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Tag Archives: Rural

Yesterday was revelation day. I met an old friend. Dr Suresh graduated from the same medical school as me. When I was a student, I was always envious of people like Suresh: his father ran a busy practice in his village and when Suresh completed medicine he would naturally join and later on fully take over daddy’s clinic. For students like us future was always uncertain and Sureshs and Rameshs who were doctors’ children left few opportunities of pointing this difference.

 

Things turned out a little different I guess. We sat together for dinner last night and I realized what medical practice is like in rural India. Suresh had a clinic in the village where he worked between 10 AM and 8 PM. He could walk home for lunch and coffee breaks etc., but only when he had no patients. There was no appointment system which meant whether or not there were patients he would have to sit in the clinic throughout the day. On an average he saw about 20 patients from within his village and the surrounding ones. I thought that was a good deal, till I heard how much he charged. He would charge each patient between 10 and 20 rupees! Some of the cab drivers in Bangalore earn more than that! But then, if he charges more, the patient will never return.

 

What about lab tests? What about pharmacy? Are these available nearby?

 

In the village clinic, Suresh explained, asking for a lab test is not practical because there is no lab in the vicinity. Also, the patient never had the money for the tests. If you advice a lab test, the patient simply moved to a different doctor. This means that practically all diseases are diagnosed presumptively and we all know how flimsy and dangerous such practice can be.

 

As far as the pharmacy is concerned, Suresh explained that he cannot prescribe medicines most of the time for two reasons: prescription medicines are costly and patients will not buy them. So, for the same fees that Suresh has collected, he is expected to dispense cheap, generic drugs to patients!

 

The other practical problem is if one patient in a family gets a prescription for, let’s say cough and cold, that prescription is never thrown away: anyone in that family has cough and cold next time, the same prescription is followed. Loss of revenue for the doctor! And if a child falls ill, half or one-fourth of the dose is administered out of the same prescription: can be dangerous too!

 

Medical practice in rural setting in India doesn’t seem as romantic and adventurous as James Herriot’s veterinary practice; or as humorous as Richard Gordon’s experiences amongst humans. Lack of doctors, paramedics, medicines, facility for safe surgery and child-birth, awareness of preventive healthcare all pose a humongous problem. Villagers, both patients and doctors seem to get a raw deal because of poor infrastructure, while plush corporate hospitals in the metros are trying to attract medical tourism.

 

Yet another irony of independent India!

 

 

 

 

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