Himmatrao Saluba Bawaskar

I read with interest the Editorial1 about the deterioration of the doctor–patient relationship in China.

I believe the situation in India is worse than it is in China. Studying in private medical colleges has become very expensive. Admission is based on entrance examination, not on vocation, aptitude, or attitude of the student. How can one expect ethics and humanity in the medical profession? Moreover, to settle in big cities, where life is expensive, doctors might unwillingly practise unethically, such as advising expensive unnecessary radiology, endoscopic, or laboratory investigations.2 In government hospitals, doctors are overworked and under pressure from politicians who can interfere with medical admission, affecting doctors’ self-esteem.

The main reasons for patients’ relatives to become violent are unnecessary investigations, delay in attending patient, request of advance payments, or withholding a deceased body until settlement of final billing. Ultimately the medical trade now involved in this noble profession has resulted in doctors, patients, and relatives’ unrest.3 Today, doctors are not recommending to their children to go to medical colleges, which is a real misery for the medical profession.

Another important issue is the involvement of drug companies in unethical trade including sponsoring doctors’ tours abroad, conferences, and offering expensive gifts. 30 mg of tenectiplase, a thrombolytic drug used for acute myocardial infarction, costs 27 000 rupees (US$450) to patients (beneficiaries), which is the maximum retail price. However, the same drug costs only 21 000 rupees ($350) to the treating physician.

Courtesy: The Lancet


Link – http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61629-9/fulltext?rss%3Dyes