‘Healthcare spends in India among the lowest in the world’

 ‘Healthcare spends in India among the lowest in the world’

Saurabh Tankha

Over decades, we have seen them scribbling prescriptions in illegible handwriting. So when the two authors of Dear People, With Love and Care, Your Doctors (Bloomsbury India), Dr Debraj Shome and Dr Aparna Govil Bhasker, expressed themselves in as many words as they did for this interview with www.lifeandmore.in, it could only lead us to one solution. Carry the interview in two parts. The only plus, they punched in their replies on a computer, thus it was legible.
Here, we present Part I of two-part series, an interview with Dr Shome who tells us that the book is a collection of heartfelt stories by doctors and patients from across the world. It provides a deep insight into the Indian healthcare system and gives a sneak peek into the world of medicine but inspires to retain faith in the relationship of a doctor and patient. The book, through inspiring stories from the diaries of 30 doctors and five patients, aims to bring back the focus on the unshakeable foundation of doctor-patient relationship.

Dr Shome super-specialises in plastic, cosmetic, facial plastic and facial cosmetic surgery. He practices at some of the top hospitals in Mumbai and is the director of the Esthetic Clinics, a chain of clinics in Mumbai, Hyderabad, Kolkata, Delhi and Bengaluru. Excerpts from the interview…

When did you decide to collect these stories?
Over the past few years, I have witnessed a slow and steady deterioration in the doctor-patient relationship. It is kind of sad as trust is a very important part of healthcare relationships and this has been proven multiple times in various research studies. Best of medicines do not work in absence of trust and even placebo works when the patient places trust in the doctor. Today our environment has a lot of complexities. There is a tsunami of technological advances but most people do not know how to handle this. They try to google their symptoms and Google only serves to confuse them further. We have an epidemic of Google doctors in India and probably all over the world. What people don’t realise is that human beings and health are very complex. No human being ever comes with the user manual and one can never fit all. Unlike mathematics, the same formula in medicine may not lead to similar results all the time. What may work for one patient may not for another. Hence it is important to trust the doctors who train for years to learn to decipher these complexities. Every patient is unique and has a distinctive set of problems. Patients sometimes do not understand this. This is the era of instant gratification where everyone wants guarantees, it is difficult to guarantee “cure” of something as complex as “disease”.

In the last few decades, medicine has evolved by leaps and bound. Today people are living much longer and healthier lives than ever before. Diseases are being treated in the womb before babies are even born. It is now possible to avoid many diseases by altering genetic structure of the cell and many similar advances are being made in the field of medicine on a regular basis.  However, it is important to know that we still don’t know everything about the human body and we may never know enough. Hence, it is very important to put things in the right perspective. This was the rationale behind compiling these stories. Every story in this book presents multiple facets. As you read through the chapters, you will be privy to various facets of a doctor’s life. The book takes you into the operating room when the first bilateral hand transplant is being performed. Through this book you can witness a doctor who is extremely scared when attacked by a mob that comes into his hospital and blasts a gas cylinder in the hospital compound. You can get into the mind of a doctor who is seeing and treating disfigured acid attack victims. This book is a journey that allows you to be in the shoes of a patient as well as the doctors, so as to understand each other better. Ultimately communication is about understanding each other better and that is why we made the effort of writing this book and decided to collect these stories from different facets of the life of doctors and patients.

Dr Debraj Shome
How did you go about choosing the doctors you wanted to include in the book?
We wanted stories from different facets and therefore, it was important to choose the doctors carefully. We tried to get a flavour of the different aspects of the doctor-patient relationship. We chose our authors very carefully on the basis of the stories that they would write in this book. The process took six months to a year.

Why in your opinion, has the sacred relationship between a doctor and patient “suffering from an erosion of faith”?
Doctors come from the same society as all of us. The ills that affect the society in general, ail healthcare and doctors too. There are a few black sheep in the medical community but it is unfair to generalise. I believe there are more good people around than bad ones and that is true for doctors also. At one point of time, the most intelligent people in our society became doctors. If doctors are supposed to be turning corrupt or becoming very materialistic then what does it say about the rest of society? The problems governing healthcare are the problems governing other industries as well. The healthcare spends in India are among the lowest in the world as a percentage of GDP. There are other problems that affect healthcare in India. Today, being academically good is not the only way to get into a medical school and the best people may not get into medicine purely from an academic standpoint. Doctors don’t have much control over governmental and societal policies and are victims too.
Most private medical colleges that charge huge capitation fees are run by people with political connections. All of this needs to be changed systematically. We can’t say that the healthcare is becoming more expensive and doctors are responsible because ultimately the corporatisation of healthcare is being driven by the fact that Government-run healthcare or the state-run healthcare is failing and there are no other solutions. There are even not enough doctors in the country. Similarly, some of the other policies the Government is coming up which include making Ayush practitioners practice allopathic medicine through a bridge course are questionable. While I have nothing against Ayush practitioners, the fact of the matter is that they are not trained in allopathy. These decisions which the Government is taking are probably short-sighted and will ultimately lead to problems between doctors and patients and a further erosion of faith. It is the lawmakers and the legislature that need to pay careful attention to why the health of the people is suffering.

How, in your opinion, can this distance be bridged?
Conversations are important and understanding the other side of the picture is very important. Communication is all about making sure that other people understand what we are trying to say and what we feel. And this book is a step in the right direction we feel. So, by writing a book where doctors have written about the experiences and patients too have written about their experiences with regards to healthcare, it becomes a way to go ahead and give people a greater understanding of the doctor-patient relationship. By having a greater understanding and by reigniting the conversation, hopefully, this ends up becoming a situation where trust between the two parties can be rekindled. Essentially, doctors and patients are two sides of the same coin and therefore it becomes important to make sure that this trust gets rekindled again.

Interview with Dr Aparna Govil Bhasker tomorrow

The cartoons, sourced from Internet, have been used to provide comic relief


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