The salaries for doctors are low and hence are not filled.
While this is causing direct damage to patient lives in understaffed government units today it has long term consequences for the nation. This will be in healthcare as well as in public health. 1/n https://twitter.com/mundra08/status/1348112563020550145

We have had a taste of the consequence of poor public health and consequently poor public policy by the copycat handling of the #COVIDー19 pandemic. There was no public discussion of options and barely any scientific publications and injudicious use of many drugs. 2/n

One does not need to look into the crystal ball to know the future. Already we have smart intelligent kids not picking up medicine as a career. Probably has already been happening since a few decades. Many who realize the issues and have the means move abroad. 3/n

I am quite confident that in a few decades except few areas of excellence and good quality care we will have an abundance of disinterested and poorly motivated medical and paramedical healthcare workers. We are already seeing this in the choice of post MBBS subjects 4/n

For more than a decade subjects such as dermatology and radiology which have less or no need for night duties or emergency care are rising above old favorites such as pediatrics, obstetrics or surgery. Subspecialisation growth has tapered off. 5/n

And this is happening with government ramping up MBBS seats due to policies of ‘experts’ like Devi Shetty. This year even those have fallen vacant. And of course we still don’t have doctors in rural areas or in public hospitals. And then there are malpractices 6/n

That are also assuming various forms and even getting institutionalized in ‘corporate hospitals’ referral cuts, business of six times the salary, unnecessary investigations. Govt isn’t behind with corruption for various schemes and so on. No law is going change this. 7/n

Neither is any public demand or lawyering or reporting is going to help. The good ones will leave or be part of isolated centers that are able to survive while the rest will find ingenious ways to survive using nefarious means. Many never intended go on the dark side. 8/n

A young radiologist got jailed due to the PNDT act as he didn’t pay the needed bribe to officials. After coming out he did the full Monty and now does exclusive sex determinations and bribes to thrive. True story but details unknown to me. This is an extreme of the spectrum. 9/n

This story will happen in different areas with different modes of operations and at different degrees of intensity. Again most don’t intend to do this. The Classic ‘admi burre nahi hote hai, halat burre hote hai’. This is a complex issue with most concerned people 10/n

Doing mostly fault finding or finger pointing without going into details. Much of this is due to poor medical leadership & acknowledging the systemic and policy issues. Ideally we need “To Err is Human” kind of report that explores this issue in detail so that we know facts. 11/n

Only when we are aware of problems can we think of solutions. Increasing medical seats or colleges is the solution that is offered by those with no insight and awareness of the problem. And we have many experienced seniors espousing this. End of rant 12/n - 12/12