Quo Vadis, Doctor?

Dr. Harish K Rao

Of late, I’ve been wondering, what makes the youth of today take up medicine as a career choice? The course is the most long and arduous one. The cost prohibitive. One needs to clear multiple examinations to get the degree. And, there is absolutely no guarantee that one will succeed at the end of it all. Most of them will be middle aged by the time they set up a practice!

Doctors have been in the news recently for all the wrong reasons. A brilliant Obs and Gyn, a mother of two young children commits suicide out of shame and fear because a murder case has been registered against her for the death of a patient. A duty doctor is assaulted by bystanders because they feel he is too late in attending to their case. A senior GP is lynched because an unruly crowd felt he was negligent. Yet it hardly created ripples in the national press or elicited serious protest from civil society. Even a high court judge severely chides protesting doctors and calls them sissy for demanding protection at workplace. The videos of the assault went viral with lots of snide comments as if to say the medical community as whole deserved it or had it coming.

In all my years as a medical practitioner the one important lesson I learnt was people just hate paying their doctor. No matter how bad the patients’ condition at admission, no matter how hard the doctor toiled to cure him, the fee charged is always too much! The richer the patient the more reluctant he is to pay. Every other job is a profession that has to be paid highly. But medical profession is a service where doctor has to be available 24 X7, 365 days a year and do it for a nominal charge.  Things became worse when doctors were brought under the consumer protection act. It just added to the stress and overheads that one has to bear. No other profession is under such close public and government scrutiny. There are multiple laws governing the profession and the list keeps growing. In all of these, the doctor is presumed guilty and needs to prove his innocence.

One of the questions I pose when I first meet a new set of students is what inspired to take up this course? A few tell me their parents are doctors and want to continue the family tradition. A few watched a favourite relative die of some disease and want to know how they can save such patients in future. The rest have no idea why they joined nor have any prior information about the field. The motive of this lot seems to be earning fame and money.

When I took up medicine, the aim was to be a competent general practitioner. Further specialization came much later. Today people join with the idea of becoming a super specialist. They want to be a cardiologist or gastroenterologist. All of these courses require them taking two further entrance tests and they are only concentrating on that. Then, in addition, there is the frequent changes made to the curriculum, most of the ideas borrowed blindly from the west, leading to confusion and further dumbing down of the course. The result is nobody has any interest in learning the basics well. The students expect to be spoon-fed and there is very little original thinking or self-study. Unfortunately, that has not encouraged the teaching faculty as well.  You can only imagine the consequence of this at the super-specialist level.

For a doctor the most important skill, I feel, is the art of communication. Your ability to inspire confidence in the patient by speaking to him is fundamental to diagnosis and cure. This skill cannot be acquired by reading books alone. One needs cultivate that while training as students.

Sadly, our students lack this basic skill because from the age of 13-14 they are cooped up in some coaching center where they are trained to clear multiple choice question exams. The five years or so that they spend there before entering professional course depletes them of all social skills and they don’t make any attempt to acquire this skill during their training. This problem continues even when they qualify and start to practice, and this is the root cause of mistrust and disputes or even violence against doctors. The other problem is not wanting to touch and examine the patient, rather hope to get the diagnosis by doing various tests and scans. They don’t realize the importance of human touch in providing relief and succor.

Yet, more medical colleges are being opened and more children are joining the rat race being attracted by the tune of an unknown piper. Little do they know that he is leading them to their doom in a dirty polluted river.  

Images – Google Images

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