Or, why “First, do no harm” feels like a scam
As a kid, I was advised to not pursue medicine because: 1) I’m bad at drawing and 2) I won’t be able to keep up with all the memorizing. A few cousins is about all the exposure I’ve really had about what pursuing medicine means. I have some vague memories of hearing about the taxing life of a doctor – long duty hours, not having enough time for their newborn kids and, rather distantly, the news of attacks on and suicides of doctors.
Most of that vagueness disappeared ~2022, after a doctor deemed me suitable to marry. Over the last three years or so, “resource scarcity in public health systems in India” has no longer been a vague set of statistics. It has become a real everyday experience – of seeing her come back home to collapse in a heap of exhaustion.
Because even at a premier medical institution (they discovered a blood group), a resident doctor has to take care of everything from typing out reports, running after paperwork for various schemes, checking & rechecking if the patient has the right ration card before operating on them, making presentations for senior faculty to present in conferences, figuring out how to fix faulty computers & printers and, oh yes, tending to the patients.
Forget about the drawing & the memorizing. I don’t think I could ever have put up with such horrific routine.
What can I do in this situation, I keep asking myself.
I get ample time to process this, you know, since her hospital never really frees her up – even when she’s back after her 20+ hour-long shifts, she’s fielding calls or working on a ppt or requesting an MR to please send in a stent the next morning. In all of that time, I’ve gone through resourcing policies for healthcare, acts and lawsuits on this, literature on healer burnout.
What did I find?
tum jaise doctors ko toh peetna hi chahiye tha
– a senior faculty member to 1st year DM residents, after a patient’s attendants tried to assault them
As if the heavy workload isn’t enough of a burden, or perhaps because of it, workplace atmosphere hardly offers any encouragement.
Faculty members tell you, “things were even worse in our days” or “office politics toh seekhna padega“, male doctors don’t bother cleaning toilet seats after them, gossiping and taunting is so commonplace that residents prefer working even when physically unwell, senior faculty members don’t seem to know regulations on hostile work environment – sexual or otherwise, hierarchy is so rigid that you have run everything by everyone from your immediate senior year resident to the all the senior faculty – at their convenience. Raising a grievance only entails closer scrutiny of your own work.
Most resident doctors, having spent more than a decade as a student, their professional practice soon-to-start, are understandably reluctant to invite more bureaucratic outlash on themselves.
Who could blame them? Senior public functionaries routinely issue statements that are at best, ignorant of their working conditions.
the working hours for doctors and other medical practitioners normally do not exceed 40 hours per week
Minister of State for Health & Family Welfare in an answer to a Lok Sabha Question1
If you are a medical practitioner, or you know someone who is, you know how laughable this is. Even before the COVID-19 pandemic, this was never true, except maybe on paper.
वेडपटपणाचे, indeed.
At the same time, top public institutions have little to nothing to say on the matter. They don’t seem to consider healer burnout a serious issue. E.g., check out what a simple Google search about burnout on the National Medical Commission’s website shows.
There are some initiatives to ‘support’ doctors by adding yoga or meditation to the routine. This seems like treating the symptom, not the cause.
Toxic work environments, administrative hurdles & resource crunches are the issues our healers face. If we care about their well-being, these are the issues that need fixing.
- He’s only talking about those employed with central government hospitals ↩︎
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