Doctor – messiah or manipulative?

A messiah, a saviour, a salve to your wounds, a divine intervention. These were the words often used to describe doctors before

Manipulative, money grubbing, narcissistic, arrogant. These are now the words used to describe some of them.

A researcher from Weil Cornell University stated that the proportion of people who have great trust in their doctors has plummeted by upto 75%.⁽¹⁾

As a medical student, I constantly hear claims like ‘Oh, you’re going to be rich only because you’ll fleece people’. It honestly, pains me to see my passion besmirched by the public. The chasm between the doctor and the patient is widening and there are days where I am lost, struggling to defend my profession.

A few decades ago, majority of the doctors were likened to God, wielding the power to save lives, and heal wounds. Their words were the gospel truth and being a doctor was the pinnacle of societal stature. And now they are met with dissent at every front. The fact is that they still save lives, but they are no longer Gods, just narcissists with a ‘God complex’ ^(2). The fact that the word is now, literally a synonym for ‘manipulation and falsification’ writes the article on its own.⁽³⁾

Have you ever felt cheated by your doctor?

Do you feel like you are charged colossal amounts of money for basic healthcare services, are made to suffer unnecessary procedures, and finally prescribed a slew of pills for ailments that can be controlled by diet and exercise?

Today, doctors are, quite unfortunately ranked by the hospital administration basis the number of procedures they perform and the profits they reap ^(4). The once sacred relationship between a doctor and his patient, has now been marred by bonuses and targets. Doctors spend a few seconds with someone who has probably travelled miles just to see them. They barely look the patient in the eye, let alone address the fears that lie behind them.

Additionally, people, and I say this with caution, know too much. Do you use WebMd to diagnose your symptoms? Have you ever been conned into believing you have a serious illness, when you actually don’t? ⁽⁵⁾

People watch the news much too keenly, follow YouTube channels of quacks and read Whatsapp forwards with fervent interest. The mistrust has become so entrenched in their minds, that they’d rely on pseudo-medicine from a machine, over a doctor in a white coat.

To make matters worse, there is no solidarity among physicians themselves. A study by the Journal of Internal medicine suggests that upto 67% of the physicians often criticise each other to patients. ⁽⁶⁾ The irony of a ‘fraternity’ that maligns one another has reached its peak. We toss the blame back and forth but really fail to realise the dominoes that fall each time.

With this downhill trajectory, I’d like to bring notice to the bigger picture. Today, the healthcare system isn’t run by medical practitioners, but by businessmen and pharmaceutical companies. With the increasing privatisation of services, the healthcare sector has been monopolised by profit over patient. And while some doctors benefit from it, others are mere pawns in the playfield. Privatisation has the benefits of increased quality, better reach and high-end technology – but at a price, and a steep one at that. ⁽⁷⁾

In India a meagre 1.5% of the GDP is dedicated to health and the doctor patient ratio of 1:1800 is abysmal.

In this dismal situation, we should take inspiration from other countries who have cracked the code on universal health. The WHO has slated its theme for the last two years – Health for All, universal health care. Healthcare is as fundamental as food and water, and we have a lot to learn. Norway and Sweden ⁽⁸⁾ have a strong, single national health insurer. It tremendously reduces the nations healthcare costs. Netherlands has a strong benefit package and a high government allocation of funds to healthcare.

India has the unique problem of a massive population and limited access. My opinion, is that a public private partnership works best in a country like India. The Niti Aayog has proposed to rope in private institutions to diagnose and treat chronic conditions but its being met with a lot of suspicion ^(9). Every private institution must also be mandated to engage in a certain proportion of free care, possibly resulting in a tax rebate. The Apollo franchise is the largest in India and is restricted to a meagre margin of the population.

Doctors also need to realise that the panacea of corporate ills can be eased by better communication. Doctors who communicate well, at every step of the treatment process and are transparent and honest with patients always stand out by a mile

Patients are also not exempt from this cycle of change. While it is good that people are aware and informed, the deluge of false information that is circulated creates a pseudo semblance of knowledge that is very dangerous.

Healthcare is the sine qua non of a society, and with increasing health scares and declining immunity the system needs a revamp now more than ever. Change needs to arrive on the part of various stakeholders – the government, the private donors, the doctors and even the patients themselves.

The question is when will the dissatisfaction boil over into a revolution?

Is it the government that spearheads the change?

Is modest profit the norm for healthcare?

Right now we have more questions than answers. But it’s about time someone starts asking the right questions.

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