Tuesday, August 26, 2008

The monsoon surge in professional work

One of the things that is unique about medical practice in India and similar tropical countries is the surge in illnesses that occurs around the time of the monsoon. This season is marked by floods, a general decline in the hygiene status of cities and metropolitan agglomerates, slush, a multiplication of the population of house-flies and mosquitoes, the ubiquitous vectors of deadly diseases such as malaria, typhoid, gastroenteritis, etc, a rise in humidity that brings in illnesses like acute attacks of asthma and croup, crowding and gathering of masses (e.g. under awnings and rain-shelters during an unexpected bout of rain), and several other factors that cause a rise in illnesses, hospitalisations, and the like.

The indirect spin-off of this is that our professional work rises too: there is a spurt in the numbers of patients visiting the clinic, a rise in patients who get hospitalised, a rise in home-visits and a sudden increase in the number of patients who call on our mobile phones for advice that is, seemingly, for problems that are so small that they do not merit a visit to the doctor - e.g. ear pain, a rash on the skin, a slight runny nose, a stickiness of the eyes, a mild cough and so on.

While advanced economies like the U.S., Europe and so on have doctors who will almost never directly take patient calls, and chemists who will never bypass doctors and never give medicines unless the patient hands them a valid prescription or the doctor faxes him one), in countries like India, this is generally not the case! This means that doctors never get paid and cannot raise bills for a telephonic consultation, patients can buy medicines from the chemist on a friend's recommendation or by showing a past prescription of a doctor, or by simply asking the chemist for, say, "Amoxil" or "Tavegyl". This skews the advantage towards the patients, and as chemists still get their pound of flesh, and the manufacturer is also not hurt financially, it is the doctor alone who gets cheated out of his rightful income.

This, dear reader, is the sad but true account of medical practice in India.

Now then, having said that, as India is home to more than a billion souls, I am certainly not cribbing that doctors do not earn well; it's just that a lot of practice gets siphoned off in the above manner.

Okay, last para: now that the monsoon has all but receded, the inflow of patients has reduced. This has enabled me to do other things, like, for example, writing this loooooong entry in my blog!

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