Healthcare in 2020: Reality Check
MAMC,10 New Delhi
Healthcare in any country stands on three pillars:
- A) The pillar that arranges: that is the government.
- B) The pillar that provides: that is the doctors and the para-medical staff.
- C) The pillar that benefits: the patients in the general population.
Even one weak pillar can make the entire building come crashing down , and unfortunately in India, we see all the three pillars shaking violently right now.
Pillar A: The government.
The government of a nation and its states are given a responsibility to form policies and give assistance to the providers: for example, providing doctors AND services as close to population and as effective as possible. On paper, there are emergency services running 24-7 in multiple areas ranging from primary and tertiary care hospitals, while the real situation may be different. For example there may be a hospital but only on paper. There may be a building, but may not have adequate staff recruited. There may be adequate staff, but there may not be indent of enough medicines. If there are enough of all three, then we (more often than now) call it a private hospital and demonize it in almost every Bollywood movie.
At times you feel it is important that government realises that a room with a doctor in a mask and a patient on a table with a red-colored light bulb outside does not make an operation theater, you need much much more than that. With a limited health budget, and rampant corruption at various steps, healthcare services provision from the government seem to function like the police in Bollywood police: too little, too late.
Pillar B: The medical and para-medical staff.
It would turn out as a biased piece if one just criticizes the government and blames the public. The medical staff shares the blame to some extent. Lack of coordination, otherwise known as ‘Game of not-my-job’, between (mostly) doctors and nursing staff, inadequately recruited and over-worked (unfortunately at times, simply work-slackers) para-medical staff, inadequate training regime, unsatisfactory pay coupled with inhumane working hours, and of course, greed, have brought down this (once) highly honored service. The doctors that were once compared to God are labelled as money-hungry butchers now, and the para-medical staff that was once fed sweets and thanked by the patients are being mistreated and manhandled.
Much needs to be done to motivate the health care providers and inspire confidence in general public around them. The doctors and nurses should stand united and come together to announce that to motivate the staff is “not my job”.
Pillar C: The patients.
The expectations of your average patient have changed. A separate bed has upgraded to a separate cabin with room service, promise of relief has upgraded to expecting immediate resolution of symptoms, and trust in your physician has been replaced by asking for discounts and expectation of charity. The day is not far when the need for sedative medication will be replaced by requests for lullaby from the doctor.
The awareness among patients has improved regarding their health but unfortunately that has made way for doubt towards your doctor while increasing trust on the ‘ultimate authority’ regarding everything living and/or dead, Internet. This particular practise, fueled by hearsay and lack of trust and patience, have become the basis of violence against doctors in recent time. A few cases have come up where people have convinced themselves that the primary disease or trauma has not killed the patient, but the doctor has. Education, vigilance, and trust on your doctor (and if not, your legal system) are needed to prevent such incidents, because every pair of hands of a doctor that you break, there is one pair less that knows how to heal.
All said and done, the three pillars need to stand together and stand strong. The last thing a country needs is a collapsed health care system causing the people to lose healthy, productive days. The condition right now is far from perfect, and statistics are there on the internet that speak for themselves. India has the world’s second largest population, and needless to say, a healthy population can make our country great, errmm, again.