HAS THE MEDICAL PROFESSION AND PRIVATE HOSPITALS BECOME SO COMMERCIALISED / EXPENSIVE AND THE HUMAN LIFE CHEAPER W

Dear Friends,

Greetings!! Happy Rath Yatra and Eid Mubarak and pray all of you have a good and a wonderful day.

I have penned below what I feel about what is actually happening to our medical practice in our country. Looks like, we just cannot think of falling sick nowadays, but being human, we cannot remain fit as a fiddle all the while. So what to do just try and do our own medication for a while whether right or wrong and if not go to see a general physician, who will in turn give us some temporary medicine to see whether it helps or otherwise undergo some medical tests or tell us to see some specialist.

Well then do we have any option?  What say you!

Take care and Cheers!

HAS THE MEDICAL PROFESSION AND PRIVATE HOSPITALS BECOME SO COMMERCIALISED / EXPENSIVE AND THE HUMAN LIFE CHEAPER

When medical students finish their course in medicine they are supposed to take an oath before starting their practice and the oath is:

"I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witness, that I will fulfill according to my ability and judgment this oath and this covenant...I will apply...(treatment) for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice." -Hippocratic oath

Big question mark is that is this oath worthy of what it says!

The medical practitioner starts off well in the initial stages of his career with a very low fee but once the practice starts doing well the fee is hiked gradually - is this fair?  We know that he has to make a living for himself but he can charge the patients accordingly.  It is raised so much so that not all of us can sometimes afford it.  In case, of an emergency in the middle of the night, you have to think twice before you can think of calling the doctor home as the fee will be double but then family is important.  Besides that the amount of medical tests which are prescribed for a patient to undergo sometimes even for fever, cough and cold, are really beyond our reach but again family is important.  Earlier on it used to be that you were given medicines to see for at least three to four days maybe a paracetamol and a cough syrup to see if it worked and then if the medicines did not work, then of course, the tests were done.  In our days the doctors would would give us some syrup from his dispensary and mind you that would work.  Now that science has developed so much so no more syrups but expensive medicines have taken over.  Followed by all sorts of expensive tests before the actual treatment is started.  But then at the same time if we are not cured then, it is just human nature to blame the doctor.  This is could also be one of the reasons for the doctors to get the medical tests prior to the treatment to safeguard themselves.

Recently, in my locality, a young man had fever for about two weeks and all sorts of tests prescribed by senior doctors were done which the man just could not afford and nothing could be diagnosed. The locality people got together and eventually had to admit him into a Nursing Home nearby and what do you think - it was just urine infection which the senior doctors could not even think of.  There must be many such cases though.   Even the pathologists always want to know under whose reference have you to do the tests.  Therein this is a system of for-profit health care, the opportunities for patient manipulation and exploitation are endless. Society must not allow the motive of economic gain to enter so directly into the practice of medicine, placing the well-being of patients in serious jeopardy, and undermining the trust so essential to the physician-patient relationship.

Earlier, setting up a clinic for practicing had lead to the booming of entrepreneurship among professionals. However, now single-doctor clinics are vanishing.

Corporate hospitals have started dominating the medical profession and small clinics are in the process of becoming their franchisees. There is no second opinion about loyalty of the corporate hospitals to its stakeholders. The doctors, who have become ‘workers’ of the corporate hospitals, are given certain targets that they are expected to meet.  

That while 15 per cent of the patients reaching for cardiac care may need procedural intervention with angioplasty, the intervention-level is up to 40 per cent.  Similarly, diagnosis for hysterectomy differs, too, increasingly depending more on commercial than the medical logic.

A research was done with the intention of improving the professional outlook and not to demean the Doctors. This research is engaged in creating awareness across the country that will help the professionals see more medical logic in their diagnosis.

This will help reduce the two basic inequalities between doctor and patients—that of medical knowledge and the power to give the right treatment. The Hippocrates’ oath morally makes the doctor think for the patient.

Commercialisation in health care basically means setting up private owned hospitals which in turn are the ones set on the business ethics of profit. But this does not mean that there is no proper treatment. Its true that the charges are more and in India where there are so many poor people cannot afford such high charges. The Govt hospitals draw a lot of people as because the charges are reasonably low and has some fine experienced doctors and not only that these hospitals cover many rural parts too. But when we compare the facilities, hygienic conditions and hospitality then certainly private hospitals are ahead but no not always now. Do the industrialists who set up these hospitals ever think of seeing for themselves to its safety, maintenance, housekeeping, hospitality  etc. as it involves a lot lives.  Some of the staff is so rude and their behaviour is such as if it will cost them to be nice to the patients. Being polite makes the patient feel good.  

Whereas the Tata Hospital I have seen for myself, they have different categories for you to choose according to your ability to pay, you are not forced.  But mind you, the treatment is the same only difference is the room facilities but what we are more interested is the treatment and that no difference should be shown between the rich and poor.  Even the General Ward is so spic and span and you have an R.M.O. on every floor and they also have male and female nurses who look after you well.  I am writing this out of experience.  But recently, sorry to say, I experienced here in Calcutta a renowned private hospital lacking housekeeping, maintenance and mind you no R.M.O. on any floor, as they are supposed to be sitting in a room in another building and even if called for take a long while in coming to see the patient as the nurses cannot take any decision without the R.M.O. consultation.   So in that case it should be made sure the R.M.O. should be easily available so the patient does not have to wait for maybe some change in medication if the patient is undergoing some uneasiness.

People from around the globe are choosing India as there medical destination not because of above facilities mentioned but because they are cheaper than other commercialised hospitals across the world.  In Western countries, no doctors make home visits and you cannot get to them without prior appointment which takes more than a couple of days. But of course when you make an appointment as the Assistant to the doctor knows your medical history and gives you an appointment accordingly and of course depending on the urgency.  Yes, of course, if it is an emergency and if you feel that you need to see the doctor then you have to go through the emergency way.  At least you know what you have to do and follow the procedure and you are not pushed from one hospital to another for maybe lack of facilities and in the meanwhile the patient’s condition worsens. Here, even if you are admitted as an emergency case no Resident doctor is going to do anything until and unless the doctor concerned comes over and sees the patient or gives him instructions over the phone.  They take their own time and the patient is left at their mercy.  At the same time, I will also say it is not always the case but recently since I have experienced it that is why I penned it down.

The thing is that in a country like ours where there are poor and rich people side by side, there should also be govt and commercialised hospitals side by side with the ultimate goal of proper treatment of patients.

Health care is the primal and major responsibility of every government. Responsiveness of governments towards providing basic, general health care facilities leads to public satisfaction; which if ignored can root the ways for medical emergency. As every coin has heads and tails, commercialization of health care does also have both prospects.

Commercialization in health care is good to an extent, until the quality of the services provided by the hospitals is established i.e-trustworthy for any individual approaching their care (their profits will also increase thereafter not to worry).  Beyond that the hospitals should focus on reaching out to the common man and help him with affordable prices and conducting camps, educating the villagers with the help of asha (accredited social health activist) to prevent and to treat minor ailments and creating an awareness among them and providing services with the use of technology such as telemedicine.  It is already done by a few corporate hospitals, but we need more of them to come forward and take responsibility. Government should bring about reforms to cover medical insurance schemes for all. It is a multifactorial approach. Whatever may it be every individual should do what is possible out of them not necessarily doctors. The development of a nation begins in the rural areas, once their standard of living is brought up, the country will unfold and rise upon itself.

In a way good for people, who are under the bracket of company insurance, but not effective for those who cannot afford basic medical treatment due to ever increasing costs. People below the poverty line cannot afford to go to a private doctor. Going to a private hospital is beyond their thoughts.

Some see that the growing commercialisation of medical care, ranging from general practitioners to super specialists, in corporate hospitals is unethical. Do you think treating patient with profit motive is unethical?   I leave it to you to judge for yourself what you think.

“You may not be able to read a doctor's handwriting and prescription, but you'll notice his bills are neatly typewritten” - Earl Wilson

Parsan Narang

6th July 2016