Indian Journal of Surgery, Vol. 67, No. 2, March-April, 2005, pp. 71-72
Modern medicine, commercial attitude and service in surgical practice
Lakhmi Memorial Hospital and Research Centre, 1/2 New Palasia, Near Nehru Brdige, Indore - 452001
Code Number: is05018
Surgery is the Surgeon's perception turned into artistic structure based on scientific facts to serve humanity gives happiness and relieves suffering. The Surgeon and his perception go together and once the perceptive spirit enlightens the Surgeon, the patient is benefitted and the Surgeon wins.
Asia and the Indian Continent of past had its own system of medicine and teaching. Doctors enjoyed a high reputation and were considered the patrons of society, having special status in the King's court and palaces. They had a set of values and the spirit of service to inspire them.
Vedas have elaborate description of surgical instruments, equipment and procedures indicating a very high quality of Medical care in this part of civilization. With the decline and fall of the older world the dark ages engulfed us and the system died. In the Vedic era we had a flourishing society with a different set of social values. The present day World, as we know, has emerged from the Middle Ages armed with the spirit of adventure and discovery. The discovery of America by Christopher Columbus led the onslaught for newer things in all fields of life including modern medicine. Europe and later America became the cradle of discoveries and innovations in this field and we feel proud to be a part of this modern society.
In the early part of the 20th century the surgical techniques and skills gave new dimensions to the understanding and treatment of many diseases. In the later part scientific inventions and development of new techniques laid the foundation of advanced surgery to overcome a number of diseases beyond imagination in the fields of Cardiac surgery, neurosurgery, oncology, reproductive procedures and other related fields. People benefited with the development of surgery, which aimed at relieving pain of the finest creation of God - Man.
Social Medicine in Europe and England is meant to serve every citizen. USA also started the same system but soon they had to restrict the benefits to those sections of society who could pay for it. This was dictated by the forces of modern market and finances in a welfare state.
India has a very old and trusted system of ancient Ayurvedic medicine and surgery where the common man was a beneficiary. It declined during the middle ages and we failed to keep pace with times. Family institutions and Gurukula mode of teaching restricted its spread to common people and it shrunk to a selected few without sharing its worth and value with the man in the street. Modern medicine downed in India in the 19th century during British rule and has flourished today to compete with the best Western institutions in the field.
Development in any field demands people with perception and determination. The lack of it leads to stagnation. Medicine in India before the 60's reached stagnation and the country suffered from mass exodus of doctors to West, specially the USA, what we call the Brain-drain. Better financial returns, better working conditions and research attracted our best brains. We will have to match these conditions to effectively check the brain drain and attract Indian talent for development of our National Health Programmes.
The Govt. of India has started five National Institutes to eater for the needs of this vast land. But the medical and health schemes are on a low priority with less than 2% of the GDP provided in the budget. We are still struggling with epidemics, population control measures and preventable diseases. Our Medical Colleges are starved for funds and lack equipment. These institutions should be linked to Primary Health Centres and social organisations for the general welfare of society. The political leadership should see the vast potential and channelise it for general welfare. Then only the PHC's will develop to be hub of health care activities in the society.
In 1970's Apollo Hospital gave a new direction to the country and corporate hospital started coming up. They provided the best facilities but beyond the pocket of the common man. This trend has led us to new thinking defining health care in a cooperative way and providing better services at cheaper rates to large group of people. Health Insurance has come a long way and the urban population can secure their health care. The position in villages is improving but at a slow rate. Philanthropic organisations and doctor's are moving to small towns with a population of 10,000 or less. But still a vast majority needs a strong basic medical structure to cater for the poor and tribal areas.
We are not much different from the other countries in medical development. Our late Independence and lack of imaginative leadership has slowed our progress in this field. Money has attained priority over service. The profession is losing sovereignty and is not given a leading role in the shaping and formulating of health policy of the future. The precedence of money over service, quality and care will result in the loss of faith in the society and lead to decay. It is high time when leaders and administrators looking after health care of the country should make way for doctors to formulate National Health Policy. They are the back bone and can change the shape of the present poor and decaying infrastructure, lack of facilities and man power. Service with a smile will restore faith of the society in doctors.
Health is a state matter and every state has its own set-up. National programmes have all India impact. The state structure is not based on any scientific data and study in relation to man power, finances, distance between hospitals and sharing of facilities. Paltry budget provisions, lack of doctors and para-medical staff fleece the system. The government will have to be serious and ready to meet these problems.
Associations of medicine, surgery and other specialist groups should join hands to formulate a National Health Policy and cooperate with the Government. The country needs a comprehensive approach with the medical associations, doctors and health workers joining hands. It is a misconception that doctors do not go to villages. If we improve the infrastructure facilities, work environment and instil work culture, Doctors will surely fulfil their duty and national obligation. Teams of devoted Surgeons and para medical staff can cluster around an operation theatre with basic equipment. Their very presence will inspire confidence and people will come out with help and equipment if needed.
Our Organisation has 11,000 members on a National level. More than 3/4ths of our members are working in far off places with various short comings. Let our Association inspire other medical specialists to come to a common platform and help design our National Health Programmes. With some positive thinking a charter can be drafted to enlighten the public, the Govt. and other NGO's about our efforts and plans. Ours will be a realistic, possible and affordable scheme to make the nation healthy.
India, A nation full of diversities and complexities has made progress in many fields. Agriculture, Industrial production, trade and commerce have shown signs of recovery. Education has shown remarkable progress, what remains is Medical care for the nation and we can workout an affordable plan with Govt./NGO's/ Cooperative groups and such other groups.
Copyright 2005 - Indian Journal of Surgery