Friday, September 09, 2011

Doctors as bottlenecks

Doctors are an integral part of the healthcare delivery system and whenever people are worried about the poor quality of healthcare in India, one of the standard solutions is to start more medical colleges so that we can train more doctors to provide better medical care for patients . I do not think an insufficient number of doctors is actually a problem .I think having too many doctors is the real problem – and creating more doctors will just aggravate this.

This is because of the way the system is designed today. Everything revolves around doctors and doctors have become a bottleneck in delivering healthcare . A lot of the things which could be done more efficiently by nurses and physician assistants . Doctors, because of turf battles, and because they want to retain this income for themselves, insist on preserving their monopoly on medical practice.

Doctors are so hidebound as a result of their 8-9 years of medical training , that they are just not capable of thinking out-of-the-box or accepting that there could be other solutions which are not doctor-dependent ! What this means is that when you have clever entrepreneurs who come up clever solutions for patients to use , doctors instead of encouraging their patients to use these tools ( which is what one would intuitively expect, since doctors are meant to be patient advocates !) they often end up hampering their adoption , so that instead of going one step forward , we seem to be taking two steps back.

Why do doctors feel so threatened ? No matter how smart or clever the patient , or how well informed he is, he still going to ultimately require a human being to hold his hand and provide him with the actual medical treatment, This is something which only the doctor can do ! Doctors need to focus on their core competence – that they are there to provide human support and real-life skills. They should encourage patients to use technology to do a lot of the other stuff which can be done without requiring their presence.

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