The doctor doth protest…..

Suddenly doctors are the new victims. They feel that they are justified in shutting down shop and getting onto the streets for what they perceive to be a good cause.

One wonders why the doctors didn’t protest when not one ‘expert’ among them was found to testify against their own kind, even in the face of obvious denial or care or negligence.

Didn’t see any docs out on the street when empanelled private hospitals were cherry picking patients for the Vajpayee Arogya Scheme, selecting lucrative ones who brought profits and refusing to touch (literally) patients who didn’t bring in profits

Where were the doctor saabs when pharma was buying them plane tickets, international cruises, international conference sponsorships, drink and dinner parties and other such cozy memorabilia?

Oh and when the fact that stents were being billed to patients at 500% to 1000% the original cost, didn’t see no doctors protesting the lack of ethics

The reason there was no real control or diktats on doctors for all these years was because there was implicit trust in the doctor’s desire to do good for the patient. The reason the control is brought in now is that there is complete erosion of that trust. So is the patient to blame for the loss of erosion? – actually not. It comes from the doctors and the medical establishment, abusing, without any form of control – either individual or as a group, of the deep trust that had been (mis)placed on them.

The amount of power that a doctor exerts over a patient is not small. This power begins right from when a patient comes with a symptom, to deciding what tests have to be done, what procedures, what drugs, for how long. It continues even when patients feel that there has been negligence and files a complaint against the doctor. The doctor has for his defence, a bunch of corporate doctors as experts who will look at the patient, or if the patient is dead, at the patient’s relatives, as though they are clearly stupid. The experts will shake their heads as though they are amused at how little the person complaining knows. They will all unanimously say that the accused doctor is right and the patient wrong. Why aren’t any so called ‘ethical’ doctors protesting this gross violation of patient rights?

If a patient has been given a wrong diagnosis, a bad drug, an irrational procedure should there be no oversight to check? Should a medical establishment not been assessed to see if guidelines are being followed?
When doctors and their friends give their medical degrees to fly by night medical colleges that get IMA clearance without having even the bare minimum facilities, do we see these same doctors protesting for violations – NO SIR, you won’t.

So clearly the protesting doctors in Karnataka are like spoilt petulant teenagers who have to give up something that they never worked for and never deserved.

Still its good that they are protesting and hope it goes on indefinitely or forever. Their patients might visit government hospitals and get more accurate treatments and may even fight for all private hospitals be nationalised. Long live patient rights, long live public health services.

http://www.oneindia.com/india/karnataka-government-moves-to-fix-rates-at-private-hospitals-doctors-go-on-strike-2465937.html

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3 thoughts on “The doctor doth protest…..

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  1. Totally agree that change is necessary. But what change? Government has totally failed and we all know just increasing government hospitals and staff will not do. Totally inefficient, corrupt and made to do more clerical work than see patients.
    In private sector there are choices unlike what most people think. If one hospital is not good, plenty of others are available in all possible price brackets. No choice in government sector.
    Expecting private sector to be uniform with uniform equipment, uniform standards, etc is irrational.
    Private sector in any can thrive only in a free and competitive environment. If we don’t want private sector in health, it should be gradually replaced.
    Throttling it will only remove the present available good care with no replacement in sight.
    Is it possible to get a doctor for non-emergency care, on ANY evening, Sunday, etc in government sector? This is not available even in western countries!!! So before replacing, plan properly by studying what is available in the rest of the world and choose the best for our country.

    Do you have faith in government sector? What people fail to understand is that in India, unfortunately, people equate getting government job to taking salary without much work.
    It is easy to criticize, what is actually needed is constructive criticism where a well thought out alternate is simultaneously put in place BEFORE dismantling the existing system even if the present system is far from perfect. Reason- private sector works, government doesn’t. It is the ills that need to be tackled. Stupid moves like trying to fit one size shoe for everyone is destined to fail. Haphazard action doesn’t work, proper assessment of problems followed by planned action is the only hope.
    Criticism is good provided it is constructive and leads to solutions.

    I don’t follow your blogs so please excuse me if I don’t reply to any other posts.

    Anyone interested to discuss please mail me at srinivasaction@gmail.com

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    1. You are absolutely correct in your assessment. The government has not provided even essential services and it is corrupt. THe private sector offers choice and sometimes is the only service provider. Yes it should be replaced gradually. However an unregulated private sector is very dangerous. Large corporates are literally dictating policy right now in Karnataka. Bill and Melinda gates, Devi Shetty, Apollo hospitals are not looking at the needs of small clinics and charitable hospitals. They are looking at making healthcare into an industry. Under VAS, 40% of the money is goiing to just 4 hospitals in Bangalore. They are pushing for a completely tertiary model of healthcare where people have to come to these large corporates even for small illnesses. They are not seeing health or people, but only profits. The policies are dangerous both for smaller clinics and charitable hospitals as well s for government hospitals. Ultimately the patient is the one who bears the burden. So the ideal situation is for a well functioning government structure and a well regulated private sector. Smaller clinics should not lose out in the process. These regulations that place a cap are a small start but they will ensure that smaller clinics can be part of service delivery. Large hospitals also put a lot of pressure on doctors to do unnecessary surgeries and investigations. doctors should also have a forum to raise their concerns. While we try to regulate private sector, at no point is anyone saying that government services are good. However the same methods cannot be used for both these because their basic principle of functioning is different.

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      1. Placing a cap hits smaller places as well. That is the problem. Lots of variation in facilities provided by smaller places also.
        Some, especially those run by non-professionals have hardly any facilities, cheap equipment,etc.
        We should not forget that it is not just big corporate entities, there are plenty of small places run by non-professional business people and technicians who are prime cause of kickbacks along with corporates.
        This puts proffesionally run places with good equipment and facilities at a disadvantage if there is a price cap. It will become financially nonviable and lead to decrease in quality. For example, a scan machine purchased for 4-5 lakhs cannot be equated to one purchased for 50-55 lakhs. There are a whole lot of machines available from 2-3 lakhs to >1 crore. Most are in 4-50 lakh range. How to cap price and still incentivise people to invest in better equipment.
        The quality of work varies depending on both equipment and the person.
        For example, a freshly graduated doctor s charges will naturally be less. Another person with say 20 years experience cannot be expected to charge the same. Suppose price of scans is capped, obviously senior people will be more affected.
        Scans are just an easy to understand example. Same thing applies across the profession.
        Anybody and everybody if they have money, can start a medical centre, including diagnostic centres, nursing homes, hospital, etc. Obviously a non-professional business investor will not look at it as anything other than a business unlike a professional.
        Anyone who looks around will realise that poor get discounts in smaller hospitals run by professionals , never ever at corporate hospitals.
        There are some advantages of corporate hospitals in that most doctors are not good at business end of hospitals and are unable to expand to large hospitals with tertiary facilities. Corporates are good at raising the money and providing high end facilities.
        As far as government goes, less said the better. Corruption, nepotism, poor quality equipment with poor quality work.
        So what are the options? How to improve? Which way would be better for improvement?

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