EXCLUSIVE: Doctor's Day 2020: THESE are the changes doctors seek in healthcare system

On the occasion of Doctor's Day 2020, 7 doctors from various specialities share their opinions on what changes they want in the current healthcare system in India.
Doctor's Day 2020,doctors day EXCLUSIVE: Doctor's Day 2020: THESE are the changes doctors seek in healthcare system
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Doctors, amid COVID-19, have been working round the clock, risking their own lives and fighting the microscopic villain on the frontline to ensure our safety. And that's why this year, Doctor's Day is of special importance. For the unversed, today, i.e. July 1, Doctor's Day is being celebrated. Every year this day is observed to express gratitude towards doctors for their selfless and dedicated service. The very first National Doctor's Day was celebrated in July 1991. The day also marks the birth as well as the death anniversary of Dr. Bidhan Chandra Roy, one of the most renowned physicians in India. 

The day is organised by the Indian Medical Association (IMA). This year, the theme is "Lessen the mortality of COVID 19". This includes awareness about asymptomatic hypoxia and early aggressive therapy. Every member of IMA will bring about a change in the current situation. On the occasion of National Doctor's Day, we asked several doctors to share their views on what changes they seek in the healthcare system.

Dr. Gunita Singh, Director, Dentem shared her opinions on the current healthcare system in India, "The health care system in our country has always been compromised though Indian doctors are the best in the world the system is rotten I strongly feel the worst part in our country is that doctors are governed by nondoctors MBA's and businessmen in all our hospitals. I belong to a hard core business family I'm not against them but what if doctors start running their businesses? I wish there was a total involvement of doctors in running hospitals. Other major problem is our insurance companies are not fair some things are covered some not so patients end up blaming doctors always at the end for being expensive like there is nothing like dental insurance."

Dr. Tanvir Singh, B.D.S., M.D.S. (Ortho) and Director, Dentem expressed, "Cost of the treatment is a major variable in our country rates of treatment in one part of Delhi are so different from the other part most of the time patient is confused if we charge more they are obviously upset but if we charge less they doubt we might not be competent enough so government should have a capping on all procedure for transparency. Also, doctors are lifesavers they are no less than soldiers they should be paid well given some perks like government employs and defence officers made to retire at the right age and given pension you see in our country doctors don't retire as there is no other source of income and they have served the country enough."

Dr. Ravi Mohanka, Consultant and Chief - HPB Surgery and Liver Transplant, Global Hospital stated, "The COVID pandemic has taught us that we need to rethink our long-term healthcare strategy. Preventive medicine and use of technology and large-scale cooperation to make translational medicine feasible, quick, and cheap and optimal high-quality healthcare delivery by a local team is the only sustainable model if we want to survive as a species."

Dr. Charu Dutt Arora, MBBS, MD, FNCC, FIID, Infectious Disease-Critical Care Specialist, "I would like to request the authorities to put more emphasis on public health, prevention, and screening activities on the grass-root level of the population ecosystem. Added to this, information-education-counselling activities and community responding efforts should be strengthened to develop a stronger global health system. There should be ample training of midwives and AYUSH doctors in regards to tackling emergency situations and outbreaks that can amalgamate with the specialist care at the city level. Well-coordinated planning at the community level can create real integrated patient-centric delivery system with high quality and efficiency."

Dr. Parag Rindani, Centre Head, Wockhardt Hospitals said, "What doctors seek in a healthcare system essentially is a well-balanced and well-rounded working environment. The hospital should be able to handle the cases appropriately because COVID-19 has woken us up in a big way, in terms of the potential hazards that hospitals and healthcare workers are facing today. Creating awareness and training doctors is the need of the hour. Moreover, the training should focus on infection prevention and newer diseases that are emerging across the world. 

"Since the last few years, cardiac diseases and hypertension have become a new epidemic. Likewise, prompt management of lifestyle diseases is also required. But the fact remains that infectious diseases are here to stay. 

Hence, it is vital to intensify the training and pay attention to infectious diseases that have actually caught us unaware. Not only this, but the focus should also be there on the infectious diseases’ hospital as well. Whenever patients are taken to the hospital, there should be a higher degree of suspicion for infections in all patients who come in for non-infectious diseases."

"There should be a system to determine which patient will be potentially infectious. Having medical expertise (nurses and doctors), and standardized infrastructure (oxygen, other equipment) is needed too."

Dr Roy Patankar, Director, Zen Multispeciality Hospital, said, “The future of medicine is going to be digital. The combination of artificial intelligence (AI), digital media and marketing will reduce physical patient contact. Also, online consultation is done and reports are being checked. The rural areas do not have adequate facilities." 

"For example- we have donated an endoscope to Dr Prakash Amte, in Gadchiroli, sent videos of the endoscopy and we can do the reporting of the endoscopy from Mumbai. We have patients all over the country, who send me reports on the teleconsultation platform that I am using for the second opinion of the cancer patients or the GI patients."

"Before undergoing surgery, the patients send me all their reports and I then suggest to them about what kind of surgery they have to undergo or whether they should opt for surgery. I see patients for follow-up too who generally have heart disease, diabetes, who don’t want to travel. Despite social distancing, there is a higher risk."

"So, it is completely teleconsultation OPD online. Even only if we need to only examine a patient, we call them. The future will gradually be less of physical interaction. And AI an also help predict which patients have trouble, identify those patients and call them here. The AI software will predict which patients have complications and will be called to the hospital. Most patients can be managed on teleconsultation. This is the future of medicine. The COVID-19 has jump-started the digital revolution in healthcare. This is here to stay.”

Dr. Priyanka Tyagi, Cosmetologist, MD, Omorfia Aesthetic Clinic, New Delhi stated, "The health care system in this country has experienced unprecedented change and growth especially during the past twenty years. These changes reflect a multitude of developments, including fundamental shifts in the political and philosophical underpinnings, dramatic advances in the technology of medicine, evolving expectations on the part of the consumer toward doctors, and different characteristics of the population and the health care problems they experience. A growing number of independent practices have been swallowed up by hospitals and healthcare systems in recent years, with the trend accelerating even faster among rural hospitals than urban hospitals. It’s great  that the economy is booming but getting highly qualified nurses and administrative staff and keeping them is that much more challenging."

"Physicians also must confront a number of ethical challenges on the job today, as they deal with life-and-death situations amid priorities that can pull them in different directions. For instance, how do you balance patient need with their ability to pay, or make decisions about expensive end-of-life care that only delays the inevitable? By and large, physicians are satisfied with the work they do, but they’re highly stressed, and stress is a predictor for or an antecedent to burnout.” The multiple challenges they face can all contribute to an increased risk for burnout. “All those pressures come together. 

And the repercussions can be dire—from doctors leaving the profession to entering a downward spiral in their physical and mental health. As Medical Economics explained, healthcare systems must also be proactive in their protection of patient privacy, which is especially difficult considering the non-stop integration of technology."