But, doctor, healing is what this is about

But, doctor, healing is what this is about
Manjiri Kalghatgi

Dr R.K. Mani is entitled to defend his fraternity (`Damning doctors: a case of misdiagnosis', September 29). However, a case of medical malpractice or negligence certainly makes sensational news. A well-known medical professional had once pleaded on a public forum: ``It takes years of hard work to build a reputation. A whiff of a mistake and you splash the scandal across the front page of the newspaper. When the law takes its course, some times months or years down the line, you have forgotten the story and don't bother with a follow up. The news that the doctor has been cleared of all charges appears as a brief item...''

But then, whether you like it or not, malpractice is where the story lies. In any case, doctors are quite adept at managing scandal. At the slightest whiff of it, there are enough people in the fraternity who are willing to rise to his defense or keep quiet over a wrong. For the lay person to take a doctor to court is next to impossible and medical councils across the country function like kangaroo courts. The petitioner, even if he is educated, is ignorant of the medical terminology used in the case papers. He is baffled by the questions he is asked by the panel of doctors and usually succeeds in appearing confused about his case. No outsiders, not even the media are permitted to attend these hearings. Candid discussions about unnecessary tests or inferior equipment or the success rate of angioplasties are usually confined to medical circles.

Dr Mani echoes the thoughts of so many of his ilk when he states that "the media takes the side of aggrieved patients..." This is usually because it is the only side available to the media. More often than not, the accused doctor is "on his rounds" or "out on calls". Why this attempt to duck questioning, why not speak out if you are in the right?

Dr Mani's defense of private hospitals brings back the words of Apollo Hospital founder Dr Prathap Reddy himself. During an interview, the man who "revolutionalised the comfort levels offered by the health industry", had said that Indians have, for too long, accepted second class service in the health sector. There is no reason why Indian hospitals cannot meet international standards. Dr Reddy certainly needs to be lauded for his initiative in creating this impressive chain of hospitals. If the Indian patient gets freshly laundered linen and clean surroundings, it is simply great. But comfort and luxury are meaningless if it is at the cost of quality medical care. If it means consultants getting "not so critical" patients admitted into the hospital to meet revenue targets. If it means a caesarian section being conducted when a normal birth would have done, then something is terribly wrong somewhere.

The doctor was once a family friend who actually listened to what you had to say about your ailment, not a corporate entity for whom you wait endlessly; who whizzes past the case history someone else noted down; and who cannot match your face with your name the third time you meet him.

This is not to absolve the media completely of its responsibilities. Certainly, mediapersons can and should display more sensitivity and rigour when filing reports on such sensitive matters. But just as there is a growing carelessness in the media, there is also a growing carelessness in the medical fraternity.

The rot starts early. In fact, at the stage when a not-so-bright but extremely ambitious teenager is bought a seat in a corporate medical college. Armed with a degree but with no experience of having interacted meaningfully with patients, the young doctor steps in for his practical training. The municipal hospital offers him filthy quarters to sleep in, terrible canteen food, an endless queue of patients and a crash course in handling emergencies. Fantastic training! But our young doctor doesn't have the marks required for this. He gets into a corporate hospital and gets the bulk of his training watching others work.

Blame it on the system.