good doctors for indian villages

COMMENTARY good doctors for indian villages "Knowledge advances NOT by repeating known facts; but by REFUTING false dogmas " Karl Popper The usual complaints from politicians are that doctors do not go to villages. They try and devise quick-fix measures; some of them might even look draconian. Nothing seems to work in the long run. I have been hearing this for decades. In the year 1982 I had written an article in the Indian Journal of Medical Education on the need based medical education for India out with the 1857 London University Syllabus. Late Dr. Udupa, the then Chair of Medical Education Reforms Committee, had invited me to join them but I declined saying that if the ideas are good they could implement them. He agreed and took 100 copies of my article to be given to all from the PM down! The then PM who was keen on it was shot at and later Udupa also died and the whole process ended there. The present MBBS course does not train a doctor in good bedside medicine to be able to practise in the villages conscientiously. Their training is technology based and as such cannot be extrapolated to a village setting. They feel like fish out of water and try and run away using all kinds of dubious methods. I do not blame them. Scientific studies did show that 80% of the accurate final diagnosis could be arrived at, at the end of carefully listening to the patient and physically examining him/her. This message does not get through in the cacophony of the technological claptrap. Today's doctors cannot diagnose a brain attack without MRI, CAT scan, a heart attack without an-giogram, and even a simple tension headache needs a CAT scan to rule out early cancer! Healing outcomes were much better long before any of these were invented even. Who bothers about auditing healing outcomes? Infact, the system of treatment audit, if implemented, can not only transform the entire healthcare in the country but also check regulate the industry induced prescriptions. We are happy with surrogate reports improving in the Euboxic medicine where all reports must be normal, even if the patient dies! This is more to save the doctor's skin in the consumer rights awareness era. The present MBBS course is top heavy with theoretical information cramming with very little hands on bedside experience. This has shrunk further with …