Saturday, July 11, 2009

Medical residents on strike

Medical residents in Maharashtra are once again on strike, asking for better working conditions. This seems to be a fairly regular event which occurs every 4 to 5 years, when members of the Medical Association of Resident Doctors ( MARD) go on strike, asking for an increase in pay , and improved living conditions . Every time , the same sad story seems to play itself out. The authorities promise to give them a sympathetic hearing and to consider their demands, provided that they first withdraw the strike. The newspapers highlight the fact that poor patients in public hospitals in Maharashtra are being put to great inconvenience as a result of the thoughtless and inhuman actions of the striking doctors ; while the judiciary claims that such strikes are illegal because medical services are covered under the Essential Services Act, and demands that the government take hardline action . While senior doctors make sympathetic noises in private, their public attitude is that such strikes are not the right way of asking for a pay hike; and that doctors should behave in a more dignified and gentlemanly fashion , as befits their profession. After a few days , the government threatens to crack down , and warns that it will be forced to expel the residents from their jobs , if they do not resume duty. Since this can result in their entire professional career being jeopardized, most resident doctors back down , and meekly join their jobs again. The unhappy status quo continues for another 5 to 6 years, until a new batch of resident doctors finds that the government has reneged on its promises; and because they are so fed up of their abysmal working conditions , they have no other choice but to go on strike again .

I have great sympathy for these poor resident doctors. I was a resident doctor myself in KEM Hospital about 25 years ago, and can vouch for the fact that the residents work under conditions which are degrading and sub-human. Resident Quarters are cramped and dirty; and they do not even have basic hygienic facilities. These are conditions which no parent would tolerate for their children – one of the reasons I did not want my daughter to become a doctor . The real tragedy is that the government does have enough funds to provide better conditions for its resident doctors - but it stubbornly refuses to do so, because it can get away with paying them a pittance.

Are these doctors asking to be paid a fortune ? Not at all ! They only want to be paid exactly the same amount which other State governments pay their resident doctors. Maharashtra is a rich state , and can easily afford to do so if they want to do. Unfortunately , because the resident doctors are not supported by their seniors, it's very easy for the government to break the strike. This is another excellent example of how politically naïve doctors are ; and how their lack of unity leads to their being treated as second class citizens.

It is easy for the rest of the world to take a moral high ground and say that doctors should not worry about petty matters such as money . They should be devoting their lives to taking care of their patients – and the money should not matter to them at all.

Unfortunately , the resident doctors have done a very poor job in mobilizing public support for their cause. If they published more photographs online about what their living conditions are like and how poorly they are treated , most citizens would be much more sympathetic to their cause. Unfortunately most of us are blissfully unaware of how difficult their life is. Society at large no longer treats doctors with the respect which it used to , and is quite happy to brow beat them.

I can confidently predict what the outcome of the strike is going to be. It is going to end up exactly the same way as all the other strikes. The resident doctors will buckle under pressure when forced to do so by the government and will resume duty. In order to save face , they will declare that the government has agreed to sympathetically listen to their demands - but in reality , nothing will change.

The biggest tragedy is that senior doctors have refused to come out in support of the resident doctors. By not supporting their cause, the medical profession has once again taken a beating. However the real sufferers are not going to be the resident doctors – it is going to be the next generation of patients. If we want our doctors to be compassionate and empathetic; if we want to train doctors who are kind to their patients; if we want our doctors to improve their bedside manners and treat their patients with respect, then the least we need to do is to treat our future doctors with respect and compassion. If we treat them badly , they are going to end up treating their patients badly too. Every good manager knows that if you want your employees to treat your customers with respect , the employees need to be treated with respect themselves. By failing to give our resident doctors a fair deal, not only have we failed them , we have failed ourselves , because these are the same doctors who will take care of us when we are ill in a few years. Rather than complain about the deteriorating doctor-patient relationship, we need to accept that a large part of this deterioration is because of the shabby way we treat our resident doctors.

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