Lots of doctors find what I say uncomfortable. I've found that calling a spade a spade makes you unpopular, because even while people may agree with you in their heart of hearts, they're not sure they want some of these dirty secrets being laundered in public. That's why doctors are uncomfortable when I'm willing to talk openly about some of the unethical practices which have tarred the reputation of our profession, such as kickbacks and commissions. They feel I shouldn't ruffle the feathers of the powers-that-be.

And, yes, I have paid the price for this. You do get hurt when you stick your neck out, but  I have accepted this reality.  Keeping quiet is much safer, but it makes it harder to live with yourself. How can you turn a blind eye to the flagrant abuse of the powers which patients have entrusted doctors with ?

I agree it's an uncomfortable topic, but I think not talking about it is the biggest mistake. In one sense we are engaging in the conspiracy of silence, and by keeping quiet we're allowing the bad doctors to continue to get away with underhand sneaky tricks, which harms the entire medical profession. It damages the good doctors as well. It's because of these unethical doctors that the entire profession gets tarred with the same brush.

In the past, the default setting between patient and doctor was one of trust, and a doctor had to really commit an egregious error before he was considered to be a bad doctor.

Today, most patients distrust doctors, and you have to work twice as hard in order to prove to him that you're not a crook. Only after you've done that will he then start trusting you. It takes a long time , and it's an uphill battle, and that's why it's important for us to speak up.

I'm fortunately at that position in my life where I'm financially well off. I practice medicine because I enjoy it. I don't need to do it in order to make a living anymore, and I guess I'm senior enough that I can afford to express my opinion . If I don't speak up, then why should I expect anyone else to do so ? And if I don't, then who will?

I agree it's much more comfortable to air your woes in private, and to moan and gripe about how the profession has gone to the dogs. I don't think that helps anyone. If there is a problem, the only way to solve it is by exposing it. We need to discuss it openly , so that we can work together to find a solution.

The reason that I'm willing to be politically incorrect is because I'm optimistic and hopeful. I think there are enough good doctors that we can find constructive solutions, and get rid of the malpractices which have riddled our profession.  I think we can get rid of the corruption if we're willing to stand up and make our voices heard.

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.

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