#SaveDoctors before Saving Tigers in India

#Save Doctors

There will be a day when #Save Doctors will be a reality in India, like Save Tigers Campaign – hence, the request to Hon,ble Prime Minister of India to seriously look into the matter.

Imagine a similar law being enacted – Compulsory Rural Service for all other professionals as well and politicians?Β  I seriously think with the current healthcare infrastructure – how many parents would want to encourage their children to become medical graduates? Please see below sample timeline of events if you want to put your child in a medical school

2015 – Joins Medical College
2016 Aug – MBBS I
2018 Feb – MBBS II
2020 Feb – MBBS III
2020 Mar – Final MBBS Results
2021 Mar – Compulsory Rotating Internship
2022 Mar – Compulsory Rural Service (note some states have recommended 3 years compulsory rural service)
2023-2024 – PG Medical Entrance Exams (there are about 50,000 + medical graduates passing and only about 14000 PG seats available)
2025-2028 – Posted in rural PHC
2028 – PG seat
2028-2031 – MD/MS
2031-2032 – Rural service post PG
2032 – Prepare for DM/MCH (for “aur iss cement mein jaan hai type guys only”) and by god’s grace maybe by 2035 – you will be ready to start scrubbing in a tertiary hospital.
Approximately spending about 20 years (from 2015-2035) and at the age of 38 starting to see the real world for a doctor this is not the end – the journey starts now with a 60-100 hour per week schedule depending on how lucky you are! (by the time Android Kit Kat/Ice Cream/Loli Pop versions may have reached Android Vada Paav, Idli Wada or Burger/Pizza god only knows!!!)

In these 20 odd years between 2015-2035 our peers in software (likes of Bhavish Agarwal of Ola Cabs, Bansals of Flipkart/Snapdeal would have started companies and crossed a Billion valuation!!!), IAS officers, CA, Lawyers and people from all other fields, maybe even a Taxi Driver working in Ola, Uber would have started earning a decent income which we are NOT entitled to because doctors belong to a breed which is soon going to be extinct and referred in history books as “Noble Profession” “Holy Cow”!!!

Having started my clinical practice from rural area after my medical graduation (along with my father who served in rural areas for 40 long years and still continues to practice in a rural area twice a week at the age of 73 because my grand mother asked him to serve in the villages and did not let him go after clearing USMLE in 1970’s) and then serving the country for 5 years as a short service officer in the Army Medical Corps – it is a pitiable condition for the medical graduates of our country. I am placing some statistics to bring to the notice of the hon,ble administrators of the land who may have weighed the pro’s and cons before passing the bill.
With the Karnataka government expecting that every year, 5,000 medical graduates and post graduates will be available for rural service – let us look at the statistics provided by the state government itself. Recently, the cabinet approved draft rules to recruit 983 specialists, 331 general duty doctors and 87 dental doctors in Karnataka. (However, most states are trying to follow the same policing approach with punitive measures rather than improving the healthcare infrastructure and salary for doctors which will naturally pull doctors to rural areas)

If 331 general duty doctors are required, where would the government send the nearly 3500 MBBS doctors who pass out of the 30 odd medical colleges in the state? Where will they go and what will they do in the absence of infrastructure needed even to sit and examine patients?
In the absence of even basic infrastructure of food, accommodation, basic education and livelihood for doctors and their family in those rural areas, how can the government enforce a hefty penalty of Lakhs of rupees for those not complying with the rural service.

The bill has lot of other flaws which will result in cascading affect in the years to come leading to further shortage of doctors, letting inexperienced doctors go to rural PHC and further impact the health indicators of the country and by no means we will achieve the MDG’s
While the real solution may be in increasing the public health expenditure and improving the healthcare infrastructureΒ and better pay for doctors serving in rural PHC’s – the current bill may do more harm in the long run than have any better impact. Please do think why do the doctors go to the urban areas? If the government can think of the below steps – maybe you will have better motivated and experienced doctors going to the rural without any need for policing or punitive measures:

1. Improve the public health infrastructure, GDP spend on health – facilities in PHC, functional medical equipments and connectivity with peers in District and State centers

2. Incentivise experienced doctors for rural practice (Army Medical Corps has special field allowance for doctors serving in high altitude, field areas and really take care of the family members and benefits while in service and after as well. The doctors usually have alternate and rotation based postings in field, peace and foreign missions)

3. Have priority and reservation for doctors in PG seats purely on merit and for those who practice in rural areas and serve the country, based on clinical experience (and not just MCQs) and not on religious, caste based reservation, and lastly NOT for being an NRI or somebody who can pay more

4. Ensure NIL violence against doctors and non interference from politicians, local goons and minimize red tapism for doctors who volunteer to practice in rural areas

5. Does the healthcare industry have any Medical SEZ like IT SEZ?Please think why the IT revolution happened in India in the 1990’s – it was not because of punitive measure or steps but when the government created favorable policy for software professionals and enabled with huge tax incentives and support with good infrastructure – India started creating some of the best software/IT professionals and companies started to set up IT ventures in India

6. PLEASE THINK WHY DO THE DOCTORS/NURSES WHO GRADUATE IN INDIA BECOME SUCCESS FULL WHEN THEY GO TO US OR UK? IN THE ERA OF FREE MARKETPLACE AND FREEDOM OF SPEECH, NET NEUTRALITY ETC ETC – DON’T YOU THINK THAT DOCTORS ALSO DESERVE A BETTER QUALITY OF LIFE FOR THEMSELVES AND THEIR FAMILY MEMBERS?

IF THE GOVERNMENT CANNOT CREATE BETTER HEALTHCARE INFRASTRUCTURE LIKE IN THE DEVELOPED COUNTRIES AT LEAST DO NOT ADOPT TALIBAN OR ISIS KIND OF POLICY FOR DOCTORS WHOM YOU EXPECT TO BE GUARDIANS OF THE HEALTH

Please sign this petition to #Save Doctors and bring back the “Care” in “Healthcare”

(Courtesy/Ref – from the below articles)

http://www.dailyrounds.org/blog/why-i-will-never-allow-my-child-to-become-a-doctor-in-india/

http://www.deccanherald.com/content/482553/chaos-over-medical-graduates-compulsory.html)

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