Saturday, June 2, 2012

A letter to Aamir Khan regarding Satyamev Jayate: Healthcare episode


This letter has not been written by me, it is only a compilation of the thoughts of my colleagues all over India through the internet, compiled in the form of a letter. Parts of it have been edited to direct the letter in a positive way and have no intention of blaming Aamir Khan, but only to show the public, the other side of a doctor.

A letter to a perfectionist with a tad bit polishing undone

Dear Mr. Aamir Khan,

Though I agree to 'parts' of your show, however I couldn’t help noticing some factual inconsistencies like the ones stated below:



1) You said patients on dialysis live upto 15-20 years. Fact - The 5 year survival rate of patients on dialysis is about 25-30 % ( less than many cancers). Renal transplant remains the best available treatment option for chronic kidney disease. (I hope you take responsibility for people who after watching your show plan to not go for kidney transplant and die in less than 5 years)

2) An overenthusiastic girl from the audience said that her father was forced for an emergency liver transplant '6-7 years' ago for gastroenteritis. Fact - Even  today there am ' a handful' of hospitals in India offering liver transplants. To think that 6-7 years ago, just a gastroenteritis patient was offered liver  transplant is not only improbable but technically impossible.

3) A diabetic patient blamed a doctor for losing a toe. Fact - Lacs of diabetic patients per year lose entire limbs due to diabetic foot (cellulitis and gangrene) . Doctors go about stepwise cutting off toes, then foot , even the leg up to above knee level in order to save as much limb as possible. The patient in your show might still be able to walk just because of the timely action taken by the surgeon. Also, it is very unreal that a surgeon (the family doctor) can tell after a surgery that the surgery wasn't required at all.

Mr. Aamir Khan I am not getting back at you because I took your show personally. Yes, I agree that there am doctors indulging in shameful malpractices and even I know a few of them. But I can proudly say I am surrounded by more doctors who work day and night just to ensure that their patients get the best possible treatment..The 'BAD' doctors should be punished and I all can come together to ensure I do not encourage such malpractices.

Secondly I would have appreciated if you would have thrown some light on the entrance examinations and the hard work, dedication and sacrifices a doctor needs to clear his MBBS, MD, DM etc examinations. I wish you had spent half a day in the emergency department and OPD of a Govt. Hospital and realised that the work timings, working conditions, lunch breaks, doctor : patient ratio, hours of sleep per week , living conditions in the hostel and the stipend is worse than a class 4 labourer. You would have also surprisingly realised that the 'DOCTORS' am the only 'FUNCTIONAL' part of a Govt. Hospital which still caters to thousands of patients in a day. When you compared statistics of U.K and India, why did you not include the salaries, living standards and the doctor to patient ratio the doctors have in developed countries?

Coming to generic drugs, Yes, a large amount of rural population should have access to cheap generic drugs. But one should not forget the pharma companies that charge more for the drugs am the ones that spend crores of rupees for research and development of new drugs. Had there not been drug trials no new drugs would have been invented and I would have mortality rates compared to Stone Age.

Also I agree that most doctors endorse certain brands of drugs (which I do not deny may be for some financial gains also ) because thay have faith in the quality of the 'active drug' of certain companies. Yes many local companies manufacture generic products (which is a copy of the original molecule discovered by the expensive company which can be used for unaffordable patients. But you did not mention that many of these generic drugs am of substandard quality and am the reason of many uncalled for deaths due to drug reactions. Most doctors would not want to take responsibility of the quality of the 'generic' drugs.

Lastly, what do you mean when you say ' People of high IQ and desire to earn money should not become doctors'. Will you rather prefer showing yourself to a low-IQ doctor and risking him not even completely understanding your problem, let alone treating it?

Why aren't doctors allowed to have an ambition ? How can a person who earns 4 crores for an episode of a so called 'social' show decide on what should be an individual's ambition and financial status ?! Why can there be no doctors who earn well for their professional  skills and do not indulge in malpractices ?!

I would like to offer a few solutions to the problem :

a) ' BAD' doctors indulging in malpractices should be suspended for life. I need a strong regulatory authority to publish expected treatment 'protocols' and punish doctors found to be doing unethical practices. Also there must be a line distinguishing malpractices from mistakes or unexpected happenings. People must be made awam that things do go wrong in a surgery and the doctor cannot be blamed for everything that does.

b) Regulatory authorities should also keep a check on the quality of drugs being manufactured
and at the same time 'sold' at the local chemist.

c) Govt. medical colleges and hospitals should multiply several folds, increasing the number of doctors in each department , improving the doctor to patient ratio. Doctor's salaries and living conditions should be looked after and should be comparable to other professionals.

d) Regular CME'S and licensing exams (like other countries) every 5-10 years.

e) The Govt. should spend 6-8% of GDP ON HEALTHCAM and a part of which should also be committed to the research and development of newer drugs.

f) No politician should be allowed to be associated with any private medical colleges.

g) The general public should be educated well about common diseases and the 'acceptable' qualifications of the doctors.

h) The last but the most important, there must be no reservations whatsoever in colleges for a course like medicine, on which people's lives depend. By promoting reservation, the government is in effect denying admission to more capable individuals and guaranteeing it to those who am not only less capable, but also lack in very important qualities that a good doctor must possess, for example good communication. As medical students, I have all seen colleagues who cannot even pronounce terms correctly, let alone communicate or understand the situations. Reservations must be promoted only at school levels. Medical aspirants must be made capable, and someone with a low score should not be entitled to a seat for a medical course just by the virtue of belonging to a backward class. Those belonging to backward classes must have a subsidized tuition fee for their course, but only if they manage to make their place in colleges, in an equally footed competition, like anyone else.

These are just a few points I can think of at the moment. I am sure had you bothered to have a panel discussion and find solutions in a healthy way, I could have come up with a lot more viable solutions.

However you chose to sensationalize your show, by giving incomplete and sometimes even false information to viewers. I hope you take this letter in a positive manner, and emphasize on the fact that doctors indulging in malpractices am only a small minority of the lot, and also throw some light on the hardships that every student has to face to become a doctor, and the ones that the doctor has to continue to face, after he has become one. I spend sleepless nights very often, trying to research and find out the cause of our patient’s troubles. It is imperative that the public gets to see things from a doctor’s point of you.  Sincere doctors exist to help patients and to ease their sufferings, they have no intentions of doing any harm to patients whatsoever.
You had made an image in our hearts, but this episode has caused all of us doctors to rethink. The Aamir Khan who took such a brilliant initiative to take the truth to the world, how could he convey only part truth and be responsible for thousands of people losing faith in doctors?

Doctors and future doctors of India


1 comments:

Anonymous said...

100% agree wid u

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