THE DILEMAS OF THE MEDICAL PROFESSION

2 May

There is a growing distance among the different sections of society, more so between the society at large and the inhabitants of the medical profession. This population is not only minuscule but is under- represented and inarticulate regarding its concerns, anxieties and problems. The spokesmen for the society are numerous and powerful with a ready audience. In this article I will try to be a spokesman for the other side.

The dilemma of choosing a branch of study is faced by all. Only a few choose the medical science as a profession, some out of choice, and many due to coercion by parents or by virtue of having to manage a nursing home to be inherited. Some few wanting to come onto the profession, but not succeeding opt for studies in foreign lands, mostly CIS countries likeRussia, Ukraine etc. Those coming out of choice do come in with a sense of dedication and willingness to serve, but the lengthy course and associated stress soon take their toll on their values. This is compounded when they find their friends and batch mates already into jobs, earning six-figure salaries, while they have to be satisfied with a measly stipend after a longer period of study. Add to that the fact that failure rates being so high, less than half complete their study in the stipulated 5 ½ years.

The next dilemma comes during internship; whether to work and learn during this period of a year (for whish it is intended) or to prepare for the post graduate entrance looming ahead. For in this branch only a student has to continue giving entrances for everything. Not doing a post graduation would leave him without a specialist degree and close further options, leaving him one of the nameless doctors wasting away in the hinterlands of the country for their sustenance. Yet preparing for the same has no guarantee of success, but one may have to spend some years to get through. And during that period, to be dependent on your parents, especially after being a doctor, is a mighty unpleasant experience.

The next dilemma facing the doctor choosing to do the PG is the choice of subject. Actually choice is only for the lucky few at the top of the rankings. For the rest it is only-take it or come back next year.

After completing the PG, the doctor is faced with choices of joining govt service, higher studies, joining pvt sector, or starting own practice. Each has good and bad points in its favour. A govt job gives security but with measly salaries. Of course, don’t count job satisfaction among the attributes, unless you are blessed. Keeping the govt tradition of putting round pegs in square holes, or vice versa, one may have to do works not even remotely connected to medicine. Yours truly had scrutinized scholarship forms and land records and measured areas of houses. Add to that posting in a god forsaken place, where you have to keep everyone happy starting from the local dada to the local leader so that you may survive to ply your trade. Or be prepared to get roughed up for some imaginary mistake you supposedly committed, starting from not attending to a patient to rape/molestation(so newsworthy events).Or better still, grease some palms to get a better posting. Now, this was not in the curriculum, was it? A pvt sector job gives you good salaries, but with no regards to anything else apart from profits. Please let go of your ethics, if you have any left by now. Higher studies entail the same problems described above, during post graduation. Starting your own practice involves a good investment and savings for the time till your practice starts looking up, which may be some years. You have to have an understanding father with deep pockets, so that he may support you, and by that time your wife (and may be kid) for some months(if you are lucky) or years(if not so).

Now assuming that our doctor has solved all this dilemmas, with his values wounded, but alive, he is faced with even more dilemmas. News like “doctor gives injection and patient dies” makes him feel like a cat caught in a car’s headlights. As if all the training he received in a decade and a half was for killing a patient .Also he comes under consumer protection act. Nothing wrong there except for some small points, like if patient is a consumer, why does he grudge you your fees? Oh! The doctor took Rs X for only writing three medicines. He cannot make them understand that the fees are for the expertise gained over years and not for writing only. The patient is always free to go to a ‘shop’ charging less. The other point is that why should other professions not be under copra? After all one can get killed when a bridge or building collapses, or by mosquito bites (dengue, malaria) and so many other causes. He is not sure whether he should attend to a patient brought to him when he is just about to die and try to revive him (which may not be possible medically)and risk being a breaking news for some TV channel, or first make an MLC ,so that his skin is saved, thereby losing a few vital minutes. Whether he should advise an investigation to rule out some problem. If he does, he risks being accused of taking commissions, and if not, then negligence, if the problem is discovered later.

Dilemmas galore, yet these are not the only ones. So many more are experienced, yet untold. Due to the circumstances, under which a doctor has to work, and the negativity which has come to be associated to this profession, the number of students opting for the course has dropped appreciably. After all, why should a student spend the best decade and a half of his best years, toiling away only to do a thankless job. The money and time invested in this course, if invested differently will fetch much higher returns. And the days when a doctor wanted his children to be doctors are long gone. Now he wants them to be anything but a doctor, unless he has an established institution to give in inheritance.

This article is not to discourage anyone from entering this hallowed profession, but to make him aware of the pros and cons of the same. After all being a doctor has its advantages as well, least of them being a no retirement. The joy felt on seeing the thankful smile of a patient expressing his gratitude for his relief, compensates for many of the negatives. This branch of study requires utmost dedication, and concentration over a long period, probably throughout life. If you have it in you, then!

About the Author:

Dr B.K.Kundu,
Rheumatology Clinic,
Department of Medicine,
PGIMER, Dr RML Hospital
New Delhi-110001.
Email: bijit73@sify.com
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2 Responses to “THE DILEMAS OF THE MEDICAL PROFESSION”

  1. Dr Dayanand I Nooli May 3, 2012 at 6:51 am #

    I congratulate you for the excellant narration u have done in your article. Gone are the days where doctor was considered as GOD. It all started with a term called MEDICAL SERVICE, now ending with MEDICAL INDUSTRY. Now this noble profession has become a business. Apart from the problems you have mentioned, lot of rules and regulations like Biomedical Waste Management, Labour Act, Nursing Home Registarion Act, Blood Bank Act, CPORA, etc have almost succeded in closure of many nursing homes across the country. No value for dedication in this field. Now central governament is coming with a rural medical degree to totally murder MBBS degree. GOD ONLY SHOULD SAVE THIS PROFESSION. Private practice will be owned by MNCs and there will not be ethics in those institutes. Dicussions of such nature should urgently begin amongst us. But our profession is most disorganised, ununited, egoistic and selfish organistion compared to other professional groups.

  2. Dr.S.V.Nadkarni May 4, 2012 at 1:05 pm #

    A very average article.Almost like a newly entered student and highly pessimistic. though some part is correct, the author seems not to have understood the competition which everyone has to face in the modern world.Those who can not swim, have to sink,now-a-days.

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