Lighter Medicine Chests

“My daughter just topped her entrance exams, but thank God, she does not want to be a doctor.” Coming from anyone, this may sound a bit strange, but when it’s spoken by one of the most successful physicians in the city, one really needs to sit up and take notice. When I heard my close friend utter these words over a Sunday evening coffee, my curiosity was aroused. His reasoning was quite simple—he had spent the better part of his life studying medicine, from graduation to post-graduation to super-specialisation, and by the time he was truly ready for practice, he was on the wrong side of forty.

Even then, to be successful was a str­uggle, esp­ecially since he decided to pursue the ethical route. On the other hand, he pointed to our friends who had made their first million before 30, and were in semi-retirement on their 40th birthday, since they pursued a career in fin­­ance. But, I argued, what about all the good you are doing and the gratitude you get from pat­ients? Isn’t that the best benefit of a noble pro­fession? “Nobility does not pay my bills”, was his pat reply.

Around the time I completed my 12th grade, the brightest took up medicine or engineering, irrespective of aptitude. Thankfully, that has cha­nged, and stu­dents have more options. Over time, the glamour and prestige of medicine has diminis­hed; no more is it the automatic cho­ice of top students. Partly, it’s due to the red­­u­ced ava­ilability of ‘merit’ seats in gov­ernment colleges and increasing fees in private institutions. Con­stantly changing policies on the duration of com­pulsory rural service, as well as adm­ission to post-graduate courses, make it even less attractive. Post-graduate courses in spe­­ci­alisations, such as radiology, can cost upwa­rds of one crore rupees, and make sense only to those who have a business in the field or intend turning it into a business (and then we wonder about ethics!).

If you join medicine for money, then you are in the wrong profession. Before you point to all the doctors that drive bmws, do remember that those are a minuscule fraction. Medical practice in India is such that 80 per cent of all the work (especially surgeries) is done by 20 per cent of the doctors.  Those few are certainly well off, but the average doctor will earn far less than his com­patriots in other parts of the world, even in relative terms. The reason is that healthcare in India is relatively inexpensive. With changing eco­­nomics, people are comfortable spending Rs 10,000 or more on beauty treatments, but begr­udge a doctor his Rs 1,500 consultation fees.

So, is there a silver lining amidst all this gloom? There certainly is. At the risk of delivering a cliche, I must admit that the look of hope on a pat­ient’s face as you hold their hand, or the joy on a relative’s face when you tell them that their loved one is out of danger, is worth all the money in the world. As doctors, we have the ability to touch people’s lives as no other profession can.

Of course, all doctors are not angels floating around, waiting to dart down and provide their healing touch. The reality is that malpractice does exist and often medical decisions and opinions are not carried out in the patients’ best inte­rest. However, in spite of all its pitfalls and dubious practices, the medical profession retains a touch of nobility that is worth preserving. Just make sure, you don’t enter it to get that bmw.

(Contractor is head, preventive cardiology and rehabilitation, Asian Heart Institute)