It’s high time the ‘noble service’ tag of the medical profession be reduced to the ineradicable minimum, and the professional terms of medical service appreciated.
On 16 January, 2018, the President of India tweeted what will be quick to pull on the moral heartstrings of almost everybody.
“As doctors, your services must be available both to those who can afford your fees and also to those who are less fortunate and cannot. It is for society to profit from medical science – it is not for medical science to profiteer from society,” President Ram Nath Kovind tweeted.
What he said shouldn’t be construed in a negative way, neither is the purport of his remark by any means impeachable. There is no doubt that making medicine a profiteering enterprise is detrimental to the interest of the entire society.
What needs to be countered, however, is the risk this remark exposes — that of doctors being portrayed as somehow responsible for this menacing trend of the medical profession — while in reality its underpinnings lie in decades of skewed policies and political preferences.
That medical education should not be subject to commercial exploitation is enshrined in the report of Abraham Flexner, a landmark document in the history of medical education not just in the United States but all over the world. Flexner observed that medical education is a social function and that there should be no place for market forces in it. The concept resounded with such force that it led to closure of many ‘for-profit’ medical schools in the US.
Even the most ardent exponents of the free-market economy turned against the idea of market forces in medical education. It is startling to note that this noble observation never made it to Indian shores.
The for-profit model of private medical education has met little resistance from our powers that be.
Post the 1980s, the erstwhile ‘not-for-profit’ model of medical education was devoured by the mushrooming of private medical colleges, which remain steady in charging exorbitant sums as fees under an ostensibly well-meaning intent of public service. The for-profit model of private medical education has met little resistance from our powers that be. Rather, multiple members of the parliament are known to either own or possess direct interests in private medical colleges. To make things worse, the recently proposed National Medical Commission bill seeks to further simplify the process of opening up new medical colleges, including those by private entities.
It is astounding to register that the present state of healthcare delivery of the country is nothing like what it was envisaged to be seven decades ago by the Bhore Committee (1946), whose report laid the foundation of India’s public health system. Even 70 years after independence, we remain distant from achieving many of the targets then prescribed by the committee, and this could largely be attributed to the inclination towards market forces in healthcare.
Ravi Duggal mentions, “Inadequate resources may appear to be a strong reason for not implementing the Bhore Committee plan but when resource allocations are studied carefully we clearly see that financial resources were largely committed to areas which helped the development of capitalism. The focus was clearly in that direction leaving for the social services like health, education and housing only residual resources.”
This general tendency culminating in the rise of neoliberalism in the 1990s begot the corporate culture of healthcare that we see today. Our powers that be continued to provide lip service to the idea of universal healthcare as the locus of healthcare provision shifted to the private sector from the public sector. What should rightfully belong to the left was pushed far to the right, quality healthcare became an exclusive preserve of the rich, and a meaningful national health system almost never took off.
What should rightfully belong to the left was pushed far to the right, quality healthcare became an exclusive preserve of the rich, and a meaningful national health system almost never took off.
With doctors regarded as the flagship professionals of the healthcare industry, it is very easy to fall prey to the erroneous impression that they are largely responsible for most of it’s ills. This needs to be realized and the impression must be vigorously countered. There are bad doctors just as there are good ones, and the scenario is similar with every profession on the globe. The problems that doctors are held culpable for could very possibly have their foundations in the long standing political inclinations of the country.
Also, it’s high time the ‘noble service’ tag of the medical profession be reduced to the ineradicable minimum, and the professional terms of medical service be appreciated. History testifies that few would scruple to dismiss the very nature of the medical profession as a ‘profession’ — and that of the doctor as a being made of flesh and blood — and set lofty goals for the profession out of an infatuation with it’s so called ‘noble’ aspect.
As such, remarks such as the one made in the tweet, which are hardly realistic and can only serve to appeal to the moral sense, should be refrained from making. A clear line should be drawn between the ‘moral’ and ‘professional’ sides of not just medicine but every other similar profession. This would best serve the interests of both the professionals concerned and the society at large.
(The opinions expressed in this post are the personal views of the author. They do not necessarily reflect the views of HuffPost India. Any omissions or errors are the author’s and HuffPost India does not assume any liability or responsibility for them.)