“There is only one wealth and that is health”, is an old saying.  However, the successive governments at the centre never recognized health as a means to achieve human development or improve the well being of society, but treated it as a minor government department that needed some allocation simply because it was there. Besides challenges of health sector neglect, Indian society is deeply politicalized and divided on lines of political affiliation, religion, caste, region etc, which is affecting trust in health providers and healthcare delivery. Will a patient having faith in BJP ideology get equal and fair attention of a doctor having allegiance to Laloo’s RJD? Will a doctor believing in Akali ideology inspire confidence in a patient coming from congress family?  Will Maya and Paswan prefer to go to doctors of their own genre? As per Hippocratic Oath doctor should treat all equally well, irrespective of their political or caste views, but in practice the mutual trust stands eroded!

As per a report published in Oct 2016 in Proceedings of the National Academy of Sciences US, they concluded that political views of physicians can affect medical care to the patients. Among the findings were that Republicans were more likely than Democrats to discuss the health implications and legal risks of marijuana and to urge patients to reduce marijuana use. Republicans are also more likely to discuss the mental health aspects of abortion and to encourage the patient not to have more abortions. Democrats were more likely than Republicans to urge patients not to keep guns at home, whereas Republicans were more likely to ask patients whether they were storing them safely. Physicians of both parties rated importance similarly for issues such as wearing a helmet, treating a patient with high body mass index, or counseling a patient who admits to social smoking. The study has implications for patients and physicians. For patients, the study suggests they may need to be aware of their physician’s political views. Just as a patient may seek out a physician of a certain gender to feel more comfortable, the evidence suggests that a patient may need to make the same calculation regarding political ideology. For physicians, the evidence calls for heightened soul-searching, they say: “It is imperative that physicians consider how their own political views may impact their professional judgments.”

In India the politics has become criminalized as well and one hue of politicians try to brow beat the others or even gets them eliminated. Politicians like Pravin Togadia, a known fiery VHP leader, though a qualified cancer surgeon would not inspire confidence of non-Hindu citizens. He is currently engaged in improving the lot of nearly 40 crore people through ‘my India Healthline Mission’, who suffer from lifestyle-related diseases like hypertension, diabetes, heart ailment and they spend a whopping Rs 14 lakh crore on medical treatment.

Political violence is in the air for doctors and hospitals

On August 25, Shiv Sena leader Anand Dighe was admitted to Thane’s Singhania Hospital . Singhania is the biggest private sector hospital in this Mumbai suburb. Mr Dighe suffered cardio-respiratory arrest – believed to be a sudden cardiac event or a pulmonary embolus – and died. Following news of his death a mob of Sena followers went on a rampage. The damage to the hospital was estimated to be around Rs 10 crore. The hospital is closed down. The mob may have been incited by a section of the leadership to settle scores with the hospital’s management, and also to assert the party’s political authority. Many medical organizations declared that medicine had become a ‘dangerous’ profession, and doctors should be provided ‘security’. Some stated that ‘doctors should stop treating politicians altogether’. Interestingly, the event registered as an attack on doctors as much as it was on Singhania hospital, a corporate body. Politicians regularly take to violence to demonstrate their clout or settle political score with opponents, a trend which has reached grotesque forms with the increasing criminalization of politics. The scale of violence also shows pent up anger among the masses against unethical and corrupt practices indulged in by some doctors.

The doctor-politician nexus

Many of doctors bend over backwards to please political bigwigs to maintain their positions, or for personal gain. Getting ICU admission for a cardiac problem has become such a standard ploy of politicians avoiding the law. Surely this is done with doctors’ collusion. Some time ago, several doctors from the JJ Group of Hospitals in Mumbai were indicted for helping criminals escape the law. One can also see the broader doctor-politician nexus in the running of private medical colleges. Such complicity can of course be dismissed as a part of a larger indifference by civil society towards the criminalization of politics. Doctors’ ethical responsibilities extend beyond the doctor-patient relationship. However, any meaningful change in the health care system can only come from political changes. The medical profession in many parts of the world has a glorious record of active resistance to corruption and oppression. It can serve as an example to the Indian society as well.

It may be asking too much from doctors to be so active, given the present state of timid and regressive mind of medical community. Doctors can begin by promoting ethical and honest voices from their profession. They can also increase their credibility by condemning colleagues who collude with criminal politicians. A violent society is detrimental to the practice of humane medicine; it negates all the ‘achievements’ of modern medicine. It also means practicing an active social ethics, being at the forefront of preventing violence and caring for all victims of violence, irrespective of their crimes and political/ideological affiliations.

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