Wednesday, July 20, 2011

Farmers, doctors and society

I was just reading a great book called, Food for Thought – Towards a Future for Farming. This is what the blurb on the back cover had to say. “ The French radical farmers union Confederation Paysanne.., has led the world in demonstrating the possibility of a socially progressive future for training. Rejecting the increasing intensification and industrialization of agriculture, the Confederation has argued for the need for local food production by small, independent farmers-both for the sake of the quality of the food we consume and to support the kind of societies we want to live in. .. the WTO’s Agreement on Agriculture are both designed to encourage an increasing free-market, profit-maximizing, destructive agriculture. The majority of farmers have lost out and continue to lose. Agribusiness thrives at their expense. “

I was struck by the similarity between the problems faced by the farming and the medical profession in today’s world . When we have dinner at home, we want to eat high quality organically grown food - not the nutritionally -poor cheaper foods sold in the supermarkets. Similarly, when we fall sick, we want our doctors to be caring, thoughtful empathetic humane professionals who will treat us with love and compassion, and we are turned off by the uncaring impersonal medical palaces we call hospitals.

However, because of the way we pay our farmers, we force them to adopt high technology intensive farming methods, so that they can survive. Similarly, we seem to be doing our best as a society to drive doctors away from providing thoughtful high quality fee - for - service one - on - one medical care, where each patient is treated as a human, towards the corporate practice of medicine, where the focus is on efficiency, pay-for-performance, throughput and numbers.

Rather than treasure our doctors as honoured professionals, we treat them as highly paid clerks, whose only job seems to be to fill in forms; document medical encounters; do procedures; and follow guidelines mindlessly. We seem to take pride in stripping doctors of their autonomy, either thanks to governmental interference or because of bureaucratic red tape. NGOs and social activists in India have taken a perverse pride in painting the medical profession as being populated with wicked people, who will do anything to make a quick buck , as a result of which while most patients still respect their individual physician, the profession as a whole is treated with suspicion .

If this attitude persists, it will end up becoming a self-fulfilling prophecy. Doctors are going to start saying – If we are going to be treated as crooks, we might as well start behaving as crooks. And when Atlas Shrugs, where will you go when you fall ill ? I hope the NGOs will help you get better !

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