If 75% medical doctors don't want to work in villages, one should look for the reason behind it. The answer is simple. Most often, a doctor in the village finds himself too lonely for his profession. If you want qualified doctors to work in the villages, build good hospitals in villages. There will be a beeline looking for vacancy, paid or unpaid.
Every qualified doctor knows that a seemingly simple abdominal pain or fever may worsen over a few hours to scare his sleep away for a couple of days. No doctor will like one-man show clinics where he will feel burdened with responsibilities he can't manage alone. He may also have to lead a ‘sarkari joint' through the un-greased and rusted government machinery wrapped in red tape, headed and looted at various levels by corrupt bureaucrats and politicians. The doctor finds himself too much alone facing an irate crowd at the front office bare-hand, for all the sins committed by self-serving 'leaders'. And remember; this is a period of ‘defensive medicine’ – as someone said, the doctor may have to think that every patient is a potential enemy. The stress is too much.
Don't be fooled by the idea that doctors will work if there is money. Of course, money is a factor but not the factor. A good hospital will mean a good academic platform to expand the doctor’s knowledge and experience. It will mean he/ she will be working with a team and the responsibility will be shared. It will also mean professional satisfaction. It can also mean the luxury of one-day-off in a week.
True, the government or NGOs should have taken care of the health of the villagers in a healthy way. Indian Medical Association or NGOs could have debated the issue and come out with some suggestions.
I understand that in some other countries, senior qualified nurses are given license to practice in some situations. (Nurse practitioner).
While a full fledged hospital may not be possible in every village, one for every few villages with conveyance facility from every village, mobile dispensaries and camps could be thought of. Of course, the local terrain and culture may have to be taken into consideration. Work in such institutions can be linked to academic curriculum, as study material and thus exposure would be enormous. Existing medical colleges should be encouraged to build a ‘village extension’ with regular visits from its various departments. Role of private investment in village health care can be thought of, and if necessary, government should encourage such ventures as well.
With the ground realities too negative, a conscientious doctor will shy away from work in villages. After burning away five and a half stressful years (or more) of his youth in a medical college, the medical graduate realizes that a life-long learning has only begun. And that every few months something new is happening in every field of medicine which he has to keep abreast with. One is at a loss to imagine how serious minded planners can design a shorter course to fast-bake medical practitioners. News is that there is a shortage of airline pilots; why they are not considering crash courses for people willing to fly aircrafts! Many doctors may be too willing.
(In response to thoughts of considering short courses for creating 'doctors' to practice in villages in India.)
