Earlier, when we fell ill, we mostly relied on government hospitals and doctors, trusting that we would be cured and treated with humility and humanity. Although government hospitals had fewer doctors and limited resources, the belief and trust in the health system were very high. Doctors were seen as saviours and gods.
After liberalization and mushrooming of the private hospitals and healthcare industry, people fear doctors, hospitals, the medical insurance industry, and their nexus designed to exploit and impoverish people. They entice us through medical advertorials, highlighting packages, facilities, and doctor’s qualifications. However, common people, particularly those belonging to the underprivileged and lower middle class, do not have medical insurance coverage are scared to go to them. It is not only the high cost and affordability but also the loss of faith and trust in the system. The increasing commercialization of healthcare has led to practices prioritizing financial gain over patient care. Private healthcare providers often engage in aggressive marketing tactics, promoting expensive treatments and procedures that may not be medically necessary. Doctors in private hospitals are given targets, forced to write unnecessary tests, hospitalize patients needlessly, prescribe costly medicines, and perform operations to extract more money. They have become part of this dirty business, forgetting their Hippocratic Oath. They do not understand the harm they are doing to their fraternity and this noble profession.
The shift from a patient-centered approach to a profit-driven model has significantly eroded trust in doctors. In this profit and market-driven medicine, which forces medical overuse, doctors have become daily wage earners in India, paid based on the ‘business’ they bring to a hospital. They are forced to become part of this malice, not following standard protocols for surgery adherence, and performing surgeries even when unnecessary. Discrepancies in opinions (between the patient’s doctor and the second opinion giver) and poor adherence to surgery guidelines across all specialties are serious concerns. Such malpractices and monetization of medical services have led to second-opinion services in many cities.
People have lost their faith in doctors and are searching for ‘Good Doctors’ who still have humanity, are knowledgeable, and trustworthy. This loss of faith has led people to seek multiple consultations compelling them to spend more. The definition of a ‘Good Doctor’ has changed. Earlier, a doctor with good education and diagnostic skills was considered a good doctor in his field and among people. The criteria have shifted to owning a hospital, nursing home, clinic, and diagnostic center. The parameters are wealth, business, and turnover. In this race, medicos have forgotten who they are. This greed has taken over the profession forcing them to become salespeople for the medical industry by joining hands with pharma companies and diagnostic centers.
In 1938, Bertolt Brecht (1898–1956), a German dramatist, poet, theatre director, and practitioner, beautifully reminded us with his poem "A Worker’s Speech to a Doctor," that every doctor should read:
“We know what makes us ill.
When we are ill, we are told
That it is you who will heal us.
When we come to you
Our rags are torn off us.
And you listen all over our naked body.
As to the cause of our illness
One glance at our rags would
Tell you more.
It is the same cause that wears out
Our bodies and our clothes.”
The silence over such malpractices by the Medical Council of India and Professional bodies such as the Indian Medical Association is a serious concern. They must come forward to address such malice. The unregulated loot and greed of the private healthcare industry are impoverishing people. Governments and regulatory bodies must enforce stricter regulations to ensure transparency, accountability, and ethical practices in private healthcare. This includes clear pricing policies, oversight of medical recommendations, and penalties for fraudulent practices. Only through these efforts can private healthcare regain its reputation as a trusted and essential component of the healthcare ecosystem.
The state should address the above and regulate the private healthcare industry. Strengthening and creating state-of-the-art government hospitals that can compete with private healthcare is another solution to address this issue in the long run. Bridging the gap between private and public healthcare systems through collaboration and integration can help address inequalities. Many government hospitals face problems of adequate financing, health human resources, and supplies that need to be addressed. Ayushman Bharat is a good initiative to provide medical coverage to the poor and the marginalized. Nevertheless, the state should revisit Ayushman Bharat and reinvest its money to strengthen the government's healthcare system and infrastructure to provide quality healthcare services to all.
The author is a Professor at Xavier Institute of Social Service, Ranchi. The views expressed are personal. Views are personal Email: pandeyanant@hotmail.com
