The State has now banned private practice by doctors who are employed under the State Government. The State in my view does have all the authority to notify so. Sikkim is not the only State which bars Government doctors from private practice. There are many Indian states that have similar arrangements in place. Similar guidelines are applicable on medics employed under the Central Government too.
Let us but dig a little more into the issue. Apart from Central Referral Hospital run by the Manipal Group, all medical facilities in the State belong to the Government. The new notification now implies that for any medical advice majority of the Sikkimese only have one place to go that is the Government facility. This is one discomfort that has surfaced immediately. For those already having a headache thinking of queuing up at the Sarkari swasthya kendra, I have the relief prescribed at the title above. Dolo khao, mast ho jao. ?? SOS ???
In larger states or say mainstream cities and centers, no one cares if the Government doctors practice privately or not. There are enough private hospitals and clinics to take care of the kind and class of patients who do not prefer Government centers. Here we do not have the privilege of high doctor density. Thus doctors being available only at the Government center will inconvenience a large population segment.
Having said that, a section of doctors too should take the share of blame for the change in regulations. Practicing privately BD may have been fine but we have seen doctors rush to make money TDS. We would have all at certain times visited a Government doctors' private clinic at 3 in the afternoon, on a working day. Also, instances of a patient getting premium attention in the hospital if his medical records contain private clinic prescriptions is common too. A patient who has to wait for hours outside a doctors clinic carrying token no 249 would have often seen a regular private clinic visitor walk in directly. A division of the patient class into a private ma ??????? and hospital ma ???????? This order does attempt to eliminate the division.
The private clinic economy is also big. Any good doctor seeing 30 heads daily, 500 a head stands to lose over 4 lakhs a month. Quite a loss, that. Also, a patient who always prefers swift private visits, having to queue with token number 249 clinched tight in his sweaty palms, a loss there too. For both the losses, please feel free to be advised by the title above. Dolo Khao Mast ho jao, ?? SOS ???.
Now a different view of the issue. There is nothing better than the State providing all medical facilities. Great economies have been doing it successfully. The new order has taken care of the consultancy part but the diagnosis part is equally important, if not more. Any Government hospital and we see private diagnostic facilities mushroom all around it, directly hinting that state owned facility at current level stands inadequate. Pathological tests and radio diagnosis are more popular outside the hospital premises than inside. A wait of a week for Ultrasound, a month for CT, X Ray films being out of stock, sometimes even vials having to be bought by the patients make things complex. To add to the jhamela, most private diagnostics also have Government doctors visit for reading and finalising of the reports, private practice there too. There may hardly be any private radiologist or pathology medic in Sikkim.
Thus having to see a doctor in the hospital, visit the private center for tests, visit the doctor with reports in the hospital again, a headache. Many diagnostic centers without a visiting diagnostic specialist means no business. Headache again. Dolo Khao Mast ho jao, ?? SOS ??
The issue thus is a complex one. I hope that all sides have been examined properly before the decision was arrived at. Also, there is an argument that like any other profession, the doctors too should have the freedom to choose what they do beyond duty hours. That point has merit.
I hope the doctors in Sikkim would have the voice to take up their issues with the Government for resolution if they feel that their rights have been violated or if an alternate system will ensure better healthcare.
Most visits to physicians and particularly private clinics are undertaken by the elderly. They may not have the energy or even assistance to visit a Govt hospital to see their regular doctor. Sikkim should not be an unfriendly destination for senior citizens.
Will this new policy result in the much needed positive transformation of healthcare in Sikkim? Or will this further accelerate our buying of flats in Pradhan Nagar or plots in Devidanga and Khaprail?
I hope it is the former but that, only time will tell.
Until then, Dolo 650. ?? SOS ???
((Deepak Tewari is a social commentator. Views are personal. Email: tewarideepak@yahoo.co.in)
