I recently met a classmate of mine who been practicing as an obstetrician and gynecologist in the city of Bombay. He was a bright student and had his own nursing home ; and had what I thought was quite a flourishing practice in the suburbs. However, when I met him , he told me he was planning to retire from medicine altogether. I was quite surprised , but what he told me opened my eyes . This is what he had to say.
I have been practicing as a doctor for the last 25 years , and I am proud of the fact that I provide good medical care . I enjoy taking care of my patients - and my patients love me . It's been very satisfying , but so many things have changed now , that it's just not worth the hassle to continue practicing medicine as an independent doctor in private practice in my 15-bed nursing home anymore.
For one thing , the rules and regulations have become so onerous and difficult that I seem to be spending half my life just filling up forms and doing paperwork - for renewing my registration for my nursing home ; for the insurance paperwork for the TPAs; and complying with the biomedical waste rules. I'm at the mercy of any bureaucrat or clerk who wants to come and trouble me , and there's very little I can do about it.
I used to do ultrasound scans , but now I have stopped doing them. Every time I do an ultrasound scan , because of the PNDT Act, I have to fill up the form which says I have not disclosed the sex of the fetus. Why can't people just accept the fact that doctors are respectable citizens ; and that it's not good for our self-respect to be treated as crooks and criminals .
I no longer have the autonomy which I used to have . A lot of my patients have insurance ; and filling up their paperwork ; getting pre-authorisation; and following up with the insurance companies for my payments has become such a pain , that I no longer have the energy to do it .
Finally, I don't think my patients respect me as much as they used to. They no longer treat me as a trusted a professional. They think I am mercenary ; and often challenge my recommendations . Medicine is no longer considered to be a very respectable profession , and I'm pretty much fed up , which is why I want to retire. It's because we have not stood up for each other that doctors like us have contributed to this decline - we only have ourselves to blame !
What will you do in that case ? You are only 50 !
That's not a problem at all . I own my own nursing home ; and given the astronomical real estate rates in Bombay today , I will get a huge amount of money by selling it . Even if I just park this in a fixed deposit , the interest I get will actually earn me much more than what I'm getting from my medical fees right now ! I'll be quite happy and contented - and don't forget I'm a Doctor , which means I am smart. I'm sure I'll find something to do without having to deal with all the daily hassles I have to put up with today.
It is a shame and tragedy that things have come to this pass. We don't realize how much harm we do by pushing doctors against the wall . Some of this damage has already happened in the US , where primary care physicians no longer want to take on new patients , because they are fed up of the restrictions which are being placed on them. Sadly , the Indian medical system seems to have imported all the bad bits and bobs of the West; and sooner or later , we're all going to pay the price. Most doctors no longer want their children to become doctors anymore , so that the profession which used to attract the best and the brightest is no longer seen as being desirable . This is one of the reasons why we have all these private medical colleges which charge huge tuition fees - and we are now producing a new generation of doctors, which is more focused on the bottom line rather than being focused on providing good patient care. I dread the day when I become older and fall ill !