Wednesday, May 30, 2012

In Defence of Aamir Khan

Aamir Khan's last episode of Satyameva Jayate dealing with unethical medical practice has raised the hackles of many of my medical friends, especially the younger generation. However, much against the tide, I will rise to Aamir's defense. While using celebrity status for social reform is in itself a debatable issue, I endorse it and found most of my friends doing the same when they perceived the issue to be clear cut good vs evil as in the case of the issues of female foeticide, child abuse and dowry. The pattern of the show is very structured and reflects the method actor image that Aamir possesses. He first defines the issue, which he carefully did and gave the clear distinction between negligence and unethical practice and focused solely on the latter. He usually starts by shocking the audience with near unbelievable and extreme examples of atrocities. Then he tries to give facts and figures hitherto unknown and which prove the seriousness of the problem. He follows that with a near court like indictment of the authorities and regulators who fail to stem the rot. This is followed by stories of hope and solutions, of which one of them is direct action focused to a limited task. And the show is summed up by a poignantly composed song which helps recapitulate the issue.

There is no doubt that we are living in times where the decay and rot of all systems have reached levels which are really shocking and seemingly unrepairable. All of us are surrounded by massive corruption and unethical persons. And none of us can remain completely clean like the metaphorical lotus leaf. Each one of us on all the above issues drew a line for oneself and decided that we should not adopt any foul means beyond a point to achieve our goals. So the same holds true for medical practice. It is a reflection of changed times that career choices are not made on the romantic fantasies noble profession and altruistic motives, but are based on the life style, material comfort and profit by any means. In the name of socialism and service oriented profession, doctors are exploited by charities, who actually profit from the doctors largesse. Also, the cost of education in private institutions, and underhand dealings have created a nexus between the regulator and the regulated, resulting in a precipitous decline in the quality and quantity of medical education. Medical research has become a tool for the pharmaceutical companies to manipulate and push expensive branded products in the market.Along with these, have come the new expensive technologies of investigation and treatment, which while helpful has made the medical fraternity dependent and created a bunch of unskilled practitioners. A decline in teaching standards has created a vacuum where commercial pharma and instrument and implant companies have rushed in with biased motivated teaching and training aimed at subtly and often times crudely enhancing their profit margins. The rampant practice of cross referencing and receiving commissions for the same have created a monster, who has destroyed the moral fiber of many a well intentioned person. When a trained medical practitioner comes out in the field of clinical practice, he or she are ill equipped to deal with these entrenched forces and the lack of work and peer pressures. In addition, the need to make up for lost time since it takes longer for a doctor to end his education than any other profession along with the peer pressure to earn well and fulfill ones desires for material comforts beyond ones needs create the soil and the bed for a harvest of unethical practices.

All of us know this and knew these facts when we joined this profession and weighed the pros and cons before making our career in this field. Some of us saw no harm in adopting foul means as we deluded ourselves into the feeling that our noble ends justify the adoption of ignoble means. If there are corrupt politicians selling medical education, they are only there because they cater to a demand from us for the same. While I do concede that the there is a nexus between government and private health care to dilute public health care to the extent that there is no alternative left, i feel that here too we are responsible since we feel that only glamorous private hospitals can give quality care. We have as a medical body have failed to stop us being used by the politicians for their commercial gains. The commercial drug companies and implant manufacturers have successfully made us partners in their criminal intent and further compromised our credibility. Trading in medical education completed the rot and enhanced it by diluting the quality of teachers and creating a scarcity of role models which medical students can look upto and emulate. Amidst all these very few remained ethical and became role models. Aamir showed us a few of these and saluted the efforts of ethical doctors. He showed us how health insurance and policy change at the highest levels can bring affordable health care to the poor and give doctors enough earnings to live comfortably and maintain great life styles. He showed us how, we as a body have failed to self regulate and opened ourselves to criticism and outright ridicule.

So where has Aamir Khan gone wrong? I do not think anywhere, for he has publicly articulated modern health cares worst kept secrets. He has made patients, aware of the decay and the rot which have reduced a noble altruistic profession to a crass commercial no holds barred race for profit and loss. To those of my colleagues, who criticize Aamir, I want to ask only one question?? Can any problem justify unethical acts, playing with the lives of the very persons we are pledged to preserve and protect??? The answer is a resounding "NO". A TV show can examine an issue and its ramifications upto a point and not beyond that, and i think that this show by its very format has  done its bit. It has clearly defined the problem, touched on its causes, asked the stake holders to answer the uncomfortable questions. He has shown the examples of heroic doctors who have swam against the tide and achieved success. and tried to give relief to the commoner by specifically trying to reduce the cost of medicines.

Every show of his has forced us to look inward and introspect and it is high time we did so, rather than criticize and fight his efforts.

Dr. Vispi H. Jokhi MS(Orthopedics)
Assoc.Prof. ESICPGIMSR, Mahatma Gandhi Hosp, Parel, Mumbai
91 9323351529