Shortage of Doctors

Even as Assam has six medical colleges with uneven manpower and quality of infrastructure, four more are coming up at Dhubri, gaon, Diphu and Lakhimpur. A groundswell of discontent has meanwhile begun to grow among senior doctors in established colleges, which does not bode well for public healthcare in the State. Several departmental heads and senior faculty members in the medical college hospitals in Guwahati, Dibrugarh and Tezpur have put in their papers and applied for voluntary retirement. They are learnt to have cited persol reasons for seeking to retire early, but where there is smoke, there must be some fire. And insiders attribute the trouble to the Health department’s skewed priorities and way of going about things. When the State does not have sufficient number of experienced doctors who can teach and train new talent, why the headlong rush to set up more medical colleges — it is being asked. As it is, the medical college hospitals at Jorhat and Barpeta are yet to grow out of their fledgling state, with idequate infrastructure and vacancies in crucial positions. Since the Medical Council’s guideline on adequate number of faculty members must be followed, it means the new medical colleges are not likely to have post-graduate courses for quite some time. There seems to be rising disaffection among senior doctors of being rotated around to the new colleges prior to visits by MCI inspection teams; this apart, they have long-standing grouses over heavy workloads while treatment facilities remain sub-standard, along with allegations of growing lobbyism and politicking in the Health department. The last factor is particularly bad for morale, for government doctors cannot afford to serve with the feeling that they would have landed ‘better’ postings if they had the right connections with the powers-be in Dispur.

There is already a crippling shortage of medical specialists in key areas, like oncologists at a time when the State government wants to upgrade cancer treatment here to another level. The Health department reportedly often finds far fewer applicants to the number of specialist medical posts advertised for. The Health Minister wants GMCH doctors to give up private practice while promising them AIIMS level payscales; but questions are being asked whether there are resources enough to enforce the ban, let alone extending it further to other public medical institutions. The Health department has also largely failed to ensure that postgraduate doctors, after completing their higher studies in State medical colleges, serve in rural areas as part of their bond condition. While PG doctors are roundly blamed by official circles for their ‘unwillingness’ to serve in the villages after having availed of State funded education, the matter is not so simple. For a young doctor, there is much to learn and gain experience from in rural postings, provided the necessary facilities are there. But Dispur needs to take a call how many primary and community health centres have rudimentary facilities, how many such centres have the minimum number of nurses and other paramedical staff. Without them, a doctor can do very little on his own. And woe betide the doctor who fails! Incidents of doctors being threatened and thrashed for botched treatment have become all too common. The trust deficit between doctors and patients has reached such levels that a term like ‘medical terrorism’ is gaining currency over earlier terms like malpractice and negligence. This in turn means security is also an issue for many doctors. Is it surprising if they gravitate to the private healthcare sector for improved facilities, higher earnings, better security and other attractions? These and other factors need to be carefully thought over to devise a comprehensive health policy for the State. This apart, Dispur is reportedly mulling over appointing magement graduates in government hospitals so as to unburden senior doctors from administrative work as well as inject a much needed degree of professiolism in these institutes. Surely, this would be a step in the right direction.