Medical Practice Can’t Be Business


I have said before that when doctors’ consultation rooms become offices, then a doctor’s practice will become a business. But can we put a price on human life; can we buy and sell organs? Are we just machine parts to be bought and sold?

The virtual world has made it worse. I received a call from a web-based company, who put my name on their list without permission. They give appointments to patients on my behalf, sending them at whatever time they please, notwithstanding the fact that my working hours are limited. I often have to face annoyed patients who have sought such services to see me, and have endured enormous waits because they arrived outside my consulting hours.

I finally received a call from a representative of the company, and he offered to recommend patients to me on a preferential basis, on the condition that I pay a premium. I was annoyed and told him off. Can I be equated to a washing machine, to be bought and sold, or a packet of biscuits on a shelf? Am I not a professional, and won’t patients who are happy with my expertise search for me?

I have many patients who travel across the globe to see me, and countless patients from remote parts of India. Patients see doctors they trust and feel comfortable with, not those listed on an internet site. Would one seek a lawyer, accountant, or architect from the net, or would one seek such a professional by asking friends who have dealt with such people, and recommended them?

Worse still is giving appointments that I cannot even remotely hope to keep. Through my days as a young physician, I picked up my bag at odd hours of the night and ran to patients’ homes. I often wondered what the definition of, ‘Have I made it in life?’ would be. Would it be plenty of money, or would it be time at my disposal?

On introspection, I think it is the ability to wake up in the morning, look out of my window from my bed and see abeautiful day, and tell myself I am not going to work. And then turn over and go to sleep again. Unfortunately, life does not work that way and the worst thing one can do is disregard a patient who one has volunteered to take care of.

Several things have changed in the medical profession. I pursue a profession that I am passionately interested in. Students often seek advice from me on which postgraduate specialist to follow. Often, their question is, which one would be the most lucrative?

I tell them that all the money in the world is not worth it if you practice a specialty you aren’t interested in. Even worse, a lack of interest ensures that you never gain much proficiency in the specialty. But not many students have the luxury of choice these days, and opt for whatever is available. It is certainly an unfortunate situation, and I tell them to choose what they like best among the specialties available.

Their problem actually starts at graduation, when seeking hospital appointments. Many go to corporate hospitals, which have plush interiors and offer their consultant staff mindboggling salaries. But here again, there is no such thing as a free lunch. I used to think that you could take home several lakhs a month, sit in an office and see the patients that come your way. If there were no patients, you could play games on your computer or smartphone. But it does not work like that. The bottom line is that if you cannot justify your salary to the hospital in financial terms, your job is in jeopardy.

This may be sound economics, but is horrible in real life. When such a consultant finds that his job is almost on the chopping block, he lets go of his ethics to ensure his own survival. This starts a gamut of unnecessary tests to feed the hospital, and unnecessary investigation and surgery, such as correcting all deranged anatomy and convincing patients that this will translate into better physiology.

In this context, there is a lot to be said for the National Health Service (NHS) in the UK, where doctors are paid adequately, and therefore need not recommend unnecessary tests or therapies. Even so, I once read a review claiming that procedures were more common in private practice in the UK, than in the NHS.

In the final analysis, you should be able to face yourself in the morning, and I for one would hate to hurt another human being for profit. I am sure a majority of physicians will agree with me.


The Article First Appeared In Mumbai Mirror

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