While lighting of diyas, beating of thalis and doing a fly past by our Indian Air Force planes to symbolically appreciate and recognise the relentless work of our doctors in these trying times of the Covid-19 pandemic is fine, but on ground, the treatment meted out to this same medical fraternity, is one of untold trauma, in more ways than one. An insight.
Early this week, a news report by senior journalist Alka Dhupkar of Mumbai Mirror, mentioned how five doctors who had signed Actor Sushant Singh Rajput’s Post Mortem (PM) report were being harassed and threatened for life through phone calls. Their names and contact numbers appearing on the copy of the PM report went viral on social media, after which, strangers made phone calls, accusing them of having taken bribes to declare his death as a suicide. The doctors are fearing for the safety of themselves and their families and so, despite support from the hospital are wary of lodging a police complaint.
In another report by Dhupkar, she mentioned the plight of doctors in hospitals who are helpless due to inadequate equipment to treat patients suffering from Covid-19. She gave an example of Uran town in Raigad with over 1.5 lakh population which has only 35 oxygen beds including four ICU beds. Already 55 patients have died and over a 1,000 patients have suffered from this pandemic. Residents protested on Independence Day against the civic authorities for these pathetic healthcare services. While this is a government’s failure, it is doctors who would face the brunt of patients’s relatives’ ire in case of his or her death.
About three weeks back, relatives of a Covid-19 patient (who succumbed to treatment), physically assaulted a doctor at the YCMH Hospital in Pimpri-Chinchwad. In Latur, Dr Dinesh Varma was attacked with a knife after a Covid-19 patient died in the hospital.
The attack seemed well-planned going by the injuries suffered by the doctor. Dr Santosh Latkar, in his Whatsapp post has rightfully stated that the hands that symbolically clap to praise the doctor fraternity in these pandemic times should be stretched to stop the attackers when they are assaulting doctors. People should also condemn such attacks, he says, by talking about them to friends and media.
In general, the pandemic has brazenly shown the utterly chaotic and pathetic public health system as well as the strained private health care system of our country, be it in cities, towns or villages.
Dr Prakash Joglekar, a veteran Pune based Doctor points out several reasons for this sorry condition. He elaborates, that, “the reason for this grim situation of the healthcare infrastructure is varied – from unnecessarily harsh government policies, non-priority for public health infrastructure, the unrealistic and exorbitant rules and regulations for running private hospitals and so on. However, the brunt is borne by the doctor who often is an employee bravely battling from the front at the cost of his own health risk, to serve patients and save lives. And therein lies the irony as doctors play the role of saviours but it is they who are victims of patients’ relatives’ ire.’’
In the various hectic discussions that are going around in social media, one of the doctors writes: “for example, out of a total bill of Rs.10 lakh odd, the poor doctor gets a mere Rs.28,000 for managing a serious patient for 15 days which does not even come up to Rs.2000 per day but gets blamed for such huge bills. God knows when Indians will stop blaming doctors for issues which are beyond their control.’’
Another doctor writes sarcastically of the government in a hypothetic first person account: `we will burden you with taxes for ventilators and medicines; we will pick up the biomedical waste but at a high price; we will charge you electricity bills and water bills of your hospital at commercial rates; we will not run our public hospitals efficiently and we are not accountable for the crores of rupees budgeted for them which vanish into thin air; however; we will take credit for patients who recover in private hospitals; we will make it mandatory for you to get licenses/certificates from 50 different government organisations to start a hospital and which gives us opportunities to take bribes; we will levy stringent norms under National Accreditation Board for Hospitals & Healthcare (NABH); we don’t care if doctors are at risk of health and life but we will levy GST on masks, PPEs and sanitisers; we will dangle a carrot of Rs.50 lakh insurance if the doctors dies due to Covid-19 and; we will keep on issuing fatwas so that the doctors get scared and quietly succumb to any such directive.’’
Dr Sachin Landge says it is time for owner doctors of private hospitals to ensure that a few safety measures are in place.
Like, installation of two cameras – one that’s visible and one that can’t be seen so that even if the people break the visible camera, the other one continues recording. Cameras should be put in the OPD and counseling rooms. Doctors should do video recording of meeting with patients and their relatives during discussions about their impending surgeries. They should take the patient’s relative’s thumb impression, besides signatures on the consent form as signatures can be forged, Doctors should create a local APP wherein local doctors of that city or town so that you can post any untoward incident in your hospital and ensure the patient’s name is tagged therein.
Build a strong doctors forum to showcase unity amongst the fraternity. Dr Landge also urges doctots to take out `indemnity insurance’ of yourself and your hospital; employ bouncers or keep them on call; employ a counselor or a public relations officer; do not make loose comments about other doctors and; learn `patient selection.’
The reason for this grim situation is the Clinical Establishment Act, “which has broken the spine of the hospital industry’’, says Dr Joglekar. He further elaborates, “ the future of the profession of doctors is very grim. Not only in terms of working as professionals but also in terms of starting their own hospitals. This is because the government has set harsh norms to open even a small private hospital. Not only does it cost an exorbitant amount if you have to adhere to the infrastructure within the premises that has been prescribed but also the mental harassment in procuring no-objection-certificates from various government departments. For example, any private hospital has to procure a NOC from the fire department annually. This in itself involves various rounds of visits to the office and continuous expenditure to buy the latest anti-fire gadgets that are recommended.’’
Very poignantly, Dr Joglekar states, “how much ever precaution a doctor takes, an unfortunate incident of death or a mistake by a doctor in rare occasions, takes place. However this becomes `breaking news’. How about highlighting the tremendously stressed public hospitals wherein four to six doctors are looking after 60-80 patients in a ward?’’
Indeed, somewhere along the line, the emotional and the humane chord between the doctor and the patient; between the doctor and the government, has severed.
To a large extent, it has been sorely exposed in this seemingly unrelenting pandemic, that we are all reeling under. Surely a time for the government to put public healthcare as top most priority, like never before and for people to re-establish their bond with their doctors, by understanding the reality of their working conditions!
#All views expressed in this column are those of the author and/or individuals and organisations that may be quoted and Pune365 does not necessarily subscribe to the same.
That's Vinita Deshmukh, Senior journalist and RTI activist who believes in journalism that reflects the views and needs of the common man.
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