MEDICINE IN BONDS
‘Paracetamol. Refer. Repeat’
I’m not against giving back to the community and serving the society but with the current scenario, I couldn’t help but wonder the loopholes that are fraught with the bond service and if it’s not looked into, it would be a waste of time and money for us, for the government and for the people. Obligation of duties can never be a solution.
Dear ‘To Whomsoever it maybe concerned’
1. You have not trained us during our final year and internship to handle emergencies. We know the names of the drugs, the side effects, the actions, we might even have mugged the dosage, the route, any special precautions to be taken, but ultimately medicine is as much art it is as science. If we haven’t been taught how to tackle medical emergencies, how do you expect us to be any good in a rural area, just after internship? Apart from treating ‘uncomplicated fever’ and referring, we won’t be of any help.
Why don’t you try to train us better? The medical education system that you have created us have made us rote textbook learners who know to ask history in a prescribed format, that too according to the prescribed books, history format which is going around since years and ultimately not used by any of the clinicians I have met. Killing creativity and not letting questions be asked has made us stereotyped vessels functioning in a particular way. Wouldn’t it be prudent to enhance creativity and research, and to teach us the practical dilemmas that we have while treating patients; patients that an average MBBS doctor should be able to manage.
2. Have you ever been to a PHC and seen the infrastructure there? With the limited amount of drugs, diagnostic facilities and expertise available in such areas, we wouldn’t be able to do anything substantial. It would be a waste of time for us because we won’t do anything but refer. What advantage does it do? Neither are the people benefiting nor us neither is the load on tertiary health care centres reducing.
3. Why haven’t you asked the Government to increase the GDP spent on healthcare before making us scapegoats? The GDP is less than countries like Uganda and Ghana, why don’t you do something about it and ask the Government to increase the budget on health. The government can spend money on statues and coastal roads but can’t provide better healthcare but are there in any accident causing mass casualties to pay fake condolences.
4. If you wish for people to provide in the rural areas, I’m sure many of them would be willing. But you don’t provide the right incentives for people to serve in the rural areas. If they are provided, then many will opt for serving the rural areas. There are many states which are functioning well and providing for their people without a bond, why don’t you take lessons from them?
5. Even if the bond is applied, are there so many positions there so that you can accommodate all the two thousand odd students that pass out every year, whom you will be sending off to serve their bond. Do you have the money to pay their salaries? Or are you going to ask us to do that for free too. Is it even logistically possible?
5. If an incident happens during the rural posting, and an MBBS doctor isn’t in a position to handle it, and God forbid if something goes wrong, marring his career, canceling his license or damaging his emotional compass, have you thought about what would you do? Have you thought about all the situations that would arise after your decision, that you consider the Gospel truth?
6. You are well aware of how doctors are becoming easy targets of the frustration of the relatives. Most of these patients do not take care of their health and come at a stage where the doctor cannot do anything. Now, let’s see a PHC, one doctor, dearth of security and multiple relatives. Have you thought of the danger you might be putting the doctors into? Have you thought of enhancing the security? Doctors are beaten up in Mumbai in spite of great security, can you ensure that we won’t be victims of crimes that we didn’t commit?
7. Why are we the only ones to serve a bond? Don’t these people need better infrastructure, better sanitation and health. Why aren’t engineers and architects asked to build better facilities over here. Aren’t they also learning on government money? But it’s fine for them to learn and settle in foreign lands. But if a doctor decides to do the same, you question our morality. Don’t you know that if you upgrade the facilities, provide better sanitation, diseases would decrease of their own accord. Don’t you have any idea of preventive medicine, the third year subject that we were told to learn but never taught. Also, don’t the people residing in the peripheries need dentists and physiotherapists? Oh, maybe they don’t develop problems requiring their presence but the burden of health has to fall upon just born doctors.
8. Your aim should be to prevent brain drain, and better the system so doctors are morally moved to provide for their people. But this would do nothing but promote brain drain.
9. You want to create softwares to track us, to tie the bell like a noose, why not implement the software for the million patients that seek health, digitalising it would be a great step to better health. But you wouldn’t use it for the right purpo
And let’s face it, it already takes nearly ten years, sometimes more, not to add the repeat attempts required to crack exams;for a person to become a competent doctor, and the process is frustrating, I can already feel it. Imposing bonds after Ug, Pg and Superspeciality would do nothing but increase the time required to become a doctor. It would be a hindrance for people to take up medicine.
We will serve the society, that is why we ended up with medicine, but we have our own life too. We aren’t gods, we’re humans too.
A bonded medical student
I don’t know if this post is going to make a difference, but I’ll believe at least I have tried. I believe in the power of social media and maybe it might reach the correct people. It’s an overestimation, but better than doing nothing.
I request you all to share this, not only for yourself but the whole medical community that you represent when you’re out in the world. We have been at the receiving end of the whims and fancies of the authorities that continuously make new rules to make us prove our credibility and morality, whether it’s NEXT or the bond.
We had shown considerable unity when one of us was beaten, we need it again because this is on all of us to at least let know the authorities how we feel about their random breakfast decisions. We have been projected as villains for no fault of us, in media and otherwise and everyone should know of the full story, including our part, because half truths are full lies.