This is your moment, Doctors of India. Make it count...

Dr Roshan Radhakrishnan
Okay. So that happened.

You write a regular blog post, hoping to hear the opinion of the usual 5-10 odd doctors who visit your site and the next thing you know, you are getting calls from friends while you are having dinner letting you know that you are in the front pages of national newspapers and on BBC.

Or as I like to call it, just another normal Friday at Godyears.

Jokes aside, I did not in my wildest dreams expect this kind of a reaction. I don't think any blogger could have, honestly. I expected the usual 300 - 400 footfalls at the blogpost before I could move on to some lighthearted post. Well, as of right now, the page views stand a little shy of 1.9 lakhs and I have no idea about all the websites who shared or opined about the post.

But thank you all. The vast number of comments that have arrived here as well as on the sites which allow comments and on my email have been supportive.
Thank you all for sharing your experiences, your memories and your opinions.

Just another life lesson from Scrubs

I guess I have to address the key issues of criticism too before I can get to what this post is truly about.

A lot of the criticism dealt with the "pole dancer" line which ended up being used by newspapers and media and ruffled a few feathers. While I did not expect them to lead with that, you know what? I am okay with it. I will gladly take the hit for that. The end point was that you all spoke up. And even in disagreeing with me, you actually ended up unwittingly proving my point.

You see, in the replies and rebuttals from fellow doctors and journalists who felt I was wrong to say such blasphemy, I kept finding variations of the same sentence "Yes, things have gotten worse and we need to change the way it is all going BUT... "

Well, here's my question... If you knew that the system had gotten worse - if you knew that things were decaying - why did none of you open up and speak about it?

Why did I have to be the little boy who pointed out that the emperor had no clothes?

Is that how you treat patients? You take histories and blood samples, look through the microscopes, identify the causative bacteria and... Nothing? You don't treat the illness? You just sit there watching the patient die a slow agonizing death?

When Dr Rohit Gupta was beaten up and the cctv footage went public, what did you do to let the public know that this was not okay? When a female doctor was manhandled, molested and threatened with rape for following triage, why did you not speak up louder?
Because it was okay? It was part of their job?

I stood up because I don't believe that suffering violence can be written off under the category of "part of the noble profession". These are not men and women trained in warfare that they know to defend themselves. For the same reason, I am afraid I will not accept comments where people try to shame me or other doctors telling us that if we can't handle the lack of facilities, man power, equipment and violence, then we not dedicated enough for the profession. That is just hogwash.
You can add a lot of things under the "selfless" package. But violence doesn't get in.

Know this - we are not facing this alone.
As the Week reported last year, 76.7% of Chinese doctors do not want their children to follow their profession for the very same reasons.  76 percent! Doctors from the two biggest populations on the planet are suffering the same level of disillusionment! It is a malaise that is affecting the profession all over the world. Now is not the time to silence voices asking to heal a wound gone septic.

Asking me to change my stand does not change the comments you see here, on Dailyrounds and Docplexus (the two other sites where the majority of comments were likely to come from doctors) - so many have already dissuaded their children from joining their field. It has already happened years before I wrote this post. So many young parents to be are already confirming on public forums that they will not allow their children to follow in their footsteps.
It isn't just my evil pole dancing girl... there are so many kids who have already been dissuaded and so many more yet to come. Instead of taking an "ostrich in the sand" stand and insulting the parents, choose to listen to why we say so and think of how we can fix it rather than just taking affront with a single word.

 My commitment to healing people is what made me speak. And whether you choose to acknowledge it or not, India responded. And the numbers in agreement far outweighed the voices of annoyance.

If this were an article insulting the medical community, the doctors would have lambasted me on the site and stopped there. They would not have shared it as widely as they did, getting the attention of the media and eventually the world. 
They did not share it because it insulted them, they shared it because it resonated with them. They saw themselves and their loved ones in that post. They saw glimpses of their past and possibilities of their future.

Just some of the many comments from our own field.
Don't you get it? If you feel that the system has deteriorated over the last few years, whether you agree with my unborn kid's profession or not, we are all on the same side.

You are angry because I spoke up? Well, I am angry that you knew that things were broken and kept quiet! Now that we have done this Magneto vs Charles Xavier tableau, having realized that we are playing for the same team, can we all talk about what we can do about it?
Look at the comments shared by doctors at the blogpost and on Dailyrounds... Look at the shares. Doctors are asking for help to change the medical system so that we can do what we were supposed to do - heal people without any violence, fear or disillusionment.
We have a chance here. People who matter are watching us. 
Let us make it count.

And that is what I want to build upon now.  
We have a patient to cure. We have identified the signs and acknowledged the symptoms. A diagnosis of a system that will fail if left alone has been acknowledged by all. Now comes the most important part - how do we treat it?

This time, I really do want doctors to chip in in the comments section. This is about you as a doctor giving a brief (let us keep it down to a 5 mark answer at best, everyone!!)  response on what must be done to improve the system. Choose your points wisely and make it count.

This will involve deep introspection - it isn't only about the things you need as a doctor. Its about righting wrongs that we have made as doctors. Most importantly, it is about healing a fracture that has been mal-united for far too long - the relationship between doctors and patients in India.

Some of you reading this are sitting in the most aspired seats of medical directors and heads of departments of the finest medical colleges of India. Some of you are consultants reading this while taking a break in the doctor's lounge between cases. Some are post graduates drained of all energy and just logging in for a few minutes before you try to catch some much deserved sleep. Some of you are undergraduates, reading this from your mobile in a dissection hall or classroom under the cover of a notebook. (Some of you are probably the lecturers taking classes for those undergraduates who seemed a little too engrossed in their notebooks! If so, I am sorry for distracting them!)

Anyway, this is the one moment in time when all your voices come together (from Sheri-I-Kashmir Institute of Medical Sciences up North to Kanyakumari Government Medical college down yonder) and count for the same. So talk. Knowing fully well that there are no short term solutions, what would you like to see change so that you can stop feeling disillusioned and do what you were originally supposed to do - be a healer.

My own suggestions -
1. The obvious one - the percentage spending on healthcare has to be raised. India's biggest asset in the end is the 1.2 billion people within it. They need to be a priority. You need to spend more to keep them healthier. So many poor people need cheaper, easier access to reliable medicines and affordable surgery.

2. If the powers that be are adamant that they will not raise the health care spending, may I suggest an alternative then? Rather than focusing on building 4-5 new state-of-the-art medical colleges from scratch, can't we identify 20 odd existing medical colleges and just upgrade their facilities for a fraction of the cost? Equip them with the best machines and improve the working conditions there rather than restarting in another corner.

3.Let us incorporate technology and link doctors across the country:-
Dr Daniel Kraft is one of the leading pioneers as a doctor and a scientist. In his last INKTALKS here in Mumbai in 2014, he showcased a lot of technology that blew the mind of everyone in the crowd, none more so than me. It was not just because he was able to show us how an upgraded mobile cover could be used to capture, save and even share our ECG instantly. It was not just that he had devices the size of a bandage that could be applied on the chest and showcase all multi-parameter vitals on any android device. It was that all this was highly economical.

Technology such as the one he proposed that day is no longer science fiction... It is here. Let's bring it to the doctors who need it. Can you envision how much benefit it will bring to an RMO struggling in some corner of a rural village if he can share his doubts about a confusing ECG he sees in front of him and get instant help from consultants reading it and assisting from a metropolitan city?
The medical community works best when we work as a team. Does that team really have to be restricted to within the hospital? Can't we extend our expertise to those working in the rural set up too? If we don't help them, who will?

4. Stopping violence - I am a little worried here as even the new law has not deterred violence against doctors. Some of the best doctors I know all seem to be leaning towards a "fight back" attitude. Surely we can find other alternatives?

5. Getting Insurance to the poor - I'm not sure how many are actually using it. I'm sure there are schemes available for the poor but honestly, as a doctor, how many of the poor do you see avail it at your hospital?

Talk, doctors of India, talk. 
This is your moment and the spotlight is on you.

Authors note - 
For those who still feel that I was being demeaning to doctors, may I kindly redirect you to my 2012 "doctors, defend thyself" post (that I honestly feel was way more articulate than the one that went viral). I'm still that guy... I'm still the one fighting for doctors to be allowed to be doctors, instead of punching bags. So stop fighting over a few words and start helping already!

Update: I am thankful to Blogadda for recognizing the value of the post and choosing it as one of their Spicy Saturday blogposts of the week. I also want to thank DocPlexus and DailyRounds for helping share the word with the medical community to get their opinions for the same. 

(28 May 2015) I asked you to have your say and I am glad for the responses that came in here and at the medical sites that shared the post too. 

For the full list of ideas presented, you can check out all the images here


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