HEALTH CARE REFORM ?

WHO IS A DOCTOR? ; WHAT IS A HEALTH CARE?     

                               ………… THE TRUTHS AND FACTS; THE GOOD AND BAD.
 


                 
THE REALITY
                                 
                   Who is a doctor? The question is really tough to ask in this ever growing, fast developing society. Doctors and medical profession are once considered noble and pure. Does the same thinking and belief exist now? What is the reason for this change? 

 Is it again an unanswerable question too!!

                        Before going in any deeper into the talks and discussion I would like to say here that I am a doctor, a radiologist by profession and I am a full time social worker by passion. So I think I have full rights and qualification to speak about this issue. I am not going to speak on any particular side or rather going to blame anyone. I will just share with you the things I faced and learnt and those certain things that have worried me. The ultimate decision is yours to make.

THE STRIVE…….

                       Let’s have a look at the life of every doctor before we get blame at them ……   To become a doctor one goes through immense hardship. Any profession is difficult but I would say medical profession is one step ahead. Though the younger minds today are gaining a freedom of choice and opinion in choosing their career, still majority of the system has not changed. Majority of the parents dream their children to become doctors. And if or if not the child dreams to be so, by the virtue of their parents’ perseverance they tend to take it their dream. Any top ranker in the school is pushed into medical profession or rather he or she chooses engineering from a top college so that he can settle fast.

OK, now the parents dream but they fail to dream or rather fail to instill the thoughts of a doctor who will serve the society into their children …now here starts the problem.

Now what you call as service? ………… does servicing means you do something without accepting money?

Or does servicing means you work with NGOS like “Medical san frontiers” and work in Somalia or Pakistan?

Or does servicing means merely doing your job correctly and without any negligence?

                      To understand doctors you really have to be one. Today doctors are blamed invariably. Hospitals private and government are blamed invariably!

WHY IS THIS?

                      First let’s go into the life of student who strives hard out to become a doctor. The top students from school go into medical profession; there they strive for five and half years to pass out as doctors. Five and half years may extend with 6 months or one year for some or many; as the pass percentage is also kept high usually.
“Wow now that after all hardship he is a doctor “…………..wait the real test is yet to come!!

GONE ARE THOSE DAYS…….

                     Gone are those days of general practitioners, family doctors who will attend patients at homes gives you tablets and tends to cure 80 percent of the patients themselves. Today medical field is vastly advanced and so are the diseases! In the past thirty years we are diagnosing conditions and syndromes which were not known previously and we are treating the same. 

                     The average life expectancy at early 1900s in India is just 20 -30. Today that is somewhere near 60-70. The major reason for same is advancement in medical field. Today there are so many specialist and super specialist narrowing down to every organ in your body. If I start naming the ‘ ologists’ it will least a take page long!

                    There is a high chance that for a fever you have, which if has not subsided for more than a week you will be attended by least four doctors! Yes it is true.
 
                    So now the student who strive out to become doctors, now strives further to study post graduation and to specialize himself. To get into it requires hardship training and to pass out of it is another big hurdle to cross. This now is another 3 years of study. Does it stop here? No most of the post graduates now specialize further with one or two years for super specialization. 

                    So that super specialty doctor you see sitting and speaking to you in a language you never can understand has toiled  himself for 10 years in studying after school and this might be added with the years he puts in to get into these.
A doctor completes his curriculum and starts his profession in proper by28-30 years. By this time most of his peers in other field would have settled off with marriage and kids even.


SO WHAT?

So what is an easy tender question to ask but a difficult daunting one to answer. 

                   Many doctors prefer private practice; in fact all doctors do private practices! Doctors striving out after 10 years of training will be paid somewhere like 38,000 in government hospitals to start with.  So, even doctors working in government hospitals will do private practice.

What happens today in the field of medicine and medical profession is an ugly unethical business. Yeah it is true!

                   Medical field and medical profession has turned into medical business. It has become a health care sector. And remember this, it is not the doctors that run and hold the major share of this business. The major share is now held by businessmen and politicians.

THE ROOTS AND POTENTIAL CAPABILITY IS VAST AND MANY ARE INVESTING IN IT. 
                  There are medical colleges which trains your doctors, hospitals which treats you, there are pharmaceutical company which provides you drugs, there are biomedical engineering services, there are industries to produce surgical equipments.
Everything has to be produced – transplants, screws, CT machines, x ray film, syringe, needle, everything and all this has to be sold. There are manufactures, buyers and vendors and even stock exchange and MARKETING in it …………and that is why; it is a business.

WELL IN THIS BUSINESS IS THERE EQUALITY?

                  How do you expect that? If you expect that you are really out of your mind! There never can be equality in anything - even in a wardrobe or food.

                 Then how can be there equality here? The level of care, the quality of care might vary so much depending on the amount you are capable to pay.

                 An operation to deliver your baby can be done at free of cost in government hospitals or by paying up to 50,000 rupees. Now those which get 50,000 from you obviously provide you with a five star hotel kind of treatment. There is inequality in everything a simple drug can be bought under various trade names from 5 rupees to 50 rupees. A simple test can be done from 1000 rupees to 10000 rupees.

It simply means one thing – if you have money you can live long………………… yeah that’s truth!


SO HOW DO DOCTORS CONTRIBUTE IN THIS UNETHICAL BUSINESS?

 

So let’s see the ugly note and ugly end or to where doctors have been pushed.

                           Negligence is a different issue and money making mentality is a different issue. No doctor would want to lose his patient.  But then there are some un-tolerable things that happen.

                         For instance let’s start from government hospitals; not many of us or any of us would prefer going to a government hospital…why? Not because the doctors there are not good. It is about the level of care. Many of the best doctors still exist in government hospitals only. But the truth is many of them won’t dedicate themselves totally to it.  In any government hospital any normal surgery without emergency will take 5 – 2weeks to happen. But if you go outside to a private hospital it can be done immediately and that to by the same doctor who will operate you 2 weeks later in a government hospital. 

                       Many surgeons use district government hospitals as patient pulling to the private setups. Now this I speak of only of the district government hospitals; other sub-centers and primary hospitals doesn’t have a doctor in it by majority.

                      Now, here come the private hospitals which practice in an entire different way. These hospitals run mainly on MARKETING and HR and PR are the major part of their business. They pull cases from doctors in rural areas and suburbs and as they refer cases they are paid referral cuts (Now let’s come to this referral cuts a little later)

The ambulances which you get in under emergency will be bribed too and the ambulance drivers will take you that hospital where the driver cut is more!!

NOW TAKE AT LOOK AT THIS

YOU MARKET, GET REFERRAL CUTS/GIVE REFERRAL CUTS/ BRIBE AMBULANCE DRIVERS/PULL CASES FROM GH…………..AND THEN?
 
                         You go to a doctor, he/she suspects something asks for blood tests, a CT or MRI done means its logical. When he/she recommends a particular lab or scan center that means there is referral cuts to him/her from there.

                        Any lab or scan center does this. A MRI will cost you 6000 in trichy and upto 10,000 in Mumbai. Out of this nearly half, say 2500 out of 6000 goes as referral doctors fee………….!!!!!!!!!!!!!!!!!!!!!!!!

                       A good concerned doctor should avoid this referral fee. Not all doctors do so.
 Scan centers go beyond extent – some leading centers in Tamilnadu run by businessman pay lakhs in advance to doctors in rural areas so that they refer cases to these centers frequently ( doctors of homeopathy, ayurveda, sida are all include in this)

IS THAT IT?

WAIT IT IS NOT OVER YET….!!!!!!
                   The major hub in business is in ‘Pharma industry’ and in ‘surgicals’. These are fields where fixed rate are not set. All drugs are to be produced under strict guidelines – if so any tablet which contains the same drug should be equal. But the cost is not so. A simple tablet called ‘Paracetomol’ which you commonly take when you have fever can be bought from 2 rupees to ten rupees, if this is so then imagine the cost of other major drugs.
I will tell you this story here so that you can imagine more.

                  We were conducting a medical camp basically for children in a rural area while we were students. We went out to buy medicines for this and approached a medical shop. We asked for ‘Albendazole’ tablet.  And the pharmacist told us that the cost for each tablet is 6 rupees. Then we told the reason we are buying the tablet for and we told we will need 200 of those. Finally we bought the tablets for 2 rupees each from the same shop.

CAN YOU UNDERSTAND THIS?

This subtle difference of  4 rupees might not be an issue for us. BUT WHEN IT COMES TO A LIFE SAVING EMERGENCY DRUG ???????????

Now that’s just an example……………….

                        When you buy any surgical items or drugs the production cost will be around just twenty percent of what you pay. The rest is in marketing, doctors cuts, the vendor and dealer cuts and profits for company.

                       Do you know how much marketing goes in to this. Pharma companies will send representatives to doctors they will offer gifts, foreign trips, flight tickets and almost anything. All that doctors have to do is write their brand name.


CAN IT EVER CHANGE?

                     Basically the first reason is the change in people’s attitude. Today people are willing to pay more. No one will go to a center where they treat you for less cost. The general belief is if you pay more you are treated well. If you eat more tablets then you are getting better fast. This is utilized and made cash off by the new growing health care industries.

                  The second and most important is a poor government governing us. They have no real purpose on anything. Health sector should be dramatically systemized and regularized.
Pay doctors high in government hospital, develop all government hospitals to top level. Completely abandon privatization of health sector. All doctors must be in government sector. They should be paid good and should be posted in their areas of interest or their native places.

                  Put a separate budget for health sector. Revise everything. Revise state taxes and get more taxes according to the tax payer capability and instead give subsidiaries in everything including health sector. Government’s hospitals can function at free of cost for below poverty line people and can function at nominal cost for affordable patients.
Regularize all pharmaceutical companies. A drug must be sold only at a particular price and not more. Invest more in research and give hope for research. All this can happen only if some serious measures are taken. 

THE GENERAL AWARENESS IS VERY POOR ON THIS ISSUE. WE MUST UNDERSTAND THE SERIOUSNESS AND SHOULD COME OUT AND DEMAND FOR A REGULARIZATION.

SO WHAT YOU CAN DO?

                    The next time a doctor writes you medicine ask him to write drug name and not trade name- never get a prescription with  a trade name. Now if you do so there is high chance on the pharma shop giving whatever medicine they feel like giving you and which is costlier – in-fact demand for the cheapest available medicine in that particular drug; remember trade name doesn’t matter, it is only the drug that matters.

                Then never go to private scan centers or labs – go to medical college hospitals or to government hospital scan centers. It will take time sometimes but if it is not an emergency then you can really do it.

Understand doctors and health care industries.

              The most important thing you have to do is come out and fight. We should demand our rights. Out of all these issues the one who is affected most is the poor –health care to him is still not properly reached but disease and disease and the disease process reaches him fast.

              If it has to change and if all should be treated with equality then we should come and fight for same.  If and if only health care system is regularized then and then only health care can be provided excellently and efficiently.

BUT AMIDST OF ALL THIS REMEMBER THIS – PREVENTION IS BETTER THAN 
CURE.

Eat healthy –plenty of fruits, green vegetables, drink plenty of boiled water, eat less munches and crunches. Avoid smoking, and tea.

Sleep healthy – don’t run for money and don’t concentrate too much on money making. Learn to love and live. Live with passion and live healthy. Keep your mind and body clean. Do meditation and exercise and do some kind of physical activity every day.
Help others a lot and shed your selfishness

IF YOU DO ALL THIS, YOU WILL NEVER NEED A DOCTOR AND YOU CAN LIVE A PEACEFUL, MEANINGFUL LIFE.

IF NOT RUN, RUN AND RUN AND FINALLY DIE BY PAYING ALL THAT YOU HAVE EARNED INTO HEALTH CARE BUSINESS.

"DEMAND THE CHANGE …………………..BE THAT CHANGE"

                                                                                       

Comments

  1. What you said in the above post, I agree with most of it and disagree with quite a few things you mentioned. Being a doctor, you should know, quite a few of these so called generic drugs are just useless. They primarily contain chalk powder. Secondly, you stop writing brand names, you pretty much stop funding pharma companies. Hence, you stop funding the research that's done by those companies. So good luck getting new drugs.
    Third, the doctor writes the generic name and prescription goes to the pharmacy. The sales guy shows only one drug and says there is nothing else on stock. What do you do next?

    What needs go be stopped is the free flight tickets etc you mentioned. And the cuts. Fleece the rich. Spare the poor.

    ReplyDelete
    Replies
    1. well my dear friend /.............. if i have a chance to mail you, i will ......... .... all that they teach us in medicine is to write drug name and not trade name .you do that; that is more than enough... the other issues of medical shops cashing in on it and all should and can be dealt only with proper regularization and legalization from the government .............. if you really want a change, it should start somewhere first................and investing on a pharma company so that they can research and all is crap ....it is not my job .............again it is the job of government ...government should invest more on research and should provide help and incentives to all those companies who come forward for researching ..........

      man as a doctor if you are strong and true step out and say i will only write drug name...........and if every doctor does this .....automatically the pharma doesn't need to spend on incentives for doctors and the cost will come down ...........as doctors first we should come down and demand for regularization ............. but it wont happen in any future as the pharma industries and the pharma giant is as big as anything you can fight it so easily specially with corrupt people and corrupt mentalities .................... if regularization is there then all these issues are not there right ..

      so lets demand for regularization...thats it

      Delete

Post a Comment

Popular posts from this blog

" THE BATTLE OF THIRUPURAMBIYAM - the victory and change of history (last episode)

Break up dialogues