can’t claim to speak for all doctors but while watching the contentious portions of his interview I thought two things stood out.

1. Playing to the gallery
2. Hypocrisy, oversimplification and denial of accountability.

Playing to the gallery

To one the questions in that interview, Modi says he eats 2-3 kilos of abuses by his detractors each day. By the same metric each doctor working in India endures much more of the same everyday from the general public, bureaucrats and politicians. So his comments were obviously well taken by the general public but the medical fraternity who know they have a very neglible influence on the government vote bank were humiliated by his comments. Modi repeated the ad nauseum attacks that the medical fraternity hears everyday from the public thus indicating that he endorses the public perception of doctors in India. The irony of it is that he chooses to say this in a foreign land, UK whose NHS has 30% of their posts filled by medical professionals from India. If the conditions for doctors in India was good enough and they were making loads of money in India, what is the necessity for these medical professionals to go abroad to make a living, struggling as second class residents in a foreign country? Imagine a youngster of 17–18 years who wants to take up medicine, what would be his/her motivation to take up this profession if the prime minister of the country abuses the entire medical fraternity working in India and why would s/he stay back in India to serve our countrymen.

On a side note it was refreshing to note many of my Modi-Bhakt doctor-friends who blindly praise Modi share their anguish against his comments on social media.

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Hypocrisy, oversimplification and denial of accountability.

No one denies there is corruption in healthcare and that certain doctors are bad apples. However, to put the onus of healthcare on individual doctors shows a certain amount of hypocrisy.

I have been writing about public healthcare expenditure in India or lack thereof since the last 4 years in various online and offline platforms including on Quora. However, there seems to be no substantial increase in budget allocation for healthcare from the ruling government in all their years in power. In fact there seems to be gradual diversion of valuable tax payer rupees into alternative forms of medicine (known as quackery to the world outside India); to insurance companies, generic pharma companies and corporate hospitals.[1]

It was also interesting to note the PM speak about knee replacements and oversimplification of the pathogenesis of diseased knees to “not doing yoga” His cheap shots about doctors going to conferences sponsored by pharma companies was totally uncalled for. The irony again is that most of the speeches and interviews including the present grandstanding speech are sponsored by opague donations from multi-national corporates and tax payer money. One can argue that his speeches abroad do nothing for the common man in India and he uses these platforms to advertise his brand to the world. (corollary to his comments that doctors don’t go abroad on conferences to treat sick patients)

I have gone on several conferences abroad and not once has a Pharma company sponsored my travel, registration fees or accommodation. Most of us doctors have spent our own hard earned money to keep abreast of the latest in our fields and to present the outcomes of the first rate medical care that is available in India despite poor government expenditure. It is surprising that Indians are able to stand shoulder to shoulder with our foreign counterparts in clinical research despite almost nil support from the government. I don’t have actual data but the vast majority of doctors I know don’t get any benefits from the Pharma or medical manufacturing sectors. I’m not denying that some doctors do have a nexus with pharma companies but the collusion is far less than what is publicly believed.

Doctors don’t decide on prices of medicines, stents or other implants. It is decided by the individual companies after lobbying with politicians to reduce regulation on drug, stent and implant prices. Why would a pharma company be allowed to sell the same molecule at different price points just by branding their drugs? Why don’t the government ban all branded medicines? It is because they know that less the 1% of medicines in India are even tested for quality and they know that banning branded medications will cause irreparable harm to the population. Anyone with a small manufacturing plant can sell calcium tablets as antibiotics for example and the public would be none the wiser. If no branded medications with quality assurances are available what will the politicians do when their families fall sick? If the quality of treatment was so excellent in government hospitals, why do politicians take treatment in private hospitals and on most occasions go abroad for treatment? So Mr. Modi boasting of opening of generic medicine pharmacies by the government rings hollow.[2]

What is sad about Mr. Modi’s comments is not that it is offensive to the medical fraternity but that the premier of a country speaking so proudly about the corruption in his own country in a foreign land. All this while he stays silent and is immune anyone’s questions in his own country by it’s citizens.

We doctors as citizens of the country also have some questions for our honourable Prime Minister.

• What is he so proud about this corruption prevailing in the healthcare sector? (Do not miss the smirk on his face while he’s speaking! )
• Isn’t it his job to check and eradicate the healthcare corruption rather than than talk about how cogs in the wheel are corrupted?
• What has he done to eliminate healthcare corruption except making fun and take cheap shots at the medical professionals, who in no way control the machinations of healthcare policy, yet are patriotic & hardened enough to serve the people in their own country?
• If the doctor-pharma nexus is so deeply entrenched, how many doctors or pharma company executives have been arrested or fined for indulging in unethical and corrupt practices till now?
• What are the healthcare policy measures taken by his government which has resulted in improved healthcare indices in the country since they have come to power?

When Mr. Modi comes back to India, he will keep silent on those questions as only those abroad are lucky to get answers from him.