If there is one thing I regret in life, it
is not studying to be a doctor. I am not usually the regretting kind –but I
have enormous respect for those that heeded the calling and chose this
profession.
There are a number of reasons I could
possibly give for my not choosing to be a doctor – but below all that is a lack
of courage. I simply lacked the courage to withstand the trauma and the gore. I
lacked the commitment it takes to work endless hours. I doubted my ability to
go those long hours without sleep and still be available, when needed, to
address the next, inevitable, crisis. I wasn’t sure that I could cope with the
expectation – to be that model citizen who unselfishly puts others’ interests ahead of his/her own.
Fourteen years ago, I made amends in a small
way by committing myself to a career in healthcare – to support these
wonderful people in their quest to keep people healthy.
A few years ago, I was discussing a mutual
passion in music with a doctor friend. The conversation veered to affordable player
options and I talked about my latest acquisition, a Bose Sound Dock. My friend
laughed and said “Rs 13,500/- isn’t a small sum of money on an associate
professor’s salary, Harish”. I came out
of the room very embarrassed by my lack of sensitivity and suitably chastised.
The incident also got me reflecting on the cost economics of becoming a doctor.
A little known fact is that a professor in
a Government Academic Centre of Excellence takes home a salary comparable to
that of the Company Medical Representative across the table from him. The figure could multiply several fold if they choose to
move to the private sector - a fact that every doctor is aware about. This begs the question “Why do these doyen of the
medical profession choose to stick to their government careers?” “Why do they resist the large financial incentives to jump ship?” and “Will this last?”
Medicine is amongst the most expensive
educations one can pursue. Even in a relatively less expensive country like
India, the cost of qualifying as a doctor can top Rs 1 Crore ($ 150,000) – in terms of
facilities, equipment, teaching faculty and support staff. It also takes
significantly longer to qualify – there is the 4 year undergraduate course,
residency and a possible 3 year post graduation. Doctors often earn their first
salaries when other professionals have bought a car and are planning their
first child. The starting salary for a General Practitioner in India averages ~ Rs 7 lacs per year. This is only marginally higher than that of an office
assistant – and significantly lower than an executive’s starting pay. Most
start as duty doctors manning the toughest shifts and the worst timings – or
are left to fend for themselves in the uncertain world of private practice.
Layer on top of this the huge gap in the
availability of qualified doctors to manage the health of a population as large
as ours. The WHO norm for is 2.5 doctors per 1000 population – a number that
several developed nations have reached and exceeded. China and Brazil have 1.8
doctors per 1000 population. The corresponding figure in India is 0.7 doctors
per 1000. Given the amazing range of professional choices available to an
aspiring youngster in our country, will this gap ever be covered? I, for one,
have my serious doubts.
What, then, is the recourse available to
us? How do we continue as a country to march towards Universal Healthcare, the
Sustainable Development Goals and delivering on the promises an “emerged” nation
needs to make to its citizens. I have listed out my list of “must do’s” below :
- Value our doctors – they chose to be where they are so they can serve us. Value their time and respect their inputs
- Support every healthcare professional to work at their highest capability level
- Use technology to free up precious doctor time
- Empower patients to take care of themselves
- Focus on prevention and early intervention
Each of these is a complex problem in its
own right – and each deserves to be dealt with in detail as I hope to do in my
future writings.
For the moment, though – I would like to
end with a salute to our doctors. You are truly an inspiration. We might not always
show our appreciation but we depend on you to keep us healthy and happy!
