'Skilled physicians required to restore patients' confidence'

It is a rare honour and privilege for an eminent physician hailing from a small city like Gulbarga to head the Association of Physicians of India (API) - the apex professional and academic body of physicians. For 71-year-old Dr Muralidhar S Rao, it’s a life time opportunity to prove his mettle as a physician-organiser of consequence.He is the 65th president of the API, elected unanimously for the year 2010-11. He’s only the second physician from Karnataka and 6th from south India to head this premier body in API’s history. In the past, API had very illustrious physicians as presidents, such as Dr Jeevraj Mehta, the first president who went on to  become chief minister of Gujarat and Dr B C Roy, another legendary physician.
Dr Muralidhar Rao has been selected for the prestigious honourary fellowship of the American College of Physicians, the US counterpart of API. He is visiting Toronto in April to receive a coveted honour for his excellent services as a physician. Dr Rao spoke to Srinivas Sirnoorkar of Deccan Herald  in Gulbarga.

Q: What are the main objectives and activities of API?
API is a professional and academic organisation striving to promote excellence among physicians by holding conferences, seminars, lectures, workshops, etc. There are API chapters in a number of states and there are even district branches. It also brings out a useful monthly journal called JAPI (Journal of Association of Physicians of India) containing research articles and treatment aspects. However, the main activity has been to bring out ‘Textbook Of Medicine’ with drastic revision every four years. API textbooks are of global standards and are widely used for teaching in every medical college of the country and also abroad including Pakistan, Bangladesh, Nepal,  the Russian republics, East African countries and also the US.

Does API have any role to play in the formulation of health policies of the states and the Centre?
We on our own do not involve in policy formulation. If anyone seeks our advice we definitely render our services. The Karnataka chapter had a major role in preparing the syllabus and evolving examination pattern of the Rajiv Gandhi University of Health Sciences. More importantly, API’s role is to sensitise physicians on the treatment of epidemics. Our basic aim is to update the knowledge of physicians. We prepare certain guidelines with regard to treatment of diseases. We have started an academic wing, the Indian College of Physicians.

It brings out monographs as and when required containing guidelines on the treatment of diseases such as HIV/AIDS, swine flu, tuberculosis, hypertension, diabetes, etc. The monographs have proved very useful for physicians, particularly those practising in mofusil areas.

Has the role of a physician become unimportant with people going to specialists without even consulting a physician?
Yes, to some extent. This is a very unfortunate trend. If there is chest pain one rushes to a cardiologist, if there is cough they go to pulmonologist and if there is some problem in kidney they straightaway go to nephrologist. Specialisation has become procedure oriented and it also fetches money. If it is done judiciously, it is fine. We need highly skilled physicians who can restore the confidence of patients. Correct advice and timely referral is what is expected of a physician. India is passing through transitional period and I hope the primacy of a physician will be restored shortly.

The Centre is contemplating to start diploma course in general medicine to cater to the medicare of rural people. What is API’s perception on the issue?
Though it does not directly concern to us, API supports the stand taken by the IMA. The IMA has already opposed the move and it does not want to dilute the medicine course in any form for whatever reason. We wonder whether our rural brothers and sisters deserve such a bad treatment? There should not be any shortcut to MBBS. The Centre’s intention may be genuine, to make available doctors in rural areas all the 24 hours but that cannot be achieved by diluting the course.

How do you think the shortage of doctors in rural health establishments be overcome?
Governments should evolve incentive oriented measures. For instance 10 per cent of the PG seats could be reserved for MBBS graduates employed in rural hospitals, better housing facilities and more cash incentives may also be considered. The hospitals down the line have been politicised with doctors at the receiving end. Rural health institutions should be liberated from politics.

There appears to be no effective checks to prevent misconduct among doctors. How best could this be tackled?
We cannot deny the fact of professional misconduct. Commercialisation of medicine is the root cause of the malady. It is unfortunate that some doctors easily fall prey to the lucrative traps of some pharma companies.
We don’t mind pharma companies lending help to the publication of health monographs, textbooks, articles, journals and hosting purely academic activities. But pharma companies sponsoring doctors on luxurious trips is quite unethical.