Anyone who has had to deal with doctors and hospitals has uplifting and depressing stories to narrate. Unfortunately, in recent times tales of horror and corruption are outpacing the feel-good narrative. It’s almost as if doctors who follow ethical practices are not only difficult to find but may even be rendered an endangered species.

Is this depressing prognosis true? Rarely do doctors look inward at what ails their profession. Dissenting Diagnosis , published by Vintage Books (an arm of Random House India) does exactly that and is a must read for all involved with healthcare in the country. Written by Arun Gadre and Abhay Shukla — both practising doctors and public health advocates — the book interviewed 78 doctors across the country. It presents some shocking revelations, besides providing insights worth considering.

Dissenting Diagnosis is not an evocatively or forcefully written book. That task is fulfilled through the personal experiences of a large cross section of doctors cutting across specialities. The book is based on a study by Pune-based NGO Support for Advocacy and Training to Health Initiatives.

Some key observations in the book may seem like generalisations, but are backed by examples and testimonies of doctors. That is why Dissenting Diagnosis is an important document. So here goes:

The health profession faces a crisis because of the crass commercialisation that has taken over. From the moment a patient approaches a private doctor/hospital, he/she is milked dry by the system.

At the diagnosis stage, labs work in tandem with corrupt doctors to provide exaggerated or twisted results to justify intensive treatment. Even newborns are not spared. One doctor recounts how bilirubin levels of babies are printed out on result sheets meant for adults to show infants have jaundice. While for adults, 1mg of bilirubin indicates danger, in newborns mild jaundice is common and bilirubin levels of 14-16 mg are not considered dangerous. But most parents are ill-informed and are gypped by unscrupulous doctors and hospitals.

Unnecessary and expensive tests are repeatedly advised by doctors, who get commissions from pathology centres. In several private hospitals with attached labs, such tests are part of the income generation process.

Unjustified hospitalisation and admission into ICUs (intensive care units) are standard practice followed in private hospitals and nursing homes. Doctors who are reluctant to cooperate with this money-making effort are quietly eased out.

Surgery and related procedures are other money-making avenues. Corrupt, scalpel happy surgeons are favoured in hospitals since they keep the operation theatres as well as post-operative care units busy.

Obstetricians who advise normal deliveries are unpopular and considered ‘unviable’.

Pharma companies wield unhealthy influence over doctors and lure them with gifts, sops and money to prescribe expensive medicines when cheaper alternatives are available.

So, is there any hope? The authors believe so, provided doctors are made more accountable, the public health system is strengthened, pharma companies better regulated and private hospitals subjected to a medical audit.

A dissenting diagnosis has been made and a prescription written out, too. But will the treatment ever begin?

(The writer, a senior Delhi-based journalist, is author of Off the Record: Untold Stories from a Reporter's Diary)

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