Thread by @docbhooshan

#Healthcare #India
#BMR ( Basics में राडा) (chaos at basic level)

Thread.

2 essential components of healthcare are a doctor and a patient. Everything depends on how this fundamental relationship works. Similar to hoe mother-child relationship defines humanity (or mammals)

All knowledge and further directions of prevention, cure and healing; all other healthcare personnel and other agencies exist to support this most fundamental relationship that is the reason of existence of everything "healthcare".

So it is natural that we put a proper label and work category to this relationship. This label will decide everything that goes into and around it.

This is FIRST PRINCIPLE of healthcare.

We have several categories available for these 2 parameters.
Patient parameter (binary) - is health a fundamental right of an individual or not?

If yes, ENTIRE responsibility of healthcare is on elected govt to make this happen with their financial and executive powers.

All individuals have same rights so healthcare available to President of India MUST be available to all Indians.

Second Parameter is doctor - What is a doctor?

We have several options -

1. A charity worker - selfless service to the needy. Offering services for free. No prior knowledge, training, standards, accountability. Only means and desire to serve. NO govt imposed rules whatsoever.

2. Employee of a larger entity (pvt or public) - trained to give services as dictated by employer. Employer will decide pre-qualification, job training and all aspects of work. No direct legal responsibility at lower levels. Loyalty and efficiency are real desirable qualities.

3. Professional - individual or group of individuals working together. Trained to standards defined and enforced by professional body. Almost no interference from govt except in criminal actions e.g. architects, lawyers, chartered accountants. Free to charge

as they want. Professional standards and grievances managed by same professional body.

4. Business - service giving is "for profit activity". Freedom to choose employees, standards and customer gathering. Little or no ethical issues as long as no proved criminal activity

is conducted. "Customer" is supposed king. E.g. Telecom business

If you have read till this far, you must have already deduced my conclusion -

Healthcare is India is a total screw up on both dimentions.

No govt since 1947 has clearly categoriesd second parameter (doctor) and dilly dallied with first (healthcare as right).

So people expect five star, most advanced service for free or near free.

Doctors keep moving from charity to job to profession to business depending on their personality and privilege.

Most play all roles interchangeably at will.

This creates even more chaos for all other aspects of healthcare like pharma, technology and other professionals.

ANY govt worth its salt should be clearly defining these two parameters and publicly accepting it with a declaration. AND organize entire healthcare around these basics.

Civilised discussion welcome as usual.
#JaiHind

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