And the recent news that the Medical Council of India (MCI) has asked state councils to de-register the names of 32 doctors who posed as full time faculty at a medical college, bears out the fact that being in a noble profession does not stop you from being human and trying to squeeze out an extra buck.
But the MCI seems to have decided to make an example of this case, after a CBI investigation found that these 32 doctors fraudulently claimed they were full time faculty at Tamil Nadu’s Melmaruvathur Adiparasakthi Institute of Medical Sciences (MAIMS), when in fact, they were on campus for just a couple of days a month.
Though some of the doctors have chosen to take legal recourse, the case serves to once again highlight the fact that medical education in India is probably nearing its nadir, barring a few centres of excellence. Like MAIMS, many medical colleges ‘borrow’ the names of doctors as full time faculty members for a nominal annual fee, usually paid in cash, to meet the norms of MCI inspection.
India has both a rich-poor as well as rural-urban divide when it comes to healthcare, with the people-doctor ratio six times lower in rural India in comparison to cities. We are unable to churn out enough doctors as we do not have enough medical colleges, and while Dr Devi Shetty’s suggestion that the government should open 100 medical colleges with upgraded district hospitals every year for the next five years is aimed at addressing this issue, we still do not seem to have enough doctors willing to teach.
The poor doctor-patient ratio also stems from the fact that there is a severe doctor drain. The Health Ministry is trying to stem this drain to countries like the US, UK, etc by insisting that doctors westward bound for further higher medical studies need to sign a bond. How effective this will be remains to be seen. But there are signs that this brain drain of young medics may be balanced by a reverse flow of senior doctors to India, who find that corporate hospital chains in India today have the capital to invest in the latest medical technologies to offer them an opportunity to showcase their skills and expertise.
A more insidious doctor drain is the loss to other non-clinical professions like the insurance sector. Doctor-MBAs are becoming more common, partly due to the fact that a business degree guarantees better remuneration without the stress and strain of being on call 24x7x365.
This trend is more commonly observed with medics from the so-called alternative schools of medicines. Referred to as AYUSH doctors, they do prescribe allopathic medicines, and though the debate on this continues to be a hot button issue, maybe it’s time to integrate these practitioners into the mainstream, after supplementary training, etc.
Will the increased allocation to healthcare in the 12th Five year plan finally do the trick? A FICCI and Ernst & Young report release earlier this year projects that the planned implementation of Universal Healthcare Coverage (UHC) is likely to increase the consumption of healthcare services. But of course, the report also highlights that one of the key levers for achieving UHC is filling the human infrastructure gap. Arresting this downward spiral will be crucial for our country.
Viveka Roychowdhury
Editor