Prescription to proscription

Dr Rashidpara
Satyamev  Jayate  a TV show by actor Aamir Khan recently highlighted the medical malpractices that shook the whole nation ,presenting various recorded cases of gross misdemeanors, it even woke up parliamentarians by surprise ,the later inviting him to address the parliament committee about his research on the subject. Was it a knee jerk reaction or an opportunity? But it is definitely a moment for doctors community across the nation and civil society to make deeper introspection of things happening around.
If media reports are to be believed, Aamir is paid three crores to play the host for each broadcast, and amazingly our political system becomes receptive only to such expensive iconic calls especially when it involves superstars of bollywood, the same problem usually goes unheard if raised by ordinary people. Battle against female foeticide is being fought vigorously nationwide and compaign against unnecessary hysterectomies is also going on in many states including ours, but due to absence of bollywood stardom in these campaigns, they go unnoticed.
Projecting doctors as vortices and fifth columnists among their own people was a big jolt and Aamir Khan’s criticism looked preposterous and infuriating. He must have succeeded in discovering huge rumblings and declaring one particular community reprobate, he inculpated doctors to turpitude and depravity but he completely failed to handle the program scrupulously and punctiliously that could have addressed the root cause of occurrence of such lowly deeds. But Aamir has to know that doctors are not demigods, he is not a preternatural, but as natural component of society as any one else. One can not isolate him from the society which he is living in. He can not be influenced by the professional ethics alone but will be equally influenced by the system he lives in. If we live in a nation where corruption is an epidemic, it will be unwise to think a doctor can not be infected.
In an era of sinecurism, where the newer generations prefer courses which are less cumbersome and more lucrative (Kam Padai Zaida Kamaii), doctors are profoundly contributing by opting for a university course recognized as the most toughest and rigorous world over, and if specialization is to be included, it takes them roughly 15 precious years to finally become pilots in the field. After having spent tiresome, hectic years with tough schedules he starts his career, and at this stage he is very honest, very dedicated and as innocent as a new born baby. He initially struggles to keep his professional acumen and talent intact as he is made to work in most unfavourable conditions where he fears to loose the sheen and get rusted which easily dents his honour and dignity. He wants to deliver to the best of his ability, but he is handicapped, he wants to prescribe the best but he is supplied with the worst, he wants to practice the latest and advanced technique but he is provided with weapons that are obsolete, and he finally realizes he is losing a battle that he had chosen to win. Discouraged and disheartened he feels he is not performing to the standard of traditional adages and maxims which describe doctors as next to god. He is not able to keep up pre-eminence and quintessence of job because of multiple negative factors and policies that he finds difficult to fight and challenge, and ends up accepting wrongs which unfortunately coats his ethics. I personally once wrote to then prime minister of India Atal Ji, for lack of blood bank facilities in rural Kashmir, the same letter was published in Greater Kashmir on 8th December 2000,though it yielded result by sanctioning blood bank to Distt.hospital Pulwama, but i had to face some internal departmental wrath.
I will side with Aamir, that certainly and unfortunately, some malpractices are there, but it will be wrong to corroborate that every medico is involved. We all consider doctor  a different entity, as he is indeed involved with the well being of human beings, but on most of the occasions we forget about his own well being. A sick can not help a sick, and disabled a disabled. A country that spends just 1.2 percent of its GDP on health can not improve the well being of medical personnel involved in multiple services of health care delivery system. A country with dismal doctor-patient ratio itself reflects how overburdened the community is, as a result the quantity overtakes quality. We can not ignore the fact that India’s fast growing economy has spreaded the tentacles of privatization in every field, it has become the fourth largest producer of drugs in the world by volume and is largest exporter in the world. Aamir blamed doctors for writing bulky and sub standard prescriptions out of their preferred brands which earns them commissions. But he failed to convey that who permits the manufacturing of such sub standard drugs in the country, and once manufactured will they automatically not find access to consumers. Who are responsible for quality checks and granting of establishment   permission to such units? Who gives them marketing licenses?   And are these people not the killers even before the doctor comes in picture. He talked of cheaper generic drugs, but failed to convey that India’s leading pharmaceutical house’s branded drugs failed to compete with American generics in quality, so how qualitative are Indian generic drugs is itself an enigma. Why have most of Indian states failed to implement drug act on pattern of Tamil Nadu, which has established an autonomous medical services corporation (TNMSC), which has been able to provide cheaper medicines and equipments to hospitals and has virtually eradicated corruption in all kinds of procurements. I hope doctors are not responsible for such non implementation but vested elements whose pockets will otherwise go dry and shrink have penetrated deep into this profession and are influencing state governments and dissuading them from adopting Tamil Naidu model. He will have to understand that his bollywood is also ruled and controlled by an underworld, similar kind of drug mafia operating in the country with strong politico-administrative backing can not be ruled out and Satyamev Jayate team will have to work on that to explore this nexus and doctor could be an unexpected unintentional end artery of this vast circulation. Many a time very good doctors have themselves raised the issue of humongous supply and availability of sub standard drugs and equipments around them, but they are either harassed or gagged for bringing the issues to limelight and such events become subterranean, buried deep enough to be unheard and unseen.
Satyamev Jayate is surely an eye opener for medicos as well, they will have to open their eyes and hearts and make self introspection that something somewhere is wrong, it is an opportunity to debug and disembody certain evils that have engulfed this prestigious profession. It should be a collective effort of all medicos to help restore honour and glory back to it, at the same time the society and government will also have to realize that doctors were angels because of the immense respect and honour you showered on them in past ,if he is no more noble is also because of you, because somehow the society feels he is a cheaper commodity whose consultation can be purchased and as a result the relationship of trust and faith of yesteryears has changed into more commercial one  ,making a noble profession of yesterday meant to heal wounds, an internecine affair. Aamir khan will also have to make an assessment that why over a period of time the people who were Tare  Zameen  Par till yesterday, suddenly become  Ghajinis. The solution is beyond 3 idiots and a separate debate for future. Doctors will have to rise again to give sanctity to their prescriptions before they become proscriptions and humbugs.
Aamir Khan  should also let us know that how film stars in India promote various products through advertisements, of whose composition and side effects they have least knowledge and are hazardous to health specially cold drinks and junk food products . Is money earned through such activity also a malpractice?