Causes of loss of Doctors image, consequences & remedy

Part 1

Dr. Rahul Jain, Psychiatrist, West Bengal June 2017

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In recent times a lot of outbursts towards doctors are being seen from public and state due to the disrespect, mistrust, aversion, and hate for them.

The conditions of the doctors in all the states are more or less the same, may be with very minor differences.

a little. To understand the reasons of this mistrust and disrespect, we need to look back

Most political leaders everywhere (regardless of their colour), try to control the populace by various means. The main pillars are – Lowering education levels, limiting culture, withholding information and spreading misinformation, censoring any means of individual expressions, maintaining poor law and order situation creating anarchy and chaos, lowering income and standards of healthcare.

Siphoning funds from the State exchequer for extra proceeds are usually the norm for them and their goons. That’s why we hear about so many scams often.

The benefit is two fold –
(1) Personal monetary gain and
(2) Engaging people to spend their time and effort on mere survival struggle

in absence of proper services, rather than have time to critically appraise the performance of the elected representatives.

This drain always creats a deficit in ministry funds which already suffers from meagre allocation, naturally leading to diminishing standards of services (though the promises made are always the loudest).

When water goes over the head and there is a big hue and cry from the dissatisfied people, the blame needs to be put on someone to divert peoples attention – and a Scapegoat is always in high demand.

In Health Sector the most handy and convenient scape goats are the doctors, as they have some special qualities making them candidates made to order.

1. They are gentlemen type (read stupid), meek, easily bullied and pushed around.

2. Always exposed to public and available in forefront.

3. Not very vocal, assertive or oppositional.

4. Not significant in numbers (in comparison to the general votebank)

5. Not at all united, so can’t get peer support.

6. Not very social – so unlikely to get any public support.

7. Can be whipped to work round the clock like a slave, by blackmailing legally,
emotionally and by tickling their sentiment).

Page 2 of 13 http://www.dailyrounds.org/blog/yet-again-politicians-come-across-like-doctors-enemies/

So, whenever things got out of hand, the blame game started –
Dear Brothers and sisters – we the leaders are so concerned about you that we do not

hesitate to sacrifice everything for you. But all our efforts are thwarted by some selfish, greedy, inhuman doctors. In spite of being provided everything, they are not doing their job, running around for personal profit, not providing services in spite our repeated efforts.

Mark them, punish them and don’t spare them!
“Pull their stethos” – an unforgettable call of a prominent personality rang throughout the state.

You can’t disprove a rumor. All their henchmen & their purchased media vultures jumped in with glee smelling sensational opportunity to boost their TRP and please their masters.

Many who had aspired to be a doctor but failed due to lack of ability, were already brimming with hatred and envy of the position & respect the doctors commanded. They saw this as a golden chance to strike, especially when protection of the State was available, turning God into Devil overnight.

People did not pause for a moment to verify what really is ailing the health sector but went along the populist craze of blaming the doctors. Easier than taxing their brain to find the truth and then to do something about it.

The politically coloured doctor representatives felt that pledging their allegiance to the party ideology would be more rewarding than voicing their member’s welfare. The apolitical ones (if there were any) felt it a waste of their time to get involved.

Where some world day celebration (AIDS, cancer, TB, Thalassaemia), some small CME’s, a small procession, some Radio interview and TV appearance suffices their purpose of higlighting self, why toil in vain?

So all blames started getting attributed to the doctors. Gradually threats, intimidations,

insults, gherao’s started. Bullying the doctors became the norm. Initially at the peripheries, in the suburbs sporadically, to now encompassing the whole place including the

capital. The medico representatives at upper echelons themselves were trembling in fear of their political masters, had no guts to say anything other than “Yes Sir/Madam”. To expect that they would provide protection for the ground level members seemed ridiculous.

City based doctors did not feel the heat initially, and the actual sufferers did not get a platform to voice their misery. Media kept filling up their quota of doctor bashing to increase their circulation and gradually the doctors began drifting away from the mainstream, all the while getting established as the main culprit.

Politicians were the happiest bunch. They could safely continuing their siphoning operation, blow their trumpet of benevolence, use the doctors as Gladiators for public entertainment and at the same time have someone to pass the blame on.

Its not that all medical leaders were the same. Some protests were voiced but could not stand before manipulation of the Statecraft. Can’t blame them very much. After all, they too are humans with their own practice, family, and career to think of.

Government allows them to hold these position for a purpose. They are supposed to impose decisions from top down smoothly – not the other way round. They are to see that their masters are not bothered with problems of lower levels. Unless they are able to do that, their own position would be in jeopardy.

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So the common level physian remained orphan in spite of having guardians theoretically.

But these undercurrents were not to be acknowledged. A formal outward show had to be maintained – even when legitimate complaints of lack of manpower at all levels (of doctors, nursing staff, Group D, sweepers, other paramedics and technicians), lack of necessary equipment, their maintenance, lack of security, lack of medicines, lack of infrastructure, from base to top establishments started coming up repeatedly. Only pacifier was that ‘Please manage somehow, we’ll look into it’.

Well these are well known facts. No need to re emphasize them here.

Gradually the unrests became too much to be pacified by words. Greivances kept cropping up and discontent increased in ranks.

The politicians were however not that naive not to have anticipated such situation. They had always known that united force of the doctors could be a formidable one. And so already had introduced their own stooges (purchased or intimidated) in key places. The sleeper cells now sprang into action.

First step was titillating the sentiment.

We are doctors, ours is a noble profession which cannot be weighed by money, comforts or luxurious life, we have chosen this profession willigly to fulfill a greater purpose of serving the humanity. Petty thoughts and craving for creature comforts does not become us. We must continue our humanitarian mission in spite of all adversities.
In other words We are the sacrificial ‘gram fed
mutton’ bred for the purpose.

Second was to dilly dally.

We are in process of talking to higher authorities – so please wait. It is known that any emergency situation simmers down in its own time – till something new happens again.

Third was misguidance, false assurances –

The Government has accepted our demands and will implement them very soon. Though once the crisis is diffused, that ‘very soon’ is never seen. Nor there is anyone to question the progress or the absence of it.

People belonging to other profession can go for strikes, demonstrations, protests for their rights but its sin for us. Our services to the poor (who, by the way, does not for a moment hesitate to beat us black and blue) cannot be hampered.
After all we belong to a noble profession.

Just few days of mass Strike (by govt. and private) doctors, everywhere together, can cripple the whole nation and bring it down to its knees. The administration can take whatever steps it wants – arrest and put to jail under ESMA, cancel registration, – but cannot produce a single doctor to combat the crisis. But we have never flexed our muscles so, in spite of facing so much injustice.

Maybe we are much too tolerant/ or much too afraid – which has brought us to the present situation.

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The High Court Bar Association decided to cease work yet again… …The lawyers had boycotted court work for a week…, …The cease work was called off after he was arrested. https://www.telegraphindia.com/1170214/jsp/odisha/story_135596.jsp#.WMz0NX20mUk

Numerous instances like these are present for others but na….we are saints.

Next step was punitive.
Divide and rule to maintain authority and discourage rebellious behavior.
Punishing the vocal ones by applying the administrative power of ‘transfer posting’,

denying promotion and legitimate rights, met’ing out punishments over petty matters and other harassments.

On the other hand providing additional and unfair advantages to the sycophants. Scattering any protesting group by punishment transfer to remote locations and at the same time warning others by making example of them.

Remember, in the meantime from 13th Nov 1996 doctors were brought under the purview of Consumer Protection Act (CPA). We became ‘Dhobi ka Kutta’ na ghar ka na ghat ka. Yet another instrument to harass the doctors was handed over to the media, administration and public alike.

All duties of a service provider (minus respect and immunity) and all the punishment for the businessman (minus income/profit) were designated for us.

We are to be humanitarian, empathize with the patient, provide treatment for free (as per recent verdicts) but…if there is any mistake or unwanted outcome there will be no limit to our fines (can reach from lakhs to crores) alongwith other associated disciplinary actions including criminal proceedings which may culminate in getting arrested.

In short, all arrangements to destroy a doctor mentally, physically and professionally are ensured, for so called Medical Negligence.

A nice term by the way. Heard only in medical cases. Never been heard in context of Administrative, Civil, Judicial, Executive, Public service, Law enforcement, Governance or ANY other field. They never err and naturally no negligence and no question of punishment.

People compare with and want a dream treatment shown in films and heard of in foreign countries – but forget that to provide such treatment, resources are needed. It has been forgotten that treatment is a team work of which doctor is only a part. Rather a view is propagated as if doctor alone is responsible for the whole process.

If hospitals are filthy doctor is to blame, bed not available – doctor is to blame, if attendants don’t work – doctor is to blame, no medicines, no ambulance, poor food, cheated by dalals, whatever untoward happens – blame it on the doctor. From A to Z problems in medical establishment – doctor is to blame. As if no one else works in health department except doctors and no one else has any responsibility. And surprisingly the doctors too never raise their voice strongly in this matter. Don’t know why.

People want our health system to be like NHS. Had the rules of NHS been implemented here they would have felt the difference.

“Forwarded message from a UK- NHS doctor

Comparison between India & UK health services
—————————————-
Very unfortunate incident. I don’t understand the public mentality.
This doctor was attacked for the death of a patient who had injuries due to road traffic accident

and died due to road traffic accident.
People are not interested in improving the road conditions, they don’t want to follow the traffic

rules, they want to drink and drive, they want to drive on wrong lanes and so on. When such victims

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are brought to hospital, they want him to become normal instantaneously, they expect miracles to

happen.
Indian public don’t realise that how lucky they are as far as the medical treatment is

concerned. The so called best health care of UK has following facts.
1. If you need to meet a GP (genral practice), you need to wait for 5 to 7 days.
2. If you want to meet a specialist, you need to request your GP to refer you to a specialist in

the first place. If he thinks that it is very essential, then he will refer you.

3. Specialist doctor appointment will take months. If you miss your appointment for some reason, you have to request and wait for next appointment. The next appointment might
take months again.

4. Emergency services are available. If you go to emergency services (A&E), you will be
assessed by a nurse or a doctor and severity of the condition will be noted. Then you are
made to wait for about 4 hours to 10 hours.

5. If you want to undergo scanning, the waiting period is months.
6. If you miss 2 appointments in health care because you didn’t turn up, you are likely to be

thrown out of the waiting list. Then you have to start from the beginning.
7. If you feel that you want to go private for health care, you have to spend about 100 pounds

(Rs 8000) for consultation.
If you want to get operated, you need to spend at least £ 10000 to £ 20000 (10 to 20 lakh

rupees), and the average UK citizen can not afford it.
8. Free health check ups, free consultations, concessions are unheard.
9. Many NRI’S take a flight to India if they want medical facilities at affordable prices and at

the earliest.
10. You can’t buy antibiotics and few of the medicines from pharmacy without prescription. 11. Cost of medicines is quite high although NHS (government run) is free.
12. There are many more things that are difficult to get in UK health system as compared to

India.
Now you can decide how lucky you are in India to have a health system that exists. I am not

saying that it is very ideal.
I have practiced in India for about 20 years and now I am in UK health system (NHS). I have

seen both sides.

I personally feel that in India, most of the doctors, nurses and other health care professionals in both government and private sector work quite hard and are dedicated. There might be few odds. (They will be there in all fields).

If the society is treating the doctors, nurses and other health care professionals in such horrific manner for no fault of theirs, then god only has to save the country.

It is not only regarding health professionals, but regarding anyone who is doing a good job for the country. If society treats a sincere soldier/government officer/banker / businessman/ teacher in a horrible way, the entire team of that profession looses interest in their work.

If we don’t support the good, we don’t get good.

Dr Umesh Nagalotimath ENT specialist
UK.”

So there have been some mistakes! Mistakes are bound to occur when you are doing something.

(�गरते ह� शहसवार ह� मैदाने-ए-जंग म�,वो �त ल या �गरे जो घटु नो के बल चला करताह�). What will happen if Doctors stop working due to fear of mistakes?

Coming back to the topic. There are always some black sheep in every profession. Next step was the inquisitions. Witch hunting started. Faults were searched for and highlighted to accuse the doctors. Anyone protesting about atrocities against doctors were told that the problem lies with us. We should rectify ourselves.

When something improper happens with women in a society – a section of people try to blame it on the women herself. Rightly, this attitude is met with an uproar by others. But when similar

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incident happens to the doctors, all the civilised citizens zip up their lips. As if whatever wrong is

happening to us – we deserve it.

http://www.anandabazar.com/state/demands-are-at-high-to-educate-junior-doctors-how-to-

behave-with-patients-1.534117

As if doctor patient relationship is not both ways. Only the doctor is at fault in case there is a miscommunication.

Patients (just because they are anxious) can get away with all sorts of misbehaviour. Doctors tooareoverworked, overstressed–whatabouttheiremotions?

Who thinks about that!

Anyway the point of the whole exercise was to divert the blame regarding the deteriorating condition of health system from politicians to the doctors. Some prominent doctors too joined the circus in eagerness to please the top brass. This gave a big impetus to the already aggressive media drive. They started flooding the market with all sorts of hyper inflated truth, half truth and at times totally hearsays as news.

The sensationalism sold as hot cakes. And the doctors turned into Devil incarnate overnight.

Simultaneously there were many other sideshows going along, which had their own implication in the whole scenario.
To facilitate vote catching and to keep earning black money numerous reservation quotas, management quotas were beingcreated to fill up medical seats with undeserving candidates,bysacrificingmerit.

Gradually in subsequent years a lot of substandard medical graduates started pouring in the health sector. This provided political and financial gain to somekey people, but at the cost of overallquality and excellence. Substandard doctors had substandard knowledge, substandard mindset & substandard moral values. Naturally the standards of treatment, doctor-patient relationship quality, honesty, credibility began falling.

Next the substandard doctors also entered the teaching faculties by further reservation quotas and began producing even more substandard students and doctors. The standard started plummeting in geometic progression every next generation.

And now even the meritorious students became below-standard in their hands. But who cares?

Heres a story of watermelons (collected) –

My village is famous for its watermelons. When I was a child, the farmers would organise a watermelon-eating contest at the end of the harvest season in May. All the kids would be invited to eat as many watermelons as they wanted.

Years later, I went to Mumbai for higher studies. I went back to my village after 7

years. I went to the market looking for watermelons. They were all gone. The ones that were there were so small.

I went to see the farmer who hosted the watermelon-eating contest. His son had taken over. He would host the contest but there was a difference.

Clinical Establishment Act 2017

taken to an absurd level – the less said the better.
“When Draco squirmed…
Draco a late 7th century BC Athenian statesman had prescribed a set of laws which had heavy punishments for small offences. I am sure if his grave is inspected there will a fresh crack or two which have appeared on Feb 27th 2017…” https://www.facebook.com/medicoslegalactiongroup/posts/1132630116847404
Impose such conditions which are impossible to fulfill, so that you can make any Doctor a Law breaking criminal whenever you feel like. All the while chanting “honest doctors need not fear, only dishonest ones will be punished”.
Really what fools we are taken to be!

Prohibition of advertising in private practice –

You are doing business but you cannot let others know your area of expertise, your location, your wares, and any special facility you might be providing. You have to build an expensive setup and then sit with the hope that maybe, maybe someday the news of your presence will percolate into the society, the market and then you may have some patients.

Forcing to write prescriptions in generic name :

• Without having the infrastructure to provide sufficient generic drugs – even the govt. supply medicines to the pharmacies of its own hospitals are some or other branded ones – not Generic.

• Without being able to stop sale of schedule H drugs OTC (Prescription must for drugs? No way…)
http://timesofindia.indiatimes.com/city/bengaluru/Prescription-must-for-drugs-No- way/articleshow/44517131.cms

• without having the infrastructure to assess their qualities, http://bangla.eenaduindia.com/News/National/2017/02/24121324/1 850-drugs-sold-in-India-Not-of-Standard-Quality-HealthMinistry.vpf

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When the older farmer gave us watermelons to eat he would ask us to spit out the seeds into a bowl. We were told not to bite into the seeds. He was collecting the seeds for his next crop. We were unpaid child laborers, actually. He kept his best watermelons for the contest and he got the best seeds which would yield even bigger watermelons the next year.

His son, when he took over, realized that the larger watermelons would fetch more money in the market so he sold the larger ones and kept the smaller ones for the contest. The next year, the watermelons were smaller, the year later even small. In watermelons the generation is one year. In seven years, Parra’s best watermelons were finished.

In humans, generations change after 25 years. It will take us 200 years to figure what we were doing wrong while educating our children. Unless we employ our best to train the next generation, this is what can happen to us.

37Shouldn’t we attract the best into teaching profession, medical profession?”

Taking advantage of the disorganised condition of the medical community, see the discriminatory steps taken against them.
I’ll simply recount some of those, though enough has been said, still enough remains to be said about them.

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• Proudly occupying 1st/2nd rank of producer of fake medicines in the world. “According to Outsourcing Pharma citing the European Commission, 75% of counterfeit drugs supplied world over have some origins in India, followed by 7% from Egypt and 6% from China” (https://en.wikipedia.org/wiki/Counterfeit_medications )
“That said, nearly every observer and researcher on the hunt for these dangerous fakes will point to two primary culprits: China and India.” http://foreignpolicy.com/2009/10/06/the-deadly-world-of-fake-drugs/

The Govt is forcing the doctors to go generic.
Actually this is part of an eyewash to blame the doctors – as if just because Doctors were writing medicines by brandname, the patients were suffering. Now the doctors are writing generic but situation has remained the same.

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The generic drugs written by doctors are not served by neither the hosp pharmacy nor the govt approved pharmacy, as you can’t force them. They still supply branded ones – the differencebeing is,nowthebrands(anobscure,unknownlocalbrand) arechosenbyaclass8 pass salesman who is untraceable, unaccountable and by the way has no restriction in taking gifts from the pharma company.

No restrictions for the drug control officer too, who is supposed to monitor all this – under whose benevolence thousands of unlicensed medicine shops flourish, thousands of medicine retail shops operate with no pharmacist available, except on register and thousands of substandard drugs flood the market. People erase date from expired medicines and restamp them for sale.

But even if the doctor does not choose the brand of the medicine or can ensure the quality of the medicine – at the end of the day, he still remains responsible for it and answerable to the patient.

What a joke.

Remember the Chhattisgarh incident.
(Tainted drugs suspected in sterilisation surgery deaths) http://in.reuters.com/article/india-health-sterilisation-idINKCN0IX0HT20141113

4. Dissolution of MCI with its restructuring –
As Doctors are no longer trustworthy.
Butbarcouncil/presscouncil/ASCI isnotdissolvedastheyarepureasdrivensnow.

5. Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act –
another horror story.
“In PCNDT act Appropriate Authority has vast powers; almost similar to the ones the authorities possessed in the draconian TADA act. Absolute and unguided powers are also likely to be misused….. Simple errors such as blank columns, not putting complete signatures, faint copy of ID proof of pregnant woman, improper referral slip/ prescription of doctor who advised antenatal scan, not having the latest copy of PCNDT act etc., have been forming sound grounds for initiating criminal prosecution of the scan centre owners. Doctors are routinely prosecuted for incomplete filling of ‘Form F’, of not displaying copy of the PCPNDT Act, not displaying notice in right size or colour. Clerical errors are not synonymous with sex determination..” http://www.tribuneindia.com/news/comment/can-pndt-act-alone-improve-sex- ratio/84766.html
http://www.livelaw.in/minor-errors-record-keeping-pcpndt-act-cant-invite-prosecution- doctors-bombay-hc/
Consumer Protection Act – Empowering consumers or beating up the innocent doctors?
http://www.dailyrounds.org/blog/cpa-pcpndt-how-two-well-meaning-laws-became-doctors- worst-nightmare/

6. Denial of Voluntary Retirement to eligible Medical Officers illegally in West Bengal
Govt. not budging in spite of court order. Selective amendment of service rules to impose on doctors only.

7. Introducing an exit test for all medical graduates to be eligible to practice medicine in the country.
http://www.sundayguardianlive.com/news/7961-medical-graduates-will-have-sit-exit-test- practice-medicine

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Whereas scraping screening test for ‘foreign’ doctors facilitating the boom of foreign MBBS racket (anotherhugesourceofincomefortheselect),sacrificingthestandardonceagain- http://www.deccanchronicle.com/nation/current-affairs/260616/no-test-post-graduate-must- for-foreign-doctors.html

8. Forcing medical students to go to serve in rural areas by denying them their degree. Medical graduates of all colleges will henceforth mandatorily have to do rural service for a year in the state. Those who refuse to do rural service will not get their degree certificate. Besides, penalty will be imposed on them,” the minister said. http://www.deccanherald.com/content/481497/rural-service-made-mandatory-medical.html
Is only medical treatment needed in villages? That too without any infrastructure.
Why not graduates from other streams forced similarly?
India need Doctors in rural areas which is not just possible by increasing MBBS seats or making compulsory rural posting.
Everybody wants better lifestyle. Once basic amenities are there and the package offered is satisfactory, a Doctor will be more than willing to go (Happy to help you in villages).
Even candidates coming from rural areas, after getting degree do not go back to rural areas or even their rural home town.

9. Cancelling registration –
The threat of cancelling registration is given so casually and frequently that it is appaling! Registration and degree to practice is EARNED and not received in alms. It takes more than half the life of a doctor to acquire it. Its cancellation is almost equivalent to death sentence to him, ruining his career and ensuring that he and his family are brought to street, homeless and jobless for life.
How can you single out only the doctors out of all jobs and profession in the society?
If a shopkeepers’ trade license or permit is revoked he may get another one in the name of any of his family members and carry on scot-free. Can a doctor do that? And even that is very rarely done or even considered. But no one thinks twice before demanding cancellation of a doctor’s registration.
There are thousands of instances of mistakes/negligence/law breaking from people in whatever profession/service they are.
Have you ever heard the demand of revoking their undergraduate/graduate degree as punishment?
A clerk (in corporation, municipality, motor vehicles or such myriad of government offices), a Pharmacist, a police officer, lawyers & judges, an engineer, school teacher, professor, staff in Fire brigade, in railways or any employee anywhere.
As punishment you may block an increment or promotion/impose a fine, in very rare case even if you terminate his service – he may still be able to get some job if he retains sufficient qualification for it.
But in a doctors case you strip off the graduate (& automatically the postgraduate) Degree.
A degree which is not able to procure him license to practice, is useless. This leaves him a higher- secondary pass man at the age of over 40 with no means or knowledge / time / money to restart a new life legally (remember he has the resposibility of sustaining his parents and family too).

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েয মানুষটার কােছ আপিন েসবা চান িক� তারপর পান েথেক চু ন খসেল আপিন তার এবং তার স�ুণ পিরবােরর

সামািজক হত ার দািব জানান – আপনারা েকমন মানিবক?

The very man from whom people seek compassionate service, they do not hesitate for a moment to destroy him (along with his whole family) for any unfavourable outcome in his job. I ask how humane are they?

The above mentioned examples are only to mention a few.

Now over all these, the Quacks are being so pampered and allowed extreme liberty in the name of shortage of doctors in rural areas. On the other hand legitimate doctors are overworked, unappreciated (http://www.theweek.in/health/cover/doctors- ill.html), rather continuously censored from all corners including the superiors of the health dept.

People blame doctors who do not want to go to the rural areas. But have they ever appreciated the thousands of doctors who are working in the rural areas year after year?

Other departments also seem to think doctors as easy and safe punching bags, including Media, NGOs, Judiciary, other public regulatory bodies like Human Right Commission and last but not the least, general public.

It seems that a third generation of doctors are about to be created. Qualified yet unlicensed doctors. After passing MBBS and doing Post Graduation it is better to get our registration cancelled so that we can join the ranks of the illegal Quacks and be free as them. Enjoy all benefits with zero responsibility.

Net result of all these factors has led to the dismal situation, where the Doctors have got their back against the wall, with no remedy in sight. The only thing that might have solved our problem was if we could get up and fight united, against all this discrimination, defamation and injustice.

We lament and long for unity, but still can’t seem to get united – but why? Lets explore

By default, with few exceptions, Doctors are Loners.
1. Since a doctor can very well carry on with his profession alone lifelong,

without the need to be a part of a larger institution/organisation/team – they don’t have the compulsion to form or join a larger community.

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Only when in serious trouble they surrender to the strongest party existing and in the process get branded. Not all are actually committed to the political ideology – most of them shift allegiance simply to save their skin in case of dire emergency.

2. Practicing medicine (by medicine I mean all streams) is a very taxing, uncertain, time consuming, and at times literally laborious job. Both in the case of in-service doctors and full time practitioners. Both face their exclusive set of difficulties.
Juggling to manage the complexities of each unique case, making tough on-spot decisions, at the same time trying to appease, meet expectations of each and every patient (with their varieties, & at time unreasonable and bizarre demands and balance it with what actually needs to be done) all at a time, takes its toll. More so with the Damocles’s sword of negligence, physical and mental abuse/insult hanging over them constantly.
At the end of the day it leaves the doctor too exhausted, with no energy for socialising with anyone (be it their own family members, relatives, medical or non medical community). More so, as they feel no real need for it.

3. As a doctor works mostly alone (at most with a small close knit unit for surgeons and likes) – the credit and the reward of the work done by him is enjoyed by him alone, by name.
On the good side, this benefit of being highlighted, getting recognised, propels him to drive for personal excellence. But on the flip side inflates their ego and prevent them from collaborating or sharing credit with peers, or to maintain humility in public – making them look arrogant .

4. Due to the vast diversity of streams they each face unique problems that are at times vastly different from that of their colleagues. Problems of a gynaecologist may be very different from that of a ophthalmologist. This also prevents them from understanding each others dilemma.

5. Add to the list, the problem of professional jousting. (http://www.capson.com/blog/doctor-jousting )

6. Doctors are generally considered as rich, irrespective of whether or not they are. So basically society as a whole (be it his relatives, acquaintances, authorities, general people around him) feel exploiting him for money or other favours is not unfair.
He is expected to treat poor or needy for free, anytime, anywhere. Give medical certificate to whomsoever whenever asked for, give maximum alms to others, amount of ‘chanda’ for him is exorbitant. To save himself from these, he generally tries to maintain a distance from everyone. That compounds the problem.
More or less, these are some of the main reasons why doctors can neither be untied as a team nor be a part of the social circle. Thus making Doctors unity a Myth.

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Well!
This far we have tried to define the problem and its background

So whats the solution?

Come
—- Lets try to find some answers in the second part —-

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Causes of loss of Doctors image, consequences & remedy Part 2

Dr. Rahul Jain, Psychiatrist, West Bengal
June 2017
(PDF files are difficult to read in mobiles. I would like to request you to read in your laptop. Also if the hyperlinks do not work in your mobile, please open with

another PDF reader app, or read the PDF in your computer)

Please note

Matter discussed here should preferably be contained only within closed medical community.
Lay people may misinterpret this as an attempt to cover up our faults, which could not be further from the truth.

This is the part which is open for suggestions from all, and further input is invited.
I have made some suggestions gleaned over time from talks with many eminent colleagues, friends and

various other sources, which you will decide for feasibility and practicability, hopefully constructively. (Pardon me as I could not cite individual sources – but my thanks to them all)

Chapter One

No matter how much we keep lamenting – Doctors unity will remain a myth, for reasons already discussed in the first part. And neither will the politicians or public behaviour change overnight. Rather signs are that it is taking a turn for the worse.

So the way-out that comes to my mind is in three parts –

1. Short term goal –

Take an immediate palliative action to safeguard us from the violence, litigation, punishments at this moment, and prevent formulations of edicts and laws against us (which will leave us more vulnerable in the future) like the WB Clinical Establishment Act 2017, by forming groups similar to the line of non-political ‘Medicos Legal Action Group’ like thing, at every corner of the country.

Regarding the short term goal, office bearers of various existing groups representing the doctors need to sit together and do something fast. Start with demonstrations, mass leaves, strikes, file court case whatever needed. Fight tooth and nail.

Till today we have made only candle marches, conventions, wearing black badges with appeals to people, media, administration, Govt., very sporadic half hearted localised token pocket strikes. Not that it is wrong, but it can bring only just so much result.

Keeping on increasing the dose of same medicine, beyond maximum limit will not improve the condition further, will only increase undesirable side effects.

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We need to change our strategy. We need to overcome the fear of change, break out of our Inertia, and do something different.

We need to change direction to look for new cheese.
(Who moved my cheese? https://www.slideshare.net/vmission/who-moved-my-cheese-

114784)

The Complete Idiot’s Guide to Doctors’ Strikes

http://www.indiamedicaltimes.com/2014/03/12/guest-article-the-complete-idiots-guide-to-doctors-strikes-by- dr-kiran-kumbhar/

Doctors Striking, an Ethical and Moral Dilemma

https://www.docplexus.in/#/app/posts/3b1cf1fd-c16f-47e3-ac4f-1f7c1710cc18?utm_term=Email-No-View-26March17- A&utm_campaign=Email-No-View&utm_medium=Email&utm_source=Docplexus&utm_content=CTA

(Collected – Dr. Naresh Krishnani)
“Strike is the only way of protesting in an impacting manner, nobody pays a heed to candle marches n silent protests due to insensitiveness of the administration. We have every right to strike for our safety. Why do politicians’ n judges get the security at taxpayers’ expense? Security of life savers should be topmost priorty, nobody is greater VIP than a doctor. Stop being too idealistic in an imperfect system, dont behave like cowards, why only we should feel guilty for patients plight? We should get idealistic conditions to work. Revolutions don’t occur by silent marches, u should be brave enough to fight for Ur rights.”

But – like bundles and not individual sticks.
A bundle strike will achieve its objective without anyone (administration, court, government, public) being able to

harm a single doctor.
Whereas stick strike will only get the strikers punished with loss of courage to protest in future.

(See ‘Madari’ movie last scene 5.00 to 5.47 min – https://youtu.be/Jnw7lRQU6xw)

Some questions that invariably pop up whenever doctors go on strike –

Who is responsible for the suffering and deaths of patients during the strike? Answer is –

First of all – “The miscreants”. Any patient, party/other people, who have abused/beaten up the doctors anytime anywhere in last 10 yrs. They are to blame. They have been relentlessly
pushing us to this moment.

The Administration and Government – which has failed to provide proper health infrastructure, sufficient funds, and proper security to Doctors in spite of repeated assurances since these atrocities have begun. And not acknowledged the facts to the public. Rather lied to them that nothing is lacking.

The Media – Instead of fact finding they go for wrong and biased reporting, sensationalising news without verifying what they are writing. (Tracheostomy becomes bypass surgery of brain)

They single handedly accuse, judge and provide verdict on the spot in matters they have no knowledge. They never follow up and make

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the politicians (who have made false promises on their chat shows) accountable for their false assurances.

The Police who have failed to protect doctors or arrest the culprits for political bias. Rather they take this as an opportunity to harass and squeeze the doctor himself for money.
They even refuse to take a primary FIR from the doctor !

The Judiciary who have failed to punish the miscreants with exemplary verdicts so that the next person thinks twice before repeating it. Their callousness in punishing the doctor for something beyond their control. How can a High Court Judge say that Doctors should resign if thay are afraid of getting beaten!
Let them set example first by surrendering the special privileges they enjoy – and then go about sermoning others.

The Inquisitors – During inquiry, 10 top specialists in their own field are brought to judge a plain RMO (accused of negligence) who cannot possibly possess their collective knowledge and has only minutes to decide a course of action on the spot. Whereas the panel of medical specialists take their sweet time to review all facts for weeks and months and then come up with a collective model course of treatment – which they compare with the treatment given by the attending doctor at the moment, to declare him negligent.

Why is there no fixed Indian guideline suitable for our infrastructure here for each and every situation, for all doctors in India to follow.
Why in India we are supposed to follow American/European guidelines which are made to suit their infrastructure, staff pattern, strength and facilities?

—————————–
What did the doctors get from there strike, except sufferings of patients?

The answer is –
That’s exactly the point! Why don’t they get anything except empty promises?
Why do doctors have to repeatedly go for agitation for the same old demands? Why is there no resolution to their malady? When the situation becomes intolerable – they complain. But their complaints are buried under tons of assurances which turn out to be worthless. Doctors go on providing services under the same miserable conditions and nobody bothers till another incidence occurs. Then the authorities and press behave as if they never knew this was happening. Height of insensitiveness, callousness and apathy.

Rather our question is – What did the relatives and the mob get, from beating up a doctor?
Did their ill patient come back to life?
Rather caused immediate suffering to the other patients, long term suffering to many other patients by destroying the equipment of the hospital and even longer term suffering to the whole patient community by destroying the moral and trust of all medical staffs (including the doctors) on patients.

Is it not unethical to punish all innocent patients for the sake of some miscreants causing a few isolated incident?

The answer is –
First of all – the incidents are no longer few or isolated.
Secondly – who are these miscreants? They are the people we are dealing with in good faith. The man who was an innocent, hapless person in the morning turns to a violent, vicious, aggressive animal in the evening. How am I to identify him and take protection in advance?

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The thousands of so called innocent patients (implying patient and their kins) can transform into Mr. Hyde at the drop of a hat. The patient’s kin who say that they have done nothing, yet are suffering due to Doctors strike, will not for a moment hesitate to beat up a doctor given the minimum chance and excuse. As they very well know any deterrent to their actions will be on papers only and never be implemented.

Every place where the doctor had got beaten, multitudes of other patient parties have stood aside doing nothing to save the doctors at the moment. But the next moment, they clamour and demand that the doctor (who is beaten black and blue, and is griveously injured) should come back and attend their patient immediately – as if nothing has happenend.

You mean these innocent people?
অন ায় েয কের আর অন ায় েয সেহ, তব ঘৃণা তাের েযন তৃণসম দেহ।

2. Mid term Goal –

Create a National Machinery to get organised better. With the help of technology at hand, improve communication among same and various streams, both intra and Inter State.

Collect information of all matters pertaining to the medical community. Like works of excellence by our doctors, laws and statutes that come into being anywhere in the country, difficulties faced, reporting atrocities against doctors, follow them up till end (not only till arrest – as they are remanded for a few days and then released on bail to go and again beat someone up), and maintaining archieve & register of all violence against doctors (like the one suggested by Medico Legal Action Group).

All of us have heard about the strike of 4000 resident doctors in Solapur, Maharashtra incidence. But how many of us know what the status is now? What happenend to the perpetrators? Are they still in jail or already released? What happenened to the assurances made by the authorities – have they been fulfilled? What happenend to the injured doctor? What improvement in the working conditions have been made?

Our memory is so short and tenacity to follow up is so poor, that its Childs play to fool us.

Chase politicians, administration and media whenever there is scope to remind them of their unfulfilled promises made and make this happen in public.

And all this information must be made available to all doctors (make a website – closed to all except the bona fide members only).

This communication network, once setup and running, will make organising future protests, reaction implementation instantaneous & very easy on a nationwide scale.

3. Long term goal – This I would like to discuss a little in detail.

We need to change the perception of Doctors in public mind, the onus of which falls on us.

Just the way our image has been tarnished in people day after day by adverse publicity, we’ll need to turn the table in favour of the medical community – by consistent COUNTER CAMPAIGNING.

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Till date only our shortcomings, loopholes, errors, mistakes (sometimes real, on occasions over inflated or at times purely fabricated) have been highlighted by sections of society with vested interest.

The first thing to do this is to unequivocally establish that in society the status of medical profession, where do the doctors stand in the matter of their work. This needs to be clear both in the minds of the doctors themselves and the lay people.

Are doctors’ professionals? Like lawyers, accountants, consultants, businessmen, traders, shopkeepers, and sellers etc who provide their wares in lieu of payment.

Or
Are they missionaries? Servers like, saints, sadhus, charity providers, organisations proclaimed to provide aid and serve humanity without expectations of any return in cash or

kind
Mixing ‘Professional’ and ‘non professional’ is creating a paradox, a myth – ‘েসানার পাথরবািট’

and the root of the prevailing Pandora’s Box.

Should I rely mainly on my clinical expertise and cut corners with the investigation process and other costly treatment, for a financially poor patient and hope for the best? –

Or
Do I need to do the necessary investigations and treatment, supplementary to my provisional clinical diagnosis (as dictated by protocol), disregarding any financial hardship the patient may

incur in the process, and again hope for the best – BUT…

I am not prepared to do both.
And in case of any untoward incident, face adverse criticism for whatever decision I had taken

in my best judgement.
If I forego investigation, I am blamed of not following protocol and experimenting with a patient’s life.
And if I follow protocol in toto, I am accused of not being humanitarian and of milking the patient (allegedly to earn commission).
Always facing a double edged sword.

You can’t have your cake and eat it too. গােছরও খােবা আর তলারও কু ড়েবা | ডু ডু ও খােবা আর টামাকু ও খােবা

THIS SIMPLY CAN NOT BE ALLOWED TO CONTINUE!!!

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Chapter Two

We refuse to be a victim of the double standards of the society.
It is high time for the society to decide one way or the other.
If they have already decided it by including us under the purview of CPA, then now they need to accept it in its entirety, with all of its consequences – and not lament about hunanitarism. Just like any case of other stream of professionals.
There is no such thing as a free lunch.

Once this stand is established – then the basic ground rules can be created.
Which when followed will leave no more ambiguity as to what is expected and what is received.

We want to be treated as simple professionals’ togther with all our good and bad qualities just as any other professional. Imposing the label of God upon us, and then criticizing us for not being able to deliver the impossible is not what we have asked for.

Till now the doctors are doing a tightrope balancing act – trying their utmost to do the impossible (provide best of both worlds to the patients). And naturally being criticised both way.

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The doctors are practising medicine as the sole source of their livelihood but yet no doctor has the guts to put in words the message which Hema Malini has so innocently and correctly said as Basanti in Sholey –

“Yunki tum aadmi achchhe ho, isliye tumse paisa toh lena nahi chahiye – Lekin agar ghoda ghas se dosti karle, to khayega kya?”

We take our dues as if we are doing something wrong, and the patients also feel that the doctor is humanitarian only if, he treats them for free.

We are always are on the defensive.
Pick any interview, seminar, discussion, debate with doctors present along with others

– you’ll notice that after meekly trying to justify themselves for a few times (even if it is no fault of theirs) – they revert back to the same broken record of “Yes, we need to improve and correct our faults, we need further self-inquiry and self-criticism”.

We have never properly condemned the wrong doers boldly, forcefully, nor strongly demanded their punishment first.

Just like a hen pecked husband, who ultimately says the final dialogue in a fight “I’m sorry, Darling. Saari galti meri hi hai”.

But not to be unfair, there are also reason for this. Media and other anti-doctor people come armed with numerus statistics, events, precedents and examples to nab us. They come in numbers and majority rules the world. Their combined surround attacks do not allow any

argument from the doctor to stand ground. দশচে� ভগবান ভু ত।
The doctors are cornered on both counts. Neither they have the vocal power, political

clout nor are they equipped with proper, relevant and authentic statistics. They simply don’t have the source. Neither do they have any solid backing/support from the leaders of their community (who will in a minute disown anything said by the doctor at the first sign of trouble).

Statistics need to be collected, organised and retrived when needed. Doctors don’t have time for it. And neither is there any central archieve (relevant to doctors) from where such materials may be available on need. So we always keep fighting an uneven battle and lose face in media – thus indirectly proving that whatever we are accused of, is true.

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We also need media spokesperson who will handle sensitive issues and also make clear the stand of doctors representing the whole medical community, in any matter regarding them.

No strong protest comes from the doctors after films like “Gabbar is back” or airing of Amir Khans “Satyamev Jayate”.

Outside of a few whatsapp comment/ facebooks posts (that too mainly in doctors groups) – Nothing.

They’re afraid to be targeted if they speak (as if they will be spared if they bury their head in sand and hide).

Whereas the Laywers protest at the top of their voice and stop the screening of “Jolly LLB 2” on the grounds that it has ridiculed them.

http://www.hindustantimes.com/bollywood/jolly-llb-2-jaipur-court-summons-akshay-kumar-for- portraying-lawyers-in-bad-light/story-czFJlVUBynetS95eZ4UexK.html http://www.mid-day.com/articles/a-lawyer-wants-llb-dropped-from-akshay-kumars-jolly-llb-2- title-heres-why/17948166

Now we must strongly present to the society the dilemma the medical community is in until the message sinks in their mind. We also need to keep projecting the brighter, humanitarian, compassionate (within limits), empathic face of the doctors in limelight, of which there are innumerable instances actually, just waiting

to be presented.

Most of the doctors still go out of their way to provide help, assistance and services to the poor, sick and needy, professionally and even financially (free checkup camps, free operations in eye camps and other, relief

works in natural calamities etc) – which media simply chooses to ignore and disregard for their own reasons.
(Man marzi of Media: The corrupt and blackmailer media – https://youtu.be/r7UhtX992Wo)

The portrayal of doctors by press and politicians have always been predominantly negative. Presenting the medical community largely as villain with a few scattered instances of some good (which are shown as exceptions to the rule) serves their ulterior motives. http://www.dailyrounds.org/blog/yet-again-politicians-come-across-like-doctors- enemies/

General people have no other option but to accept this propaganda by media etc, in absence of any opposing viewpoint or publicity.

Our goal is to change this media generated lopsided concept regarding health service providers.

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Psychiatrists do counseling which is a direct part of their treatment. But all other doctors too, have to assess the mentality of a patient and their kins, and counsel them in their own way as part of the treatment, in daily practice.

In Psychiatry patients come with so many distorted and false ideas and delusions regarding self and others. Ideas of paranoia, persecution, infidelity, grandiosity, guilt, inferiority, misplaced anger and what not. Doctors identify their problem and gradually bring them back to reality and back into mainstream of their life and society.

This is also not dissimilar – only the scale is different. Here instead of an individual, couple or family – there is a sort of mass hysteria propagated and fuelled by some agencies with vested interest. But the treatment is the same, albeit with a different set of tools. No single method will work – we need to adopt Chanakya’s approach of ‘Saam, Daam, Dandya, and Bhed’.

Proper identification of cause, then diagnosis followed by administration of proper treatment is the only solution. We have done the first two but lagging in the third.

Sometimes we need to be stern and give the bitter pill to public if needed. Or else it will be ‘spare the rod and spoil the child.’

If we Doctors cannot cure this disease from the society then we are not resourceful enough and are failing in our job!

Chapter Three

It’s not that whatever doctors do, is good
But at the same time, it’s also true that the doctors do some good too!

The struggle of doctors as a human being(since student life ), their various challenges, torments, pain & sufferings, tension and anxieties, tremendous mental, physical and financial pressures, misery and anguish, harassments – their limitations, bindings, tolerance, diligence, social contributions also needs to be focused upon.

A doctor check up the health conditions of the riot victims in a relief camp in the riot affected Kokrajhar district of Assam state

The way the doctors are providing round the clock non-stop service to the humanity, in so many different and difficult conditions, in so many places and situations, despite various handicaps and lack of even basic infrastructure, needs to be brought to the notice of general people.

They also should know that it’s not all silk and roses – behind the scenes there’s blood and sweat story too.

On searching the net very little pro doctor material could be found, though gradually more is coming up. Whatever few there is – are mostly in English (not in any local vernacular) and they don’t match context of our country at large. Moreover they are quite big and lengthy. Very few would have the patience to go through them. Some good inputs have started coming

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through but are scattered all over the place. They need to be consolidated and used

appropriately at the right time and place.

We will need short, sharp, relevant & to the point materials. Which we can

continuously, day after day, year after year, gradually and relentlessly spread little by little

across all kinds of audiences, channels and platforms available to us. Side by side also keep countering the bad publicity and incorrect information spewed by press.

Mind you – the keyword is “RELENTLESSLY”. Not grossly or overtly, rather very very subtly but effectively.

I know, I know, I know.
I know what you must be thinking at this point.
All this is cliché. Nice to say, nice to wish for, but practically improbable.

How will it be done? Who’ll do it?

Please!!! Be a little more patient – and read on.

Chapter Four

How may we hope to implement this?

At the very beginning we need to admit that this is impossible for any individual or any small isolated group. Even if we can’t unite individually – we need to unite as units.

We need to project properly what we want to say and if we are at a loss, as what to say and how to say it, we can seek professional help.

Professional advertising agencies, small documentary/film makers, writers, singers may have to be recruited (directly and indirectly). Theatre personalities, theatre groups, folk artists,poets, littlemagazine,healthmagazines,andsmalllocalnewspaperanyandeveryone can lend us their expertise.

Those from Easten Zone may remember • the “O Daktar” song by Nachiketa

(https://www.youtube.com/watch?v=H4dJ0AGbYAo )
• the film “Olik Sukh” the reference of which pops up whenever there is talk about doctors.

(https://youtu.be/ARiJExqqIWY)

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These professionals are the maker / breaker of images, they understand the pulse of populace and have the power to change the perception of the society. Till date they have been showing one side of the story but have the capability to flip the coin.

After all, we are not asking them to lie. Just show our good side which organised media has been ignoring till date to suit their need.

So the basic material may be available from them.

Next Question:

Who will get it done by the professionals and why would they agree to it?

In India every other day, week, month, quarter and year some or other stream of doctors (physicians, cardiologists, orthopaedics, psychiatrists, dermatologist etc etc) have ongoing Local, Zonal, State, National, International conferences. They arrange various programmes, seminars, functions and substantial amount is spent to organise them.

One of the main purpose of these conferences (besides gaining, exchanging knowledge and ideas) is also “To build awareness”. Among the doctors, among the community.

Just as it is our duty to create awareness about various issues like AIDS, Hepatitis, Diabetes, Depression, TB, Leprosy, Thalassaemia, Cancer…in both medical and general community, similarly we also need to make the people of the society aware of the ground reality in which the doctors work. Their involvement, success, their limitations, constraints, sacrifices, helplessness, efforts in providing care to all.

Unless we can uphold and bring to the eyes of the people all our endeavours for them and at the same time expose the dual role the politicians, media play and the hurdles they create – general people will never empathize with the doctors nor the sacred Doctor-Patient relationship ever survive and develop.

Every Conference has a theme – Keeping that as the central point a competition could be arranged. Various creative inputs (as writings, songs, stories, recitation, pictures, arts, sculpture, mime, live performance, audio video materials or whatever they can think of) may be obtained from all medical/non medical participants.

It can be impromptu or may be announced weeks or months before the conference, giving time for willing candidates to prepare and submit their best ideas.

1st, 2nd, 3rd prizes may be given as incentive and simultaneously we will be able to collect various promotional ingredients. The only condition being that
every idea or presentation must have a clear cut pro-doctor element in it.
In recent days we have seen so many excellent writers, poets, singers posts
coming up in social medias (with lot of contributions from the medical
fraternity), but due to lack of uniform spread these do not penetrate all
strata.

(Each conference could earmark a special award paper incorporating the theme of this doctor society relationship, the experinces, views, problems, observations, suggestions, remedies in perspective to that particular area and have open sessions).

Training workshops, mock sessions, role playing can be done as how to face media, patients, and parties, any inquiry (police /court/other agencies) interrogation etc. What to do in an emergency situation. How to go about in a case of litigation or any other legal matters etc. Who may be able to help us? Create a national helpline.

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There are innumerable facets of medical practice in addition to the direct treatment part. We can invite experts from other related professions like Lawyers, Police, and Judiciary etc to give us their viewpoint and guidance in related matters.

The Medicos Legal Action Group is doing good job since around 2013, but not many of us know about them. We need more of them and we ourselves need to be more involved if we are to carry on with our profession safely in future. Any way I’m drifting away. Please excuse me)

Again what’s there to prevent us from alloting funds in each conference budget for this purpose? With this fund the organisers can recruit some professional talent to create some awareness/training material.

Round the year the local IMA can collect a small sum from their members (say as little as Rs. 100/mth or whatever is reasonable and by concensus), send the collection to the central unit and gradually raise a fund for this purpose. This will also produce a feeling of being involved directly to the cause, a sense of ownership. (The only thing we need to be careful that this does not turn into a money collecting scam by any politically oriented doctor leaders leaving the true objective high and dry)

The practicing doctors are not the only ones suffering. The participation can be extended to the level of students, interns, house staff and PGT’s too. Each year new situations emerge for them with their own set of difficulties and hurdles, which also need to be addressed.

The problems in pre doctor level are also significant, and the best ones to describe them are the ones who are facing them.

The student bodies organising fests and meets are the best candidates to make their statement there.

Below there are example of some materials which might be of use –

1. 31https://youtu.be/ei_tyWEAtKw 31 Save the doctor
2. https://youtu.be/JeHqgambbcI
31 The doctor who walked away

3. https://youtu.be/sHxd60nSp9U Distressed doctors pushed to the limit

4. https://youtu.be/qyVAtZ9VZ4Q Why doctors kill themselves

5. https://youtu.be/X9Bl_CegaLE Life of a P.I. (Post Intern)

6. https://youtu.be/nScRudj-OAY
This is why doctors in Maharashtra are on a strike and what they are demanding is not just for them 7. https://www.facebook.com/R.Jain.Dr/videos/1288970144543162/

‘Do Doctors really deserve assault?’ collected from a friend
8. http://www.thehindu.com/news/national/kerala/doctors-let-fingerprints-do-the-

talking/article17814837.ece

Doctors put fingerprints together, create Guinness record.
Not all of these examples are very interesting or convincing. But some are.

TELL YOUR TALE
WRITE A SHORT STORY WITHIN 100 WORDS AND WIN A PRIZE

Today is Mothers Day – Combine it With the theme of this conference & submit your story by 27th September .

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If they could be in our local vernacular, if they could address our issues to the point and finish in 3 – 5 min max, then they would have been more acceptable and effective. Availability of that sort is limited now and maybe that’s why doctors’ plight is not leaving a mark in minds of people.

This is the age of advertisement. No one is taking the trouble to verifiy the truth. Our cries for justice are buried six deep under the avalanche of adverse media criticism. Ultimately only the stronger publicity prevails and shapes public opinion. When propaganda establishes that we’re bad, then it doesn’t matter whether we are really good or bad.

A great virgin territory is lying bare, which has never been explored by us before in an organised manner, in large scale. It was never needed. This arena of publicity. We have always thought ourselves above it and hence are now finding ourselves at its wrong end.

Now we can make an attempt to turn it around to our advantage. Even if not totally – but we too can take partial rein in our hands to turn the tables. Otherwise we will forever be at the mercy of media and politicians propaganda.

The biggest advantage we have here is, that there is no one to obstruct us. Neither party, govt., department, nor any third person can impede us. (I know we can’t stop the political colours bleeding into it a little at times – but if we are vigilant we can overcome it.)

EVERYTHING, BY THE DOCTORS, FOR THE DOCTORS ONLY

At every conference and meets – can’t we produce a limeric, a jingle, a picture, a cartoon, caricature, a song, a professionally made crisp, sparking one or two minute video which will penetrate the hearts of millions instantly!

Social media is the new warfield today –
We’ll distribute these gradually and discreetly in various platforms like –

 Whatsapp, facebook, youtube, vimeo, twitter, instagram & other social medias

 At other places – like locally organised events (by IMA/other medical fraternities), events organised by friendly organisations (like pharma companies, other local voluntary social bodies, health camps, blood donation
camps and various others you can think of.

 At interviews given by doctors in various newspapers, magazines and
radio+TV channels

 Informal sharing at personal events.
Sources can be anonymous if wanted, but contents will be in favour of doctors.
Not necessary that whatever material is generated will be relevant and be usable immediately. We can use whatever is appropriate and make a central archieve to deposit the rest. The archieve can collect, sort, grade, optimize, store and release all materials collected from all units of all streams for future utilisation.
Just like there is an acdemic committee for
academic publications – similarly a PR committee
for this purpose can be made. This will send all the
materials to an All India PR Committee, formed for this purpose, taking representatives from different sections of the medical streams and community.

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A semi-annual/annual recognition prize could be awarded to the best region

producing the most effective stuff that year as incentive from the central committee.

In cases of defamatory/incorrect/biased reportings by local, state and national dailies and media, we usually have no recourse than to send a protest letter or explanatory letter to the concerned newspaper. More often than not, they either do not publish it, or publish it after editing in an obscure 7th page corner and that too including their own comments which again invalidates the protest letter.

Every State IMA can have their own official blog (maybe some already do – but not all of us know of it) where they can write their own views, opinions, demands, and suggestions, highlighting what the local media is publishing about doctors in their region.

The Central IMA blog can collate this and make an online daily newspaper of the doctor community maintained by a dedicated panel of editors from medical community. Could be honorary, could be paid job, can be done by any general employee supervised by Doctors panel.

True, we have our own online news letter like e-JIMA etc – but it is monthly and deals mainly with the academic part.

We need something daily, non-academic, in a newspaper like format instead of a magazine format, with collections of news clippings from leading dailies (English and vernacular) relevant to medical professionals from all States and Regions.

If it is centrally published, then we can also keep it free of regional political bias. We will have a space to reply to various biased reporting in other newspaper here (even doctors are at times misled by media reports in absence of access to the other side of the story), to express our own opinions (obviously screened for content and appropriateness by an editorial board).

Just as we go through our chosen newspaper daily, we can also go through this daily morning to keep abreast of news of doctors all over India (in addition to just our local area). A doctor in Lucknow will be updated about authentic news in Goa, similarly doctor in Kochi will immediately know what is happening in Guahati.

A mobile app can be made or may be sent to all in epaper format

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Our own e-newspaper – “The All India IMA Daily”

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I know this is not something that can be done in a day. And the results will also take a L–O— N—G, L–O—N—G time to manifest. (both within the doctor community by creating a national solidarity, and also within the minds of general people who have been victim to a lopsided view of the medical community till now).

But it is bound to make a difference in the long run if we can keep it up.
The most difficult part is the initiation. Once it starts rolling it will soon gain

momentum of its own. After that it’s just the matter of guiding it.

Just as regular friction of a rope can erode a stone – eventually our goal will also be realised.

Last but not the least.
The biggest disadvantage of a doctor is that he/she spends three fourths of their life

in reaching a stage of success – but a single unfavourable incident can topple his life’s acheivement like a house of cards, ruining him completely.

That’s the reason why he is so timid, afraid and fearful to stand up for his rights.
If only he would have built some other means of earning (non medical) side by side, to fall upon in crisis situation (other than his primary medical profession), he could have been so much more powerful.

We have seen actors, models, successful sports personalities, even politicians do it. They know that their career will not be at the same height always. So they use the money earned during their prime to build something different alongside their main career, for future survival.

But we are like the ostrich. We think we will always be in our prime and be able to single handedly fight and always win. Ours is a one-
man show and a very fragile one at that. Most of us
have put all our eggs in a single basket and so when
we loose it, we loose all.

That is our main vulnerability. And people are exploiting it.

Think about it!
And if possible do something about it – both for

yourself and for your son /daughter.
It may be too late for some, but not yet for many.

Now this is a small germ of an idea. I know it will need a lot of polishing, altering, and defining which I leave in your collective and able hands.

Many alternate and even better suggestion, thoughts and ideas are bound to come up when the entire medical community starts brainstorming.

What we would need is something which will not be any single person oriented, not dependent on the ability or charishma of a single leader, not too drastic/difficult, implementable and sustainable with minimal effort – and it will take us out of our present difficult situation and keep us from being victim to external pressures in future.

Share only among Doctors if you feel it is worth.