The many dilemmas of a GP
General practitioners or family physicians are in a soup and may soon become an extinct species.
1. The GPs are surrounded by quacks. Instead of quacks competing with them, they end up competing with quacks.
2. There is no structural education program for GPs after they pass MBBS. They are not being allowed to grow.
3. Patients are directly opting for specialists today. Unlike the legal system, specialists take up new cases without GP or family physician referrals.
4. In the current system, a GP who charges Rs. 100 to 200/- as consultation fee cannot survive. He gets no exemptions for water electricity bills or other such expenses.
5. With Clinical Establishment Act coming up, he will be bound by stricter regulations.
6. If he dispenses drugs, the VAT department issues him notices.
7. If he uses his residence as a clinic, the house tax department expects him to pay commercial tax on the area used.
8. When the patient is not satisfied, he is liable under CPA and the amount of compensation awarded against him can be up to 1.7 crores.
9. If he opens a collection center for lab services, he is charged for practicing unfair practice and booked for taking commissions,
10. If he wants a radiologist to visit his center to do ultrasounds, the PNDT Act stops him from doing so.
11. If he wants a cardiologist to visit his center to do Echo, the PNDT Act stops him from doing so.
12. He has no means to update his knowledge and if he attends an education program organized by a pharma or equipment company, he is charged for having a nexus with that pharma company.
13. If he believes in writing drugs from standard pharma companies, he is looked upon as a pharma agent.
14. If he has confidence in a particular pathology or imaging lab, it is presumed that he is getting commissions from that lab.
15. If he refers patients for admissions to a particular hospital, it is presumed that he is on incentive list.
16. If he admits a patient in an establishment, the center deducts 25% of his fees.
17. If he draws blood in his center he needs to pay Rs.1000/- every month to biomedical waste collection agency.
18. If he ends up with a serious patient at 2 am in the night, he or she is expected to stabilize the patient and then transfer the patient without charging any fee.
19. He is expected to attend to all emergencies and not charge any fee from them.
20. If he visits a dying patient and spends 2 hours in reviving that patient, he gets one visit fee and if he is unsuccessful he is not expected to charge.
21. He is expected to write only the generic names of drugs, which are not available in the market.
22. He is expected to charge only nominal fee.
23. If he wants to do a side business to earn more money, he is not permitted to do so.
24. If he wants to open his own chemist or pharmacy shop, rules and regulations do not permit him to do so.
25. He is not allowed to advertise.
26. He is not expected to marry his patient without first severing any connection with her as a patient.
27. He is not expected to pay for his admissions, investigations and drugs.
28. He is not supposed to hire the services of doctors from other pathies.
29. If he is registered with state council he can be fired, but if he is not he is not touched.
30. If he gets a government job, he earns Rs. 60,000/- per month but in private practice he is offered only half of this.
31. If he does double duty in two establishments, he is punished.
32. If he is seen talking to a nurse while on duty, it is presumed that he is not working and giving the necessary patient care.
33. He is expected to spend a few years in a village before he starts his practice.
34. He has to pay crores to get his children admissions in MBBS or MD courses.
35. If he becomes old, his own medical expenses are not covered.
36. He is supposed to sacrifice at least 10 years of his life for others. Doctors die on an average 10 years earlier than non-doctors.
37. He is supposed to maintain medical records for over five years.
38. He is not allowed to promote his knowledge and skills.
39. He is not supposed to have market promoters but hospitals are allowed to market, advertise and do PR activities.
40. He is supposed to document all illnesses to corporations facing all hierarchies.
It is the black sheep doctors who should be punished and not an honest GP

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