Doctor’s Day: There Is Need To Look At Role Of Major Stakeholders
Patient should obviously be at the centre of focus, but has little say in the treatment and services that he gets
On this Doctors Day, it is time to reflect on achievements and shortcomings to re-dedicate to address the shortcomings. As many will speak about achievements, I will focus on how we address shortcomings.
Patient should obviously be at the centre of focus, but has little say in the treatment and services that he gets. There is therefore need to look at the role of major stakeholders, viz. the government, hospitals, doctors, manufacturers and distributors of medicine and devices. The last couple of years have witnessed several confrontations among the stakeholders: government and doctors; manufacturers and distributors; government and manufacturers; distributors and government; and so on. The questions that come to mind are: Is it possible to replace confrontations by collaborations? Would it lead to better outcomes? The confrontations arise mainly from a desire to dictate, to regulate, and to control the other stakeholder. Take for example, the latest controversy over making generic prescriptions mandatory in India. The doctors thought that their right of choice is threatened; the manufacturers thought that their right of mark to distinguish their product from others being taken away; and so on. In this context, it is important to communicate to the concerned stakeholders what is it that the government is trying to achieve by the proposed change? Is it to reduce drug prices and improve access to medicines? Is it to break the nexus between doctors and manufacturers? Is it both these and something more? If only someone in the government had taken a lead and shared its objectives with the stakeholders (in this case, doctors and manufacturers) and sought their inputs to achieve the same objectives, could the government have achieved collaboration, instead of confrontation?
Some do not think so. They have cynical view of doctors and the manufacturers. It is unfortunate. They perceive the entire profession and the industry through the same prism. The domestic manufacturers have a face. One can identify the promoter and enter into a dialogue with him. They spend on schools, colleges, hospitals and such institutions because they care. Likewise, doctors render free services, dispense free medicines and avoid unwarranted investigations because they care. If one were to overcome this cynical view and develop a collaborative approach, the outcomes would be certainly far better.
One more area that needs re-thinking. We have National Health Programmes for Communicable Diseases, Non-Communicable Diseases, Injury & Trauma, Rastriya Varishth Jan Swasthya Yojana (RVJSY), The Pradhan Mantri Swasthya Suraksha Yojana (PMSSY), Rashtriya Swasthya Bima Yojana and Poor Patients-Financial Support, Prime Minister’s Bhartiya Janaushadhi Pariyojna, a campaign to provide quality generic medicines at affordable prices; AMRIT outlets for selling affordable drugs for cancer and heart diseases; State Corporations like TNMSC in Tamil Nadu or PRAYAS in Rajasthan; to name but a few. Each programme or scheme has different focus. However, they all aim at affordable healthcare. Some provide free medicines, some free healthcare, some others provide medicines at “affordable” prices. If only one could bring all these under one umbrella and give freedom to the States to run them as a comprehensive health programme, the potential savings from procurement and in administrative expenditure would go a long way to improve the delivery of healthcare.
Disclaimer: The views expressed in the article above are those of the authors' and do not necessarily represent or reflect the views of this publishing house
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