Skip to main content

Rejoinder: Why doctor treating individual patient is no humble person these days

By Dr Maya Valecha* 

The article by Dr Amitav Banerjee on association between doctors and the pharmaceutical industry (Counterview, August 31, 2023) is based on a few important issues. First is the worry for the most concerned people -- that higher up research bodies, regulatory bodies, and even the World Health Organisation (WHO), are playing in the hands of pharmaceutical companies, and therefore opposing these higher authorities is very important. But we cannot say that doctors who are treating the patients directly are any less harmful.
The second assumption -- which is actually the reason for the first reasoning -- is that medical research, medicine production, medical practice/ healthcare system and allied industries, which are now considered important, have to be in private hands.
Dr Banerjee says, “Louis Pasteur’s work on rabies vaccine led to the rise of the vaccine industry. Alexander Fleming’s discovery of penicillin changed the course of medical history and spawned the huge pharmaceutical industry.” Indeed, he is absolutely right: the doctors helped the pharmaceutical industry. But that is not the same thing as the collaboration of the two or helping the humankind.
To quote Rene Dubos in Mirage of Health:
“. . by the time laboratory medicine came effectively into the picture the job had been carried far toward completion by the humanitarians and social reformers of the nineteenth century. Their doctrine that nature is holy and healthful was scientifically naive but proved highly effective in dealing with the most important health problems of their age. When the tide is receding from the beach it is easy to have the illusion that one can empty the ocean by removing water with a pail.”
The modern “heresy” that medical care (as it is traditionally conceived) is generally unrelated to improvements in the health of populations (as distinct from individuals) is still dismissed as unthinkable in much the same way as the so-called heresies of former times. And this despite a long history of support in popular and scientific writings as well as from able minds in a variety of disciplines.
History is replete with examples of how, understandably enough, self-interested individuals and groups denounced popular customs and beliefs which appeared to threaten their own domains of practice, thereby rendering them heresies (for example, physicians’ denunciation of midwives as witches during the Middle Ages).
However, even under the somewhat unrealistic assumption of a constant (linear) rate of decline in the mortality rates, only whooping cough and poliomyelitis have approached a significant percentage, which is only to be expected. The remaining six conditions (tuberculosis, scarlet fever, pneumonia, diphtheria, measles, and typhoid) showed negligible declines in their mortality rates subsequent to medical intervention.
Association of TB and nutrition is well known, and all of us know it, yet the Indian Council of Medical Research (ICMR) conducted a study to know that improved nutrition can reduce cases and mortality of TB. Let's tell them it's true for all infectious diseases, so that they don't waste public money on studies and vaccines. There are people who barely manage one meal, and no vaccine can save them.
There have been many other researches after this which show how almost all diseases were at their bottom-line when the vaccines were introduced. The recent example of cervical cancer declining with non-pharmaceutical interventions suggests vaccines are no full proof for prevention, and still doctors use it freely in private sector, with the government introducing it as national programme – which is an eye opener.
Dr Banerjee says, “The real conflicts of interests are upstream at the level of the WHO and ICMR rather than at the downstream where the humble doctor is treating individual patients.”
The doctor treating the individual patient is no humble person these days. He acknowledges this and tries to find some moral solution for this, which is not possible in this money-centric capitalist society. When money can buy every institution, it can buy the individuals easily. As this study suggests, doctors do not want to even answer about big gifts to them. In fact, big pharma marketing influences prescriptions of 98% doctors.
I do not believe in centralised authorities controlling the society but the example of two consenting adults having liaison harming no third person is totally misplaced. In fact, liaison between doctors and pharmaceutical industry is affecting vast number of patients getting subjected to unnecessary investigations, medicines and even surgeries.
Opposition by the Indian Medical Association (IMA) is being taken lightly, but let me ask one thing: is it not the height of brazen attitude of doctors when they say that they don't have money for their own further learning? How do other professionals keep themselves updated? 
Under the current system, Continuing Medical Education (CME) is not a compulsory thing. Thanks to influence of vulgar money from the profession, it attracts only the most genuinely interested persons. Genuine literature and conferences at low cost can only be organised with government funding, which wouldn’t help enjoy five star facilities.
The real solution lies in complete overhaul of the system with socialisation of the pharma industry and healthcare system. They need to be under complete control of the people through participatory democracy. This will solve the problem of the higher authorities colluding with vested interests and controlling the system, thereby our lives. When the system is so rotten from top to bottom one cannot change it by just dressing it up.
*Senior physician based in Vadodara


Dr S Jagtap said…
CME is compulsory to renew registration with MMC at least!!!!


'Flawed' argument: Gandhi had minimal role, naval mutinies alone led to Independence

Counterview Desk Reacting to a Counterview  story , "Rewiring history? Bose, not Gandhi, was real Father of Nation: British PM Attlee 'cited'" (January 26, 2016), an avid reader has forwarded  reaction  in the form of a  link , which carries the article "Did Atlee say Gandhi had minimal role in Independence? #FactCheck", published in the site The article seeks to debunk the view, reported in the Counterview story, taken by retired army officer GD Bakshi in his book, “Bose: An Indian Samurai”, which claims that Gandhiji had a minimal role to play in India's freedom struggle, and that it was Netaji who played the crucial role. We reproduce the article here. Text: Nowadays it is said by many MK Gandhi critics that Clement Atlee made a statement in which he said Gandhi has ‘minimal’ role in India's independence and gave credit to naval mutinies and with this statement, they concluded the whole freedom struggle.

BSF should take full responsibility for death of 4 kids in West Bengal: Rights defender

By Kirity Roy*  One is deeply disturbed and appalled by the callous trench-digging by BSF in Chetnagachh village under Daspara Gram Panchayat, Chopra, North Dinajpur District, West Bengal that has claimed the lives of four children. Along the entire stretch of Indo-Bangladesh border of West Bengal instead of guarding the actual border delineated by the international border pillars, BSF builds fences and digs trenches well inside the Indian territory, passing through villages and encroaching on private lands, often without due clearance or consent. 

A Hindu alternative to Valentine's Day? 'Shiv-Parvati was first love marriage in Universe'

By Rajiv Shah*   The other day, I was searching on Google a quote on Maha Shivratri which I wanted to send to someone, a confirmed Shiv Bhakt, quite close to me -- with an underlying message to act positively instead of being negative. On top of the search, I chanced upon an article in, imagine!, a Nashik Corporation site which offered me something very unusual. 

How GMOs would destroy non-GMO crops: Aruna Rodrigues' key submissions in SC

Counterview Desk The introduction of Bt and HT crops will harm the health of 1 billion Indians and their animals, believes Aruna Rodrigues, who has made some 60 submissions to the Supreme Court (SC) during the last 20 years. As lead petitioner who filed Public Interest Litigation in 2005, during a spate of intense hearings, which ended on 18 January 2024, she fought in the Apex Court to prevent the commercialization of genetically modified organisms (GMOs) in Indian agriculture. 

Social justice day amidst 'official neglect' of salt pan workers in Little Rann of Kutch

By Prerana Pamkar*  In India’s struggle for Independence, the Salt Satyagraha stands as a landmark movement and a powerful symbol of nonviolent resistance. Led by Mahatma Gandhi, countless determined citizens walked from Sabarmati Ashram to Dandi in Gujarat. However, the Gujarat which witnessed the power of the common Indian during the freedom struggle is now in the throes of another significant movement: this time it is seeking to free salt pan workers from untenable working conditions in the Little Rann of Kutch (LRK).

Corporatizing Indian agriculture 'to enhance' farmer efficiency, market competitiveness

By Shashank Shukla*  Today, amidst the ongoing farmers' protest, one of the key demands raised is for India to withdraw from the World Trade Organization (WTO). Let us delve into the feasibility of such a move and explore its historical context within India's globalization trajectory.

Jallianwala massacre: Why Indian govt hasn't ever officially sought apology from UK

By Manjari Chatterjee Miller*  The king of the Netherlands, Willem-Alexander, apologized in July 2023 for his ancestors’ role in the colonial slave trade. He is not alone in expressing remorse for past wrongs. In 2021, France returned 26 works of art seized by French colonial soldiers in Africa – the largest restitution France has ever made to a former colony. In the same year, Germany officially apologized for its 1904-08 genocide of the Herero and Nama people of Namibia and agreed to fund reconstruction and development projects in Namibia. .

Livelihood issues return to national agenda ahead of LS polls: SKM on Bharat Bandh

Counterview Desk  Top farmers' network, the Samyukta Kisan Morcha (SKM) has claimed big success of Grameen Bharat Bandh and industrial /sectoral strikes, stating, the “struggle reflected anger of farmers, workers and rural people across India”, adding, the move on February 16 succeeded in bringing back peoples’ livelihood issues in the national agenda just ahead of the general election to the Lok Sabha.

How retraints were imposed on academic freedom on the IIM-Ahmedabad campus

By Sandeep Pandey*  This is the seventh consecutive academic year when I would have gone as a visiting faculty member to the Indian Institute of Management at Ahmedabad to teach an Elective course on Transformational Social Movements to the second year of Post Graduate Programme students. But the invitation has not come so far and it looks like it is the end of my teaching stint at IIM, at least, so long as the Bhartiya Janata Party remains in power at the centre.

Supreme Court Bar Association letter to CJI 'meant to defame' protesting farmers

By Prem Singh*  Have we ceased to be a wakeful and sensitive civil society and instead have become the horns of parties, leaders and governments? Whatever profession we are in, have we lost all respect for our responsibility and dignity?  It is understandable that a pro-corporate government should launch a campaign to defame the farmers from the very first day of its agitation against the government's apathy to their long-pending demands. Because it considers the people of the country, especially the hardworking farmers, labourers, artisans, unemployed and underemployed, not as citizens but as subjects who live at the mercy of the government.  But the professional noblemen of the civil society should defame the farmers in an organizational manner -- this explains our fall as a civil society.  It is a matter of utmost regret that the president of the Supreme Court Bar Association has written a letter to the Chief Justice demanding that he take suo motu cognizance of the “erring” far