By Dr. K. Javeed Nayeem, MD
I have this rather odd habit of asking every youngster I meet what he or she wants to become in life. After listening to their dreams I invariably advise them to consider the option of becoming a doctor if it is not already on their menu.
Many parents who want to make their children doctors and who are aware of this bias in me, very often bring them to me with a request that they are in need of that ‘one tiny nudge’ that can help them to overcome their indecision when they are poised over the brink.
Becoming a doctor and a very ‘big’ one at that was my only dream in my childhood which I was thankfully able to realise in full measure, going by my own yardsticks, at least. Ever since I can remember and recall, my daily bedtime prayer among my many other wants, always used to include a very passionate plea to the Almighty to make me a ‘Bada Doctor’! I had even informed my parents the length of the table spread and the exact menu that would have to be there on it for the thanksgiving feast upon my return home as a fully qualified doctor!
With this kind of an affection for my profession it is no surprise that I was very happy to read in my newspaper yesterday that the Government at the Centre was thinking of starting 75 new Government Medical Colleges across the country that would open the doors every year to nearly 16,000 young aspirants wanting to become doctors. This is one of the best things that the Government would be doing and it is actually something that it should have done long ago.
Many of my colleagues may be a little surprised that I am applauding a move that will only be increasing the competition that we doctors will have to face in the coming years. But this is not the right attitude that we should have as human beings as it is very akin to the mentality that we see in an unreserved Railway compartment. The very same people who cling precariously to the hand rails with just one of their feet on the foot boards and plead to be allowed in, themselves try to prevent others from getting in once they are inside! The fact is that there is a very great mismatch in our country between the doctors we need and the doctors we actually have to take care of the health needs of our population. And, this disparity is not good at all for the health of our nation.
While most developed countries have more and the WHO recommends a minimum of ten allopathic doctors for every ten thousand people, this figure is just four or even less in our country which is abysmally low and inadequate. When you also take into account the great disparity that exists in the concentration of doctors between our cities and rural areas, the latter are almost bereft of bare minimum medical care. To serve the medical needs of all our citizens reasonably well, we need many more doctors coming out of many more medical colleges than what we are seeing at present.
To view this as something that will lessen the opportunities for existing doctors is a very selfish attitude. We doctors should understand that it is our competence, bedside manners and the quality of the care we provide that will eventually decide whether patients come to us or not. And, it is also very fair that our earnings should depend on these three factors and certainly not on a scarcity of doctors! Doctors would therefore do well to welcome more new entrants into their fold in the interests of the needs of our country while keeping their own work ethic in good health.
While most doctors these days lament that the going is not very good anymore with the many restrictions that are being imposed on private medical practice, it is strange that there is still such a great demand for the study of medicine in our country. It is so difficult for our youngsters to enter the medical stream that the announcement of the selection lists is undoubtedly the biggest annual source of frustration and grief for all those who fail to make it. I feel that a medical career should be more accessible to all our youngsters both in terms of competition and the cost too.
Today it is one of the most expensive courses to pursue both in Government and Private Colleges and only those who have the wealth to afford it can enter its hallowed portals. But there is no denying the fact that many join the medical course just because they qualify in the entrance examinations while not being cut out by their personalities to become good doctors.
There have been times when I have been compelled to feel that one needs to have a calling to become a doctor. So I feel that in addition to merit there should also be some kind of a screening process to assess the aptitude of a candidate on the lines of what we have in the civil services selection process. While welcoming the move of the Government to establish more medical colleges I am a little worried that it may not be easy for it to find good and capable medical teachers to run them.
This is too real a problem in our country since the scarcity of doctors with Post-Graduate qualifications far exceeds the scarcity of doctors with basic under-graduate qualifications. Even those doctors who have adequate PG qualifications to serve as teachers in Medical Colleges hesitate to join the teaching profession as it does not pay them as much as private practice pays. This can be mitigated to a great extent if the Government makes medical teaching more lucrative with increased salaries and other perks. A second measure that can help greatly would be to increase the retirement age for medical teachers.
I believe that all good teachers, of all classes and all courses, can do without retirement as the ability to teach has an immortality inseparably enshrined in it! Here, a system of assessment by students through secret ballot to decide who should get this extension and who should not can be of immense help because even among teachers we have both cabbages and kings! Let me warn you that while some may be retired but not tired, a few others are already dead much before they are shed !
e-mail: [email protected]
This article fails to emphasis the personal responsibility of every person, to look after his or her health Choice of food, exercise and clean living are emphasised in Western countries: for example obesity arising out of the wrong diet and sans exercise is often the main reason for coronary -related diseases as well as the on set of type2 diabetes. More doctors in India, means more private clinics and more swindlers of patients. More doctors does not mean they are able and knowledgeable. In my experience, most Indian doctors look obese, some smoke and others have other habits and they look more sick than their own patients . If many of them have their own illnesses, how they can advice patients? I knew an Indian doctor , a cardiologist friend in Mysuru, in his forties , underwent a triple-bypass operation, after a heart attack. He used to dish out advice to others including me, a slim man, about keeping good care of health, but himself, over-indulging in fat-filled diet! Finally, fearing his early demise, he went to Singapore for treatment, where, he was given a stern advice to watch his diet and do regular exercise-walking, not part -driving and part walking as he used to do! This pontificating person, finally realised, how inadequate he was, despite his postgraduate degree, and how little he knew about keeping good health, became a model doctor after his experience of seeing slim cardiologists in Singapore hospitals, who took regular exercise and watched their diet. He used to say, the fellow cardiologists he knew all died of heart attack, not following the simple rule on diet and exercise!!
Health is a personal responsibility. In most cases, this responsibility fails, and the fleecing doctor comes in to take away, the hard-earned savings! In the Western country, where I live, the emphasis on the above personal responsibility of following a regimen of health diet and exercise. The specialists I meet say the less they a patient, the more healthy he or she becomes!!1
Ridiculous article. More doctors does not mean better health but poorer patients after paying doctor’s bills, unnecessary tests and medication. Indeed, patients are better off not visiting doctors , but taking care of their health through , as the poster says, better diet and exercise. Mysuru of those days in 1950s had less doctors, and still people enjoyed better health. People then walked or cycled to their work, ate proper food with plenty of vegetables-no fancy fast food chains then, and ailments like chest infection were unheard of, as there was clean air with the absence of too many automobiles, and with Mysuru being small , surrounded by forests, which gave the essential eco balance.
The only bunch of people who needed to see specialists were the Santhepet merchants, all of them obese, and many suffering from multiple ailments because of poor exercise. The KR Hospital specialists lke Jadhav, Das, Govindappa etc.. pocketed the non-practising allowance and did roaring private practice, thanks to the above rich Santhepet merchants. They kept the above specialists, so called, as these specialists got their MRCP in England ., as the awarding body knew that they will return to India. That was the case for returning doctors who sat for the MRCP exams. Anyway, they did not produce better health for their patients,. Their bank balances were improved immensely!
Simply churning out more doctors does not improve the nation’s health. The Western countries have realised this and hence the emphasis on each person to ensure that he/she looks after his/her diet and do plenty of exercise, and avoid smoking and consumption of excessive alcohol.
That advice holds good for India too.
When it comes to medical care, it is not quantity but quality matters! Increasing the quantity of doctors can only control the population! We have sim doctors and specialists in SIGMA hospital who are just greedy and turn out to be messengers of Death! So, anybod who happens to be a patient are advised to make their Final will! Majority of government doctors are top housing times superior to these leaches that kill!