THE BLOG

Why I Feel Like Less Of A Doctor After 12 Months Of Rural Service

The post of a rural medical officer just doesn’t offer enough—and I don’t mean money.

07/09/2017 9:05 AM IST | Updated 07/09/2017 9:05 AM IST
Adnan Abidi / Reuters

My eyes rove across the lush green farms adjacent to my Primary Health Centre (PHC), blessed by the monsoon of 2017, when it suddenly dawns on me that I'm just a couple of weeks short of finishing my compulsory rural service bond with the Maharashtra government. The dry, desolate fields of the summer become a sight to behold in the monsoon. I remember driving into this place a year ago with excitement mixed with trepidation, and feeling enlivened by the sight of these fields like never before. They offered a rare reprieve from the bustling city life of Mumbai, and in my mind I relished the thought of working here for an entire year. The enchanting scenery of the countryside, the verdant hills, and the pristine and untainted village air left an effect so magical that I toyed with the delightful possibility of extending my term of rural service.

Today, the mesmerising sights and the sweet petrichor rekindle an entire year of reminiscences. But there's also something to adumbrate those happy reminiscences, and the thought of extending my term here produces a peculiar ennui. I won't say that I've been in pain or suffering anywhere along the way, but I feel an obtrusive dreariness at the thought of working here any further. For some reason, my mind craves an escape into hospital wards again; it seeks the roaring city traffic and the overburdened life of a city doctor. As I examine my mind, I am assured it isn't an eroding sense of duty or patriotism, or a greed for more money, but a feeling of sheer boredom overriding the happy reminiscences of rural service.

With a sparse population, workload didn't pose a concern—but a nagging worry of being reproached for even a minute's delay in attending to an emergency often tormented me through the night.

I embarked on this journey knowing that my workplace was notorious for doctors getting beaten up for the slightest of miscalculations; for a precarious ambulance service that would often prompt irate patients to shatter our windows; and for a dismal record of staff and infrastructure shortage. The place was destitute of any real modern amenity within a radius of several kilometres, and the concern that my accommodation came with precarious electricity, leaking roofs, and clogged toilets was comfortably shrugged off by the higher authorities. My impression of a medical officer as an exalted government official took its first major blow.

With a sparse population, workload didn't pose a concern—but a nagging worry of being reproached for even a minute's delay in attending to an emergency often tormented me through the night.

An askew doctor-patient relationship prevailed here. Patients often came with their own rigid reservations about the treatment and medicines they wanted. It's similar to possessing shopping preferences that one carries to a supermarket. Denying these wishes would often have repercussions. A skewed understanding of a lot of people that a doctor is a gluttonous mercenary feeding upon village taxes blew life out of the doctor-patient relationship.

The reason why rural service has been rendered unattractive to me... is because it has little to offer to a dynamic doctor in terms of professional satisfaction.

However, as I look back, I believe none of these factors has had a significant bearing in making rural service unattractive to me. My rural service tenure can be credited for teaching me to be an able administrator and an effective communicator, if not a better clinician. I learnt how to fight the most formidable problems when our back hits the wall, and was witness to a process which saw the most ferocious patients turn into amiable gentlemen. Neither is the bitterness towards the medical profession a feature exclusive to our villages. The reason why rural service has been rendered unattractive to me, and I believe to many others, has little to do with greed or immoral character—it's because it has little to offer to a dynamic doctor in terms of professional satisfaction.

Today, after 12 months of rural service, I feel I'm less of a doctor than I was back in my training days. I crave for a setting with an adequate infrastructure where I can practice scientific, cutting-edge medicine and not have to stand helpless in the face of surmountable challenges. I wish not to lose my patient's faith to a quack simply because I refuse to cave in to unfair demands, or because they charge a deceptively small fee. I hanker for a dynamic career which lets me showcase my skills, and is devoid of the bleak flatness that rural service represents to me. I long for an environment where I get knocked down, get back up, and get better in the process, even if it means not holding an exalted public rank.

I hope the powers that be brainstorm on how to make rural service an attractive endeavour over the longer term, rather than dishing out feeble incentives and coercive policies...

Seventy-one years after the idea of a primary care-oriented health system being first proposed, I believe we have failed to project the post of a Medical Officer, PHC as an attractive career option for MBBS doctors, for reasons mentioned above. A career as a rural medical officer, though quite secure, offers little of allure to a dedicated doctor. Critics are always quick to jump to conclusions and decry the morals of doctors reluctant to opt for rural service. However, the fact remains that few ambitious and dynamic doctors would ever get any amount of professional satisfaction out of it. The result is that the position of Medical Officer, PHC, envisaged to be quite prestigious on paper, fails to stick well with our doctors.

So what's the solution to the gaping doctor shortage in the rural sector? While this article is a personal reflection more than an attempt to answer this question, a lot of things come to mind—increased remuneration, better promotion prospects, adequate infrastructure, and improved working conditions. For now, I hope I've been able to outline how things play out for an ambitious doctor in rural service, and the need for systematic efforts towards making it attractive to doctors. I hope the powers that be brainstorm on how to make rural service an attractive endeavour over the longer term, rather than dishing out feeble incentives and coercive policies year after year.

Male Child Abuse Survivors

More On This Topic

SPONSORED BY MYNTRA