Monday, February 12, 2007

an apple a day..

a visit from one of the medical reps led to some discussion and debate on the standards of medical practices, here in dubai. the increasing medical charges by many of the doctors. and the mushrooming of polyclinics everywhere. recently lot of patients have come to my mom where the doctor has so to say taken the patient for a ride. asking them to do tests which aren't necessary. prescribing medicines that arent necessary..etc.
a particular hospital where many a patients were being reffered to, since it was the one which had the least "magaj maari" (headache) and probably was one of the more affordable ones. but now ever since they changed their salary scheme for their doctors from a fixed pay to a pay based on salary + commision on pathological tests, the "treatments" have extended from one visit to three/four visits. not to mention the "international" hospitals that keep popping up and charge an arm and a leg(almost like youre staying in a 5 star hotel) for one nite. as one doctor friend puts it its the pits for those without medical insurance here. theres a certain rumour doing the rounds that a mere consultation at the dxb health city will be a good 2000 AED ( approximately 600 USD).
lets face it no one really comes to the doctor coz they want to. or feel like it. its only when they dont feel like it, they do. =). and mostly people go to the doctor when "paani sar sei upar hogaya hai" i.e when you're in the worst state. there is also no, of lack of a a better word, "output" so to say. no fancy haircut/manicure as when one goes to a parlour. or great clothes to show off after a visit to your favourite store. many think its an added expense, and sometimes there is so much attitude by patients as if its the doctor's fault that such a thing has happened to you. of course this doesnt apply to a gynaecologist or a plastic surgeon. so you can imagine how much whining is going to occur for those hike in fees. but fikar not, one still has medical insurance. at least we think so.
its a different post altogether about how insurance companies remind you to that reading the fine print is somethign you should always do. a friend of mine's medical insurance company refused to pay her bill on the grounds they didnt cover such a case. her brother who is a physician read through the contract, took out the medical dictionary highlighted passages in it and sent a photocopy of it back to the insurance company. the company succumbed and paid it. isolated incident. but how many pple will actually fight back or even know that htey can?
so whose to blame here, the doctor who is threading in dangerous unethical waters. perhaps they have their own majboori, rising costs, spouse and kids demands. medical insurance companies? is it the government who keeps increasing prices? is it the divide between the rich, richer richest and the poorest? who is to say. i really dont know.


Ashraf's Pen 11:28 AM  

I think its the rich n the poor divide thats most dangerous. One day if costs continue to rise as such the poor may be unable to afford most of the complicated surgeries and treatments.

They would die not from lack of good health but lack of money. And this is most dangerous. COz with desperation and hopelessness comes strife.

A Soul In Exile 8:44 PM  

This is nothing new to yr city...Its true all over India as well. Here if you go to a doctor, the first thing he/she asks - instead of asking about your problem - is whether you have medical insurance or not or what do u do? The moment the doc finds that u have medical insurance or you are in a well paid job, he starts working on a huge bill for you... which even means an Xray and CTscan for a common cold, an MRI for a jaundice. Sounds weird but its true...

But then if you look at their logic - they are just getting their pound of flesh back. A doctor takes 12-15 years to reach a good practice...after 7-10 yrs of education. Whereas good for nothings get 10L starting salaries the moment they step out with eng/MBA degrees - degrees through which they barely bothered to study either... I know some young doctors who feel pretty cheated because of this - especially when you look at the salaries govt hospitals or even pvt hospitals offer. Something is not rational - so they use other methods to try to even it out - though it hurts where is shouldnt, where it seems unethical. In a world where being a teacher and doctor are deemed to be the most noble professions, it is ironical that they get paid lowly. And hence they are not honest to their job... I am not justifying there dishonesty to their profession, neither am I or anyone in my family a doctor, but something still doesnt seem right.

life in words 10:51 PM  

ashraf pen's: i think its already happening.

asie: sure, i agree with you. doctors are even here in some places are one of the low paid people. i know for sure in india there are. pple at call centers are makign more than them.and obviously its frustrating. maybe its the case of demand versus supply. maybe its the mentality that becoming a doctor/engineer is still one of the ultimate goals and that demands most respect for most desi families. maybe its a cultural thing. maybe its the govts fault who has overlooked this and should set a higher minimum wage for doctors. but where do they draw the line. how about nurses- without who a doctor cant function. what about pharmacists/lab technicians. engineers? who is to say whose work is most important.

despite all that, i dont think one should be in this profession if one is in it for the money.

A Soul In Exile 4:16 AM  

Hmmm....You say "i dont think one should be in this profession if one is in it for the money"

Wonder what you would say to all the doctors then who get educated at the cost of common tax payers and then leave India after their MBBS/MD for gulf, Europe, US just because the returns are much better there.

See...everyone is in it for his self-interest. Though it sounds sick and demeaning - unfortunately it is the fact of life. Of course there are those rare individuals who do stick it out selflessly. But a single swallow doesnt make a summer. 95% people are there in it for the money. And why not? afterall 99% people in the outside world are doing what they do for money as well.

Ironically the demand and supply isnt the problem here. India is hugely undersupplied. We have a huge dearth of doctors in India - primarily in primary health and rural areas. Just because u can get all hi-fi treatment done in an Apollo or Jaslok in India doesnt mean we have provided basic healthcare to all. Far from it...
Yet our leadership is so dumb witted that no one sees reason in why doctors and teachers should be paid more.

Reminds me of my professor in MBA - he was an IIT Madras prof and used to take classes for MBA as additional/part time. He would often elope for weeks together to Malaysia and other places - often having us to attend bulk classes in one short to make up for the time lost. One day we enquired abt his absence and foreign trips and he told us about the consulting work they do abroad. And he had a valid point. At 50yrs, he was seeing students he taught in IIT rake in offers 5-6 times what he was earning in his salary - even the low performers were getting better jobs than what he earned in his IIT job. So he said something to effect of "If we don't indulge in consulting thru IIT (of which they get a percentage) we will be a bunch of frustated prof's otherwise. So to retain some self respect and sanity we have to slog it more this way...or we have to quit and join these new age jobs."

In this case - at least there work around found is in line with their ethics and goals... whereas doctors tend to fleece and exploit to make it up. Its not a fair world either way.

Sharique 5:33 AM  

. of course this doesnt apply to a gynaecologist or a plastic surgeon.


a soul in exile,
That is very true. IIT professors have kind of an inferiority complex by the pay IITians get. And this frustration gets out in terms of grades! BTW you an MBA from IIT Madras? There seems to some problem with your profile link.

life in words 6:58 AM  

asie: Honestly, I really dont think anyone has done any wrong in moving from India to "greener pastures".

is the common tax payer really funding the education of aspiring physicians?

my parents and doctor siblings have moved. and yea it is for better returns. I never said doctors should be selfless totally and work for free. They have their lives, their family. The point I was trying to make is if your goal is to make better returns anyhow. and if your only goal is to make money. i.e by burdening patients and like your example asking for Xrays and CTScans for no reason,etc. in other words, where you are being unethical. then, in that case, then one shouldnt opt for this profession. coz if someone truly loves this profession, they wouldnt be able to do such a thing.

I know lot of people who never really wanted to be doctors, but due to family pressure were forced into it. some didnt even study but made it through by different means. and it scares me that there are doctors like this today. one of them didnt even know what a lymphocyte was in their final year of MBBS. something you study in 10th grade. so there are lot of loser doctors even. i dont know how it works in India but at least here there is a notion that if you are super specialized you will make it to a higher bracket. if thats not the case in india then i still dont get why people like this want to become doctors?

I agree with the requirement of doctors in rural area. Who is going to go there though? You are away from your family and you dont even get paid decently enough for this. My mom did her mandatory year after mBBS in rural area. ironically she says it was one of her most rewarding years. despite the lack of basic amneties there. patients were nicer and showed respect to the doctor. and if they got better, they appreciated it.

your point about your prof is so true. "to retain some self respect and sanity we have to slog it more this way". This reminds me of my mothers professor and his wife. His wife ribs him a bit that his colleagues have gone so far ahead and have opened polyclinics or are some big shots in big hospitals in India. But hes still stuck looking at patients in poorer areas. Sometimes its not even you who doubts your sanity and self respect its sometimes external influeces - your family/friends/aquaintances etc which makes you dobut yourself and make your achievements seem small.

I think if doctors pay are increased, perhaps some problems will be solved.

You write so well. you should have a blog, if you dont already.

shaarique: i wonder why they would have a complex. Its thanks to them, that these students have a chance. Aren't they professors out of their own will?

Sharique 10:53 AM  

but they are more concerned with the money!! money counts and is sadly treated above all

A Soul In Exile 9:13 AM  

Nope... the prof was a visiting prof at an Exec MBA program - not in IIT.

And yeah... I do have a blog and a profile too :-). But then I tend to write only about stuff I am too passionate about...I believe that "jo baat dil ki gehraaye se na nikle uss baat mein dum' nahi"

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