-Dr Tapan Saikia |
Never considered practice of medicine as a business…it wasn’t necessary for me…but in truth, it’s a business…it’s beginning to dawn on someone thickheaded like your truly…it probably would have never bothered, in a normal situation…these are extraordinary times…
It’s a definite business in a true sense…not in derogatory sense…business isn’t bad, as long as one isn’t too greedy to suck the consumers dry…or let some go without a fee..
More than 70% of healthcare in India is in the private sector…it can thrive only when a profit is made or break even…applicable for big players, mid-level ones or start ups…these are owners of healthcare facilities and they employ people who have families to look after….of course, the owners have to look after themselves…
Those who are on government jobs…are safe for the moment…a little cut in pay cheques is ok…until a day appears when the state governments send out a circular…’our coffer is empty, fighting the virus’…they’ll be in the same boat..as we will soon be…
Coming to an individual like me – lived in a comfort zone for years…people found me, rather than finding people to treat…therefore, replying emails, text messages to tens of patients daily has been a pleasure, without bothering about compensation, what we call doctor’s fee… some have offered and I politely declined…then, why the change now?
Dramatic arrival of RARS-CoV-2 in recent months out of nowhere…changed the scenario…lockdown (unlikely to change in a jiffy) has stopped travels, forced less hospitalisation, compelled less aggressive treatment – even if such less effective treatment might be deleterious in the long run…
So, our livelihood has taken a hit…it didn’t strike in first couple of weeks…hoping this too shall pass soon…realising quickly that it’s going to be a long haul..perhaps old order will never return..this forces one to think differently…
I have carefully avoided telephonic consultation…in oncology, it’s fraught with many a concerns…no physical check, need for repeated tests before a decision is made, counselling…time constraint…and, most importantly, misunderstandings….patients/families asking something, I answering something else, designing a treatment protocol, delivery of these at a distant centre…taking care of complications….assessing response…follow ups..all these are very complicated…I agree, not impossible but very imperfect….then,
the issue of legal validity of such an approach…
Where do I (we) go from here, if we realise that the world is about to change..change drastically….and, learning the tricks of a new world order…young ones will pick up quickly and adapt as the situation demands…
The large private players will have to come up with satisfactory strategies…will not be able to bully the doctors as they do now…specially when a clinician can operate from home ( no, not surgeries, that would be too much – family acting as anaesthetist, nurse, OT boy, pathologist and more) …sending out legal prescriptions, planning surgery and asking the hospital to give a bed and OT…I don’t know who will be more powerful in negotiations…we’ll watch with interest..
My immediate concern is – what do I do about distant communications…for the present, mind is clear…no fee, but provide all that is necessary…avoid telemedicine unless unavoidable…but,
only tomorrow knows what’s in wait…we’re learning hard way…no astrologer, no science could tell CoV was prowling around for a vengeful return…in another avatar…I don’t know if it’s Kalki !!!