When someone is told by a parent, “I want my son to study medicine,’ or when a student says, ‘I am hoping to enter medical college,’ the usual response is, ‘that’s good,’ or ‘that’s a very good choice’ or something that goes on similar lines. But, how many ask the most pertinent question: “Why do you want to be a doctor?”

Oath that’s in breach
This query is rarely or never posed, if it is, the responses are likely to be coloured towards gains and achievements of personal and material kinds. How many have heard responses pronouncing the noblest reason–to heal the sick? Just one, or two–maybe. All doctors like witnesses in courts of law, take the famous Hippocratic Oath–or the amended ones supposed to be more appropriate to modern climes. But despite the godliness of the oath doctors who wish to genuinely serve the sick appear to be as a rare as an albino hippo family in dark Africa. And while those swearing to ‘say the truth and nothing but the truth’ in a witness stand can be held responsible in the event of perjury, doctors who do not keep to their Hippocratic Oath do not appear to be answerable even if they keep breaking it– habitually. Perhaps the persons in charge of institutions supposed to police doctors’ performances in following protocol of the noblest profession are not concerned; under pressure not to be concerned; or are as guilty as their counterparts in not following written, unwritten or inferred codes of conduct expected to be adopted by healers.

Real reason to heal
In the modern day practice of medicine, the magnanimity of the healing profession has disappeared over many horizons. And despite several calls of ‘physician heal thyself ’ in many senses, doctors have become active players and willing pawns in a massive commercial health industry that makes money unashamedly from the sick and the dying. So now we know why parents want their children to become doctors and why students want to study medicine–it is to heal all right, but to heal to their material advantage. Patients though being the primary ingredient in the doctoring industry are just secondary concerns. The proposal of having private medical colleges to churn out doctors to enter the health care industry is a bonanza to the huge population of potential mudalalis in the doctoring business. This plan is most attractive to the wealthy who can afford to study medicine at expensive private medical schools. In any event the cost of being a doctor wouldn’t matter because there are rainbows at the end of the cram.
The growth of ‘private practice’ and private hospitals star graded like hotels bear testimony to those who unashamedly grow rich at the expense of people–rich or poor–who are sick. And they are free to charge according to their whims and fancies that have no bearing in the quality of professional service rendered by ‘specialists’ and ‘consultants’ of all types whose names appear in the hundreds in notice boards of star class private hospitals as if they are Nobel Award winners. But haven’t we heard of medical and surgical ‘misadventures’ as they are termed in the hands of these medical maestros? If the number of messed up cases and the infringements of patients’ rights at these medical bucket shops are considered, there will be enough material to sue doctors, specialists, consultants, nurses, technicians and the hospitals out of their minds. This can happen only if the law provides adequate ammunition that could fire confidently against healers who deserve legal whipping.

Charge rates per minute
In hospitals offering ‘channeled practice’ bitter lessons in medical ethics can be learnt in the hands of off-hand receptionists; gruff and glum cashiers; chattering nurses who look like ‘O’ Level failures on holiday and dozens of doctors who have learned to relate their charge rates to the amount of time spent with each channeled patients–about five minutes on average. That means if he charges Rs 1000 as consultation fee his rate is Rs 200 per minute–and he examines, diagnoses and prescribes between 20 – 40 times a day–after his usual working hours–supposedly. Some doctor will go beyond this limit by examining patients at a higher fee. So in addition to bribes of various sorts and commissions of other sorts within the healthcare trade, doctors earn millions. The major part of it is tax-free. More exposure to medical ethics in channeled practice can be learned by a stay in an air conditioned box with a TV etc. in a star graded hospital.
Mrs Gladys de Mel channeled a doctor about a small lump on her hand. After ordering a hundred different tests, the doctor recommended immediate surgery. As a result, one evening Mrs de Mel was admitted to a star class hospital for the operation scheduled for the following day. By the next morning Mrs de Mel had run up a bill of over Rs 25, 000. After a 20 minute cut and stitch affair under local anesthesia she was discharged that evening after paying Rs 62,000.
Similar dramas of medical hit men go on…every day of the year.

A perennial business
Medical ethics were followed by doctors who really cared for their patients. But, that was eons ago. Today what matters is money. And in that context the healthcare industry is at a clear advantage. Unlike other businesses that are blown away when pundits do not forecast economic futures accurately or when governments blow stupid economic whistles healthcare industries are perennials simply because people are falling sick all the time. And its supply is guaranteed never to run out. Make no mistake about it. The practice of medicine is a huge and profitable business in which drug manufacturers, hospitals, medical laboratories are hand in glove in doing well for themselves. That is all right, but, they can be fair and reasonable by the sick and the dying, can’t they?
All doctors are not of the medical mudalali fraternity. But they are as rare as flawless fifteen carat blue sapphires worth a king’s ransom. And sometimes such doctors pay a heavy price as in the recent case of a genuine healer of ordinary people being murdered by a man whose medical laboratory business was affected by the doctor’s honesty.

Theory on healthcare laissez-faire
The open robbery in healthcare is not new. From time to time, governments have been making noises about introducing new laws, amending and strengthening existing ones to stamp out the wrong doings and clip the wrong doers–but it was only air–nothing has changed. In fact the situation has got worse as more and more are joining the orchestra of the medical mudalalis.
Something is terribly wrong in this scenario because the official indifference and foot dragging in bringing doctors and their business partners in private healthcare to heel remains as mysterious as ever. This situation has given birth to a plausible opinion that some authorities holding major shares in local corporations with medical interests, do not wish to rock the boat–rather the Titanic.

Source: Daily Mirror - Sri Lanka