Medicine is the only profession which relentlessly toils to eradicate the reason of its existence. Death is the sole certainty in life and yet doctors continuously strive to fight it. A doctor spends the better part of his youth pouring over books, borrows money to set up a health facility , seldom attends social functions, is rued for missing family occasions, skips countless meals and spends sleepless nights treating patients. Sadly, his stress doesn’t end here, he has to worry about outdated laws, frivolous law suits, and now even lawlessness.
The recent incidents of violence against doctors are disturbing to say the least. When I came across a video clipping with the caption ” Doctor beaten to pulp” I thought it must be an overstatement . I was horrified by the first minute of it and didn’t have the stomach to watch the rest. The details of the case are appalling. A 80 yr old patient of alcoholic cirrhosis with hepato- renal failure (severe malfunction of liver and kidneys) was brought in. Sick enough to require intensive care, he died of his disease and the attendants beat up the doctor. The doctor in question is not of questionable credentials , but a respected Gastroenterologist, a super specialist. To his discredit, in the decade he spent in medical school, he wasn’t taught how to grapple with Yamraj !
The attitude of the authorities too, is appalling and ranges between apathy to unwarranted incrimination. It is strange how the government is using all it’s might to protect the public from ‘erring’ professionals but feels no obligation to check the proliferation of quacks. And though IMA and MCI have submitted an Anti Quackery Bill, the Government is sitting on it . In fact it keeps assuring the unqualified health professionals that they will be used to meet rural health requirements. So while qualified doctors are bogged down by various outdated laws which require tons of paper work, the quacks are allowed to practice with gay abandon. PC-PNDT act, MTP act, Consumer Protection act, Biomedical waste act, Narcotics and Psychotropic drugs act, are some of the grounds for harassment by government officials. Apart from these doctors have to contend with laws which govern any workplace. Doctors being punished for clerical mistakes is now a sad reality. It is no longer an exception but the rule.
With the consumer protection act hanging like Damocles sword over their heads doctors are forced to practice defensive medicine. Good faith has been replaced by evidence based medicine which helps the doctor stand ground if he is sued in court. Though scientifically more sound, it is also more expensive. Earlier doctors would rely on their experience , now they depend on investigations and protocols to corroborate their diagnosis This has significantly increased the cost of health care. Also, if a doctor refuses a patient he is punished for not providing first aid and if he initiates treatment that has an unfavourable outcome he is liable for negligence. The problem is that there is no clear demarcation where first aid ends and definitive treatment begins. In such a scenario doctors are harassed if they do, punished if they don’t. They are indeed a troubled breed.
There has been a recent spate of untoward incidents against the medical fraternity, either more are happening or more are being communicated. Social media has helped doctors share their woes, most of which would earlier go unreported. Between draconian laws and deplorable lawlessness doctors are in difficult place today. In these times of strife the only consolation is that it has helped them come together. When people are unjustly pushed against a wall they tend to unite. It makes sense to hang out together than be hanged separately!
A lot has been said about the desirable qualities of a doctor. An ideal doctor is expected to be empathic, competent, even tempered and have good judgment that is not clouded by commerce. He should constantly update his knowledge, always be available, place patients first and work for a pittance. It is time to educate society about the desirable qualities of a patient. An ideal patient should be trusting, compliant, grateful, willing to pay for services, non abusive, non violent and most importantly, patient!!
In our country an ideal doctor has been equated to God. It is time the public realises the difference between the two for however hard he tries he will lose some fights. After all he is just human and needs to be treated like one. Few people realise that a little of the doctor dies with every patient he loses.