A heartless profession

It is the Holy Grail for almost every parent: that their son and or daughter go to medical college, become doctors, and embark on a thriving career that brings laurels - and sure, some lolly.

Dr Sandeep Jauhar has been there, done that - and not liked it one bit. And he's blown the whistle on his profession - or ripped it apart with a scalpel.

Medicine, as practiced is sick - very, very, sick. In a devastating - and immensely self critical - book that is making waves physician, with specialization in cardiology, describes how the medical profession has become a

1. pitiless, mercenary medical profession, 
2. money ripping vocation where doctors treat patients as revenue generators rather than human beings, 
3. keep patients in hospital longer than necessary to bill them more, 
4. order needless tests to generate profits, and 
5. cozy up with drug reps helping predatory pharmaceutical companies sell dangerous drugs. 

Doctors are suffering from a "collective malaise" of 

1. discontent, 
2. insecurity, and 
3. immoderation. 

None of this is a great secret; discerning 

1. patients, 
2. activists, and 
3. even many physicians themselves have recognized this for a long time  
4. layman alike, 

Shattering the image of the doctor as a 

1. do-gooder 
2. epitome of nobility. 

No one comes out looking good in this tortured, self-lacerating book: 

1. not Jauhar himself, 
2. nor his brother (also a cardiologist), 
3. nor physician friends and mentors, and 
4. not the system. This is the Ferguson moment in medicine - ugly but true. 

Asked in an interview on Thursday if he intended to stay on in the medical profession at all, given the shock and horror his book is creating , Dr Jauhar said he owed it to his readers to give them the 

1. unvarnished, 
2. unfiltered truth, without being irresponsible. 

"Probably the person who comes in most for criticism is myself. When you are willing to be self-critical, people will appreciate it," 

"I am disillusioned with how medicine is practiced but not disillusioned with being a physician. "Jauhar's sulfurous chronicle of the medical profession in the begins almost as soon after he graduates from fellowship and takes a salaried job at a hospital (after 19 years of college education, including a Ph D in physics). 

1. The hours are brutal, 
2. the money is meager, and 
3. before long he becomes part of the venal system, 

treading dodgy ethical terrain to keep his 

1. body, 
2. soul, and 
3. family together. 

He moonlights on other jobs and shills for pharma companies as he observes 

1. compromises, 
2. cronyism, and 
3. corruption . 

flow like crud through the system

1. Doctors, 
2. hospital administrators, 
3. the health insurance sector, and 
4. pharma industry collude and conspire in sundry ways to rip-off patients - some who want to live forever despite being at their careless best. 

The dysfunction is not entirely due to doctors. Jauhar describes how external sources - 

1. the government, 
2. the insurance industry, and 
3. pharma companies - have all played a role. 

Doctors, particularly primary care physicians and internists, who previously spent 20-30 minutes with each patient, now hurry out after 10 minutes because they now have to see twice the number of patients to generate the same revenue. As a result, patients do not get the attention they deserve and are not diagnosed properly. 

Meanwhile, some specialist doctors get to bilk the system (which is why everyone wants to specialize and there are fewer primary care doctors ), prescribing a 

1. multitude of tests and 
2. treatment 

Some to cover for malpractice liability, others to generate more revenue. Patients who came in complaining of even routine breathlessness are hustled into taking nuclear stress tests and bumped into cardiac procedures. 

That's because insurance companies 

1. don't pay doctors to spend time with patients trying to understand their problem. 
2. But they pay for CT scans and stress tests whether they're needed or not. 

Elsewhere, hospital administrators are also constantly putting pressure on doctors to keep

1. occupancy rates high enough 
2. generate profits (somewhat like hotels). 

Personal Note : Article Not Restricted to a Particular Country, hence modified for universality 

http://timesofindia.indiatimes.com/home/stoi/deep-focus/A-heartless-profession/articleshow/40839153.cms