As a kid whenever I was asked the staple question, "What do you want to be when you grow up?", my answer was always anything but a doctor. I've wanted to be everything from a dancer to an advertising professional to an astronaut and a teacher, but never a doctor, much to my parents' dismay, who always wanted a doctor in the family. (I detested engineering too in the beginning, simply because it was so cliched to become an engineer, but well...) I don't know why I felt that way, though I have a lot of respect for doctors, to me hospitals have always been a repulsive place. I'm not scared of blood or pain or anything like that - indeed I happily did dissections of cockroaches in biology labs in XII std., but
I don't like the atmosphere, the gloomy, smelly, damp place, the all-pervasive negative energy, the despair. My parents made peace with my choice, and I chuckled silently watching friends slog out for years incessantly studying to become doctors.
But apart from a personal choice, there is a why to be answered here that I never thought so much about earlier. All my life I, like most of us, have heard politicians speak about health as a priority, read and watched people dying because of lack of medical facilities and/or irresponsible/absent doctors, debated about why healthcare for all is still such a distant goal in India, and of late heard plenty of noises coming from
US about universal healthcare etc
And then there was
this story in HT a couple of days back as part of an ongoing series about my locality, that got me thinking. Hospitals repel me the way they are; they shouldn't be this way.
Why do I hate Max at Saket less than my local private hospital, because for all its exorbitance, it at least does not look so gloomy? But does it need to be exorbitant to be dignified? Why can't our hospitals, esp govt hospitals (the ones that exist) look like the facility in House or Grey's Anatomy? Okay, that maybe a stupid question, when our country doesn't look remotely the same, but the point is, why can't we care a little more?
Why are doctors looked upon so widely as fleecers, unethical and careless in a country where we, at the same time, equate doctors with Gods (and with the same fervour of faith!)? This story, also in HT, couple of weeks back, sounded like a positive step. However, the why goes deep, and remains unanswered.
We are heavily criticial of the lack of healthcare facitilites, particularly in villages and poorer parts. We morally look down upon the city-educated doctors who refuse to go work with poor patients in parts of the country that need it most. We are proud of our super-speciality surgeons who perform challenging surgeries on patients from all over the world at a low cost. We want the doctors to be sympathetic, kind, helpful and always right. The smallest mistake is unpardonable because somebody's life is at stake. It is their duty to care. But do we, collectively, ever care about the doctor, the individual under stress? Hear me out here.
What kind of students go on to become doctors? Mostly, not the extremely rich ones - unless they belong to a family of doctors - at least they don't practice/study in India. Really bright students then, mostly from the middle class and the poor. But the poor, in most cases, cannot afford to study for so many years, assuming they do complete school in the first place. They do not have the awareness and the resources needed more often than not, which leaves the crux on the middle class, also bereft of resources.
Do you know what a medical education costs?The competition is deadly just to get an MBBS seat in a profession where "just an MBBS" is so not enough! Students kill themselves slogging to get admission in a handful of institutes, among which most of the private and small-town ones are a joke. But they're all we have.
In a country with acute shortage of doctors, where IITs are being carved every month and engineers churned out in lakhs, why is medicine so ignored? And the situation is almost horrific in PG level courses. Less than 1000 seats nationwide, and most of the private colleges demand exorbitant amounts of "donation" for a seat. To meritorious candidates only. A friend of mine who just finished BDS has been asked to shell out 36 lacs for an MDS seat in a college no one has heard of. Over and above all the regular expenditure. Another paid 51 lacs + 10 as fees last yr for some other speciality course.
These people are regular middle class folk. Where do they get all the money from? Why?
And once they finally get a degree and work some more years to establish a practice, having put in ten yrs of hardwork, assets and savings of their parents, govt jobs that pay 25-30k a month are not enough. They cannot clear off that debt ever if they were always doing social work, working in a village and treating poor for free, while not overcharging the rich. It's difficult to be moral for the average 28 yr old.
I'm not making a case for quacks and evil, irresponsible doctors here. I'm saying, at the first step, we NEED more colleges for doctors, subsidised education and high vigilance to curb corruption. We need more PG seats desperately. We need to incentivise and monitor functioning of hospitals, dispensaries etc. We need to incentivise hospitals that adhere to quality stds. We need to involve citizens and get their feedback to give each area what it needs.
We need to care.
