Indian doctors are well known around the globe for their talent, dedication, hardwork. Many have become great administrators, researchers and role models. But doctors have become an easy target when anything goes wrong with in the health system in India.
Health care in India has been solely equated to doctors and they seem to be responsible for everything when it comes to delivery of health on ground. But when it comes to policy making and allocation of resources affecting the health care of more than a billion, the doctor community is kept at bay. This is down to the VVIP culture and the all-knowing mentality gifted by British and inability to let it go.
The Indian Medical Association (IMA) unlike its counter parts in other countries like British Medical Association (BMA) has failed its purpose and most doctors do not identify with it. In UK, BMA plays a major role in health policy and works closely with department of health. It influences most of the policy decisions including salary, working hours and staffing levels.
The Medical council of India (MCI), in addition to maintaining medical register is responsible for the quality of medical education and training, which it has completely neglected. If one tries to find the curriculum and syllabus for any speciality, trust me it only leads to disappointment. The examination system is archaic. Although medical science has changed completely in last 50 years, we
are still carrying on with the system which was in place at the time of independence. There is no effort on personality development, communication, ethics and research. There is no support for doctors in training and bullying is quite prevalent. It has also failed to make doctors accountable for their actions and one off registration for life time is offered without any reviews and revalidation as is
common in most developing countries.
There are innumerable challenges when it comes to working as a doctor. Indian health system is supposed to be free and based on three tier primary care, secondary care and tertiary care as is in United Kingdom. Having worked in both India and UK, one could see how in India the system is on paper only. The primary care is mostly defunct and even if doctors are posted in meagre number
of primary health centres (PHCs) catering to a humongous population, the resources in terms of manpower, essential drugs, equipment is next to nothing. For the same reasons doctors feel reluctant to work in the rural set up fearing loss of skills and negative impact on career progression. We are still expecting newly qualified MBBS doctors to work independently and man any situation, which is actually unfair on them and their patients. Most countries have further training of at least 3 years for doctors to become general practitioners (GPs), who in return form back bone of the health system and manage all kinds of ailments in primary care.
Also the situation with district hospitals is not any great. As the primary care fails, patients usually rush to bigger centres. These hospitals are run on similar lines and specialists working there are not given due support, career progression and resources to do what they are qualified to do. This has led huge pressure to tertiary care hospitals. People walk into any tertiary care hospital with
minor ailments which could easily be managed in community if the system is put in order. The referral system is completely broken and poor patients cannot be blamed to pitch at tertiary centres.
Although doctors form an important part of health system, they can’t act in isolation in current day and age keeping in view the advances in medicine. There is a need to inculcate culture of multidisciplinary team work and inclusion of other allied professionals like nurses, pharmacists, physiotherapists, social workers etc. Health spending is still in pennies compared to rest of
the world. Common man needs to make health as a priority and force their elected representatives to bring in the change. The draft National Health Policy 2015, has proposed a target of raising public health expenditure to 2.5 % from the present 1.2% of GDP. It also proposes making health as a fundamental right, which is a welcome step.
Dr Mudasir Firdosi is working as a psychiatrist at South London and Maudsley NHS Trust and Institute of Psychiatry Psychology and and Neurosciences (IOPPN) London. http://healthanalyticsindia.com/healthanalytic/dr-mudasir-firdosi.html
Health care in India has been solely equated to doctors and they seem to be responsible for everything when it comes to delivery of health on ground. But when it comes to policy making and allocation of resources affecting the health care of more than a billion, the doctor community is kept at bay. This is down to the VVIP culture and the all-knowing mentality gifted by British and inability to let it go.
The Indian Medical Association (IMA) unlike its counter parts in other countries like British Medical Association (BMA) has failed its purpose and most doctors do not identify with it. In UK, BMA plays a major role in health policy and works closely with department of health. It influences most of the policy decisions including salary, working hours and staffing levels.
The Medical council of India (MCI), in addition to maintaining medical register is responsible for the quality of medical education and training, which it has completely neglected. If one tries to find the curriculum and syllabus for any speciality, trust me it only leads to disappointment. The examination system is archaic. Although medical science has changed completely in last 50 years, we
are still carrying on with the system which was in place at the time of independence. There is no effort on personality development, communication, ethics and research. There is no support for doctors in training and bullying is quite prevalent. It has also failed to make doctors accountable for their actions and one off registration for life time is offered without any reviews and revalidation as is
common in most developing countries.
There are innumerable challenges when it comes to working as a doctor. Indian health system is supposed to be free and based on three tier primary care, secondary care and tertiary care as is in United Kingdom. Having worked in both India and UK, one could see how in India the system is on paper only. The primary care is mostly defunct and even if doctors are posted in meagre number
of primary health centres (PHCs) catering to a humongous population, the resources in terms of manpower, essential drugs, equipment is next to nothing. For the same reasons doctors feel reluctant to work in the rural set up fearing loss of skills and negative impact on career progression. We are still expecting newly qualified MBBS doctors to work independently and man any situation, which is actually unfair on them and their patients. Most countries have further training of at least 3 years for doctors to become general practitioners (GPs), who in return form back bone of the health system and manage all kinds of ailments in primary care.
Also the situation with district hospitals is not any great. As the primary care fails, patients usually rush to bigger centres. These hospitals are run on similar lines and specialists working there are not given due support, career progression and resources to do what they are qualified to do. This has led huge pressure to tertiary care hospitals. People walk into any tertiary care hospital with
minor ailments which could easily be managed in community if the system is put in order. The referral system is completely broken and poor patients cannot be blamed to pitch at tertiary centres.
Although doctors form an important part of health system, they can’t act in isolation in current day and age keeping in view the advances in medicine. There is a need to inculcate culture of multidisciplinary team work and inclusion of other allied professionals like nurses, pharmacists, physiotherapists, social workers etc. Health spending is still in pennies compared to rest of
the world. Common man needs to make health as a priority and force their elected representatives to bring in the change. The draft National Health Policy 2015, has proposed a target of raising public health expenditure to 2.5 % from the present 1.2% of GDP. It also proposes making health as a fundamental right, which is a welcome step.
Dr Mudasir Firdosi is working as a psychiatrist at South London and Maudsley NHS Trust and Institute of Psychiatry Psychology and and Neurosciences (IOPPN) London. http://healthanalyticsindia.com/healthanalytic/dr-mudasir-firdosi.html
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