead of Saraswati), humility and compassion are bound to be replaced by arrogance and entitlement; and human values will be the first to be sacrificed.
    Like mr. Ramaswamy, I can narrate many instances from personal experience of similar nature but I don’t think it’s necessary.

  8. Yes this is true…. but the doctors also need to be apolitical and have basic discipline and ethics in place.

    • Your post is very hypocritical.
      I assume you are Mamtaz supporter.
      Patient’s families have NO RIGHT to physically assault the doctors.
      For that matter no one has the rights to physically assault people in civilized society.

      You are deliberately trying to divert the topic.

    • May I know what your knowledge is on the discipline and ethics of the medical profession and its practical applicability in real life situations in India as compared to other countries? Why do you think these incidents do not take place in other countries [even dictatorships & monarchies]? If Indian doctors do lack discipline & ethics, how is it that Indian doctors are the most sought after in the world [both First world & Third World]?
      Your comment is simply reflective of the same mindset as those who assault doctors. You consider anyone who is showing humility as ripe for extortion, threats and lynching.
      As soon as doctors do realise that it is their humility that is inviting the violence, and you have successfully pushed them into the corner, then the story will change drastically.
      There is wise quote from “ART OF WAR” by SUN TZU -“Never push a cornered enemy after he is encircled and he knows he is defeated. Leave him a chance to escape. If you still harass him after he is defeated, he will fight with renewed vigour since he has no choice but death anyway. If you create such a situation for the enemy in war, it is very much possible that the apparent winner will lose the battle against the defeated enemy.”
      I have paraphrased this wise quote to make it more intelligible to the common man. Hope you get the advice.
      If there is an actual corruption or deficieny of service, then patient always has the choice of changing his doctor [which is actually not available in public health services anywhere in the world, for your kind information.] or he has the choice of complaining in several fora such as Medical Council, Human Rights Commission, Consumer Forum, Civil litigation & Criminal litigation, not forgetting the latest weapon in the arsenal of patients – defaming the doctor on social & electronic media.
      Just ask yourselves as to how many other professional streams are accountable on this many fora – especially for a highly niche subject such as medicine.
      Are you even aware that even courts of law & the judges, do not take expert opinion or advice to know about the merits of the case, before passing judgement in these cases?
      You are free to read the Medical Ethics Code for various nations for the allopathic professions. Ours is available on the MCI website. Complementary medicine rules or AYUSH professions are available of the Central Council of Indian Medicine website.
      Of course, when the tallest and most powerful leader ever elected in this country without any proof of his education, himself shoots off his mouth against modern medicine doctors in general but does not have the guts to say it within the country or prove it, it is not a surprise that the layman of the country has a big enough mouth to shoot at everyone.
      Even Hippocrates would have modified his oath if he were alive today to see these incidents which happen only in India. For God’s sake, even terrorists and naxals all over the world spare doctors, nurses, patients and hospitals. So, what do you call people coming in lorry loads and attacking all medical personnel in 5 different medical colleges over period of 4 days?

  9. You have dragged in the name of the Hon.Prime Minister unnecessarily and presented an extremely one sided story.
    At the outset, let me make it clear that any sort of violence in a civilized society is not acceptable.FIRmust be lodged and strict action taken against them as per law.
    However, I am personally aware of medical malpractices in renowned hospitals of delhi and other big cities. A friend of mine in his sixties was asked to undergo coronary bypass operation in a reputed Delhi hospital, __r _an_a __m, and hounded to get admitted. He went to National Heart Instt and Dr RML where he was told there is no need of coronary byepass.
    In the city I live in majority of hospitals employ Ayurvedic doctors to do the rounds and administer injections , check up patients etc. One of them who did not understand the difference between iv drip and iv injection, administered iv injection to a patient when he was to be given drip over 12 hours. It was the patient’s presence of mind which saved the patient. ICUs are routinely left in the hands of paramedical staff. The list is endless. Patho tests are manipulated to suit doctors. Doctors get a 30% commission on the tests recommended. Even expired stents are inserted in patients. I am stating this based on persinal knowledge.

    So do not criticise the Hon PM without going into the matter in detail.

    S Ramaswamy

    • Do you even know the honorable PM’s educational qualifications? Has he ever produced a verifiable certificate? If he is aware of the malpractises of the medical profession, I am not against it. Let the PM lodge a complaint against the specific doctor that he knows did such malpractise. You can also do the same.
      Secondly, the interview in London mentioned in the article was sponsored by Pharmaceutical company, SUN PHARMA, belonging to Dilip Sanghvi. Does the PM of the country need sponsorship for his foreign trips? If he can take sponsorship for pharma companies, why cannot doctors?
      Third, in the same interview, the PM mentions how doctors go on foreign trips sponsored by pharma companies. Yes, we do. I personally have not gone till now. Most doctors do the trip to attend conferences and present research combined with some tourism. They cannot afford it out of their pockets and hence, are sponsored by companies. If doctors cannot afford, then how did Modi in 1978 do a tour of USA? Someone did sponsor it right? What about the electoral bonds whose sources are hidden from public? What about the election expenditure? What about his Rs. 2 lakh suit? Was it bought with his own money or with taxpayers’ money or did some company like Adani buy it for him? You are aware that there are rules for that in government, are you?

    • As follow up to my earlier comments, and to some of the comments you made, do you know that RSS run hospitals many times do not have any modern medicine consultants and is run almost completely by AYUSH doctors, unless some allopathic consultant actually volunteers. You are free to check out their hospital in my town namely JAYABHARAT HOSPITAL. The prices are reasonable, it is not completely free, they run the state insurance scheme [surprising since they have hired 0 doctors] but do not have single qualified, modern medicine doctor on duty at the hospital. All outside consultants admit their own patients here for the nursing care.
      You made a comment that one of the points of corruption is the hiring of AYUSH doctors by corporate hospitals. Then why is the honourable PM and his coterie & cabinet bringing a law for bridge courses? If AYUSH branches are effective, why don’t they run 24 hrs hospitals staffed by AYUSH doctors only under the same rules and regulations as Allopathic doctors? Why aren’t Ayurvedic medicines regulated in a similar manner? Why don’t AYUSH researchers need to take consent from patients before involving them in research and ethics committed permissions before starting a research project?
      Finally, whatever is said and done, there is far more corruption in every field in India, even bureaucracy, army and government. Have you counted how many of them have been thrashed like doctors are thrashed? Why is moral standard applicable to only doctors but not to Modi.
      Respect has to be earned and a big mouth not backed by proof only results in the person opening his mouth losing all respect and honor.
      You do not even seem to be aware of what the term “honor” means. Mob lynching is not honorable. Keeping silent as a leader when your own followers do not have the guts to fight one on one but will gather a mob to beat up one man is not honorable. What nonsense are you talking using words like “honourable”? That is the title he receives by virtue of being elected PM. It is addressed to the whole population of India whom he represents as PM. If he can do something to correct it, then he has been given the authority to do it but definitely not to worsen it with his arrogance.

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