Warrier's Collage on Sunday March 9, 2025

Welcome To Warrier's COLLAGE On Sunday, March 9, 2025 Friends Happy Birthday to all readers having Birthday this week. M G Warrier A Cover Story Are doctors entirely to blame?* Many of my readers complain that I do not point out the deficiencies and faults of doctors that they feel is behind the mess. I do not agree to the extent of the popular perception because I envisage the role of the system in shaping them. The doctor traditionally became a part of modern medicine because she or he wanted to genuinely help people. Disease had become a part and parcel of society (thanks to the extensive more than a century old small pox vaccine campaign that has a list of 62 adverse effects associated with it), and people were moved enough to study medicine and do their bit to alleviate pain and suffering. Modern medicine appealed to the heart because it offered an easy way out. Just diagnose a disease based upon a classification of symptoms and prescribe medicines to cure it. It was a short cut compared to the labyrinth of theories offered by traditional methods that required understanding and intuition to understand why the body was expressing such symptoms, and the responsibility of the person to rectify what was wrong in order to recover. The results were instantaneous at first. The symptoms just disappeared upon medication. The cold vanished, the cough cured, the diarrhoea stopped and pains subsided. What more did one need? However the first doctors soon found out that the drugs had adverse effects too and they became wary of prescribing. They also studied the alternative views and realized that disease had a cause other than germs and viruses. They mostly waited out the disease rather than stop the process and harm the patient. They spent at least an hour with every patient trying to understand the cause of disease and if at all they prescribed something it was about bringing a little comfort. Thus their fees were higher than the cost of medications they prescribed. They often fell back on home remedies and prescribed ayurvedic formulations that they observed were very effective. But then things changed. The pharmaceutical industry had developed medicine as a business model and they were wary of doctors that cared for their patients and wanted cures. Cures are bad for business. So certain steps were taken. The State run medical colleges were the culprit. Therefore private medical colleges entered the picture in large numbers. State run clinics and hospitals faced competition as private players opened hospitals with all facilities offered for handsome payments. Medical representatives were hired to entice the doctors with handsome commissions against fulfilment of targets. This was not all. The doctors were reminded that they are but practitioners. They are to obey rules. The rules encouraged long prescriptions and an array of expensive tests that too had handsome referral payments. They were forbidden from prescribing anything other than what pharma came out with. They were well and truly caged. Still many stayed out of the trap. However with diseases spreading the canard was spread that it required an MD to manage the complications. MBBS doctors became second grade and were shunned by people who wanted to purchase health. Obtaining an MD degree was easy in private medical colleges. You had to pay through your teeth but you got a degree. Soon there were only MDs and the MBBS disappeared. The intent to join medicine changed. The increased income made it a good career option. Now people became doctors because their well off parents invested in their children's career hoping for good returns. The rest took hefty student loans hoping to clear them once they started earning. A good MD degree costs a fortune. Currently you invest over Rs 2 crores. The doctors join swanky private hospitals that pay well. The clinic is now a side business. The doctors depending on their own clinics face a grim future because the general population is attracted by the 5 star hospitals and setting up a clinic is pretty expensive too. The doctor's position changed too. From practitioner the job profile now was target achievers. MBA graduates rule these hospitals and the doctor receives a long list of targets to achieve to earn that fat salary. The doctors sweat it out as they have loans to repay. Many of them continue because they have adopted high society lifestyles and have high monthly EMIs to meet. Medicine today is about sales, profits, targets, commissions, incentives, gifts, perks, and promotions. The patient is an opportunity to achieve all of that. Tests are prescribed needed or not, medicines are prescribed needed or not, surgeries are performed needed or not, patients are shifted to ICUs needed or not, hospital bills are high as they contain products and services that are never delivered. Many patients bear with it because the insurance company pays. The premiums are high but less than the hospital bills. It is another thing that what is purchased, most being not needed, destroys health and also takes life. Those without insurance exhaust their savings, sell their property and go bankrupt. The system has both the doctor and the patient in their pocket. The governments gain from revenue and look the other way as the economy is important. If the $ 13 trillion pharma empire collapses the economy would collapse and unemployment would reach a peak. Therefore 74% of deaths in society happen to be from chronic disease, 50% of people go bankrupt, and 66.5% lose jobs and go bankrupt because of disease (the last two are US figures; land of the best 'healthcare'). What the doctors are guilty of is not organizing themselves to oppose the obvious harm. But then powerful medical associations exist to punish them and cancel their licence if they do. Privately the doctors dread the mafia and submit. or not, hospital bills are high as they contain products and services that are never delivered. Many patients bear with it because the insurance company pays. The premiums are high but less than the hospital bills. It is another thing that what is purchased, most being not needed, destroys health and also takes life. Those without insurance exhaust their savings, sell their property and go bankrupt. The system has both the doctor and the patient in their pocket. The governments gain from revenue and look the other way as the economy is important. If the $ 13 trillion pharma empire collapses the economy would collapse and unemployment would reach a peak. Therefore 74% of deaths in society happen to be from chronic disease, 50% of people go bankrupt, and 66.5% lose jobs and go bankrupt because of disease (the last two are US figures; land of the best 'healthcare'). What the doctors are guilty of is not organizing themselves to oppose the obvious harm. But then powerful medical associations exist to punish them and cancel their licence if they do. Privately the doctors dread the mafia and submit. Doctors wallow in misery because there is no job satisfaction that comes from curing people. Disease management is a cobbler's job. It is stressful and the knowledge that you are not doing any good eats one from within whether one admits it or not. Faced with this situation the doctors suffer from what has been termed *cognitive dissonance.* They believe in the lies of pharma and pretend that all is well. There is no other way. They cannot live a lie. Therefore they pretend that the lie is the absolute scientific truth. Pharma provides them all the forged studies and outcomes they need to convince themselves. Currently it appears there is no hope. The doctors are incapable of rectifying themselves. The honest ones know it is impossible to check the dishonest. Many have responded to the adage; if you can't beat them join them. They carry on waiting for the day the entire thing would collapse. That collapse is inevitable and probably very close. End Note By M G Warrier Long ago the joke was "Cold will be cured in seven days, if treated." and "Cold will take a week to go, left untreated " There's no escape from modern medicine for us, wherever we live. There are multiple views about the efficacy of medicines and the professional competence of healthcare personnel. The UK system of Family Doctor helps to a great extent. Having a familiar doctor in the contact list or having a doctor in the family, reduce suspicion and distrust to a great extent. B Media Response The Editor Business Manager Response March 6, 2025 Employee Relations The debate on Employee Relations (Business Manager, March 2025) is timely and very relevant in the context of present uncertainties about future of employment security. A trustworthy employer in terms of job security is becoming a rarity. When Raghuram Rajan talked about 10 year horizon for jobs during early 1990's, job market in India didn't take him seriously. Now, it has become a reality. HR managers are having a tough time handling job migrations. The job security concern has started affecting employee efficiency. Getting replacements in key positions is not easy now. The issue should get boardroom attention now and here. M G Warrier C Women's Day Women's Day is being observed on March 8, 2025. https://www.brahmakumaris.com/blog/specialdays/from-shadows-to-light-womens-journey-in-brahma-kumaris/ D Collage in Classroom Recently I overheard a conversation between book-lovers : A : What inspires a writer to write? B : I think most of them get inspired by the urge to become famous. But I know individuals who write without any motives, so to say. A : True. But that is a generalized thought. If we go little bit into the details...Say taking examples of a couple of famous writers, say Tagore and HG Wells... B : I think Tagore was inspired by his own life's experiences...But words danced to his tune with ease. Wells, I think had an imagination beyond human comprehension. Whether science or fiction...Wells could handle with the ease a potter handled clay... A : I agree. I would classify writers into several categories. Like : 1) Those who tell stories based on their own experiences. 2) Those who observe life and happenings around and use them as major ingredient in their writings. 3) Those who do a lot of research deep into the past and then trying to relate them with future possibilities.