Wednesday January 17, 2018

India short of 500,000 Doctors, the Doctor-Patient ratio of 1:1,700 is worse than Vietnam

India is short of nearly 500,000 doctors, based on the World Health Organization (WHO) norm of 1:1,000 population, according to an IndiaSpend analysis of Government data.

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New Delhi, September 1, 2016: Needless to say that, Health-Management failure is prone in India. The depth of this fact can be measured only if we go through with these examples.

In Odisha, a man slung his wife’s body over his shoulder and carried it 10 km after being denied an ambulance on August 24, 2016.

In Kanpur, a man’s sick son died on his shoulder after being denied admission to a hospital on August 29, 2016.

Such cases become visible when they get social media and television attention, but millions cannot access India’s overburdened hospitals and inadequate medical facilities, a crisis illustrated by the fact that India is short of nearly 500,000 doctors, based on the World Health Organization(WHO) norm of 1:1,000 population, according to an IndiaSpend analysis of government data.

With more than 740,000 active doctors at the end of 2014 — a claimed doctor-patient population ratio of 1:1,674, worse than Vietnam, Algeria and Pakistan — the doctor shortage was one of the health-management failures cited by the report of a parliamentary committee on health and family welfare, which presented its findings on March 8, 2016.

Illegal capitation fees in private medical colleges, a health-services inequality between urban and rural India and a disconnect between the public-health and medical-education systems were among the issues the committee investigated while probing the Medical Council of India, the 82-year-old organisation responsible for medical-education standards.

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Up to 55 percent of India’s 55,000 doctors graduate every year from private colleges, many of which charge illegal donations, or “capitation fees”; in Tamil Nadu, it now costs a medical student from such a college Rs 2 crore to get an MBBS degree, the Times Of India reported on August 26, 2016.

The imbalances begin with access to medical education.

States with nearly half the population have only a fifth of MBBS seats

“Six states, which represent 31 percent of India’s population, have 58 per cent MBBS seats; on the other hand, eight states, which comprise 46 percent of India’s population, have only 21 per cent MBBS seats,” said an unnamed expert who deposed before the parliamentary committee.

These medical-education imbalances reflect larger public-healthcare issues. In general, poverty is correlated with the lack of healthcare. For instance, among states with the highest proportion of undernourished children, Jharkhand and Chhattisgarh have the worst infrastructure for institutional deliveries.

India’s poorer states have health indicators that are worse than many nations poorer than them, and India’s healthcare spending is the lowest among BRICS (Brazil, Russia, India, China, South Africa) nations, as are its health indicators.

Every year, 55,000 doctors complete their MBBS and 25,000 post-graduation nationwide, said another unnamed expert. At this rate of growth, he told the committee, India should have a doctor (allopathic) for every 1,250 people for a population of 1.3 billion by 2020, and one for every 1,075 by 2022 (population: 1.36 billion).

“However, the committee has been informed? that doctors cannot be produced overnight, and if we add 100 medical colleges every year for the next five years, only by the year 2029 will the country have an adequate number of doctors,” the second expert said.

The shortage of doctors, the report said, is despite the increase in medical colleges, from 23 in 1947 to 398 at the end of 2014. India, the report noted, has more medical colleges than any country, and 49,930 admissions were available in 2014.

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“An expert who appeared before the committee submitted that India was very very short of doctors and to meet this shortfall, India needs to have not four hundred, but one thousand medical colleges,” the report said.

The central government has approved 22 medical colleges with 1,765 seats in the last two years, according to an e-book published by the Ministry of Health and Family Welfare.

The NITI Aayog, the government’s think-tank, has prepared the draft National Education Commission Bill, 2016, to reassess India’s healthcare and medical-education infrastructure.

While 11 new All IndiaInstitutes of Medical Sciences (AIIMS) have been added with 1,100 seats, the government has proposed an additional 4,700 MBBS seats.

As many as 5,540 MBBS seats and 1,004 PG seats have been added in the last two academic sessions, the e-book said.

Medical-education shortages manifest themselves in under-staffed public-health services nationwide: There is an 83 percent shortage of specialist medical professionals in community health centres (CHCs), as IndiaSpend reported in September 2015.

Public-health centres across India’s rural areas — 25,308 in 29 states and seven union territories — are short of more than 3,000 doctors, the scarcity rising 200 per cent (or tripling) over 10 years, IndiaSpend reported in February 2016.

The committee was, thus, sceptical of the government’s claims of the doctor-population ratio.

“Given the fact that the Indian Medical Register is not a live database and contains names of doctors who may have passed away or retired from active practice, by now, as well as those with a permanent address outside India and that there is no mechanism in place for filtering out such cases, the Committee is highly sceptical of the ministry’s claim of having one doctor per 1,674 population,” the parliamentary report said. “In view of the above, the Committee feels that the total universe of doctors in India is much smaller than the official figure, and we may have one doctor per 2,000 population, if not more.” (IANS)

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  • Kabir Chaudhary

    There are more than enough doctors graduating from medical schools in the country but they seem to run to other countries to earn cash, rather than saving and treating patients in their own country.

    • steve webster

      That is because in Canada they can often go back to school one year plus take up junior position under a doctor here in a rural area for 2 more years . After the first year they are often sending $3,000 to $4,000 per month back to their family in India to cover debt to cover education . After being in Canada 3 years they can make many times what they would in India, It very frustrating to be in country short of ambulances and supplies for the bottom third.

  • Kabir Chaudhary

    There are more than enough doctors graduating from medical schools in the country but they seem to run to other countries to earn cash, rather than saving and treating patients in their own country.

    • steve webster

      That is because in Canada they can often go back to school one year plus take up junior position under a doctor here in a rural area for 2 more years . After the first year they are often sending $3,000 to $4,000 per month back to their family in India to cover debt to cover education . After being in Canada 3 years they can make many times what they would in India, It very frustrating to be in country short of ambulances and supplies for the bottom third.

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Rene Laennec : The man who invented the stethoscopes

He invented the stethoscope but that wasn't his only major contribution or achievement in the medical field.

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Rene Laennec- The man who invented stethoscope. Wikimedia Commons
Rene Laennec- The man who invented stethoscope. Wikimedia Commons
  • Rene Laennec invented stethoscopes in 1816
  • He also coined many other medical terms which helped us in understanding a different kind of diseases
  • His contribution in the field of medicine are immense and will always be remembered

One thing which is most frequently associated with a doctor is a stethoscope. Be it advertisements or real life, a stethoscope is one thing which we see hanging around every doctor’s neck.

The stethoscope is an instrument which is used by doctors to hear a patient’s heartbeats and to check their breathing. This medical instrument is used to hear the resonance of sounds made by our hearts and lungs for evaluative purposes. The instrument has been an object of fascination for a long time, because of its simple design, which consists of just a resonator and two tubes.

Stethoscopes are quintessential to a doctor. Pixabay.
Stethoscopes are quintessential to a doctor. Pixabay.

But who invented the stethoscope?

René-Théophile-Hyacinthe Laennec or simply known as Rene Laennec, was a French physician who invented stethoscope in the year, 1816. He invented this medical instrument while working at the Necker Hospital in France, and used it in diagnosing various chest and lung conditions, pioneering the whole concept.

Rene-Laennec invented the Stethoscope. Wikimedia Commons
Rene-Laennec invented the Stethoscope in 1816. Wikimedia Commons

He was born on February 17, 1781, Brittany, France and died on August 13, 1826, Kerlouanec due to Tuberculosis.

Necessity for this invention

Rene Laennec invented stethoscopic or stethoscope because of his embarrassment while treating women. He didn’t like to put his ear at their chest in order to diagnose their problems, especially in the case of overweight women. He also found this method of listening to heartbeats very ineffective.

The original stethoscope was just a piece of paper rolled into a cylinder. Pixabay.
The original stethoscope was just a piece of paper rolled into a cylinder. Pixabay.

As a result, he invented an instrument which won’t require him to put his ear on his patient’s chest and will be more effective. He rolled a piece of paper into a cylinder and placed one side on the patient’s chest and the other near his ear. He found that he could hear the sounds better.

His contributions to the Medical Field 

He invented the stethoscope but that wasn’t his only major contribution or achievement in the medical field.

He famously coined the term ‘melanoma’, which is a type of cancer that typically occurs in the skin but rarely occur in the mouth or intestines. He was the one who recognised that melanotic lesions are the result of metastatic melanoma.

Laennec is also well known for his studies of peritonitis, amenorrhea and tubercle lesions. He also coined the term cirrhosis, which is a lung disease. His works played a huge role in the understanding the of this disease.

You may also like: Acharya Charaka: Indian father Of Medicine, Author of Charaka Samhita “science of Ayurveda” 

A difference in the design of Traditional and Modern Stethoscopes

The modern stethoscopes that we see today are not what Rene Laennec invented. His original design was rather simple. The doctor’s stethoscope that we see today is much more complex that Laennec’s simple design.

His original design was just a tube, which could be made of wood and copper. It could be assembled and dissembled easily as per the convenience of the physician. The new age stethoscope is a modification of his original design.

The original design of Rene Laennac's stethoscope. Wikimedia Commons
The original design of Rene Laennec’s stethoscope. Wikimedia Commons

His original stethoscope was replaced by the stethoscopes using rubber tubes by end of the 19th century.

A modern day stethoscope using rubber tubes and a resonator. Pixabay
A modern-day stethoscope using rubber tubes and a resonator. Pixabay

Achievements

The government of France honoured Rene Laennec with First Prize in Medicine and Sole Prize in Surgery in 1803.

He was also conferred with the title of the ‘Knight of the Legion of Honor’ in 1824.

His contributions in the medical fields are immense and for it, he will always be remembered.