Beating up doctors won’t solve ills of public healthcare

Outside the intensive care unit of a private hospital in Mumbai, the guard on duty is full of anxiety. It is not uncommon for him to be harassed by a crowd of attendants. They often become aggressive and violent when a critically ill patient dies. Sometimes it’s just a handful people, on other occasions it’s an entire colony. They can also beat up the doctors. Threat and intimidation are part of the menu and abuse is unhinged.

Obviously, the attendants are sad and angry at the death of their loved one. Then, they also have to pay the fees of the hospital before they can take away the body. Death hurts but when you have to pay money for something that couldn’t prevent death, it hurts even more.

Doctors are no gods. Everyone knows that. Yet, when they save lives, they are treated as one, at least momentarily. On the contrary, when someone dies despite the doctor’s best efforts, they come under fire immediately. They are vilified as irresponsible. They are sued in courts for negligence. The media loves to write stories about uncaring and exorbitantly priced doctors. Everyone loves to suspect their integrity. Yet, in times of illness, they are the people we rely on.

Medicine might be a noble profession. But people who practice medicine are not saints. Though they are expected to be moral, they aren’t social workers. What people often find difficult to understand is that doctors are basically service providers, no matter how noble or important their work is. You don’t beat up a teacher if a student fails despite the teacher’s best efforts. Then, why do we treat doctors as if they have to save every patient brought to them?

This anger towards the doctors is like confronting a symptom that affects our health without recognising the disease. In fact, the disease or multiple diseases that are ingrained in the system at a deeper level are often left untreated.

One disease that ails our health is the public healthcare system. Public healthcare in this country suffers from institutional defects. There are few specialized doctors at the primary level. Lack of good human resource only adds to the problem. Then, there is rampant corruption at all levels, from transfers/postings of doctors to supply of essential medicines, there is money to be made by everyone, everywhere. The government hospitals at district level and big cities are better but they are overcrowded and are found wanting under the growing number of patients.

The second disease at the centre of this broken system is medical education. Doctors have to spend a big part of their young lives studying. Medical education is often expensive and difficult. After years of studying, many young doctors today prefer going into a corporate set up or private practice rather than being part of the government system. It’s a better deal in terms of money and time. More importantly though, they don’t want the institutional baggage that comes with being part of the government set up.

There is a perception that for a doctor working in a corporate hospital and getting high salaries is somehow wrong. Of course, private, corporatised hospitals can be a costly affair. But at times, their quality of service is far better than in government hospitals. Actors go there, so do politicians, professionals and even those who can’t afford it because the government set up is simply not trustworthy. So instead of focusing on changing our public system, we expect private entities to abandon the search for profit and work for some greater good. That is something naive in a capitalist world and bound to make us angry at some point.

At the same time, it is true that not all doctors are good at what they do. Some of them are cheats and frauds. Some are simply bad doctors. You might ask how can they practice openly if they are so bad, or worse still if they are fake. Let me tell you why. It is because the body governing medical education and administration in India, the Medical Council of India, is an institution that has outlived its value and credibility. The mystery of why MCI is still so powerful deepens with passing time. One hears talk of reform before every election but there is just silence thereafter. Medical education and administration is a very big business and there is big money at stake. 
Everyone, from political parties to small and big business have their share of investment to cater to.

We, as citizens ought to be angry. We ought to be angry at the primary healthcare system in the country which fails miserably. We ought to be angry with the corrupt and fraudulent medical education system which produces bad and unqualified doctors. We must be angry at nothing being done about solving any of these problems. But to direct all of that anger towards only doctors would be a colossal mistake. For a start, the next generation of doctors must believe in public service and not see the entire public medical system as a physical and economic hazard. By attacking them, people are only sowing the seeds of mistrust and misgivings that will only do more damage to public healthcare in India.

The author is a poet and activist based in Delhi