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Friday, 5 August 2011

Who said doctors can’t be ethical and successful?

(This article was published in The Hindu on July 24, 2011)

-By Dr. K.R. Antony




When doctors enrolled themselves in the profession, they are bound to observe certain professional ethics and decorum. That is not for sainthood but for the upkeep of a certain code of professional conduct which was practised by our seniors. That gave us the social recognition and dignity we earned collectively.
Now there is value erosion, everybody admits. Breach of medical ethics is seen not as grave, restrained and punished timely, but is being overlooked and condoned easily as an “inevitable evil of the prevailing conditions.”
The strength of the majority is not used to correct the wrongdoing of a minority, but to justify its misdeeds and approval by the whole body as a “survival strategy.” Professional associations are also resorting to strikes to safeguard their business interest and protection from the “public” whom they are supposed to serve. The old fashioned and the not-so-smart ethically practising doctors are becoming a minority. Even a laughing stock! No wonder, the same society that treated us once as “god” is now treating us as “dogs” as lamented by Dr. Manorama Gadde (Open Page, The Hindu, July 17, 2011).
Who is at fault? Rather than taking it to the “media” accused of using “doctors as punching bags,” it is high time for introspection.
What happens, for example, if we refuse to pay 25 per cent of the fees to the local RMPs to get referral cases? My firm belief is that if a doctor is ethical, skilled and very good in his/her profession, people flock to that doctor. Client satisfaction is the best advertisement for a doctor or hospital. People may be unlettered, but their wisdom can differentiate the bad from the good doctor. It is only the mediocre and below average who need advertisement props.
I have seen very poor patients travel from far off tribal areas and districts and across State borders to Ganiari near Bilaspur city to receive the good services of a group of committed specialist doctors who passed out of the AIIMS, Delhi. These doctors do not even put up a decent nameboard.
I started paediatric practice in a 150-bed mission hospital in a rural area where not more than five or six patients came a day. Within a few months, the number grew up to almost 90, and it became unmanageable for me as a specialist to give quality time and attention to my patients. Finally, I was compelled to restrict my outpatient tokens.
Many local practitioners referred patients to me, instead of to the district headquarters hospital, because they knew I did not pass any remark on the missed diagnosis or the not-so-correct case management by the referring doctor. Moreover, would get a return referral slip, in a sealed cover, on what the diagnosis turned out to be upon investigation and the lines of management that I followed.
In India, no qualified doctor willing to practise ethically is going to starve. There is enough revenue generation from consultancy for everybody’s need, but may be not enough to everybody’s greed. The “greed” is often perceived and firmly believed as “need” when you actually embark upon certain ambitions of life for the sake of survival in cut-throat competition. One more building block, one more operation theatre, a CT scan machine and similar sorts, for which banks are ready to advance loans fast but also quick to retract when EMIs are delayed. The stress is passed on to the middle class patients who might not have actually needed it at all. Why join that rat race?

(The writer is a former Health & Nutrition Specialist for UNICEF and former Director, State Health Resource Centre, Chhattisgarh. His email id is krantony53@gmail.com)

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