Thursday, July 17, 2014

LETTER TO AMIR KHAN

LETTER TO AMIR KHAN
[a work of compilation from facebook/news/tv/personal opinion of various doctors]


From- ALL MEDICOS N DOCTORS.

Dear Mr. Amir Khan,
 “NOT ALL DOCTORS ARE GREEDY”
“THERE IS NO PROFESSION THAT IS ABSOLUTELY CLEAN”
“DOCTORS ARE OBLIGED TO SERVE BY CHOICE, NOT BY COMPULSION”

Sir,
I have been a big fan or your work, life and principles. I am also a fan of ‘Satyamev Jayate’.
I saw your show on the status of medical healthcare in India on star plus and doordarshan. It highlighted to society the concern about the healthcare that it receives at the hands of brutally dishonest and unethical doctors also known as ‘maut ke saudaagar’. Web- Link of that episode is-
 I understand that there are sections of the medical fraternity that behave in ways that do not bring glory to the profession but I was shocked to see the episode on 27th May, 2012. You are an Icon. You should have thought well and done the homework before doing such a biased show. There are only two people in the film industry that are being taken seriously by the thinking class of society, you and Amitabh Bacchhan. So, when you give such a biased and one sided version of a story, it hurts. Speaking about such a thing on a “commercial” TV show is bad. (I am sure you have taken a big amount, only doctor are supposed to do charity and social work, not actors!!! Right! ) I want to highlight few important points here. And yes I am qualified to make observations as I am a medical student. Dear Mr. Aamir Khan, I have been trying hard but cannot get over the fact that you can 'sell' ignorance with such ease and honor.


1. You said that the most brilliant students who take up medicine, should take it only for service to mankind, they should go to other fields if they want to earn. What do you mean when you say ' People of high IQ and desire to earn money should not become doctors’? Why? Are doctors not allowed to earn and spend a good life? Are we living in imperialism? Why aren’t doctors allowed to have an ambition?? How can a person who earns 4 crores for an episode of a so called 'social' show decide on what should be an individual's ambition and financial status!! Why can there be no doctors who earn well for their professional skills and do not indulge in malpractices? It just reflects your hypocrisy.
It’s not a fight sir but we have few questions for you and public
1. Does a doctor get any special discount on MRP of consumer goods?
2. Does any school waive its fees for a doctor's kid?
3. Does a doctor get any special tax rebate?
4. Does the govt. gives permanent jobs to doctors in village?
5. Does the court convict the people who attack doctors on duty?
6. Does a doctor get any discount on railway, airplane
ticket, or petrol?
7. Is the doctor responsible for poor health infrastructure or the
politicians whom you elect on the basis of caste, religion or quota sops?
8. Does Amir Khan treat u when you are ill?
9. Why should a doctor not be paid well for saving your life? Or
is it that your life is worthless?
10. Is Amir Khan promoting good health by doing ads for
coca-cola and earning millions?
11. Why should a doctor sacrifice his life and happiness
for you? What have u done to deserve it?


2. You said since 2001, government opened 31 medical colleges and 106 private institutes were opened. Please note that today in India; there are a total of 181 Private and 152 Govt Medical colleges. So the number is not as bad as you projected. Don’t project only the time period which suits your story. Either you give a complete picture or do not give a picture at all and also, please find out how many of these private colleges are owned by politicians? 95% of Private colleges in India are owned and run by politicians. It is a bloody nexus between politicians and MCI. The corruption by politicians is to be blamed for the mess, not doctors!!!

3. One of your guests (Dr. Gulhati) said that doctors ask for 30% commission from Pharmacy companies to write their drugs. That is baseless, over-the-roof and sensationalizing the matter. That is as true as “Most Leading actors ask newcomers to sleep with them” or “Lawyers take money from both the sides in a legal battle” or “Most chartered accountants teach their clients how to save tax and also pass info to taxman on where his client saved tax”. I know all of you will shout “Where is the proof?” So are doctors!!! I am not trying to sensationalize things as you did on your show by shading those fake tears, but just trying to project that allegations are easy to make. I know you will say that this was the opinion of our guest, and not yours. But you provided a platform for these fake allegations.


4. You compared the numbers of Licenses cancelled in England and in India. I must say your team is quite resourceful and please collect and compare following details also –
a. Number of doctors beaten on duty by goons from various political outfits in government hospitals in UK and India in last 10 years, and also the number of people convicted for such crime.
b. The Stipend (Salary a post- graduate trainee doctor/intern gets) or Salary, living standards and the doctor: patient ratio and accommodation facilities provided to the doctors of the two countries.
c. The duty hours and working conditions of the doctors of the two countries 
d. The academic and research infrastructure being provided to the medical students.



5. Your guests and audience (the words were almost put in their mouth) said that private colleges charge a capitation fee of 40–50 Lacs for MBBS; you should have also produced some evidence of such practice. Like you call a victim in all your episodes, why not here? And do the same story on Engineering, Architecture, Law and MBA colleges; do you think they are clean? Why to target doctors alone? You spoke about doctors buying medical degrees for 40-50 lakh rupees. Here are some figures for you. In 2011, 2, 21,867 students appeared for an entrance examination into medicine called the All India Pre Medical Test (AIPMT). They were competing for 1887 medical seats in government colleges. After listening to your show, every doctor who has worked tirelessly and endlessly to get into the profession, and in spite of ALL odds, qualify as a doctor will be viewed with suspicion by his society, as someone who may have “bought” his degree. You have condemned me, and thousands, perhaps lakh of young and upcoming doctors like me, who struggled among 2, 21,867 people to get those 1887 seats, to a lifetime of suspicion and ignominy. You then went on to chat with a gentleman from Wales about how he had to flee India due to rampant malpractice. In doing so, you have encouraged thousands of young Indian minds into falsely believing that the west is the destination where they will have a clean, ethical and well paying job. You have just doubled the brain-drain singlehandedly, Mr. Khan. And you have condemned every Indian to losing the best minds they could have had treating them in India.



6. Why only Doctors are being forced to work in rural and government hospitals after their study? Why only we should pay government if we don’t want to do it? The rural/Govt sector needs help of Engineers, Lawyers, Chartered Accountants and MBAs also. Why aren’t the Engineers sent to rural areas to design and monitor roads and industrials development? Why aren’t the Lawyers forced to work as Public prosecutors before they can join some big foreign corporate firm? Why aren’t the CAs asked to work in CAG office and various other government financial sectors before joining Multinational Giants? Now government wants that doctors should not immigrate to other countries without asking them. Why? Are the IIT/IIM students stopped before they flee to foreign countries for big fat salaries? So, why only us? What is it that government of society has done for doctors that they should repay? They bloody can’t even protect them from goons while on duty.


7. You say that doctors are writing unnecessary and costly medications. Do we decide the price of a drug? Do we manufacture or give license to drug manufacturers? Controlling the price of essential drugs is a government job. We are helpless. Sir, it’s easy to point fingers. We don’t say that all is well. But all is not well anywhere. It’s a different thing creating awareness about dowry or female feticide. But it’s entirely different to comment on such a technical and complicated issue without getting into the details of it. You have maligned the entire medical fraternity. For every 10 doctors who are doing wrong, there are more than 1000 healers. You owe us an apology!!! This issue is not as simple as you think it is! Please show stories which are unbiased and straight-forward. You cannot do justice to such an issue, especially after charging a whooping amount for creating awareness!!!(We hear that Amir has charged 3crores for episode of satyamevjayate in which he spreads the message to doctors that they should not make money and do social service!! How sacred!! I don’t know if it’s true, but well, it’s the season of allegations. Doctors may be doing little social service, but at least we are not charging for it".

Coming to generic drugs, yes, a large amount of rural population should have access to cheap generic drugs. But one should not forget the pharmacy companies that charge more for the drugs are the ones that spend crores of rupees for research and development of new drugs. Had there not been drug trials no new drugs would have been invented and we would have mortality rates compared to Stone Age. Also I agree that most doctors endorse certain brands of drugs (which I do not deny may be for some financial gains also) because they have faith in the quality of the 'active drug' of certain companies. Yes many local companies manufacture generic products (which is a copy of the original molecule discovered by the expensive company which can be used for unaffordable patients. But you did not mention that many of these generic drugs are of substandard quality and are the reason of many uncalled deaths due to drug reactions. Most doctors would not want to take responsibility of the quality of the 'generic' drugs.

 
8. Sir, we don’t say you are wrong there are bad doctors out there as well but you projected whole medical fraternity as fake corrupts and evils.Mr. Aamir Khan I am not getting back at you because I took your show personally. Yes, I agree that there are doctors indulging in shameful malpractices and even I know a few of them. But I can proudly say I am surrounded by more doctors who work day and
night just to ensure that their patients get the best possible treatment..The 'BAD' doctors should be punished and we all can come together to ensure we do not encourage such malpractices

9. I'm a doctor because I’m capable and not because of charity.....I’m qualified on my own merit and not because u elected me!!
You were asking Dr. Devi Shetty whether he can do humanitarian work and Earn at same time? This is like asking Amir Khan or Shahrukh khan their income and generalizing it for every actor in the industry (Even junior artists). Sir, just as there are only few Khans and Kapoors,There are even fewer Devi Shetty and Naresh trehan who run their chain of Multi-specialty hospitals spread all over the country. See what it takes to become a doctor and then give such “Geeta-Gyan”.
A.  5 and half year of MBBS training and 1 more year of Compulsory Rural Internship at Rs. 15000 - 20000 per month. (Any other field e.g. Engineering, Management, a person would become Postgraduate in this much time and start earning double the amount.) If one doesn’t study further, the pay at this step is 22,000 per month.
B.  After above 6 and half years of Graduation, SERVICE BONDS RANGING FROM 2 YEAR TO 10 YEAR
C. 3 more years of Post graduation, followed again by compulsory rural / Government job for 1 year to 5year or pay Rs. 25Lac to 2 crore bond. If one doesn’t study further, the pay at this step is 40,000 per month.
c. After this above 10 and half years, 3 more years of Super specialty, followed by 1 year of Govt job or a Bond of Rs. 2 Crore. And the seats are so few with tough competition, there tends to be a gap of a year or two in preparing for various entrance exams.

10. We don’t sleep at nights to have knowledge about your pain. My life is just books and tests because I have to save your life in future. Secondly I would have appreciated if you would have thrown some light on the entrance examinations and the hard work, dedication and sacrifices a doctor needs to clear his MBBS, MD, DM etc examinations. I wish you had spent half a day in the emergency department and OPD of a Govt. Hospital and realized that the work timings, working conditions, lunch breaks, doctor: patient ratio, hours of sleep per week, living conditions in the hostel and the stipend is worse than a class 4 laborer. You would have also surprisingly realized that the 'DOCTORS' are the only 'FUNCTIONAL' part of a Govt. Hospital which still caters to thousands of patients in a day. I am always exposed to infections coz I am always around the sick. My job is not from 9 to 5 but it is 24*7 till I die. My family life is a mess because I don’t spend time with them instead treats you. I study all my life just for u people...so RESPECT DOCS.

11. I understand that your aim in this episode, and on the show, as a whole, is to make society aware of the issues that plague India, and help it to move towards a better place. I also understand that you may have, unfortunately, done the exact opposite, at least with this episode. I’ll tell you why.

You started the show with the story of a diabetic losing his toe. (You did not tell us that he is diabetic, but the footwear he was wearing hinted at that.) This gentleman was retrospectively told about the possibility of medical management of his toe infection. You should know few statistics about diabetic foot disease (yes, Indian doctors also are aware of research methodology, like your famed “research” team).The foot ulcer incidence rates range between 2% and 10% among patients with diabetes mellitus. The age adjusted annual incidence for non traumatic lower limb amputations in diabetics’ ranges from 2.1 to 13.7 per 1000 persons (as per a study published in the Journal of American College of Surgeons in 1996). India has approximately 50.8 diabetic patients, according to the world diabetes foundation. Assuming that Indian doctors are competent enough to treat diabetes as well as their counterparts in the US, (where, presumably, you will be going for your medical treatment, as you proudly proclaimed that you will not undergo any medical treatment in India) that translates to about 5 million Indians having a chance of developing a foot ulcer, and about 500 thousand Indians needing lower limb amputation. Each of those 5 million people who develop the foot ulcer, will remember your episode, and will opt for medical treatment, which, if it fails to work (which it will, Mr. Khan, in a more than a few cases), will convert a toe amputation into a below knee or above knee amputation, or even death, depending upon how long the patient chooses to be on medical therapy. You have just condemned 5 million Indians to uncertainty, loss of limb more than what would have been, or even death. And you should know that the patient in your show might still be able to walk just because of the timely action taken by the surgeon.

     
Next,
There was a chat about “unnecessary” Kidney transplants. Here are a few facts, Aamir. In the United States, the general hemodialysis and peritoneal dialysis populations have 2 hospital admissions per patient per year; patients who have a renal transplant have an average of 1 hospital admission per year. Additionally, patients with ESRD (End Stage Renal Disease) who undergo renal transplantation survive longer than those on chronic dialysis. The mortality rates associated with hemodialysis are striking and indicate that the life expectancy of patients entering into hemodialysis is markedly shortened. In 2003, over 69,000 dialysis patients enrolled in the ESRD program died (annual adjusted mortality rate of 210.7 per 1000 patient-years at risk for the dialysis population, which represents a 14% decrease since peaking at 244.5 per 1000 patient-years in 1988). The 5-year survival rate for a patient undergoing chronic dialysis in the United States is approximately 35%, and approximately 25% in patients with diabetes. Though there are no nationwide records to calculate the incidence of ESRD in India, a population based study done in Bhopal showed the average annual crude and age-adjusted incidence rates for the period were 151 and 229 per million populations, respectively. Extrapolating this data to the population of India, we have 200 thousand Indians with ESRD. Again, if you are willing to believe that Indian doctors are as competent as their western counterparts, only 25 percent of these will live beyond 5 years without a transplant. So renal transplant remains the best available treatment option for chronic kidney disease. You have just condemned 150 thousand Indians to uncertainty, indignity and death. You said patients on dialysis live up to 15-20 years. (I hope you take responsibility for people who after watching your show plan to not go for kidney transplant and die in less than 5 years)

Next,
You spoke about doctors asking for “unnecessary” tests, and even went to the extent of describing a “basin” test in jest. In doing so, you condemned every clinical practitioner in the country to a lifetime of uncertainty about how his patients will react to his demand for justified investigations which will undoubtedly save the patient’s life. And get some research done on the cases of somatoform and somatisation disorders where patients have only a psychological belief about some serious illness inside them. In such patients we need to prescribe some costly medicines maybe just multivitamins to act on their psyche and placebo effects are generated to correct their cognitive distortion. Some times in doing so we need to order some apparently unnecessary investigations but they are all justified in the eyes of a TRUE HEALER just to get rid of the illness and not to get money.

Next,

An overenthusiastic girl from the audience said that her father was forced for an emergency liver transplant '6-7 years' ago for gastroenteritis. Fact- Even today there are ' a handful' of hospitals in India offering liver transplants. To think those 6-7 years ago, just for gastroenteritis 999 patients (according to your data) were offered liver transplant is not only improbable but technically impossible.

I could go on with this dissection of your well researched show Aamir, but I just want to end this issue with a story. There is a man, who was educated in rural India, came to a city with next to nothing, practiced as an honest doctor there for 30 odd years, refused to give or accept commissions or cuts, stayed simple, worked hard, and gave his family a decent life. Today, you have condemned him to being seen as a criminal in the eyes of the same people he served.


16. Here are some of suggestions to heal the ill medical and health system of india.

1.  Govt. medical colleges and hospitals should multiply several folds, increasing the number of doctors in each department, improving the doctor: patient ratio. Doctor's salaries and living conditions should be looked after and should be comparable to other professionals.
2. Try to maintain the govt. hospital up to the standard of private sectors. And this is the job of govt.
The Govt. should spend 6-8% of GDP ON HEALTHCARE and a part of which should also be committed to the research and development of newer drugs.
3. Public too bears the responsibility to maintain the govt. property like hospital.
4. Stop corruption at top level that eats the major% of hospital fund.
No politician should be allowed to be associated with any private medical colleges.
5. Give doctors the proper social security.
6. The primary school education must include more and more health related topics because who can be fooled? Only those who don’t know about It.! So t
he general public should be educated well about common diseases and the 'acceptable' qualifications of the doctors
7. If treatment of better quality (at lower cost) is available at govt. hospitals, why would we go to empty our pocket at corporate hospitals?
8. Public should know that good treatment doesn’t come just by money.
9.
' BAD' doctors indulging in malpractices should be suspended for life. We need a strong regulatory authority to publish expected treatment 'protocols' and punish doctors found to be doing unethical practices.
10. After this show people just lost their mind. They must use their brain coz it’s a sensitive issue. Aisa na ho ki real me surgical emergency ho but wo doctor badal le ye soch k ki doctor ka paise thagne ka  bahana hai!!
11. Have regulation over pharmacy companies. They are the real money maker. Doctors are just the apparent culprit. Regulatory authorities should also keep a check on the quality of drugs being manufactured and at the same time 'sold' at the local chemist.
12. Jb hamare top leaders and stars private me treatment karayenge to govt. doctors pe bharosha kaun karega. . They often prefer foreign doctors and corporate hospitals.
13. Doctors too r human being. They too need money for survival. So people should not exaggerate the GODness of them. But yes it’s true that bad intention is always a shin either in a doctor, a businessman, an actor, politician, a bureaucrats or a common man!


These are just a few points I can think of at the moment. I am sure had you bothered to have a panel discussion and find solutions in a healthy way, we could come up with a lot more viable solutions. However you chose to sensationalize your show, by hiring 'few' people with 'fake' or 'amplified' problems and shed a few tears. Hope you understand that Your allegations like 'HAMARE DESH KE DOCTORS ITNE BIMAAR KYUN HAIN' and 'MAUT KE SAUDAGAR' are as serious as calling all actors 'Rapists' (after the shiney ahuja incident ) and all Muslims 'Terrorists' .Knowing that you twisted not one but  many known medical 'facts' to strike a chord with the 'ignorant' 'naive' audience, How do you expect me to have faith in you and the stories you would project in the upcoming shows. You have betrayed a large segment of the 'classes' as well as 'masses'. All i can say is I feel sad for the death of the 'image' you created in our minds and hearts. An unbiased Aamir who strives for nothing but the truth and the betterment of the society was after all a MYTH. Condolences….

In the end I would just like to narrate this poem...
Box me up n send me home,
Put my papers on my chest,
N tell my mom I did my best,
N tell my dad not to bow,
He will not get tension from me now,
Tell my brother study perfectly,
Keys of my scooty will b his permanently,
Tell my sis don’t b upset,
Her sister will not rise after this sunset,
Don’t tell my frndz they r hearties,
N start to ask for parties,
Tell my love not to cry..coz
" I'M A DOCTER..
BORN TO DIE...”

                                                            Source:- a medico’s diary                

                                     http://medicosdiary.blogspot.in