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Humane doctors and inhuman society
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Posted in Publishaletter.com By :
Letter to the Editor Sent to :
Times of India, The
Humane doctors and inhuman society
Dear Editor: A noble profession indeed! Caring for patients and/or curing them takes a considerable toll on personal and emotional resources. At the same time, a medical professional in today's world is expected to be abreast with technical knowledge, required skill and minimal error rates. Under these conditions, the ‘art’ of medicine somehow takes a backseat. In fact, an ability to communicate, display empathy and be sensitive to a patient’s context is characters that make medical profession noble. The editorial “Why doctors need humanities: Including it in medical education is the best way to bring back humanism to the profession” (28th Feb 2017) spells out a number of problems ailing the medical profession in contemporary times. The lack of human element of health care provision, insensitive ways to deal with human suffering, the lack of doctor-patient trust and above all the arrogance of medical professionals make the present health care scenario of India counterposed to the very aim of healing the sick. The solution proposed, therefore, is to include the humanities and arts as part of the medical curriculum. In fact, such aspects have been repeatedly debated and even experimented with in the West. Though the proposal is very useful, yet the larger issues that constrain benefit from it need to be understood for a clearer grasp of the problems. Since doctors form a very small part of the health care system, it would be naive to seek solutions that only target them. The larger structures constituting and contributing to the system (though have been partly discussed in the same editorial) are that of commercialization in medical education, corporatization of metropolitan health care and the influence of technological transformation on clinical practice. An analysis of these structures/systems then becomes an important aspect of evaluating deteriorating service quality in health care and how they may impinge professional behavior in patient care. Technological transformations in medical care though have brought about various advancements yet the way they have been exploited for commercial interest can be considered outrightly unethical. This has been fuelled by the transforming business model of medical education as more students from middle-class families have entered private medical colleges often burdened on loans to finance their studies and thus somehow shift this burden to society in return in return. On the other hand doctors in the corporate healthcare industry work under immense pressure to increase financial returns for their managers resulting in various irrational practices so as to retain high salaries. Moreover, the general climate of the use of medical practice as a business enterprise has resulted in this exploitation. Furthermore, within the Indian society’s excess in corruption and other forms of unethical conduct, the practicing doctors are expected to be epitomes of morality. Though the former cannot be rational for unethical conduct, yet doctors are an integral part of society who is born, grow up, live and work within these variegated social structures. Doctor-patient relationships, on the other hand, are profiled by class differences between the doctor and the patient (and her care provider). These differences are even sharper in the public healthcare setting and the so-called rudeness on the part of the doctor is often multiplied. Thus corruption and inter-class rudeness in the doctor-patient dyad also reflect the broader nature of the social order. Medical education works in this context and humanities have a role to make aware of the nuances of the workings of society, to question prevalent practices and being ethically aware. Therefore the value in educating our medical graduates addressing matters that goes beyond training a handful of skills. Yet there may remain some doubt as to how much such a move can achieve to refashion the very constraints within which doctors work.
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