Expert Talk

Emeritus Scientist, National Institute of Immunology, New Delhi
Q. What, according to you, are the attributes of a good doctor?
A good doctor has to be good and up-to-date in his professional work. Therefore, he should be a competent doctor. The second most important attribute is compassion. You cannot be a good doctor without compassion.

Q. What is your opinion about medical training in India? Why are we not able to retain talent?
The medical training offered in India suffers from some severe constraints many of which are happening because of the mushrooming of private medical colleges. Although the curriculum, even if a little out-of-date is sound there is a shortage of teachers in many subjects, lack of proper infrastructure, lack of monitoring of the quality of training and entry of persons to the courses due to “money power” and not due to merit. The one big reason why talent leaves India is because the newly qualified and even more senior doctor feels that promotion and recognition in our medical training centres is not on the basis of merit, qualifications and performance but on other factors. While this may not be so at all medical colleges the perception is very much there and justified and that is why we cannot retain talent.

Q. Do you think health information websites are useful? What are your views about our health website?
Health Websites are very important because the people and the patients need objective information to empower themselves to look after their own health. There is tremendous potential in this approach, which has hardly been used. Our health website has been running a very useful programme and needs to be congratulated. 

Q. Why did you choose your present job?
I had certain qualifications and experience in research and teaching – mainly postgraduate medical teaching at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh and the World Health Organization. After return to India on retirement from WHO in 1991 I did whatever job I was asked to do. These included setting up the Delhi Medical Council, helping the Indian Council of Medical Research, being a WHO Consultant, Chairman of the Selection Committee of the PGIMER, Chandigarh for five years, helping the Apollo Hospitals Educational and Research Foundation to set up an active research and training programme and setting up a model programme for rational use of drugs in Delhi State. I did not choose any of these jobs but did whatever I was asked to do.

Q. Could you describe your typical working day?
I work at the Internet in the morning from 7.00 a.m. to 9.00 a.m. answering the e-mails which have accumulated at night particularly from USA and Europe over the night. At 10.00 a.m. I go either to Apollo Hospitals or to the WHO office. I have Scientific and Board meetings and video-conferences till 6.00 p.m. I go out to meetings at the Ministry of Health and Family Welfare, ICMR, Population Foundation of India or NACO as required. I reach home at about 7.00 p.m. with a briefcase full of things to read. I have to write out a talk or a paper every third day. After dinner I do this till I fall asleep. In between I answer about thirty telephone calls every day on my cell phone. A pretty uninteresting day to most people. I look forward to spending some time with my wife and our Alsatian dog in the evenings or talking to my sons on telephone.

Q. Does the Indian health care system have any problems? If yes, how would you tackle these?
There are about 400 million people in this country who have inadequate access to health care. They cannot get free medicines – except for a very few – and they cannot afford to buy medicines. Public Health measures to prevent diseases are lacking and there are not enough public health experts. There is no referral system. Finally governance of the doctors is weak and very often patients are exploited. All these can be classed as problems of access, lack of monitoring, lack of accountability, failure to maintain standards, lack of governance and corruption. How to tackle this – to provide better health: Set up a cadre of Public Health persons with a B. Sc. Degree in Public Health to promote good health practices, prevent ill health wherever possible and empower the people to look after their own health. Set up programmes of Rational Use of Medicines so that all citizens can get always 25 Essential Drugs without spending more than what they do today on drugs. Improve Management Procedures more in Health. Use Information Technology more. This will reduce corruption.

Q. Is there anything you think must be done for better health for all?
The government and the private sector and the public need to work immediately and seriously on a health insurance system whereby all Indians are insured for basic health care and emergency care. If Brazil, Thailand and China can do it why can we not do it in India?

Q. What would you have been if not a doctor?
I would have been a historian as I love history.

Q. Who is the person you admire the most or are most influenced by?
The person I admire THE most is Professor EP Abraham who was my tutor at Oxford. He was a member of the team, which discovered 'penicillin' at Oxford and then went on to discover 'cephalosporin'. He remained a simple unassuming person till the end and donated all the earnings from cephalosporins and his own house to the University of Oxford.

Q. What has been the professional achievement that has made you most proud?
I think, as far as professional achievement goes I am proud that in the field of training I set up with my colleagues the DM Course in Clinical Pharmacology at the Chandigarh Institute. About forty clinical pharmacologists are holding top position in this specialty all over the country and abroad. The course was set up in 1978 and remained the only such course in Asia till 1998. I am also proud of establishing the Delhi Medical Council as Founder President. Finally, I am proud of setting up a model programme of Rational Use of Drugs in Delhi State.