When in doubt, blame the system
Whenever you find yourself ‘against the wall’ in life, remember the three golden words – “Not MY Fault”. In today’s era, blaming someone else is no more a fad, but a necessity. Take for example, any economic or political setback that you see, some expert blames it on the government policies over the years made by people currently in opposition, the opposition blames the current government and the current government blames the paternal uncle of the nation. This blame game keeps on looping until the problem is solved or, in best-case-scenario, forgotten.
It is, however, a different ball game in the medical world. The whole blame-loop swirls inwards until all the arrows are pointing at you, the Doctor on duty. A critically ill patient dies on your watch? You must be the culprit. You ordered investigations to diagnose the ailment and the pathology lab charged the patient more than what they were willing to pay? You’re a money-hungry heartless devil-reincarnate. You performed a surgery with known complications but the patients family thinks otherwise? Your professional ethics will be degraded on Satyamev Jayate and Aamir Khan will shed a tear (and then walk home a billionaire).
Well, someone needs to speak against it. Well, not exactly speaking and making a difference or bringing out a revolution, but at least ranting out. The power of anonymity provides a (relatively) safe platform, and ranting helps to vent out, lest we puff up and burst out at the wrong time like a faulty pressure cooker. Again, I fold my hands and request you not to read this piece with any hope for radical ideas or an attempt at causing a change, or even a little amount of sense. The contribution of ‘Op-Eds’ to any social cause is exactly equal to the contribution of movies like Dostana to Gay rights – absolutely ZERO.
So, the approach the writer is going to take is to ‘blame the system’. Not only does it help to be vague in pointing fingers, it is also a popular Bollywood dialogue and is the closest the writer will ever come to feeling like one of the cast members of Rang De Basanti (preferably Siddharth, practically Sharman Joshi). It is important to know that when I say the term system, I do not pin the blame on the government (well, not entirely). I talk about almost the entire medical system: the hierarchy, the current profit model and the edge-of-madness consumerism. And of course, the government.
There is a popular set of rules in medical hierarchy:
1. The Senior is always right.
2. The Junior is always wrong.
3. In case of any discrepancy, rule number 1 holds absolute validity.
Now I do agree that generalizing ‘seniors’ into a single bunch and targeting them with inept criticism is (probably) wrong, as people also do to vilify supporters of political parties or Bigg Boss watchers. I also understand that medical decisions should come from the point where the buck of vicarious responsibility finally stops, but where does that leave us in terms of sharing opinions and discussions? With some know-all Oracle-embodying seniors, a query is a challenge, a discussion is an argument, and an argument is blatant insubordination. Alleged insubordination usually ends with “GET OUT OF MY SIGHT AND CALL YOUR JUNIOR” which, one fine day, may become a popular simp response to spurned advances.
Any ‘system’ is doomed if it doesn’t have a good management/leadership. The brilliant plan of letting MBAs run hospitals has done the same (dis)service to the health system that the age-old voting-in of uneducated people to the government has done to the nation. I have heard the argument that MBA in healthcare, theoretically speaking, is different from regular MBA – as they add the term ‘Hospital’ in every sentence featuring the word ‘profit’. It is subjectively easier to hide behind the doctor and HR department while making decisions for/against patients and staff, respectively, than say, sleeping at night believing that the workplace stands for ‘targets’ and not ‘patient care’.
Now, I’m not one to suggest that all MBAs are bad, or that only doctors and and should run healthcare. It is like saying “Wow Canada chose an astronaut as a transport minister, it makes so much sense”. NO! A former astronaut may know absolutely nothing about truckers or public transport. The only ministry an astronaut-turned-politician deserves without a challenge is Ministry of Astrology, as he is one person who can actually go up in space and verify whether the sun, moon and the planets are actually in the correct position or not.
A doctor as a health minister makes sense on paper, but the real minister is only a leader. Minister must possess the necessary leadership and policy-making skills, while having competent doctors on the advisory board. Letting MBAs run medical institutions and advisory boards is like letting YouTubers run news channels – you get a useless, consumer-clicks-driven 10-minute video based on four similar-agenda headlines on every topic (or as it is known in popular journalism, serving ‘A Dhruv Rathee’)
If you’re still with me, we can finally talk about consumerism, you know, the concept of treating a hospital like a Gaffar/Crawford Market where you deposit your electronics and get results or money-back guarantee. The only analogy I can fathom for human body is that a healthy body is chrome on a new phone, where as age and illness takes it towards the ‘Explorer’ browser on a windows device – slow, incoherent, and the issue of “I have no idea about the source of that sound”. Otherwise, human body is the God’s creation, and we’re still trying to fully understand it, while doing our best to treat it.
Yet, doctors only oscillate between ‘God’ and ‘murderer’, with the only character-defining stop in-between being ‘money-siphoning leech’. In a government setup, you’re a servant who’s being paid from the taxes that the consumer pays, and in a private set-up, you’re being paid directly. Hence, it makes sense that any untoward incident is a doctor’s fault (unless proved otherwise) because we know that every patient on earth is an indestructible, Milind Soman-esque peak-health specimen otherwise. Years of books and anti-social lifestyle and premature greying of hair, all for a non-medical genius to beat you up citing that the 85-year old relative of his had only an 84-year long smoking history, uncontrolled diabetes and heart ailment, but was hale and hearty otherwise and it is your injection which killed the relative.
While you’re getting thrashed, the MBA is at home and your senior’s phone is unreachable. You reach home with plastered limbs and a black eye, and log on to YouTube to watch Dhruv Rathee explain faults in the Indian health policy based on what he read in ‘The Washington Post’ and ‘BBC Hindi’. You take a deep breath, and say “the entire system is broken”.