I bet that you would agree with me when I say that it was Government policy and not just a quack’s intervention that led to Mr. Yadagiri Reddy’s unfortunate death, once you go through the story.
And the story is: Mr. Yadagiri Reddy (not the real name), had just turned 42 years, when he had an upper abdominal and lower chest pain. He lives in a village where he called his friend and RMP doctor (Registered Medical Practitioner, though not registered by the Government anymore) who, while well meaning and experienced, attributed the pain to "gas pain” and gave treatment. The next morning, the pain escalated and Yadagiri was rushed to a private hospital in the nearest town. On the way Yadagiri had a vomiting and he stopped talking. He was declared DOA (Dead On Arrival) at the town hospital.
This story is nauseatingly common in rural India. I have nothing against the RMPs or PMPs. They bridge an astonishingly yawning gap in our health care system. They are favored by the villagers because their services are inexpensive and they are available at all the times. They make house calls; they make sure that the patients are compliant with the medication. They understand the social fabric that the patient lives in and blend in the same.
But people like Yadagiri Reddy often lose their lives because of the mistakes made by these individuals, who practice medicine without a formal medical education. In addition, some of them propagate corruption in the health care system, the price of which the patient has to pay. The government does not allow them to practice freely nor does it strongly prohibit them from practicing. It cannot employ adequate number of qualified doctors to work in the villages, but even when it does, most doctors try to escape from the villages as much as possible.
So, what it is the Government doing to solve this tricky situation? It presently has a three pronged approach:
- It increases the MBBS seats and sells some of the seats under the management quota
- It increases postgraduate seats and creates more specialists
- It will try and force the postgraduate medical students to work in the rural areas for at least some time.
Common sense tells me that these approaches are not going to work. Increased MBBS graduates are all looking to specialize in some department of medicine with a view to live in an urban area. Increased post graduation seats will only help the urban populace. Forcing the postgraduate students to ‘serve’ in the rural areas against their will can never work, because well! You can only take the horse to the water.
The ambitious MBBS graduates study medicine to become great doctors in the cities with lots of recognition and wealth. The only rural areas they will be willing to work in are in the US or in the UK. The more are the doctors in the cities, the more they try to compete with each other for patients. Among other tactics, they will try to endear themselves to RMPs, who can send them patients. So counter intuitively, increasing the MBBS seats will only increase the number of RMPs, and people will still be getting the short end of a very long stick of medical practice. This way, unwittingly, the Government is promoting the fallacies in the present health care system.
So the problem is a difficult one to solve. What exactly do you think will give a solution to this menace? Please post your responses. I will present my own solution in my next blog. Let’s brainstorm.