Three decades ago, that is when our Gurus , current Senior consultant and professors started their practice, they were synonymous to God in Asia. Doctor were the angels between Death, which was a well accepted thing and life. People accepted outcomes well, they accepted doctors try their best, but death is a possible outcome. Even a decade back, death during hospital treatment were easily accepted and easier to counsel. The backlash of anger and frustration on healthcare personals were rarely heard of.
So What Happened in Between this time? How things got worse?
- Death became unacceptable:With the improvement in healthcare and easy availability of health care facilities, death rates among all age groups came down sharply. With availability of modern devices, diagnostic tools, investigations, and availability of intensive care facilities, survival rates improved even in critically ill patients. Gradually, acceptance to death started becoming less among people and when ever an adverse event occured, backlash started to be seen among health care personals and facilities. Many news of doctors and nurses being assaulted. hospitals vandalized keep coming into headlines. It has become so common that , it has become acceptable to the society and security agencies.
- The rise of Money-minting medical Universities– Privatization of Medical education: The reputation of Doctors rapidly deteriorated with medical colleges under Private universities started making Medical degrees a money making business. Medical dream were sold and people spend tonnes on their children’s education. Some sold lands and took loans, to secure the future of children but without understanding if their children are capable of going through the medical school and what their interests were. Initially private colleges met quality with huge failure rates in exams but gradually they bowed to Money, They began trading degree for money. Any student who paid full fee, was deemed to pass. Students realized it and then the things got worse. Anyone would pass in such corrupt universities. Demand was out-surged by production. Rapidly, people began to realize the medical education corruption and reputation of doctors fell to low levels.
- Media into Evil role: The mainstream media made a big blunder. They started targeting medical professionals and hospitals in search for TRP. What they did in past 1 decade, is the thing only they know and most probably regret. They are the main culprit of modern day Mayhem in patient-doctor relationship. Mainstream papers publishing articles like Doctor cut open the newborn abdomen, Doctor killed patient by piercing the intestine, Hospital killed the patient, Hospital took hostage of poor patient etc. instilled hate and fear among society that permanently damaged the field. After the mainstream media, hold their nerves, the unregulated low quality media in dotcoms, facebook and youtubes started minting likes from such news.
- Political Havoc: Believe it or not, the political cadres are the ones involved in hostile activities against health care centers and doctors. They along with goons, are the ones who bargain money after such incidents. Once a Hospital manager in Nepal said,” the Goons are theirs, the Police are theirs , the Government is theirs, we had no other option than to submit them the Ransom. ” This was in response to the Hostage situation in Hospital that rose after death of a patient, and that ended in a huge Payment ( Ransom rather then compensation).
- The Periphery contracted: Once the brave doctors who performed major surgeries and saved lives in peripheral centers started referring patient to Centers. Centers were loaded and the cases reached private hospitals, where the patient would have to pay good bills. In the end, the people without money and power suffered.
- Rise of the Businessmen and Corporate in Health: It is was known fact that, in poor nations, the health, education and transport need to be taken care by the government. That did not happen, Education and Health are the most privatized and capitalized sector in Asia. The investment from politicians to what not. The middle person, started sucking up capital from people and doctors became the face of expensive healthcare. But doctors lifestyle did not improve, only the hospitals got fatter.
Why Healthcare cost will skyrocket in Future?
- Rise of compensation claims and medical litigation: The cost for all this needs to be covered up from somewhere and most obviously, patients will be paying for it. Few hospital add 5% charge over bill in Asia, for settling such matters. Doctors are now practicing defensive medicine. More investigations and more drugs. Doctors have become protocol robots from intelligent humans.
- High cost of equipments and drugs that are mostly produced outside the nation: Most of expensive equipments, drugs, investigation tools are imported from Europe – Germany, Sweden, Italy and America, Japan and China. So, more the cost of health care equipments and devices, the costs will likely shoot up to recover the investments.
- Rising taxes: All end up in rise in cost to patients.
- Insurance agencies entering the Health, will only make Health care unaffordable for the uninsured group. This is a well known thing all over the world.
- Higher education: Doctor studying more and more, will only bring quality of care but also added cost.
- Corporate hospitals paying Doctors like Football clubs, will do everything to get their returns. Unnecessary investigations, fishy packages to fooling patients.
Will the Doctor and patient with no middle man scenario ever come back?
A table, torch, stethoscope and weighing scale and a BP Cuff. This was all was needed in OPD along with few other equipments. Most diagnosis were clinical and least number of investigations. Few pills and the illness is gone. 50% drugs and 50% trust cured the illness. Will the days ever be back in Asia? Never, not until an Apocalypse bring people back to Stone ages. But there are few things that can be done to improve the scenario:
- Government needs to make commitment to citizens health- Better government facilities, cover up for poor and needy.
- Control the Corruption in Medical education
- Restraint the Media who write without evidence and enroll medical journalist proper in all major papers. Make them responsible for their news.
- Create a system to restrain the hooligans and sabotage in health facilities with strict punishment.
Lets keep our fingers crossed, patients have no alternative than to keep good faith on doctors and doctors need to do everything to keep their pride retained. Else we will all be on losing end.