New Delhi: The prevailing conditions of the government hospitals in Delhi are hideous. Well known hospitals like AIIMS, Safdarjung and RML don’t have sufficient equipment for treatment. One bed is shared by two-three patients. Urine bags are kept in extremely dirty conditions. The ones who suffer the most are the “young doctors”.
A patient of Deen Dayal Upadhyay Hospital told India Medical Times, “Before the OPD gets closed at 2:30 PM, you will only see patients. Sometimes, it gets difficult for the doctors to control the crowd.” The situation here is pretty similar to the situation of other hospitals. As many as 10,000 patients reach the OPD of AIIMS daily. At the end of the day, who are blamed? Doctors.
On July 22, 2016, three resident doctors of Lady Hardinge Medical College were assaulted by the relatives of a three-year-old patient. A senior resident doctor said that the family was informed in the beginning about the meagre chances of the kid’s survival. The doctors were attacked by a mob as soon as the child died and one of them was bitten in his hands. After the assault, 1200 doctors protested against the poor security system of the hospital. They demanded the installation of CCTV cameras in the premises. A similar incident took place at Safdarjung Hospital in November the same year, a junior resident doctor was manhandled by a patient’s family. This led to the strike of many resident doctors of the hospital demanding an increase in the security system.
Young doctors in hospitals like AIIMS, Safdarjung and RML attend 300-400 patients in a day. A junior resident doctor working in the casualty department of Rao Tula Ram Hospital told India Medical Times, “Patients keep on coming. From January 1 to January 10, our department attended 2554 patients.” On being asked about the increasing number of cases of manhandling faced by doctors, he replied, “Such cases do happen; they have happened in other hospitals but I haven’t heard of any such case happening in this hospital. Security is a very important concern. Security should definitely be increased.”
Adding to the agony of young doctors, the government released the 7th Pay Commission with measures deemed unfavourable to them. Commenting on the 7th Pay Commission, a junior resident doctor, on condition of anonymity, told India Medical Times, “In Delhi, there are contractual doctors; many senior resident and junior resident doctors are on contract basis. I don’t know about the contractual employees of other departments but for junior and senior resident doctors, we are not getting the benefit of it.” He further said said that he was individually affected by the Pay Commission.
Long and continuous working hours is one of the biggest difficulties faced by young doctors. Resident doctors of government hospitals work non-stop for 36 to 48 hours. A 32-year-old resident doctor of Ram Manohar Lohia Hospital is used to work continuously for 36 hours. On an average, the 32-year-old has performed 500-600 catheterizations and cannula tweaks, two surgeries and served 50 patients on his desk in 24-hours’ time on his own.
However, the condition is not the same in every hospital. The junior resident doctor of Rao Tula Ram Hospital said, “Actually, our duty is 48-hours a week. It is totally up to us whether we work for 6 hours a day or we may work for 12 hours for four days or even for continuous 24 hours for two days. Most of the junior residents are preparing for their PG entrance. I am also preparing for my PG entrance. Most of us prefer 24 hours a day. Which means two days a week. So, we get to study for five days. But the administration says, work for 12 hours a day so that you can concentrate better on your patients. The working hours system is better here as compared to other hospitals.”
We would never appreciate a taxi driver continuously working for 24 hours, as we believe that risking with the driver’s life is risking our own life. But we don’t apply the same logic for young surgeons who also need a good amount of rest for the proper functioning of their brain. A schedule of 63 hours a week (which is nine hours a day for seven days) is considered a blessing for doctors. Young doctors who join fresh after post-graduation accomplish their duties with a smile on their face. Far away from their families, these young resident doctors of government hospitals work in pathetic conditions with a constant effort of making their patients happy.
In India, there are 0.7 doctors per 1000 patients. The doctor-patient ratio in India, compared with countries like China (1.9), USA (2.5) and UK (2.8), seem horrible. However, the reason behind the long working shifts of young resident doctors is not just due to lack of doctors but also due to senior consultants’ unavailability for emergency hours in government hospitals. As per regulations, the presence of senior consultants for grave emergencies is mandatory, but such regulations are not followed most of the time. Many times, interns handle ICU when junior doctors treat the patients of the emergency ward. The resident doctors are taken for granted in government hospitals.
A study by Harvard Work Hours, Health and Safety Group discovered that 35.9 per cent of resident doctors commit serious errors when working for 24 hours or more. There are strict regulations for the working hours of doctors in western countries.
Young doctors spend their lives in saving the lives of their patients, yet they don’t get the respect they deserve. And the government further added to their problems by introducing the 7th Pay Commission. The NPA (Non-practising allowance) was not just demerged from the basic salary of doctors but also reduced in the 7th Pay Commission.
Doctors work to preserve lives. They put in years of hardship and studies to save the lives of others. A profession considered to be “respectable” is being “disrespected”. Students work for years to crack an entrance test to get admission in an institute like AIIMS. After doing five years of MBBS and two years of specialization, they dream of a successful and respectful life. Once they enter a government hospital, the bustle of the place, the patients and finally the pay depress them. As humans, it’s our duty to be humane to the “ones” saving our lives.
by Megha Acharya