No Charity

SHOULD DOCTORS SAY NO TO CHARITY …

The title may not sound good enough but doctors have been pushed to wall in this testing times. All through Covid pandemic as people from all walks of life continue to come forward with a scalpel to cut across this community of doctors with their criticism and to demean touching & healing role of doctors in society. Many examples are on record when Medic & Paramedics have been handled brutally or slapped a legal consumer court case for an undesirable outcome for a patient. This Covid-19 period has exposed our health delivery & care system as bare  as possible while both government as well as private sector hospitals have failed miserably. Government hospitals continued to be an ill equipped and ill skilled with manpower since ages with most economical packages as norms of no facilities no payment continued sarcastically. On the other hand private hospitals took this as an opportunity in adversity as with their hundred percent bed Occupancy and a long waiting list for admission seekers, pricing escalated manifold as private hospitals collected and now sitting on a pile of Huge cash. This has presented with a sort of exploitation of citizens in this never seen before pandemic adversity. This may be a perception and may be true but if we try ever to understand, Medical Engineering has costed hell lot of medical professionals. Simple X Ray with an age-old machine cost around rupees 300 for chest while the same X Ray costs now a days around rupees 600 to the patient while x-ray is done on Digital X Ray machine. CT Scan is a Marvel of Engineering but only around 30 years ago. Now MRI Scan, PET scan have been on the top of state of Art of Engineering to pick up smallest possible space occupying lesion (SOL) or FDG hotspot to reach to a Diagnostic conclusion at an early stage event for cancer or anything like that. HIGH end Engineering has escalated both diagnosis of regular course and rare course diseases both alike. Same way high end Engineering have asked human resources to get trained amicably for different interventional procedures or laparoscopic surgical procedures or to recently evolved robotic surgical procedures. All these technically advanced skills have reduced the time consumed in hospital stay and have helped in quick diagnosis altogether. Exponential Medical Technology growth and advancement of Medical Science to reach never before molecular level, have costed dearly to one and all.  And here is the difference between government hospitals and private hospitals as variety of financial factors play limiting or liberal roles in their setups. Budgetary constraints in government sector have been a common factor possibly because of political or bureaucratic indecisions and likelihood of corruption. Medical community has been considered as a soft target for their deeds by means of Criticism or Consumer Protection Act or legal actions or even Media Trial to get invariably be held responsible scapegoat by neck.

Why and how?

IT may be answered but political commitment and bureaucratic, red tapism will be caught at wrong foot who are at the top of power hierarchy. Whichever political party rules the State, Health sector and medical education always remained on neglected platform with the wheels on loopline, both for budgets and human resources management.

 The easy way out to handle such problems in health sector requires  to –

Ask medical schools to inculcate training programs in rural areas with attached Primary Health centres, Community Health centres and hospitals to them.

Ask government Finance Department to allocate budget to medical schools and district hospitals under different heads of regular expenses heads and upgradation heads.

Ask government procurement Agencies to seek proper demands from district hospitals, Community Health centres and Primary Health centres & for those demands a Central level purchasing committee has to be established which executes with proper negotiation regarding specification, installation annual maintenance contract and services through portals like government electronic market.

Ask medical colleges and NGOs like Indian Medical Association to impart 1-2 your educational and training programs specifically in some Lifestyle diseases and surgical interventional procedures compulsorily for doctors on credit points basis so that skill development in general and in specific speciality fields can be achieved.

 Ask state government to recruit doctors, paramedics on contractual basis for Short Service Commission sort of method.

Ask top bureaucrats to post doctors and nurses with such preferences to their home town where district hospital or community health centres have at least one operation theatre for emergency surgery along with a X-ray and Pathology Laboratory be run on a minimum working basis. Operation theatre without an aneasthesia doctor is just a room. At the same time surgeons working on pregnancy or on broken bones or on general surgery will boost the action plan at the hospital. Proper human resource management will make a deciding difference.

To best of my knowledge, doctors do Charity to their maximum to extend their favour in their fee, discount in investigation and drugs as well. Despite all these favors doctors are always pushed to wall for all possible non-creative criticism are made and are made scapegoats. This misbehaviour has rendered good doctors to practice defensively and have let them develop a psyche that save yourself fist. Abolition of concept of family physician and mushrooming of corporate hospitals has dented the society very negatively on finance front. Its true though corporate hospital have helped raise the bar of saving precious lives of citizens with their state of art diagnostic and interventional procedure and super qualified human resources.

Still a question props up, shall doctors come forward to stop extending all Charity to patients and start working to stringent rules with no flexibility. As this is being followed, costing and pricing of medical treatment and cure will again be enhanced.  Work to stringent rules with keeping no probability and uncertainity may pose a threat to many lives of patients in emergency. In non emergency situations alike as laid down protocols will attract undue delay in interventions scanning and in surgical as well as OPD patient dealings. Healers need a positive and sympathetic approach of society so that the low socio economic class of society continue to get healing touch from the Doctors and doctors also continue to get their bread & butter in return.