Tuesday, September 6, 2011

Medicine as a business

I write this post in the light of case being heard in the Supreme Court of the country between the pharmaceutical company Novartis and the Indian government regarding the patenting of new forms of old medicines. The drug in question is Gleevec about which quite a lot has been written. You can read more about this here.

When I read this – I’m reminded of a story told my one of my senior mentors in college who happened to be a retired professor in medical school. He was speaking to a group of freshers (new admissions in MBBS) in one of the medical colleges in Kerala sometime in the early 1980s. He asked the new entrants on what their desires in life were. Along with the usual answers which you get during that time like the desire to serve, the doctor father wanting his progeny to follow suit, the desire to do research to help mankind etc., and one kid told him that he wanted to buy a Mercedes Benz. The professor replied that leave alone a Mercedes Benz, he would not be able to buy even the tire of a Mercedes if he becomes a doctor.

Unfortunately, times have changed. My mentor was wrong. Medical profession is one of the most lucrative professions in India. The flash and the glamour associated with the profession are quite on the rise. We have heard about stories of one of our professors coming for work in their cycles. But, not anymore. The flashy cars doctors drive to work is one of the major driving forces for many a parent to dream about sending their children to study medicine.

I’m sure that one of the major contributors to the transformation the of medical profession as a lucrative business is the pharmaceutical industry (My blog on pharmaceuticals). And the Novartis vs Indian government is just the tip of an iceberg of the extreme profiteering that pharmaceutical companies want to continue doing. The way new drugs are being pushed into the market is just an indication of how much profits they look towards making.

I remember a drug called Rofecoxib which was brought about in the Indian market sometime when I was finishing my house-surgeoncy. It was marketed as the wonder drug for pain relief especially in osteo-arthritis. I had gone for it’s ‘release’ in Trivandrum. It was a very glamorous event. Later, I was told that our professors were taken to a more glamorous event in Chennai for its’ inauguration in South India. Most of the doctors know what happened to Rofecoxib in the next 5 years.

A lot of unaccounted deaths due to cardiac failure started to happen and investigations revealed that Rofecoxib has cardiac side effects. The shock came when it was found out that that Rofecoxib was in fact found to have fatal cardiac side-effects even during clinical trials information of which was suppressed. However, over the 5 years the company had made its’ profit.

Once I happened to go to a meeting where the main speaker was someone who had made quite a lot of money in the stock market. I remember him telling the audience very clearly – ‘Always be on the lookout for oil companies and pharmaceutical companies. Do not miss investing in them whatever be the cost. Humans need oil for their machines and medicines for their bodies. The demand will never go’. He was true.

This is where I hear the very different message from the Holy Bible. Jesus Christ, whom I believe as my Lord and personal Savior was the best doctor. There have been many instances of him healing the sick. And if we read the instances where he healed the sick – there are few things which come to our immediate notice which are major learning points for us in the business of health care. In the light of my meditations on Matthew 8 and 9 over the last 2 days, I just thought of jotting few aspects which could help us to be better doctors to our patients.

The first is ‘Touch’ – instances of Jesus touching his patients – Matthew 8:3, 13; Matthew 9: 21, 25, 29. And the second aspect is ‘Compassion’ – which is quite a easy word to understand but quite difficult to practice. Matthew 9: 36. The third aspect is the speed with which he was doing things. Being God, he could completely heal people so fast. But, when I look at myself, many a time I find myself scheming on what to do to the patient. How much I’ll make out of him? How much investigations I need to write? How much medicines I’ll give to him? If I do such a thing, will this fellow come back to me?

The very fact that we do not have much time to talk to our patients is in itself a major problem whereby our patients do not find immediate relief upon coming to us. This is something where ayurvedic practitioners and quacks (read more about quacks here) score quite high over us.

I think most of the problems that we in the medical profession faces today where we stand accused to be next only to politicians in the making of money can be got away with if we could rediscover the art of touching patients, being compassionate to our patients as they come to us and looking at immediate and fast ways and means to make their lives easier in the given circumstances. And this ultimately it would do a lot of good in keeping us in favor with both God and man.

1 comment:

  1. Dr JK Just hope you are not referring to homeopaths as quacks! Homeopathy treats holistically and that requires extensive case taking. Often the classical homeopath may require two to three sittings before prescribing any medicine, this is because there are many finer points to consider and that the first presription is very valuable. Thanks.