Monday, April 24, 2017

Do doctors charge too much ?


A doctor's income seems to have become an extremely sore issue in this day and age. Lots of people, right from the average citizen to the PM , feel that doctors charge way too much. Their belief is that medicine is supposed to be a noble profession,  and doctors should not allow their minds to be contaminated by base commercial considerations .  After all, doctors are highly educated professionals, and they should take delight in helping their patients to get better, rather than trying to maximize their income.
Lots of people believe that doctors have become too commercial and uncaring, and that their primary focus is on earning more, rather than providing good clinical care. This is why we are now seeing a backlash against doctors. They are getting beaten up by angry patients; the judiciary as well as the media are happy to criticise them; and  politicians are happy to pander to the masses by putting a price cap on procedures and medical equipment, so that they can make healthcare more affordable.
Doctors, on the other hand, feel very embittered that in spite of sacrificing the best years of their life burning the midnight oil in order to master medicine, they make a fraction of what corporate executives do. It burns them up that hot shot lawyers charge over 10 lakhs for making an appearance in court, irrespective of whether they open their mouth or not. They are knowledge workers, just as lawyers are, and yet people grudge them their fees. They can't understand why society uses such double standards when dealing with doctors. All a lawyer does is win a case, whereas a doctor can actually save your life - and how can anyone measure the worth of a life ? Doctors hare the fact that when a doctor messes up, judges are quick to  fine them crores of rupees, but when they perform life saving surgery, patients are reluctant to pay even a few thousand. Where's the justice in this ?
The problem is that we can't put a price on saving human life, which is why we expect doctors to be satisfied with compliments and gratitude. While these are great for enhancing a doctor's emotional income, how do they expect a doctor to survive on these ?
While an emotional income can be personally satisfying, how can the doctor use this to make a living ? He needs to pay money to buy a house to live in ; and send his children to school. Even if we wants to run a clinic to treat his patients, he still needs to buy the office space , the medical equipment, and pay the electricity bill.
The divide between doctors and patients is progressively widening. A doctor feels he gets grossly underpaid . No matter how many hours he may have spent in the middle of the night, struggling to save his patient's life, when the patient gets better, all he gets is gratitude. However, when the patient doesn't do well ( often for no fault of his) he becomes the patsy who is at the receiving end of the patient's ire.  This is why doctors feel they are getting an extremely raw deal.
There is no correlation between the amount of effort and time which he has invested in his career , and the return which he is now getting. This causes a lot of heartburn, and this is one of the reasons why doctors no longer want their children to become doctors anymore. They feel that all those years of hard work they have put in are never adequately compensated. Now it's not that doctors are greedy  - if they were, they would have become bankers - they are intelligent enough to have got into any profession of their choice ! They don't expect to roll in wealth , but they do want to make enough to be able to live comfortably.
I think we need to stop grudging them their fees. I agree there are a few greedy doctors, but by being miserly and by underpaying doctors, we're harming everyone in the healthcare system. It's because doctors are not paid well that they to resort to all kinds of underhand means in order to increase their income levels.
I think this is one of the problems we are seeing an epidemic of medical corruption today. It would be far healthier if doctors were paid freely and fairly for their professional services, and were given the value and the respect which they deserve.  Unfortunately, in India , we don't seem to value advice.  Thus, while patients are willing to pay surgeons a fat fee for doing an operation, they are not willing to pay family physicians for the advice they give , even though the advice may be far more valuable because it helps to save them from unnecessary surgery. Underpaying doctors just increases medical corruption because doctors can't live  on love and fresh air.

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