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Experts Talk
Dr SK Pandya 
Neurosurgeon,
Jaslok Hospital & Research Centre, Mumbai
 
DoctorNDTV: Does the Indian health care industry have any problems? If yes, how would you tackle these?
Dr SK Pandya: I see the following as the major problems. (There are many, many more but listing and commenting on them would take up time and space.)
  1. Failure of the Medical Councils - Medical Council of India and the state medical councils - to perform efficiently, with integrity and transparency.

    We have tried hard to tackle these through our journal (Indian Journal of Medical Ethics), fighting a case in the High Court in Maharashtra and through discussions at many gatherings. I regret to state that our efforts have not borne the expected fruit.

  2. Progressive devaluation of public sector teaching institutions by government and municipal corporations. When founded, the Calcutta Medical College and Hospital, Madras Medical College and Hospital and Grant Medical College and Sir Jamsetjee Jejeebhoy Hospital were the principal teaching institutions in the country. Subsequently, others were set up in the different parts of the country. Till 1947, these were the best equipped institutions, staffed by the cream of the medical profession and respected all over the world. Today, 61 years later, most of them are in shambles, with continuously falling standards in medical education

    and patient care. The quality of research in most of them is not not worthy of any reference.

    Political interference in the management of these institutions is now at an all-time high. Witness the affairs at the All India Institute of Medical Sciences during the past decade or more and you realise the extent of the tragedy. Medical colleges and their hospitals in Maharashtra have been devastated by the vicious policy of transfers of

    professors and deans based on considerations other than merit. There is now no loyalty to the institution in which most of these senior doctors serve.

    Private medical colleges have been started by individuals and groups whose prime consideration was and remains the rapid amassing of wealth. Barring a very few institutions (the Manipal Medical College

    and associated hospital in Manipal is one example), most of these institutions are woefully staffed and equipped and are in no way superior to existing public sector medical colleges when they were set

    up.

  3. Lack of instruction on medical ethics and disastrous slide in the ethical conduct of doctors. For details I recommend study of the issues of the Indian journal of Medical Ethics from volume 1, number 1 to date.

  4. Progressive devaluation of the classic research laboratories that served pre-independence India. I refer to the Haffkine Institute in Mumbai and the institutes in Coonoor, Kasauli and other centres.

  5. A proliferation of funding agencies that defies common sense and logic. We are not a nation that can afford to squander trillions of rupees. We need to ensure that each rupee is well spent and we obtain 100 paise of value from this expense. Why do we need Indian Council of Medical Research, Department of Science and Technology, Department of Biotechnology and Council of Scientific Research - all of them often dealing with the medical sciences?

    Requests have been made for a cost-efficacy analysis of ALL research projects funded by these agencies from the start with details on how much benefit has followed to science, health, prevention of disease and cure of disease. To be useful, such analyses must be made by eminent scientists of unimpeachable character who are in no way dependent on any of these agencies or the government. I know of no such analysis to date.
 
 
DoctorNDTV: What, according to you, are the attributes of a good doctor?
Dr SK Pandya:
  1. An aptitude for medicine.
  2. An overwhelming desire to help the patient and the patient's family.
  3. A special desire to bend over backwards to help when the patient is poor and downtrodden.
  4. Modesty in behaviour and in the aspiration to earn the means to care for himself and the family.
  5. Keeping up with medical progress through indexed journals and books.
  6. A healthy cynicism towards what is beamed towards him by companies making drugs, instruments.
  7. Following the principles of medical ethics - especially those laid down by Charaka and Susruta.
 
 
DoctorNDTV: What do you think are your greatest achievements?
Dr SK Pandya: Maintaining the high standards laid down by Dr Homi M Dastur, the founder of our department at the KEM Hospital.
 
 
DoctorNDTV: Is there anything you think must be done for better health for all?
Dr SK Pandya: Better health can only be achieved through education, sanitation, nutrition and medical care. For improvement in the health care of the nation we need as Ministers of Health and Education, and as the top bureaucrats in their ministries, persons possessing the finest brains and unimpeachable characters in their respective professions. They, in turn, will ensure that the Medical Councils function, medical colleges and their hospitals are staffed by the finest doctors and that education of high quality is delivered to all our citizens from the primary schools onwards. Merit, and merit alone, should be the qualification governing selections for ALL posts in these ministries, the Medical Councils, in medical colleges and hospitals and all our research institutions.
 
 
DoctorNDTV: Would you like to tell us about any recent development in your specialty?
Dr SK Pandya: We are progressing well on all fronts in neurosurgery and its allied sciences and have young professionals who can compete favourably with the best in the world.
 
 
DoctorNDTV: Do you think Indian health websites are useful? Your views about DoctorNDTV?
Dr SK Pandya: Dr. Samiran Nundy has put together a fine team and an excellent series of programs including DoctorNDTV.
 
 
DoctorNDTV: Where is medical practice in India heading?
Dr SK Pandya: I wish I could be an optimist but reality demands that I point out that we are rapidly placing the best of medical care beyond the reach of our poorest patients. Until we can ensure that the poorest person in India has free, ready and easy access to the same high quality of medical care that is available to a member of the families that run the Reliance, Tata, Infosys and Wipro organisations (to give you just a few examples), India cannot claim to be shining.
 
 
DoctorNDTV: Is the doctor-patient relationship changing in India?
Dr SK Pandya: I fear it is, for the worse. The rupee now plays an overwhelming role in determining the care the doctor gives the patient.
 
 
DoctorNDTV: What would you have been if not a doctor?
Dr SK Pandya: Librarian or historian or photographer.
 
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