A time to hang up the Stethoscope?
Columns, Over A Cup of Evening Tea

A time to hang up the Stethoscope?

By Dr. K. Javeed Nayeem, MD

Every morning of every working day, over the past forty years, with a silent prayer to the Almighty to make me an instrument of His Grace, I’ve been picking up my stethoscope and putting it around my neck with a sense of elation and pride that only a fellow doctor can understand.

It may seem a little surprising to others but the fact that this is a routine daily act has not diluted the intensity of these two emotions in the tiniest measure! Elation; because it is a reminder that medicine, the art and science that I have learnt with a passion, has been providing me and my family a means of livelihood and thus a dignified and comfortable existence. Pride; because the same art and science has given me the power to heal and thus ease the pain and suffering of others.

It is my unshakable conviction that in no other profession can a person do as much direct service to mankind as in the practice of medicine. But although the sense of elation and pride have both thankfully remained intact, the practice of medicine itself over recent times, seems to be going through a silent but significant metamorphosis for the practitioners of the art themselves. And, sadly, while it should have been the other way around, it is a metamorphosis from pleasure to pain and from delight to disgust, thanks to government insensitivity and interference.

The governments, both at the Centre and the State, which themselves run very large health care establishments, that need much cleaning and tidying, seem to be hell-bent on making life miserable for the private health care providers who have been doing a significantly better job of managing the health of the nation. I say this from the observation that all those who wish to seek good and dependable health care and who can even slightly afford it, shun government hospitals like the plague and turn to private hospitals. They do not mind borrowing money to get treated there. Statistics too, which people say are a bunch of lies, say more or less the same thing…that seventy percent of people in our country prefer to get treated at private hospitals when they fall sick.

When this is the case, the government too should have been happy that private health care providers are doing a significantly decent job and focussed its attention on improving the quality of services in government hospitals which stink of inefficiency and obsolescence. But this does not seem to be the case.

While  the Central government seems to have completely bought out the Medical Council of India, a governing and regulating body that is itself desperately in need of some transparent governance, our State Government in a rather rash and rasping move, plans to bring in legislation that can literally hamstring and cripple the private health care mechanism in the State. This disgusting dose of lethal medicine is coming in the form of an amendment to the already very irrational KPMEA Act that was thrust upon us about six years ago without our consensus. The new amendment has an overt threat for private doctors and hospitals in its every paragraph. The quantum of modification that has been made from the original act is very interesting and noteworthy. Wherever the penalties for lapses were around rupees five thousand they have now been made rupees one lakh. They now come with the bonus of a mandatory imprisonment for the heads of hospitals that can range from a minimum of three months to a maximum of three years. These penalties can now be applied for something as silly as an error made by your billing clerk or cashier!

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The amendment also says: Every private medical establishment shall follow the rates as fixed by the government including the package rates for investigation, bed charges, operation theatre procedure, intensive care, ventilation, implants, consultation and similar tests and these procedures shall not attract additional charges over and above such rates fixed by the State Government. Apart from regulating the costs, this amended Act imposes umpteen other restrictions that dictate how private hospitals should function. They say that hospitals should not insist on the payment of an advance at the time of admission and should allow the patients to go home even if they are unable to settle their bills. The Act says that dues should be collected later from the patients’ relatives … as if patients’ relatives will happily make themselves available for settlement of bills once the crisis is over!

Now my question is: why has the government singled out only the private health care players for this regulation? When it is supposedly doing all this in the interests of patients, why has it very conveniently left out every kind of quality control requirement for government hospitals which are actually in a most miserable condition across the length and breadth of the State? Are the people who go there  not patients? Are they not in need of quality care?

According to some members of the drafting committee, when the amendments were drafted all the quality control provisions in it were supposed to be applicable to all government hospitals too. But when they were released, the government, to avoid embarrassment to it, has very conveniently deleted them. What I would like to ask is when there is absolutely no cap or any kind of restriction on the pricing policy of other professions like hotels and restaurants that cater to the needs of the public, why should it be there for hospitals and nursing homes? When it is natural for hotels and restaurants to fix their charges depending on how posh they are, what is wrong in hospitals fixing their charges on how advanced their equipment and services are?

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As it is, medical equipment is among the most expensive hardwares and it has the shortest useful life considering the rapid attrition due to technological advancements. How can the government which is famous for ill-understanding ground realities in every single field, decide whether the charges it fixes for hospital services can help them to sustain themselves, let alone making profits? Lawyers too deal with people and their problems. Why has the government not thought of fixing charges for their services based on the number of court appearances they have to make for each case? Does it have the guts and gall to do this? I think not.

On the contrary, our government itself has been very willingly and meekly paying astronomical fees to the lawyers it has engaged to fight its own cases on matters like our river disputes. It has been doing this year after year without as much as getting itself a stay from the Supreme Court on the daily release of the Cauvery water even in the time of a State-wide drought. I think the time has come for all private doctors to unite in the interests of their dignity if not their livelihood and oppose any kind of harassment and end it once for all.

We should end our soft and laid back approach and stand up for our rights. We should take a leaf out of the lawyers’ book of unity and solidarity that deserves to be appreciated and applauded for its unwavering steadfastness across the length and breadth of the country and make it an example for forging our own. The battle  that we fight now should be the mother of all battles.  And, the only way to do this is to hang up our stethoscopes, shut our establishments indefinitely and take a much-needed break with our families and let the government taste its own medicine by managing the health problems of the public on its own with its own rickety infrastructure. And while we are at it, we can also watch the fun on our TV screens!

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June 16, 2017

ONE COMMENT ON THIS POST To “A time to hang up the Stethoscope?”

  1. Sam says:

    Many of my doctors or friends are very good professionals and that gave me an impression that doctors are there to serve the people, but money was just a consequence! Accordingly, an immense respect they got from their patients and their family, they truly earned it! Of late, in the past few years, with many (lots of)private hospitals joining the fray many of the ethics have changed. The doctor had to make money for the hospital and practice has been twisted to add unnecessary tests, scare tactics and even tampering of the patients health in some cases! The insurance companies have joined the scene for their pound of flesh has complicated the matter that now every patient is billed as though he has a strong insurance company paying his bills! This has ruined many patients and families that this is somewhere between extorsion and blackmail!
    Yes, the government has no business telling hospitals or any orivate business for that matter! But, if good doctors take the advise from this gentleman and hang up their stethoscope, then , people will suffer and even die(or who knows, they may even be better due to not going through unnecessary treatment and may get to eat good food instead). Was this the doctors took the oath when they became docors!?
    There is a difference between any other business and medicine! A person in ICU , nobody knows what treatment the patients are getting, only bills are the indications! In many such cases, people have sold their assets!

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