This is in response to the article written by Dr. Jeevana Mendis under the headline, “Are doctors wasting public money spent on their education” published in the Daily Mirror on Wednesday May 24.
Before I start my formal response I must emphasis that I salute those (perhaps a minority) of doctors who serve the public of this country with dedication and commitment. These are the doctors who are selfless in service and are driven by values of caring for and safeguarding human life.
Dr. Mendis argues that doctors do contribute by serving in public hospitals without seeking greener pastures abroad. He also maintains that they maintain high standards of healthcare.
Yes, doctors do serve in hospitals however, they are remunerated well for their service. Their salaries are high compared to most government employees’ and they have many perks and further, public money is utilised for further training of doctors which includes specialisation training abroad. So while doctors do serve in public hospitals, I argue that you are relatively well remunerated (according to Sri Lankan public sector employee pay scales) and that the people continue to invest in doctors by way of paying for perks and further training. The majority of other government servants do not enjoy these benefits.
In his article, Dr. Mendis does not touch on the vast unregulated private practice industry that goes on in this country. I will just mention that the public spending on doctors’ further training enhances your capacity for private earning. So you are in a win-win situation at the expense of the public.
Going abroad in search of greener pastures comes with the burden of accountability. Doctors in countries like Britain, the USA, Australia, etc. are made accountable for their actions. An incorrect diagnosis which could cause a patient to suffer or die will result in that doctor being permanently struck off the medical register and possibly be put in jail if negligence is proved. There is no such accountability in Sri Lanka and bad medical decisions and negligence are not challenged nor is there any action taken. So doctors have it easy here where accountability is concerned.
Yes, doctors do serve in hospitals however, they are remunerated well for their service. Their salaries are high compared to most government employees
Sri Lanka may have good medical standards compared to SAARC countries but its nowhere near the best (Switzerland, Norway, Australia). Yes, we are a developing country and spending on public heath is a challenge and its the governments responsibility to manage the public health system. However, the attitudes and mannerisms of most doctors in this country leaves much to be desired for. Everyone I know complains that doctors do not take time to explain to the patients about their health condition, they do not explain what medication is prescribed and why it was prescribed, they do not inform patients of any potential side effects of the prescribed medication, they do not like being questioned and act in a manner which sends the message that I am the doctor, I know what is best and you the patient has to keep quiet and listen to me. This sort of attitude from doctors is not a sign of a medical system that adheres to high standards.
Dr. Mendis paints the plight of medical undergraduates striving away for five years under hardship....what he does not say is that the rewards at the end of the five years are high, good salary, perks, further training at public expense, lucrative unregulated private earnings, skills which can be used to migrate, membership of a union (GMOA) that is all powerful. Now consider the plight of a poor arts student, the hardships are the same but there is absolutely no guarantee of rewards at the end. I do not think the people have much sympathy for the plight of medical students in our state universities.
Dr. Mendis also critisises politicians in his article. There is no argument that politics in this country is appalling and that the people are disgusted by the state of politics. However, we must remember that politicians do not have to pass exams, nor do they have to go through a demanding five-year university course to do their job. Criticising politicians is not going to garner much support for doctors, the people expect high standards from the learned medical profession and I feel the entire country feels let down by the medical profession and in particular the GMOA.
At the end of the day if politicians in this country go on strike, undoubtedly the country will be better off, but when doctors go on strike people suffer and can die.
In conclusion, my answer to Dr. Mendis’ question is in the case of most doctors and in particular considering the members of the governing body, GMOA, we feel let down and think our money has gone to waste.
I must state here that there are first class doctors who work selflessly in rural and difficult areas serving the poor and disadvantaged. There are also first class doctors serving with tremendous dedication in hospitals in the big cities. My feeling is that they are a minority. My general criticism of the profession is in no way intended towards them, I wish the majority of your profession follows your lead and serve this country and earn back the dignity and respect it is fast losing.