Webster’s Third New International Dictionary defines the word ‘noble’: 1) possessing outstanding qualities such as eminence and dignity; 2) having power of transmitting by inheritance; 3) indicating superiority or commanding excellence of mind, character, or high ideals or morals. These three attributes befit the profession of Medicine. and regulations relating to the Professional Conduct, Etiquette and Ethics for Registered Medical Practitioners that time NMC was MCI (Published in Part III, Section 4 of the Gazette of India, 2002).
Over centuries, the Medical fraternity has maintained the standards of ethical and humane practice. Their magnificent contributions and landmark discoveries in medical science and innovations in diagnostic and therapeutic techniques have revolutionised patient care, saved countless lives, and significantly improved longevity and the quality of human life. Generations of Doctors have developed and improvised their professional skills and passed them on to succeeding generations, as they have to me and to each one of you, to take into the future. Beyond its scientific and technical contributions, medicine is uniquely fulfilling as a,’ Noble profession”.
In return, it has been accorded the respect of society and of other professions as a noble profession imbued with eminence, dignity, high ideals, and ethical values. It has a rich and proud heritage. Its altruistic stance has served it well and has been the reason for its constancy and consistency. In the recent past, unfortunately, there has been a sharp decline in the ethical conduct of some of the medical practitioners. Materialistic influence has produced a highly selfish mentality in some practitioners, and while engaged in professional activities at times, they lose sight of the ethical, human, and noble values of their profession. They try to attain gain, name, fame and wealth by resorting to unethical practices which in turn may result in the exploitation of the patients. Say something nice about someone nobody will listen to; make it mean and malicious publicity is mercilessly focused on the story. To what extent do viewers/readers place faith in the media’s portrayal of social issues? … “Lifting a profession up to ridicule and defaming their character.”
Most of the doctors complain by generalisation of the issue that “malpractice such developments can seriously hamper the doctor-patient relationship, and a delicate mutual trust which existed in this noble profession is lost. ” How early it can be reclaimed depends on how soon we all realise our collective and individual responsibility on this issue. The fact that patients are not feeling entirely satisfied with the care is not breaking news, as there are a lot of misperceptions involved on both sides. Whether these are genuine doubts or unfounded fears created out of vested personal or professional vendetta or rivalry with the hype of ugly incidents of malpractices in the media, unfortunately our focus has been mostly on managing the crisis “du jour”: “Name, blame and shame”. As a result, physicians find it increasingly difficult to meet their responsibilities to patients.
Always bear in mind that “Healthcare” is a sickness treatment system. Neither the Government nor the providers can deliver a ‘cure’ to the public; a cure lies with the Creator. A doctor is just a conduit. Swami Vivekananda says, ‘Money does not pay, nor name; fame does not pay, nor learning. It is dedication that pays; it is character and morality that cleaves its way through adamantine walls of difficulties. The principles and responsibilities of medical professionalism must be clearly understood by both the profession and society. Essential to this contract is public trust in the doctor, which depends on the integrity of both individual physicians and the whole profession. I know, and many people in society will acknowledge that most physicians are good physicians, and the scared relationship between patient and doctor which has existed for ages will not perish with certain aberrations here or there. This doesn’t mean all the doctors are noble. As with any profession, we do have many bad apples who need appropriate treatment – some physicians are greedy, but most physicians are altruistic.
We all agree medicine arose out of the primary sympathy of humankind with other creations out of desire to help those in distress, need and sickness. This relationship arises out of the pain and suffering of one person and an offer of hope by another, and factually, most doctors are fulfilling this obligation. It is unfortunate we have begun calling the Medical professionals “businessmen in an industry” – it somehow undermines and discourages the dedication of the majority of medical professionals involved in the care of the patients and denigrates the “noble profession”. Society in general and patients in particular may also play a part in this discontent; Physicians are constantly faced with patients and their relatives who have begun to respond in high-tech ways. Amidst the menace of the dangerous practice of self-medication prevailing in the valley, some patients, after going through web, acquire some knowledge of disease and required tests, and feel that if a practitioner does not order a fancy new test, he or she is not at the cutting edge of medicine.
The fact is that tests are ancillary and not a panacea. At present, the Medical profession is confronted by an explosion of ‘technicalisation’, specialisation and commercialisation, changing market forces and problems in the quality of health care delivery. Despite initiatives by authorities, it remains an over-promised, Over-burdened, over-spent but not overhauled’ sector. At times we are facing a shortage of resources due to a shortage of beds or care providers (specialists and paramedics) or modern machinery. As a result of deficiencies in Healthcare policies and procedures on Accountability, in such an atmosphere dedicated physicians find it increasingly difficult to meet the expectations of patients from giving the standard care they need. These challenges centre on increasing disparities among the legitimate needs of patients, the available resources to meet those needs, the increasing dependence on market forces to transform health care systems, and the temptation for physicians to forsake their traditional commitment to the primacy of patients’ interests. In these circumstances, reaffirming the fundamental and universal principles of primacy of patient welfare and values of medical professionalism, which remain ideals to be pursued by all physicians, becomes all the more important. This principle is based on a dedication to serving the interest of the patient.
The medical profession everywhere is embedded in diverse cultures and local constraints. Market forces, societal pressures, and administrative exigencies must not compromise this principle. I am confident that the medical profession is still a noble profession and the sacred bond between patients and practitioners will endure despite new storms. Altruism contributes to the trust that is central to the physician–patient relationship; its members continue to share the role of healer, which has roots extending back to Hippocrates to the Oath of a Muslim Physician. Even in these uncertain times, I am proud of my daughter choosing a giving profession – and in a moment like this, I continue to believe in the innate moral strength and humanity of my profession. I quote Thomas Macaulay, “The highest intellects, like the tops of mountains, are the first to catch and reflect the dawn.”
MAY Allah Give us the fortitude to admit our mistakes, to amend our ways – Give us the understanding that ours is a profession sacred that deals with your most precious gifts of life and intellect. Therefore, make us worthy of this favoured station with honour, dignity and piety so that we may devote our lives to serving mankind, irrespective of caste, colour and faith, with patience and tolerance with virtue and reverence, with knowledge and vigilance, with Thy love in our hearts and compassion for Thy servants, Thy most precious creation. Aameen
