MORE THAN DOCTORS, INDIA NEEDS- policy shift and respect for the modern medicine!
On 27-Jul-2022 -The Union government, counting AYUSH practitioners or professionals trained in traditional medicine at par with MBBS doctors, has claimed that the doctor-population ratio in India is now 1:834, better than the standard prescribed by the World Health Organisation (WHO).
The government aims to achieve the modern doctor patient ratio of 1:1000 -- as prescribed by World Health Organization (WHO) -- by 2024. Likewise, there is a shortage of medical education seats. Last year, a massive 1.6 million candidates appeared in tests for admission to some 90,000 seats in medical colleges.
Fees in private medical colleges are high, at times touching up to Rs 1.5 crore for a degree when a government college charges between Rs 70,000 and Rs 3 lakh. No wonder, parents often find a medical degree in countries like Russia, China and Ukraine cheaper than a privately acquired one in India. Some send their children even to Georgia, Kazakhstan, and the Philippines.
According to information provided by the government in the Rajya Sabha, there are over 1.1 million Indian students studying various courses in 99 countries across the world. These students cumulatively spend more than ₹2 trillion (approximately $30 billion) overseas for their education. For fiscal year 2022-23, India’s budget for higher education is estimated at ₹1.04 trillion.
In the last two years, there have been many lessons from global pandemic for policymakers, doctors and researchers. India needs to tap the reservoir of medical potential that is second to none in competence.
wastage of human resources due to poor planning and leadership! :
A large section of newly qualified physicians are spending considerable years in dysfunctional status due to mismanagement in human resource in health in India. There are very few employment opportunities for qualified doctors in public sector; at the same time the average salary of MBBS doctors in urban private hospitals is very low.
Paradoxically, in a country of 1.4 billion populations there is no actual demand for medical professionals. While the popular perception is that young doctors are not willing for community service, a reality check is required on the count of intent and capacity of public sector as well as Health care service sector' towards engagement of medical doctors in the process of service delivery.
No evidence based policy making in INDIA!
Today with more than 600 medical colleges (largest number in the world) we are producing more than ONE LAKH MBBS doctors per year. In a country where we continue to talk about about deficiency of health care professionals, majority of newly produced doctors are under employed or unemployed.
By 2030 India will have 1.5 million additional MBBS doctors; currently being produced @100,000 per year who would remain dysfunctional and not have any work in a country of 1.30 billion population.
No campus interviews for MBBS Doctors ?!
As a common sense, a lay person would like to believe that most of the MBBS doctors are greedy professionals who wish to live and work in urban areas for monetary benefits or worldly pleasures. But the the evidence is otherwise. There is no campus interview for any level of medical qualification at any medical institution in India, including All India Institute of Medical Sciences (AIIMS).
The false halo /myth around the modern doctors!
The average salary of a fresh medical graduate (MBBS) at private hospitals in sizzling cities like Bangalore, Hyderabad, Chennai and Mumbai is much lower than an entry level call center employee. At most cities this income cannot support a lower middleclass living.
majority of the medical graduates are engaged in postgraduate entrance test for the first 5-10 years of their career and youthful lives instead of fruitful engagement with the health system. Is this a default situation? Or is it design to keep the doctors away from communities, maintain high level of morbidity and create an environment where people have compulsion to visit hospitals for industrial consumption of medical goods.
Rotting at root :
Majority of the Indian doctors (general practitioners, family physicians, medical officers, resident medical officers, recently qualified medical graduates) are disfranchised from the academic and professional leadership positions.
Medical professionals are compartmentalized into caste like rigid occupational vocations. The vocational training and long-term career path for primary care doctors have been blocked at the regulatory level. Primary care physicians do not have any representation at NMC .
Non-medical professionals may not be aware that primary care doctors are also legally barred from becoming faculty at medical colleges.
Due to aggressive unregulated business practices of the Pharma and medical device industry and corporatization policies of the government, an environment for mal practice and corruption has been created for industrial consumption of pharmaceutical and consumable medical products.
Physicians and doctors who used to be trusted partners of the patients and communities are losing faith of the people. so, CPA&VIOLENCE issues perpetuated year by year. How long this will continue?
India needs to invest in human resource for health .
Indian population currently at 1.40 billion,increasing by one crore every year. and also aging results in more geriatric people with lot of health issues.
Our doctors now at 1million,adding 50000 new doctors every year,but still the D:P ratio(modern doctor:patients) will be maintained at 0.75: 1000.
The new WHO norms of 44 healthcare workers (doctors, nurses, technologists) per 10,000 population (4.4/1000) . It is the same story with nurses (just double the doctor numbers) and technologists.
But as per ISO, a value of 5.9 skilled health professionals (midwives, nurses and physicians) per 1000 population was identified as the workforce requirement for achieving the SDGs. At present in india, The combined - midwives, nurses and physicians - number is 2.5 / 1000 people.
so, the need is to double it on war foot!
Screenshot of WHO website :
The National Sample Survey Office (NSSO 2017-18) on active health workforce, the study estimated a total stock of 5.7 million health workers which included allopathic doctors (1.1 million), dentists (0.27 million), nurses (2.3 million), pharmacists (1.2 million) and traditional medical practitioners (AYUSH 0.79 million.
However, the active health workforce size is estimated (from NSSO 2017-18) to be much lower (3.04 million), with allopathic doctors and nurses estimated as 0.78 million and 1.36 million respectively.
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