Looking at the teeming millions of people in our Mighty Nation of 1.4 billion can be both a thrilling and an appalling experience. Thrilling because we know we are the youngest country in the world with a booming economy and burgeoning middle class. Appalling because just by lifting up the bed covers we see the truth of the vast majority denied basic human amenities and their rights.
I have been trained for the last 12 years in an institute par excellence for the service it was created to provide. I have been influenced by many pioneers in the field of mission hospitals and have been trained to make a diagnosis and look for any possible menas to make their burden lighter than what it was before they met me.
So my current take on the healthcare situation in India is dismal. Though we have AIIMS, PGI, CMC Vellore, Ludhiana and many more premier institutes doing work that is truly commendable the answer to India's problem is hardly touched.
Lets look at our nation a land of many languages and cultures all woven into one by the British Raj.
The Urban Rural divide. The <4% GDP dedicated to Health. The corruption in the Government Health sector.
The poor facility in the Civil Hospitals dissuading both Health Professionals and patients from availing of it by choice.
On the other extreme are the corporate hospitals doing excellent medical care affordable to almost <1% of the country. The steeply rising cost of living and alongside it rising surely the cost of decent healthcare make health very expensive. We boast of our standard of Health Services being Internationally recognized as proven by the influx of Medical Tourism, which I am proud of, but the services it provides is affordable to only a miniscule in the country.
Is that all? One on side the failed Government Health System (affordable but useless) and on the other the corporate profit making Institutions ( excellent but expensive).
I believe there is a way out and that is through Non Government Organisations like CMC Ludhiana, Vellore, EHA and many others seeking to provide Low Cost Effective Care to those 90% Indians over looked and ignored by others.
My question is why can't each premier institute ( or Premier Dreamer) set up secondary level hospitals in his or her community ( this needs to be done strategically in semi urban to well populated rural areas or the hospital will die). Each of these secondary level hospital can have 7 -10 primary level hospitals in less populated areas manned by Junior doctors and nurses with ambulance facility. Each of these primary level hospitals can employ 4-5 field workers to monitor health of 1-2 village each and door to door visiting collecting data on Maternal and Child Health as well as non communicable diseases [diabetes, hypertension, mental and physical rehab, drug addiction, stroke, etc] ( there is hardly any data from North India). Each primary level hospital will then cater to 1000 X 5 families. Each Secondary hospital will cater to 1000 X 5 X 10 families. By doing this we will not only be a social impact but we will be academically brilliant, financially viable too. Each secondary level hospital can tie up with a regional tertiary level hospital for expert opinions and rare referrals. With tele medicine being made available even difficult consultations can be done online from anywhere in the World without risking unnecessary physical referral in an ambulance.
Sadly the whole impetus in Medical Education is on super specialisation. It is needed but lets be realistic keeping the Nation in mind. We need many more well trained MBBS and BAMS doctors then family physicians than we need MD Medicine/ MD Paediatricians. We need many more Gynecologists than we need DM Neurologists/ CardioThoracic Surgeons. Every one seems to be running a race with no direction.
There is no job satisfaction even after years and years of study as we always feel under paid, over worked, in secure.
I believe it is because we need to see things differently and make others see differently too.
The undergraduate training in MBBS needs serious monitoring as the doctors we produce are not confident of even talking to patients let alone his relative. Basic medical diagnosis and treatment with minimal resources needs to be stressed. Very often we find MBBS doctors feeling helpless even in a primary level hospital. The Post Graduate training programme needs to be more comprehensive with hands on skill demonstration made compulsory during training and in the examination. Super Specialisation should be encouraged within limits. The Government should make it easier financially and competetively for the more Basic and Essential courses. The doctor choosing Semi Urban or Rural India to set up health care facility should be interviewed and standards required discussed and then given subsidy for Land, Water & Electricity and can initially even be financially compensated with Rural allowance currently available only to government employees . Even doctors starting Health care Facility in Urban slums should be provided for.
As a doctor professional satisfaction is very important. Financial security is essential. All we ask for is what all professionals enjoy.
I dream of seeing health professionals achieve this by working in smaller set ups that are strategically planned and managed. I dream of seeing several secondary level hospitals set up as mentioned with low cost effective care being the foundation of decision making. Profit (with limits) oriented, Financially viable hospitals where Research and Community Health are stressed. Professional satisfaction derived from Autonomy, Respect, Access to Medical Information and Diagnostic Aids through in hospital testing, Central laboratory liaison and Internet, and of course decent salaries with enough savings. One day I dream of seeing a shift of preference among Health Professionals from Large over populated Cities and treating only the rich to the cleaner and fresher environment of Semi Urban and Rural India where Service is not a Sacrifice but a joy!
Then he said to his disciples, "The harvest is plentiful but the workers are few. Ask the Lord of the harvest, therefore, to send out workers into his harvest field." Matthew 9:37,38 The Bible.
I have been trained for the last 12 years in an institute par excellence for the service it was created to provide. I have been influenced by many pioneers in the field of mission hospitals and have been trained to make a diagnosis and look for any possible menas to make their burden lighter than what it was before they met me.
So my current take on the healthcare situation in India is dismal. Though we have AIIMS, PGI, CMC Vellore, Ludhiana and many more premier institutes doing work that is truly commendable the answer to India's problem is hardly touched.
Lets look at our nation a land of many languages and cultures all woven into one by the British Raj.
The Urban Rural divide. The <4% GDP dedicated to Health. The corruption in the Government Health sector.
The poor facility in the Civil Hospitals dissuading both Health Professionals and patients from availing of it by choice.
On the other extreme are the corporate hospitals doing excellent medical care affordable to almost <1% of the country. The steeply rising cost of living and alongside it rising surely the cost of decent healthcare make health very expensive. We boast of our standard of Health Services being Internationally recognized as proven by the influx of Medical Tourism, which I am proud of, but the services it provides is affordable to only a miniscule in the country.
Is that all? One on side the failed Government Health System (affordable but useless) and on the other the corporate profit making Institutions ( excellent but expensive).
I believe there is a way out and that is through Non Government Organisations like CMC Ludhiana, Vellore, EHA and many others seeking to provide Low Cost Effective Care to those 90% Indians over looked and ignored by others.
My question is why can't each premier institute ( or Premier Dreamer) set up secondary level hospitals in his or her community ( this needs to be done strategically in semi urban to well populated rural areas or the hospital will die). Each of these secondary level hospital can have 7 -10 primary level hospitals in less populated areas manned by Junior doctors and nurses with ambulance facility. Each of these primary level hospitals can employ 4-5 field workers to monitor health of 1-2 village each and door to door visiting collecting data on Maternal and Child Health as well as non communicable diseases [diabetes, hypertension, mental and physical rehab, drug addiction, stroke, etc] ( there is hardly any data from North India). Each primary level hospital will then cater to 1000 X 5 families. Each Secondary hospital will cater to 1000 X 5 X 10 families. By doing this we will not only be a social impact but we will be academically brilliant, financially viable too. Each secondary level hospital can tie up with a regional tertiary level hospital for expert opinions and rare referrals. With tele medicine being made available even difficult consultations can be done online from anywhere in the World without risking unnecessary physical referral in an ambulance.
Sadly the whole impetus in Medical Education is on super specialisation. It is needed but lets be realistic keeping the Nation in mind. We need many more well trained MBBS and BAMS doctors then family physicians than we need MD Medicine/ MD Paediatricians. We need many more Gynecologists than we need DM Neurologists/ CardioThoracic Surgeons. Every one seems to be running a race with no direction.
There is no job satisfaction even after years and years of study as we always feel under paid, over worked, in secure.
I believe it is because we need to see things differently and make others see differently too.
The undergraduate training in MBBS needs serious monitoring as the doctors we produce are not confident of even talking to patients let alone his relative. Basic medical diagnosis and treatment with minimal resources needs to be stressed. Very often we find MBBS doctors feeling helpless even in a primary level hospital. The Post Graduate training programme needs to be more comprehensive with hands on skill demonstration made compulsory during training and in the examination. Super Specialisation should be encouraged within limits. The Government should make it easier financially and competetively for the more Basic and Essential courses. The doctor choosing Semi Urban or Rural India to set up health care facility should be interviewed and standards required discussed and then given subsidy for Land, Water & Electricity and can initially even be financially compensated with Rural allowance currently available only to government employees . Even doctors starting Health care Facility in Urban slums should be provided for.
As a doctor professional satisfaction is very important. Financial security is essential. All we ask for is what all professionals enjoy.
I dream of seeing health professionals achieve this by working in smaller set ups that are strategically planned and managed. I dream of seeing several secondary level hospitals set up as mentioned with low cost effective care being the foundation of decision making. Profit (with limits) oriented, Financially viable hospitals where Research and Community Health are stressed. Professional satisfaction derived from Autonomy, Respect, Access to Medical Information and Diagnostic Aids through in hospital testing, Central laboratory liaison and Internet, and of course decent salaries with enough savings. One day I dream of seeing a shift of preference among Health Professionals from Large over populated Cities and treating only the rich to the cleaner and fresher environment of Semi Urban and Rural India where Service is not a Sacrifice but a joy!
Then he said to his disciples, "The harvest is plentiful but the workers are few. Ask the Lord of the harvest, therefore, to send out workers into his harvest field." Matthew 9:37,38 The Bible.
