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.
17 Comments Add yours
To believe that a federal-private partnership is the ideal way to move forward, is to address only half the issue. Healthcare is a fundamental human right and there should be no caveats regarding it. The only logical way forward to ensure that every individual gets the care that they need and deserve, is to implement a universal single payer health care system, replacing private insurance. There can be no room for discrimination based on nationality or income.
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I agree, but that’s a rather utopian view considering the health budget of the country and the population. The partnership is a start in the right direction
Possibly utopian yes, but if you don’t pursue the ideal then what is the purpose? As far as the financial concerns, they can be resolved by addressing the atrocious wealth disparity in India today. There exist around 130 odd billionaires and more than a 100,000 millionaires in India. Higher wealth taxes on those with extreme wealth can help fund not just wealth reform, but housing and education reform.
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Very well written, can relate to it, good post 👌👌
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You’re most welcome 😊😊
This is a very important and well educated post Shruti.
We all need health care for sure and we all need to be proactive about our health by taking care of ourselves nutritional, physically and emotionally.
Neither a God nor a money grubber is needed is needed in medicine.. The truth is Doctors are underpaid and they are mandated only a certain amount of time and are blammed. Otherwise, concierge docs can be paid to be more available.
Such an important topic.
Yes, I love the concept of univeral health care for conditions that are out of peoples control… Thanks!
Very well researched post!
Great post Shruti … a lot to learn n a great research… your articles bring the imagination in my mind
Interesting write and interesting questions:
I have an ongoing battle with our drug prescribing medical system and have dropped most of my meds and cut the remaining in half (researched).
I’m approaching 80 but look 60. It’s not nature, it’s nurture. At 50 I looked and acted 60.
I had all of the serious health issues of my immediate family: high blood pressure, scarred arteries, irregular heartbeat, A-fib, you name it. And they all had bypass surgery, heart attacks and strokes. Me, a minor stroke this year with no significant problems.
One thing definitely missing in 8 years of med school are courses in real health like lifestyle and the power of what we eat, drink, think, do and finally do-do!
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While I do agree with the importance of holistic care- diet, mental health, exercise and how that’s sometimes even more important than medication- I must say we do learn it. It’s probably not emphasised enough or in the right way, and hopefully we see improvement in that over the next few years. Additionally giving someone medication is easy, asking them to change their entire lives isn’t as easy. But I completely agree with you- lifestyle changes can be literally ‘life changing’
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Doctors I’ve talked too came from a different system and indicated they didn’t have any natural health training. Glad to see it is changing.
Was diagnosed with insufficient kidneys based on blood tests. Went to a kidney special who looked at my meds and indicated it could be caused by the interaction of my statin drug and Tricor. He said stop the Tricor, get a blood test and come back on two weeks. I did and the next time everything was normal and I’ve never seen him again. My triglycerides were over 500. They are now normal using lifestyle changes.
Been taking Digoxin for decades. Over the past few years when I had a blood test my doctor’s would call and tell me to stop for a couple of days (too high). No doctor every examined my dosage. So I did some research and found that because of my age (78) and kidneys numbers the dosage was too high. I cut my dosage to 125 MCG. My doctor did not like that but my level has been normal for over a year.
My wife had bleeding and sores over her body and used bandaids for the worst. Went to doctors including a dermatologist with no useful results except creams and such. One day she was very upset so I did a search of her symptoms and got a hit in less than 30 minutes. Went to a drug store and bought a common vitamin. Gave it to her three times a day, it cleared up and has never returned. She had vitamin C deficiency.
This is just the tip of the medical iceberg for me. The last drug, Lithium, sent me to the hospital for 4 days requiring dialysis to recover after a week of taking. I NEVER overtake a med. I turn the bottle upside down after I take a med.
This is such a well researched and informative post. I really like the concept of universal health. It’s so vital to adapt to it. Thank you for writing this, Shruti. Great post!
I don’t like to say this but, healthcare is one of the most blooming ‘business’ currently. And now it is turning into an evergreen one.
I know, I don’t like it either…
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An expert patient that I am, I have often come across some doctors waning me, “come back to this hospital only if you have a health insurance! Here they will charge you 3 times the normal fees!” Some leave a warm note by adding, “please do tell me where you took the treatment, just want to be sure you’re alright”! Sometimes, it’s the helplessness of the doctor as you said!
Good Post, you really need to have a health insurance if you are to be treated in a Pvt Hospital