Dr. Jaison Philip Sheds Light on Challenges in the Medical Sector (Part 2)

Dr. Jaison Philip: See in every magazine, every film, every report portrays doctors in a negative light. You're going to increase the environment of assault on doctors. That's a wrong thing and they should increase the salary of government doctors. See after completing 25 years of going through government exams and having MBBS, MS, MH surgery, MCH in Urology; I think it is 1000 times more difficult than IAS. Also getting into MCH in urology in Tamil Nadu was hard. There were seven seats in Tamil Nadu. I got the third rank and I entered MCH. Let an IAS officer try to go through the grind of MS surgery once or MCH urology or DM Cardiology this medical field is the toughest and these are the toughest exams in India. I have no doubt about it. The UPSC is not the toughest, JEE is not the toughest exam. Medical exams especially the post-graduate and Super Specialist exams are the toughest in India. I have cracked MBBS, I have cracked MS, I have cracked MCH and then you give me 1 Lakh per month salary. I mean what a ridicule. My cousin earns 6-7 Lakhs after finishing basic computer courses in Information Technology from 3rd tire Engineering Colleges of India.

Dr. Jaison Philip: Of course, that's what after 25 years of serving the Tamil Nadu government.

Dr. Jaison Philip: The salary would be higher, but they would hire and fire you. You see surgery is a dangerous thing you see. Not even the Lord Jesus Christ can come down and perform these surgeries perfectly, correctly, without complications or without a death. So, you have a few deaths or a few complications. They kick you out. See, my friend was an HOD of Urology for 17 years in a private, corporate hospital one of the top most hospitals corporate hospitals in Chennai. One fine day the owner of the hospital calls him and says "You're dismissed here are your emoluments. You can go away." But that kind of cannot be done in a government medical college hospital, or in a government hospital because we have our unions. We can file great petitions in the high court, so government doctors are unsackable. We have job security here while private hospitals don't have it. The private hospitals do offer 3 or 3.5 lakhs in Kerala. A urologist salary starts at 3.5 lacs. It may go up to 20 lacs for some people per month. I know of urologists who earn 20 lacs per month. A lot of people and I don't grow for those who have. I mean one of my friends is a Psychiatrist in Kerala who owns seven fancy cars. You can earn money in the private sector, but their job security is not that I told you of a classmate. Who had been a urologist for 17 years in the particular top end hospital corporate hospital in Chennai and one fine day they just sacked him and he was on the road with his wife and children. He's on the road not he's not there in 17 years. He has made a lot of money that not that he's begging, but he is jobless. I mean he's trying for a next job. I hope he gets it so job security is not there in private hospitals you do get a lot of a lot more salary. Not just MCH in Urology even MD. General medicine can get two lacs or two and a half lakhs in almost all the states in India. But the thing is you can be sacked at any time. South India is brimming with doctors. I believe Tamil Nadu which has a population of some 7.6 crores must have some 0.6 crore doctors. There are so many doctors so if you are ready to dismiss one, there is another urologist waiting to fill your place the very next day. Chennai has thousand of urologists in Madras Urological Club. There is a club called Madras Urological Club where Chennai urologists enroll themselves and there are 1000 members. Those who are not enrolled we don't know. So, with so many with plenty of supply, supply supply-demand market is more in favor of supplies. In private hospital, there is no job security though, even though salaries are much higher and commensurate with the work that you do and with the qualifications that you have.

Dr. Jaison Philip: See most Tamilians cannot speak Hindi so when you talk to a patient, the patient expects the conversation in their mother tongue so that he or she can explain the symptoms exactly and that is also expected by the management and to an extent by the doctor because we want an exact accurate summary of what the patient wants to convey so most Tamilians (I don't want to get into politics) will not speak Hindi. So, we are completely ineligible to work in North India. I mean I've been approached by brokers from Uttar Pradesh and some other Bihar and Jharkhand and all also that those states they expect you to speak very fluent Hindi. I speak Hindi but with a very high South Indian accent and that is not acceptable to them. So, the problem is Tamil Nadu has been following a two-language policy for a very long meaning in Tamil Nadu only Tamil and English are allowed. So, we can't migrate to these states where there's a deficit. Suppose the deficit of doctors and take up jobs there and also. I mean even in Kerala, Malayalam and Tamil have basic roots as I speak both languages. The thing is the job insecurity. See, I said that in a recent interview, my classmate who has done only MBBS, is serving in ESA, KK Nagar gets 2.5 Laks per month. I mean this is a take home salary. He has done only MBBS and his capabilities are likewise limited. I have an MBBS, MS General Surgery, MCH in Urology. I am a senior transplant surgeon and I am given 1 lakh by the Tamil Nadu Government. So why is there a disparity? We both are working in Chennai. He works a few kilometers from my place. But he gets a Central Government salary of 2.5 Lakhs and I get a state government salary of 1 Lakh. Both of us have 25 years of government service. So, is this justice? Is this justified? We've carried out so many agitations for a pay rise, but the Tamil Nadu government simply win. They say "See if you go, another doctor will come. So why should we give you money? That money can be spent on tablets, new instruments, or new hospitals. Why should we increase Government doctor's salaries?"

Dr. Jaison Philip: We can keep up appealing to the government meaning to the state government to raise the salary of government doctors and we've been doing that for decades. Actually, I've been in the doctor’s union, I've been an office parent, doctors’ union and we conduct talks with the Health Minister and sometimes the Chief Minister and they always say mean, we don't have money in the trust that means they can always find an excuse. I mean a solution to this problem beats me. What more can we do? We can agitate, we can organize, agitate and we can put for the demands peacefully or with strikes and all that stuff. But in the end, don’t achieve a solution to this problem. and this disparity bids mean but you can Tamil Nadu allows private practice but problem is all 7.6 crore residents of Tamil Nadu are doctors. Everybody has an MBBS, MS, MCH, MD, DM degrees yes so given. Tamil Nadu has the maximum number of medical colleges, has the maximum number of doctors. The patient-doctor ratio is 1:250 which is the same as of the US, Norway, and Finland. But do we have the infrastructure that Norway or Finland or all these Scandinavian countries have or the US? We don't have it. So, with just the mass-producing doctors, you don't solve any problems, the doctors should have the ability and you should have the infrastructure to be of service to the people. Ultimately that's what we need to serve the people in a meaningful way and to solve the medical problems. Are we doing that? Are we going on this in the correct path just by building medical colleges? No professors, No assistant professors; by ghost professor? On the day of the NMC visitor you transfer, ask, process one college to another and show them as Munnabhai MBBS Professor and Assistant professor. Is that a solution? So, the solution should be to increase the salaries of government doctors and give them quality education. Give the students quality education by recruiting more assistant professors, by recruiting more professors, not by ghost faculty, and not by cheating the National Medical Council NMC previously it was MCA Medical Council of India, now this is National Medical Commission or whatever is it NMC, so raise the salaries and increase more Assistant professors and Professors in medical colleges, if you are building more medical colleges.

Dr. Jaison Philip: There is an age factor. I'm too old to switch or to play. So, to the US or the UK, I have to start my career afresh. Here at least I am a well-known doctor, a urologist in Tamil Nadu and Kerala, and also an andrologist. So, at this age, there is an age factor. At my age, I cannot migrate to the US or Western Europe. Why restrict to the UK in there are vacancies in France to the Germany and all that stuff and these languages can be learned. So, all over Western Europe. Australia is a very big market and 60 percent of American Psychiatrists are Indians. 60 percent of practicing American psychiatrists are Indians meaning Indian born. So given another chance at another life I would have certainly taken USMLE, PLAB, and taken the first flight out of India after finishing my MBBS, MS, and MCH to have a glorious life there instead of the hardship that we are putting in here. The terrible bureaucracy that we work under the IAS officers who control us. They don't know the full form of MBBS, but the IAS officers control us, they control our salaries, and they control our rules. They control the drugs that are applied to us. We have to apply to IAS officers to get. They don't know what a drug treats, what the disease is, and what is the patient load for that particular disease. So given another chance, I would certainly migrate. My advice to budding medical aspirants is; to take a flight to the UK, cracking PLAB is easier than cracking USMLE. Migrate to the UK and then you can go to Canada or the US or any other Western European country or Australia. Austria has a huge market for Indian doctors. Please tap it. That is my advice to medical aspirants.

Dr. Jaison Philip: Toxicity is very high in MS. In MD General Medicine, you have the medical textbook, you have a stethoscope, and you have a patient in the ward. Even at nine o'clock in the night you can take your stethoscope and listen to the murmurs or examine the patient and check with the book and much of it is learned by yourself. But surgery is not like that. You can't just open your surgery book. "Oh, this is how the artery should be cut. This is how the harder the artery should be tight. This nerve should be cut and then you can't just open the human body and do surgery." An assistant professor or professor has to hold your hand and say this is this artery, tie this first and after that tie this first; Cut this first, and then just gently navigate. He has to hold your hand instill. This is what gives them the privilege. They won't teach you if you don't pamper them. The incubation period, the time to attain reasonable prosperity is much higher in surgery. All you need is the stethoscope and the work-life balance is better in medicine than medical specialties and general medicine than in surgery and surgical super specialties. There are very less calls & night calls in medicine but not as many as in surgery. You get a head injury in casualty every day, several head injuries, and several other surgical injuries, both general surgical, urological, urn-surgical, & other surgical emergencies, but much less in a medical specialty. So, work-life balance is better in medicine, general medicine, and super specialties than in surgery and super specialties. So that is why everybody is intelligent. I mean even the 17-year-old school pass-out is very intelligent today, so he pragmatically chooses medicine or surgery and I think that's the choice.