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Interview: Ayurvedic doctors should be deployed for basic disease treatment — Dr Jagdish Prasad

Dr Jagdish Prasad is director general, Directorate General of Health Services (DGHS), Ministry of Health & Family Welfare, Govt of India. He has also served as the founder principal and professor & chief of cardiac surgery at Vardhman Mahavir Medical College and medical superintendent of the associated Safdarjung Hospital in New Delhi.

Dr Jagdish Prasad
Dr Jagdish Prasad

Dr Prasad did his MBBS and MS (General Surgery) from the All India Institute of Medical Sciences (AIIMS), New Delhi in 1977 and 1981 respectively. He did his super specialization (MCh) in cardiothoracic and vascular surgery from KEM Hospital, Mumbai in 1985. He has also done DNB in cardiothoracic surgery in 1986.

In recognition of his contribution to the field of medicine, particularly cardiothoracic and vascular surgery at Safdarjung Hospital and economizing the cost of cardiac surgery, the President of India conferred on him the Padma Shree Award in 1991.

In an exclusive interview with India Medical Times, Dr Jagdish Prasad shares his views on the overall healthcare sector in the country and some of the major issues concerning the medical profession:

Dr Jagdish Prasad
Dr Jagdish Prasad

How do you view the overall healthcare sector in India?

Overall healthcare sector is divided majorly into two — one is rural healthcare and the other is urban healthcare. Technically, we are very advanced as any other country such as in Europe or the US. Be it brain surgery, cardiac surgery or heart transplant, result-wise we are as good as they are. Take medical tourism – it will go up gradually, especially in private hospitals that are providing five star facilities which people want.

On the other hand, doctors are concentrated only in cities, not in villages. The reason behind this is not only doctors but the whole education system. There is no control over the education system in the country. Suppose if you are giving donation for studying in a private medical college, obviously you would like to earn the money. That means you can’t work for small amount, you would look for bigger opportunities. So this donation culture needs to be stopped completely.

Why doctors are protesting against rural posting?

Doctors are protesting against rural posting because they know infrastructures in the villages are very poor. Suppose you are posted at a village or in a block, you don’t get a house, how would you stay? There have to have some infrastructure, some schools. Now suppose a person who passes BA and becomes a deputy collector, and then a block development officer, the moment they become a block development officer, they get a car, a house, servants and, of course, power. Doctors don’t want power, but there has to be basic infrastructure such as house or at least they should have a quality infrastructure to work. A surgeon posted at a district hospital doesn’t have instruments, so how do you expect him to work.

But then it is both ways. Sometimes doctors are also bad — some doctors, who are posted at district hospitals, will go for one day in village and take the whole month’s pay. It will continue to run this way, until a consciousness comes that doctors should be provided basic infrastructure facilities such as house, water, instruments, electric supply, roads etc. Until the government develops these facilities, you can’t expect doctors to go and work in villages.

The time has come now that we must have a community type of basic healthcare centre and government should work on preventive and promotive healthcare structure. Even when you are healthy, you should have a regular health check-up rather than falling ill and then spend lots of money. For example, in the case of breast cancer, if diagnosed at very early stage, it can be 100% cured and one can lead a normal life but a little delay and you would end up spending lots of money. The same is with coronary heart disease, diabetes or hypertension, a regular check-up means prevention of further development of complications and your medical cost will also decrease. This, the government must understand and the people too.

Dr Jagdish Prasad
Dr Jagdish Prasad

There is digital India plan now being thought of, how do you plan to implement it in the Indian healthcare sector?

There is a big project that we have already planned but its implementation will cost a huge amount of money. Putting huge amount of money is not a very tough job but before that you also have to have an infrastructure.

No doubt, digital healthcare will make things very easier. Recently, we have introduced ‘Nischay’ (नि:क्षय) – a project where every tuberculosis patient is enrolled. We are giving palmtops to every 2.5-lakh population and they will keep the records so that we can follow every TB patient. This kind of digitisation we are doing in public healthcare system. In public healthcare system, or telemedicine system, it can play a tremendous role. For example, PGI Chandigarh is doing the treatment of psychiatric patients through telemedicine. They have connected with normal medical officer at district hospitals who collect the history of the patient and then introduce the patient to doctors sitting at PGI, explain the problem and the doctor then gives his advice.

So, digitization of whole system is going to help in big way in every sector — be it public service or education or healthcare treatment or diagnosis or teleradiology or telepathology. PGI Chandigarh has started telepathology. They (doctors at district level) put a slide on the microscope and send the picture to Chandigarh and then get the report. They think digitization requires a lot of money but that’s not true. If you digitalize the things then you can decrease the duplication of investigation to a great extent. Suppose, you have blood test done at one place and get the record, then if you visit to other doctors for consultation for the same disease, you don’t have to redo it and thus can save money. But then there is fault in doctors also, prescribing unnecessary medical test which is not required, and for that we are putting the Clinical Establishments Act which is getting objections from doctors. The Act is not to harass doctors but just to regulate the treatment and avoid the harassment of patients. Consider a chest pain case, which is a muscular pain, it can be cured without requiring angiography or angioplasty or anything but some doctors would prescribe it unnecessarily. This type of malpractice needs to be checked but it’s a difficult task.

To curb the unethical marketing practices of pharma companies, the government has issued a uniform code of conduct. How do you feel about it?

You have to change the basic foundation first.

How it can be changed?

We have to stop selling education in the country. Increase the facility, the infrastructure and don’t treat the doctors like an officer; they are professional people, they should be treated professionally. Doctors put hard labour; to become a surgeon it takes eight years, to become a cardiac surgeon ten years. It requires a constant hard labour and then you are treating them with a person who has just passed BA and becomes a bureaucrat. You need to give doctors some importance but the irony is… importance is realized only when they fall ill. Foundation of the doctors has to be taken care of; infrastructure has to be built up. The standard of education has come down. There is no uniformity in this sector, which is the biggest drawback in medical profession at the moment.

Dr Jagdish Prasad
Dr Jagdish Prasad

Do we need some changes in medical curriculum as well? There was news about NEET and Exit Exam.

It (NEET) was nixed… the Supreme Court judge could not understand that he has done a great harm to the country, to the whole citizens. It should have been implemented.

There was also news that the government has filed an appeal against this judgement?

Yes, it has been filed. Government has to change some policy. They have to check the basic structure, basic foundation, and correct it.

I will share an incident, 10-12 years back when I was on a tourist visit to Hong Kong, I saw there that at that time, one constable was paid (equivalent to approximately) Rs 1 lakh and the Prime Minister’s salary was Rs 5 crore in a year. The government was paying enough. Now compare this, I will give you another example, a CBI SP came to me (I will not take the name) and said, “Dr Prasad, can you refer some job for my wife, she is a senior doctor? As I have been transferred from state to centre and I am not getting that much (pay). It’s very hard to live here.”

So what pay government is giving? The cost of living has gone up. After doing 10 years of IPS service, if you are not able to give good education to your children then what are you forcing and to whom? This has to be changed. Things will change only when you make the facilities available. If you go to Cuba, education is totally free, they will give you books free, hostel is free, and almost everything is free but then they will post you in district hospitals. The doctor also does not hesitate to work in a district because he was trained, educated there only. Here (in India) students suddenly come from a village to Delhi, Mumbai, Allahabad, Lucknow, see the city environment where they get good facilities but when they look back at the village there is no light, no house, no roads. The infrastructure is also lacking, also there is lots of pay disparity, many other problems.

So, does that mean we need to set up more medical colleges, may be at district level?

No. No need to set up more medical colleges, we have enough medical colleges. It’s a wrong way to say that we can improve healthcare, get more doctors, by opening more medical colleges. No. Whatever doctors are available at the moment, if properly distributed, we will have enough. We have nearly 8 lakh doctors available in Ayurvedic system; we have to drag these doctors also for the basic disease treatment. Every single disease doesn’t require surgery.

But many doctors are against equating Ayurvedic doctors with modern doctors, some even call them quacks?

Government should take the policy decision, not protestors. How can they call Ayurvedic practitioners quack, they also study four and half years, they can cure some diseases which we cannot. They can’t call them quacks; they are qualified and registered practitioners. Ayurveda, Yoga, Homeopathy — all these forms are well-recognised systems of medicine which can’t be ignored. It has to be brought up in the mainstream.

There is no need to open more medical colleges. The need is to make the infrastructure good and available. Like in a village the need is to build a nice operation theatre, a blood bank should be available. You are making a district hospital but there is no blood bank. How the surgeon will operate? There is no instrument, there is no light, there is no water supply, there is no toilet… there are so many problems. The doctor has no place to stay, no house, they will ask you to rent a house. If you are making a hospital, make it a residential hospital – for the nurses, for the doctors, for the class-IV employees… why do people want to come to the All India Institute of Medical Sciences? Because every facility is available… they are working for the same amount of pay, even for less amount… nobody wants to leave, because the infrastructure is such. If they want to do research, they will do research; if they want to do good operations, they can do it; if they want good instruments, they will get it. So, if you make the facilities, definitely, they will come.

Antibiotic resistance is a major challenge in front of India and we are one of the largest consumers of antibiotics. How do you think we can cope up with this challenge?

Even though it is a tough task, the government has started surveillance in different places. We have taken the help of Pharmacopoeia Commission and we are taking pharmacovigilance. We have brought some medicines under the ‘Schedule H1’ category, which can only be given on prescription. We have also requested MCI to make it mandatory for every medical college to have a pharmacovigilance committee so that what antibiotics are used, why it is used, can be monitored. So that at the tertiary hospitals at least the use of antibiotics is not indiscriminate. Because the problem mostly occurs in the ICU, where lots of resistance come up. Few countries such as Sweden do not use antibiotics until and unless they do a culture test but in our country it is not possible. Suppose you are in a village and had a throat infection, you will go to a chemist and ask for an antibiotic. Though it may be get cured by a gargle but you will take some antibiotic. And you are not at fault because there is no doctor available to consult. This problem will take long time to resolve but there is definitely requirement to have a comprehensive check on the sale of antibiotics and lots of education is required for doctors as well, patients awareness is required too.

Dr Jagdish Prasad
Dr Jagdish Prasad

Nowadays, many of the doctors are attacked and manhandled at healthcare centres. How to tackle this issue?

In our country, the number of patients is more than the number of doctors, especially at public hospitals. If you go to Safdarjung Hospital’s gynae department, everyday you will see huge number of patients, mainly because all other hospitals close by evening. Imagine 100-110 deliveries in one day and suppose five patients require surgery but at one moment only two surgeries can be done because there are only two operation theatres. Other persons are also waiting, crying in pain. Those people can’t wait; they will ask: ‘operate my patient first’. At this point, both are agitated and annoyed — the doctor is agitated because he has been working since morning and the people are agitated because patient is suffering, the result is a tussle between them. This tussle is because the gap between the supply and demand. There is in no adequate infrastructure — only two operation theatres and 100-110 patients are waiting for delivery.

So, according to you, how to tackle this problem?

All the hospitals in the periphery should start working 24×7. After 4pm, apart from Safdarjung, Lady Harding and Ram Manohar Lohia Hospital, all other hospitals stop working. So, the entire load is on these three hospitals. Government should ensure that other hospitals too should be available for patients. Delhi government should make sure that all patients should go to the nearby hospital for delivery rather than flock into these three hospitals.

What message you would like to share with your fellow doctors?

I would only say: follow the ethics, do the research which is required. Talk to the patients nicely, and think of them as your brother, sister, mother. You must have a feeling of family towards your patients; treat them as your own.

by Vidhi Rathee

14 Comments

  1. akhilesh akhilesh Thursday, August 4, 2016

    Dear Sir,
    I have some pics of the allopathy doctors consultation papers of preclscribing ayurvedic medicine .
    So they are also termed as quacks.

    Waiting for your Answer

    Dr.Akhilesh Soni
    BAMS MBA(HA)

  2. Dr Sunil Kumar Dr Sunil Kumar Friday, November 27, 2015

    Hi I am not in favour or against Ayush or MBBS doctors. But we must remember but after Medical Practice. I felt that. Most of the patients are died because they are not properly educated by Physicians why to take normal BP Sugar Medicines, They went to another doctor they perscribed but again they are not taught proprly. Here role of GP is main atleast the patients should not halt life saving medications. We must know our Limits we must not hesitate to accept that I can’t treat know senior doctor must be consulted. Once the patient is treated It must be again refered to GP so that patient must not halt unnecessarily drug. Currently the public is having more faith on TV Channel companies advertisements & Baba’s which may be right or wrong But if patient is in right hands Both MBBS and AYUSH doctors are face death of their patient in their practices. Atleast they can guide patient properly. Govt also wants to reduce IMR MMR death rates Accident. If we have any idea or program then we must go to nearest CMO or DC and gave them purposal. they can help via means like NGO’s Govt schemes.
    1. Educating patient has key role This will also increase our practice.
    2. More patients will be maintained in practice.
    3. Atleast patients will be referred to higher fascilities in time

  3. Jugal Kishore Jugal Kishore Sunday, October 4, 2015

    Interview of Dr. Jagdish Prasad, DGHS of India has brought many issues to light boldly. He has shown his concern to health system of India and where we are lacking. His vision is clear and concerns are genuine. His focus on infrastructure and basic facilities development in rural areas, involvement of AYUSH, rational use of drugs, admission of MBBS through donation and its ill effect was relevant. Out bureaucracy and politics should give their attention towards the issues raised by DGHS if they really want India to have better health system. After all he is a surgeon, having long experience of administration, himself a reputed professional and Director General of Health Services, Ministry of Health & Family Welfare, Govt of India should received positively rather than picking few lines and words to criticize his views. As a public health specialist I personally feel that he has thorough understanding of public health issues of India which is for masses, poor, and most deserving citizen of India. I personally salute for his wonderful interview.

  4. Dr Bashar Dr Bashar Friday, September 25, 2015

    It is nice to read the interview of our DHS, Dr Jagdish Prashad.However, there are quite few points which I would like to mention.
    1. The doctor’s rural posting by compulsion is not a just decision because there is very little incentive given to them given the difficult situations in which they are required to worK. You cann’t expect a doctor to work in a remote area with no lodging and security. They are constant threat from local leaders and politicians as they have to deal with medicolegal cases. Some states give a meagre salary of 20,000 to a freshly joined medical officer.
    2. The current state AYUSH education system is pathetic.most of the colleges don’t have a proper hospital of their own. The students taught there have hardly any knowledge of their own system of medicine, they hardly have seen any cases or patients in their training. How can they treat the patients with allopathic medicines when they are not competent enough to treat the patient with their own system of medicine. So, govt.should first reform the AYUSH education system to make them competent enough rather than allowing them to practice allopathic system of which they are just as any lay man.
    3. They level of MBBS education in our country is maintaining quite high standards and is comparable to those being taught in developed countries, barring a few private colleges. So, it’s very easy for them to clear various foreign residency exams like USMLE . Unless and until, they would not be provided with good working conditions and good incentives, a large chunk of them would continue migrating to other countries and the loss would be of countrymen

  5. Chakravarti Chakravarti Wednesday, May 6, 2015

    The only voice of AYUSH doctor`s in this discussion thread cannot even type a grammatically correct English sentence. If this is the quality of English, I could gauge his/her scientific knowledge.
    I acknowledge with pride our glorious PAST, & take pride in being from the country that produced Charaka, Susruta & others.
    But then, can our distinguished friends with professional AYUSH degrees produce the kind of evidence which is acknowledged by scientific communities worldwide, like Randomized control trials backing their claims of superiority / equivalence to existing allopathic treatments? If NO, then till they do it, our friends should stop living in PAST & giving themselves ego massages by taking the names of our greatest grandfathers.
    I are not against AYUSH it has its place & should be offered to consenting people who wish to undergo such procedures, but asking an AYUSH doctor to prescribe allopathic medicines, asking him to perform MTP using allopathic medicines whose knowledge he/she does not understand (because he is trained in ayurveda and not allopathy) would be going against the very principle of “DO NO HARM” of the Art of scientific or rational or modern medicine.
    What is disheartening is that our young nation(68 years post-independence) fails to understand that such a regressive attitude(taking pride in past & looking for shortcuts everywhere including in the health sector like posting AYUSH doctors to perform MTP using allopathic medicines/prescribing allopathic drugs) is going to harm us in long term rather than reduce the burden. Such short sightedness is going to make our already moribund health services ineffective.
    By the way, I do agree with my learned AYUSH friend that those allopaths who are prescribing Ayurvedic medicines are also indulging in quakery. That said, I propose that such people (allopaths/ayush indulging in quakery) should be dealt by criminal courts because they are endangering the very lives of people they are dutifully bound to protect.
    Also, if any smart politician or health minister is going through this discussion, I urge him to post senior consultants (in the last five years of their service) at rural places with a task of making the area of posting a model health centre, rather than posting the amateur junior doctors(who hardly have any connections), as these senior people know the system and will definitely make a change when compared to youngsters.

  6. Dr.Sampath Dr.Sampath Wednesday, April 22, 2015

    AYUSH is being given importance by the Government, because all of these are indigenous systems of medicine.However the AYUSH graduates are not being encouraged to practise these systems

    It is difficult to get a seat in MBBS in the government sector.Private medical colleges are offering seats at a price which can be afforded by rich persons only.

    Public are inclined to take medicines of allopathic system.
    Keeping in view the craze among the public towards taking treatment through the allopathic system,many AYUSH doctors are interested in prescribing allopathic medicines.For quite a few people, getting a seat in the graduate course of AYUSH is like getting a passport to become a doctor and make money. Moreover the latest trend is to do an MD course in the AYUSH discipline and practice as a specialist in allopathy.

    The entire system needs to be overhauled.Service to the patients should be encouraged and making money should be secondary.
    Giving postings in government allopathic hospitals to students of AYUSH discipline should be discouraged and they should be trained to give treatment in the respective medical fields.Basics of public health should be taught to them in their own colleges

  7. Anand Anand Thursday, April 9, 2015

    alopaths r doing more harm 2 mankind by advising unnecessary lab tests n prescribing 2 or more antibiotics 4 simple or common ailments . Even specialists r indulged in this inhuman practice for d sake of ” extra” money .This is and must b termed as a quackery .

  8. agrwl agrwl Monday, March 23, 2015

    he confirms our concern that biggest draw back is lack of uniformity in medical profession. he says the supreme court judge has done great harm to country & it’s citizens. who than is sitting on proposal of national exit exam for mbbs graduates india to bring uniformity in medical education & thus doing greater harm to the country & citizens. j.p.nadda must come clear as who is sitting on this proposal. is it is health ministry or medical council of india or both?? enjoying fruits of corruption???
    sign the petition for better medical care tomorrow.
    https://www.change.org/p/2009230?just_created=true
    kindly visit national exit exam for mbbs graduates india. not to block any one in life is it’s stated official policy.

  9. agrwl agrwl Monday, March 23, 2015

    he confirms our concern that medical mafia produced money hungry doctors r responsible for poor service to rural population as they prefer urban postings to recover their investment in medical education. & poor facilities in rural areas is just an excuse. facilities for o.p.d. r almost available or can b created easily. that is what rural people need rightly pointed out by dghs at end of interview while talking about how to control misuse of antibiotics. the o.t. facilities he is talking about can wait. & what shall rural people do till so called facilities suitable for mbbs graduate is created. he can’t b left to die? let their b rural doctor scheme. let their b uniform exit exam so that standard of mafia produced graduates has some scrutiny. it will also increase no of doctors as people will b free to study anywhere in world without any fear of discrimination. but if every body is subjected to uniform test who will give crores to medical mafia? so they oppose uniform exit exam, so they oppose rural doctors scheme. to create monopoly of short supplied mafia produced dubious doctors. their cronies in mci & ima dance to their tune. j.p.nadda seems joining.
    sign the petition for better medical care tomorrow.
    https://www.change.org/p/2009230?just_created=true
    kindly visit national exit exam for mbbs graduates india. not to block any one in life is it’s stated official policy.

  10. agrwl agrwl Monday, March 23, 2015

    Dear Narendra ModiThere is dire need for allopathy trained doctors in rural areas. But it seems govt plans to do with ayush doctors. Most of them practice alopathy in rural areas. That is QUACKERY. Dangerous to patients. We need large no. of allopathic doctors in rural areas & can’t leave them to quackery. But medical mafia lord KETAN is sitting on supply taking crores to produce money hungry doctors preferring urban postings to recover the investment made in medical education, putting forward excuses for rural postings. In the same breath they oppose rural doctor scheme. They also don’t allow foreign graduates to pass out & serve in rural areas.What shall than rural people do till india can afford the so called facilities suitable to mbbs doctors? Reason invariably given is that rural people also need good care. But since, u r not coming to give good care citing facility issues, why not let them have rural doctors or foriegn doctors for primary allopathic treatment. They will b better than quacks. Further, when it comes to checking quality of medical mafia produced allopathic doctors every one sings medical mafia lord KETAN tune that they r of unquestionable quality. Let their b a uniform exam & know who is better. This will increase no. of doctors as people will b free to study anywhere in world without fear of discrimination. Every one knows how these colleges r recognised or derecognised by KETAN, Having placed his cronies in MCI & IMA, they too sing his tune. Dedicated souls coming in this profession thus reducing day by day. What people get is dubious money hungry doctors out to recover their investment in medical education. And our beloved Health minister J.P.Nadda happy sitting next to medical mafia lord ketan.
    SIGN THE PETITION FOR BETTER MEDICAL CARE TOMORROW.
    https://www.change.org/p/2009230?just_created=true
    Kindly visit NATIONAL EXIT EXAM FOR MBBS GRADUATES INDIA. Not to block any one in life is it’s stated official policy.

  11. Dr Chandan Kalita, BAMS(Gauhati University) Dr Chandan Kalita, BAMS(Gauhati University) Thursday, March 19, 2015

    M not only saying about some alopethic Dr but also some other non medical professionals. …..which of them has no knowledge about anything ayurveda…thinking by them. ..ayurveda means only herbal medicine. ..in ayurvedic system mineral medicine (rasa shastra) also known as hindu chemistry have equal contribution. ….but u people don’t know anything. ….before saying something about other first read them clearly and after that if u have found anything wrong than plz comment……

  12. Dr Chandan Kalita, BAMS(Gauhati University) Dr Chandan Kalita, BAMS(Gauhati University) Thursday, March 19, 2015

    If one BAMS Dr prescribed alopethic medicine than this is called quackery system. ..If he is doing mtp under mtp act this is called wrong amendment decision that what will given by supreme court. ..but some of alopethic Dr prescribed ayurvedic medicines that even they don’t know what is the composition of that medicine and it’s effect. .In ayurveda surgery gynaecology obstetrics and even plastic surgery also mentioned. ..khara sutra is also mentioned by international books. .n internationally recognised. ..but u indian some alopethic Dr don’t want to know anything about ayurvedic system n always criticise … u have no major contribution in modern medicine n surgery as like other country n they have. ..scientists invent modern instruments n modern drugs but u alopethic Dr called that alopethic instruments. .etc. ..We means ayurvedic Dr also read modern pharmacology according to the syllabus of CCIM. …but u people don’t hesitate to criticise us. …we r fully prescribe ayurvedic drug ..n also prescribe alopethic. .in rural area ..because they have no money to bear ur fee’s….we r doing delivery because no proper facility for communication to the city hospital ….even govt given us lowest salary than u ….u will not change. …first be indian ..than western. ..Otherwise one thay all topics of ayurvedic system will stolen by other country’s. …first read sushruta samhita ( greatest book of ayurvedic surgery) …after that u will coment. ….if there will u have found any wrong methods of surgery. .n otherelse. …

  13. Dr. M C Gupta, Advocate Dr. M C Gupta, Advocate Thursday, March 19, 2015

    It is a pleasure to read the interview by Dr. Jagdish Prasad, DGHS, who graduated from the same place (AIIMS) as myself. His views are forthright. I have only one comment to make.

    Dr. Prasad said—“How can they call Ayurvedic practitioners quack?”

    >>> They are called quacks only in terms of Supreme Court judgments like

    i)– Poonam Verma Vs. Ashwin Patel and Others, decided by the Supreme Court on
    10.05.1996, reported as 4 SCC 332,

    ii)– Dr. Mukhtiar Chand & Ors. Vs. State Of Punjab & Ors., decided by the Supreme Court on 08/10/1998, reported as AIR 1999, SC 468, (1998 (7) SCC 579).

    As per these judgments, hakims and vaids and homeopaths commit quackery if they practice allopathy.

    As DGHS, he certainly knows the above and also knows that the government is promoting the above mentioned AYUSH quackery and is planning to amend the MTP Act to permit AYUSH to perform MTP. He should have spoken against the above.

    –Ex-Prof. M C Gupta, MD (Medicine), LL.M., Advocate

  14. Dr Bina R Sawhney Dr Bina R Sawhney Monday, March 16, 2015

    Excellent, commendable
    First time some body has spoken in favour of medical fraternity
    Mostly people are only criticizing the doctors
    Nobody feels for the doctors
    Hats off to our DGHS!

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