By Dr. Raghavendra Bhat
Mangaluru, Feb 7, 2015: Gone are the days when a doctor was considered a God, though many holy books propagate this sentiment. Later the doctor was revered and valued though not treated as divinity. Often, the doctor formed a part of the family and was indispensable for all festivals and functions and consulted for all medical and even social problems.
I remember distinctly an occasion when a patient died at home. He was regularly being treated by my father who was the family doctor. It was a Sunday and my father had taken all of us to the beach that evening. All of a sudden there was chaos on the beach. Two people were running, who we later realized, were desperately looking for my father. I was really surprised when I realized that they were looking for my father after the patient had died! My father later explained this phenomenon to me describing it as a ’bond’ between the doctor and the patient. It was imperative that the doctor who has treated the patient must see the patient after death so that the ’soul rests in peace’. This was in the mid 60s when I was a primary school student. I was really overwhelmed!
Later I completed my MBBS and went on to Post graduate studies in Medicine. I saw and treated patients at the Government Wenlock Hospital. It was a very heartening and a satisfying experience. The patients selected the government system knowing fully well that it was far from perfect. The doctors knowing this, went out of the way to compensate with compassion and the nurses and the other paramedical staff also did their best. The team work seemed to satisfy the patients who came from far and wide. Of course, some were unhappy; they shifted their patients to other hospitals. Some patients died - often this event was predictable. Sometimes death was unexpected but doctors were around at the time and shared the sorrow of the patients. The trainee doctors acted as a buffer between the patients and the treating doctors never letting down their teachers whom they held in high esteem.
In the present times, there is visible and complete change in the scenario. The patients do not respect the doctors in the same set up. Doctors are ‘uncomfortable’ and insecure. Patients demand miracles. Even when they are aware of the limitations, their demands are unrealistic. They unreasonablly expect senior doctors to be around all the time. The doctors known as ’honorary’ doctors belong to a cadre who are not paid anything by the Government for their services lent to the Government system. On the other hand they ’ volunteer their service’ part time’ in view of their teaching roles. Obviously they need to look elsewhere to make a comfortable living - which is the basic expectation of any professional with 15 years input into training, excluding the costs. They are into private practice as a norm. In any professional system, there is a hierarchy and the system is closely followed. This happens in all government organisations including the DC office, RTO, etc.
Not only the doctors are expected to be present all the time, they are also expected to solve all problems medical and otherwise. It is certainly beyond all reason to expect flawless treatment and services in any context and medicine is no exception, money cannot buy everything. Doctors too are human and have their own limitations, a doctor cannot substitute God. Shortage of medicines, substandard drugs, non availability of space in the ICU, shortage of beds cannot be addressed to by the doctors. A road traffic accident is a case in point - death or serious injury results from an accident. Such a patient is brought to the hospital and the relatives are naturally emotionally upset. Doctors become the target of real and imaginary shortcomings of the hospital or the system and any adverse outcome of the event.
First of all take the larger picture, the inputs for the accident - why did the accident happen at all? One common scenario for example; an unscrupulous person bought a non roadworthy painted up bus and got it certified fit for use by corrupt officials of the RTO. City corporation officials made a road out of what was left after sharing most of the sanctioned money at various levels. The so called road is a true mutant with many pot holes and accident prone spots. An unsuspecting two wheeler rider who is innocently concentrating on avoiding potholes and keep on the road or what is left of it, is mercilessly hit and knocked down by a speeding bus often from the wrong side. He is rushed to the hospital and the relatives are not prepared for the event, outcome, or the expenses. In this emotionally charged condition they try to vent the anger on the immediately available person - the doctor! Naturally the doctor who is trying to do his best against all odds humanly succumbs to emotional collapse. The doctor is the only present visible easy target in the whole show! Everyone is unhappy and the real corrupt antisocial culprits have gone scot free! Nothing ever has ever happened to the bus owner, bus driver, RTO official, corporation road contractor, or road tax collector, or administrators. Only the doctor is an available soft target. All these other real culprits should be made accountable - at least they must be given the responsibility of transportation of the patient and must be made to bear the expenses of all the expensive treatment modalities, diagnostic tests and costly medicines and also the cost of treatment in a better well equipped medical centre as needed.
This is my personal observation based opinion. A beautiful honorary system will die down if the steps are not taken at the right time, better late than never. And that time is now!
Dr. Raghavendra Bhat: A gold medalist in studies, the author is a professor and medical practitioner, has 5 medical books and an anthology of poems to his credit. Also an eminent speaker, Dr. RV Bhat, practices at Chitra Clinic, Hampankatta, Mangalore. The author can be contacted at: firstname.lastname@example.org