The recent agitation by the medical students in India is not a new thing. At various times in the past the doctors, either in the making or the junior doctors in hospitals, have been agitating for  better treatment from the medical care system or the government. The medics and the medical system in this country are a victim of the grand hypocrisies prevalent in our Indian society. The agitation of the medical students against the extra one year working in rural areas has to be seen in the light of these grand delusions we suffer from.

We have a number of hypocrisies. We have a penchant for deifying people or certain categories of people. There are several such deities. We have Naari Shakti — woman power or women called as goddess Shakti. We put them on the pedestal and then totally forget them — nay, even abuse them. The number of rapes taking place all the time — not necessarily restricted to Nandigram and Jammu & Kashmir — tell the real story.
Similarly, we deify certain professions. We say Acharya devo bhava (the teacher should be treated as God) and then do not even pay the salaries — which is a pittance, generally — on time for the teachers of our government primary schools. Gods do not eat real food, in any case.

Teacher, as per our ancient lore, has been a Bhikshuka ie one who lives on alms. The celebrated Dronacharya — in whose name a national award is given — was so poor that his son Ashwatthama was fed on rice gruel instead of milk before Drona took up teaching the princes of Hastinapur. Teaching is, in Indian parlance, a “noble” profession. So, teachers at any level get poorly paid.

Medical profession is another profession that is also considered “noble”. How many times have we not heard our friends and acquaintances telling us that a certain doctor is so good that he charges very little or “does not take fees for a revisit”. There are tales of doctors  in the past who took only one rupee for consultation and then the present generation of doctors is compared to these doctors of the folklore.

If doctors make money, it is “bad”. If medical students protest going to the rural areas, it is “unethical”. Of course, software engineers writing computer code and making a six-figure income monthly can have a choice of being either in Bangalore, Hyderabad, Pune or Mumbai. A fresh MBA from a business school of whatever quality can earn ten thousand or much more and can exercise his choice of location — rural or urban.

It is the doctors who should not protest. If they get a pittance — lower than a fresh BPO employee — for doing emergency duties at any hour in hospitals, they should not grumble. Under the Essential Services Maintenance Act (ESMA), they cannot go on a strike.

These are double standards. On the one hand, the society claims that doctors are essential for saving lives; on the other hand, it treats them shabbily. If indeed it is such an important and vital profession, the society should pay them and treat them accordingly. At the least, it should not ill-treat them. One need not follow the American model, but the British or any other European model of medical system can be adopted.

There are other anomalies. We have allowed several medical colleges in the private sector, which take “management fees” that run into several lakhs of rupees. The medical student pays a lot for his basic medical education. The so-called “free” seats are also not very inexpensive, in most cases. On an average, a basic MBBS doctor spends a million and a half rupees from his pocket for the degree. It makes little sense to make him spend so much and then expect him not to feel that he deserves a decent salary.

What happens in reality is that he gets a pittance even while doing a  24-hours-on-call duty as an intern or as resident in the hospital. The system is breeding discontent and a generation of youngsters who feel cheated. Instead of giving positive incentives, if threats — of dismissal or holding back the degree — are made, it would only be counter-productive.

The allegation that many doctors go for jobs abroad should also be seen in the light of what is happening with respect to other professions. Aren’t engineers going abroad? Aren’t boys and girls (and many a time their parents) clamouring for a seat in computer engineering or computer-related subjects? A medical graduate is not an ascetic. Asceticism should not be forced on anyone.

Another hypocrisy is regarding the government’s own track record in the area of health-care in this country. Governments have spent abysmally low amounts for the primary healthcare. The lack of care is evident in the fact that diseases like poliomyelitis, tuberculosis and malaria are not yet eradicated. In fact, the latter two diseases are showing  increasing incidence. India has one of the largest number of HIV positive cases. Instead of rallying everybody, the government is busy alienating the young medics.

The government is, after all, a representation of the society. If the society suffers from delusions, so does the government or the people manning it. It is time we the people are present to the hypocrisies — regarding doctors included — and get real.

(The writer is former professor, IIM, Bangalore)