`Many doc­tors are sim­ply busi­ness­men'

Down to Earth - - ANALYSIS -

SAMI­RAN NUNDY, chair­per­son of the depart­ment of sur­gi­cal gastroenterology and or­gan trans­plan­ta­tion at Sir Ganga Ram Hos­pi­tal and ed­i­tor-in-chief of the jour­nal Cur­rent Medicine Re­search and Prac­tice (CMRP), has stirred a hor­net's nest by writ­ing an ed­i­to­rial in the Bri­tish

Med­i­cal Jour­nal and also in CMRP about ram­pant cor­rup­tion in the In­dian health­care sys­tem. While speak­ing to KUN­DAN PANDEY, he presses on the need for im­me­di­ate in­ter­ven­tion to check cor­rup­tion in the health­care sys­tem. Ex­cerpts:

Why did you raise the is­sue?

Aus­tralian doc­tor David Berger, who worked in a small hos­pi­tal in a Hi­malayan state, wrote that cor­rup­tion is rife in In­dian med­i­cal care and no­body seems to want to do any­thing about it. So I thought we should get to­gether and do some­thing. The first thing I did was to write an ed­i­to­rial for our jour­nal.

Please elab­o­rate on the na­ture of cor­rup­tion in health­care?

I have spent many years in All In­dia In­sti­tute of Med­i­cal Sciences, Delhi, and I know the poor can not get ad­mis­sion there the nor­mal way. You know how they get ad­mis­sion? They bribe some ward at­ten­dant who comes to a res­i­dent doc­tor or fac­ulty mem­ber and says, "this is my brother, he has come from the vil­lage", and the bribe-giver gets ad­mit­ted. In the public sec­tor, there is huge po­lit­i­cal in­ter­fer­ence. It is also a form of cor­rup­tion. Politi­cians keep dic­tat­ing things like who will be pro­moted as pro­fes­sor.

What are the root causes of cor­rup­tion?

It is im­bal­ance of knowl­edge on the part of doc­tors as well as pa­tients. The other prob­lem is that pa­tients re­spect what­ever the doc­tor says and the lat­ter take ad­van­tage of that. Gov­ern­ing bod­ies and med­i­cal coun­cils are also not strong enough to pre­vent cor­rup­tion.

Has pri­vati­sa­tion played any role in fu­elling graft?

Yes it has. Arnold Rel­bon, who was the ed­i­tor of the New In­dian Jour­nal

Medicine, said that in the US grad­u­ally more and more medicine is be­ing done for profit and this has fu­elled cor­rup­tion. Sim­i­larly in In­dia, many doc­tors are no longer aca­demi­cians and pro­fes­sion­als, they are sim­ply busi­ness­men.

Apart from aware­ness, what is needed to curb cor­rup­tion?

Trans­parency is needed and it can be achieved by us­ing elec­tronic med­i­cal records, the type Barack Obama has pro­moted in the US. All in­ter­ac­tions with doc­tors should be recorded elec­tron­i­cally and pri­vacy can be en­sured by lim­it­ing ac­cess. I am part of a sys­tem called Raxa doc­tor, which is a free, open-source elec­tronic med­i­cal records sys­tem where peo­ple can pri­vately store and re­trieve their per­sonal med­i­cal data. Pa­tients can share the data with doc­tors.

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