One of the many things I tend to miss about home in my life in the US is Indian television (I know they’re available, but I’m too cheap to get the desi channels on cable, and too lazy/busy to watch random TV online). Whenever I’m back home I tend to get an unhealthy dose of TV shows amongst other things like chaat, mangoes and my mothers cooking. I had heard some of the buzz about Aamir Khan’s Satyamev Jayate but hadn’t really been able to watch any episodes until a recent trip back home where I did manage to catch the show about medicine in India.
The show’s highlighting of the way medicine is practiced in India, with a special focus on how hospitals and physicians work on commissions for referrals did not win it many friends in the medical fraternity. There was a strong reaction from the Indian Medical Association, asking Aamir Khan to apologize, who of course, refused to do so. Many of my friends are physicians and I recall my Facebook newsfeed being cluttered with disparaging remarks about the show.
Medicine, like many other things back home, is in a rather sorry, disorganized state. That is not to suggest, even remotely, that things are perfect in the US. Each health care system is bound to have its flaws and is eventually going to evolve according to the needs and culture of the society it services.
Being a physician, this is an issue that I feel strongly about. I haven’t really practiced medicine independently in India since I left for the US shortly after completing my internship, but I saw enough of the ‘real world’ to know that Satyamev Jayate wasn’t making stuff up. Even in my brief clinical time in Ahmedabad/ Ghaziabad / Delhi I came across plenty of situations where reasonably senior physicians were talking about ‘commissions’ or ‘incentives’. I was hence not particularly surprised when I saw the show delve into these subjects and was actually rather impressed by the thoroughness of the show and their team’s research.
That should, however, take nothing away from the thousands of doctors who work incredibly long hours and spend years training to excel in their chosen fields. Residency training, especially in government hospitals in India can be particularly brutal, where the resident doctors have no time to call their own. It is virtually indentured servitude for a period of anywhere between 3 and 6 years. Indian doctors are in general very skilled and the respect they have gained not only in India, but the world over, is testimony to that.
There will sadly always be rotten apples amongst the good ones. The problem here though, is unfortunately on a scale much larger than the individual. It is a problem of the ‘system’. It has become a part of the culture; just the way the private practice medicine world is now. A combination of peer pressure, a lack of education about ethics (we had zero classes on the subject) and a fear of lagging behind in the never-ending rat race are probably what make many of the same hardworking doctors act in an unethical manner.
Like many of the problems that plague India today, there doesn’t seem to be a clear solution in sight. Some semblance of action against individuals involved in unethical medicine would certainly be a deterrent. Introduction of medical ethics in the medical school curriculum could potentially be helpful. The best place to start with though is with oneself, as clichéd as that may sound. One of the most important things I’ve learnt during my training in the US is an oft-repeated phrase – “Do right by your patient”. Perhaps if we all just focus on doing the right thing, we can fix this problem, and fix it soon.
Photo credit: cryptome.org