Indian healthcare stands at important Crossroads
| 27 Sep 2016
| NOP Bureau National

Indian healthcare stands at
important Crossroads

In his book “The Ethical Doctor” published by “Harper Collins India”, Dr. Kamal Mahawar examines ethical and systematic challenges facing healthcare in India and provides suggestions about how to deal with them.

Onkareshwar Pandey
New Observer Post

New Delhi, 27 Sep. 2016
In June 2016 a seventy-five years old man was left to die because he couldn't afford a bribe of Rs. 50 at a Govt. hospital in Kolkata. That same month a gang that duped women into selling their eggs for surrogacy was busted in Pune. Similarly, in Nov. 2014 eleven women died at a sterilization camp in Chhattisgarh because of negligence by the doctors. Dr. Himmatrao Saluba Bawaskar (MD) a senior doctor working in rural Maharashtrawrote recently onDNA, "Last March, I received a cheque for Rs. 1,200 from an imaging and diagnostics centre based in Mumbai and Pune. On inquiry, I discovered that the cheque was a professional feefor referring a patient to the centre for MRI. The patient had already paid my professional fee when I had examined him at my hospital. So, I returned the cheque, which was reimbursed by the MRI centre to the patient at my request. I lodged a detailed complaint against this unethical practice with the Maharashtra Medical Council (MMC)."

Although a large number of doctors in our country are very sincere, honest and ethical, unethical practices have unfortunately penetrated every segment of the medical profession. And due to these unethical practices, faith in the medical profession, which was once considered to be the noblest of all, has taken a beating.The medical profession in India is now plagued by scams and malpractices: poor health care, commissions from needless treatments and tests, and exploitative drug companies. How then do patients trust doctors, hospitals or medications? And how does a doctor work effectively and honestly in a deeply troubled system?These are some of the issues along with the roles of the government and the judiciary in policy-making in medicine that Dr. Kamal Mahawar examines in his recent book titled "The Ethical Doctor" published by "Harper Collins India". The book asks an all-important question: is it possible to be an ethical doctor today?

Dr. Kamal Kumar Mahawar, a graduate of Calcutta Medical College and post graduate from Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, is now a Consultant General and Bariatric Surgeon with Sunderland Royal Hospital in the United Kingdom. He is also an Associate Clinical Lecturer with Newcastle University and on the editorial board of renowned scientific journals.

Dr. Mahawar says, "News of what is wrong with our healthcare system keeps surfacing from time to time and reports of unethical and corrupt practices amongst doctors have now become commonplace. Though one could argue the situation with medicine is not much worse than other walks of life, as a doctor, I feel compelled to at least set my house in order. Yes, a lot of the doctors today indulge in unethical practices but we don't pass out of medical colleges aiming to become such a doctor."

Recently two other doctors Dr. Arun Gadre and Dr. Abhay Shukla wrote a book entitled ‘Dissenting Diagnosis' published by Random House India and listed down such malpractices in the profession. They interviewed 78 specialist doctors, who told them about the extent to which doctors indulge in unethical behaviour.

So what is new in Mahawar's book? Dr. Mahawar has an answer. "I have resisted the temptation to simply list the gory details and ask doctors to become more honest. Such an attempt would not be very successful in our society where corruption has become a way of living and any attempt to fight it is usually dismissed as impractical idealism. This book would have been incomplete without a comprehensive list of all that is wrong and unethical within our healthcare and as a matter of necessity, I have had to enumerate them all. If patients know what is happening, they might be able to protect themselves to some extent. However, I have attempted to go beyond that and that I believe is the hallmark of this book. I have tried to examine the forces that make it impossible for a doctor to practice ethically."

He further says, "Moreover, though we are quick to criticize our private doctors for their failings and there is no reason why we shouldn't, not much time is spent evaluating the effort of our government and public sector doctors. It is almost as if it is all right to be inefficient and incompetent as long as you are not corrupt. One of these days, we will have to recognise in India that lack of action and accountability is probably the most rampant form of corruption in India and certainly the worst. The book examines our public sector healthcare provisions or lack thereof."

"A major illness is one of the most unfortunate things that can happen to anybody. In civilized societies, we should have mechanisms to look after each other in such times of need. Doing so will preserve our social fabric and give individuals a sense of belonging. Though the task is herculean, it cannot be impossible to achieve provided we all engage in serious introspection and that is precisely what this book attempts to do on behalf of us all," Dr. Mahawar says.

Dr. Mahawar should be credited for a balanced take on the real issues without indulging in any blame game. This book is an honest examination of all that is wrong with our healthcare and provides practical suggestions for its improvement. It is a must read for all those who care about healthcare in India.




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