Addressing escalating discontent among medical professionals will strengthen the healthcare system in India

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In a march to Rajghat, a few months ago, doctors articulated 13 long-standing demands. While these demands are not novel, the accumulation of system anomalies, mishandling by various stakeholders, and a history of inaction has compelled doctors to voice their concerns. These issues encompass a spectrum of challenges, including violence against doctors, several regulatory hurdles, and increasingly adverse opinions against doctors held by various parties involved.

The appreciation of doctors who worked tirelessly during the COVID-19 pandemic, often at great personal risk, has quickly faded from public memory. Regrettably, the resurgence of mistrust and instances of personal violence against doctors have resurfaced. Even more disheartening, some articles on these issues have seemed to pass judgment against the medical community. Further, while the hard work rules imposed by the National Medical Commission were well-intentioned, they have sparked an acrimonious relationship between the Commission and doctors. Unfortunately, none of these critical issues have come close to finding a resolution.

Battling violence against doctors

On September 28, 2020, the government passed the Epidemic Diseases (Amendment) Act, 2020, a significant step to address violence against healthcare personnel during any crisis. This act classified acts of violence against healthcare workers as cognizable and non-bailable offenses, setting a strong precedent for safeguarding their well-being.

However, with the decline in COVID-19 cases, the commitment to protect doctors from violence seems to have waned, as instances of violence against doctors are on the rise. According to a recent statement, the draft of the Healthcare Services Personnel and Clinical Establishments (Prohibition of Violence and Damage to Property) Bill, 2019 was prepared and circulated for consultations. Unfortunately, it was subsequently decided not to enact separate legislation to prevent violence against healthcare professionals. The reasons behind this abrupt change remain unclear, and it has sown seeds of distrust between doctors and the government machinery.

Treatment-related freebies, interference, and the challenge of balance

The recent enactment of the Right to Health Bill in Rajasthan has ignited a firestorm of controversy, prompting healthcare professionals to take to the streets in protest against its implementation. The crux of the bill is a provision that guarantees every resident of the state access to emergency healthcare treatment and care “without prepayment” at any “public health institution, healthcare establishment, and designated healthcare centers.”

Among the doctors’ prime concerns is the fear that this bill will pave the way for surged bureaucratic meddling in the functioning of private hospitals. They contend that the bill potentially violates the provisions of the Minimum Wages Act, which safeguards private workers from being compelled to work for free. The culmination of these concerns was a significant strike by doctors, causing disruptions and discomfort for both the medical community and the public.

While such “freebies” in healthcare are not uncommon worldwide and are often employed by governments to bolster their popularity, their implementation should ideally entail direct and transparent dialogues between political leaders, bureaucracy, and the medical fraternity.

Striking a balance: NMC regulations 2023 and the pharma conundrum

On August 2, 2023, the National Medical Commission (NMC) introduced the Registered Medical Practitioner (Professional Conduct) Regulations, 2023, a significant development designed to address various aspects of medical practice. Notably, the Regulations called for prescriptions to use generic drug names instead of brand names and ceased direct pharmaceutical funding for conferences and honorariums.

While the concerns raised about these regulations hold validity, it’s crucial to avoid an overtly draconian measure. A graded approach, accompanied by enhanced transparency in all financial transactions, could be the key. This would allow pharmaceutical companies to play a role in medical education while following strict regulation. However, the implementation of these ideas lead to intense debate, interjection by top health leadership, leading to the temporary withdrawal of the Regulations by NMC.

Reassessing patient concerns and public perceptions: A call for narrative change

The NMC, in a recent statement, highlighted that a major source of tension between patients, their families, and healthcare providers stems from a communication gap. Enhancing the depth and quality of communication could mitigate numerous cases of violence and litigation and enhance trust. 

In parallel, the media bears the responsibility of a balanced perspective. Rather than rushing to harsh judgments, there’s an opportunity to present a complete and fair narrative. Listening to both sides of the story before passing any verdict is essential. By doing so, the press can serve as a critical agent in enhancing the public perception of doctors, thus facilitating a more efficient and effective healthcare system.

Many doctors are contemplating leaving the medical profession, and bright young graduates no longer view it as the prime destination it once was. In India, where the need for a high-quality healthcare system is paramount in the face of relentless health challenges, addressing the discontent among doctors becomes even more crucial.



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