Are Indians feeling the shortage of doctors?
India is short of 600000 doctors. This works out to be approximately 1 doctor for about 1560 people or 1 doctor for 1,634 people. Other statistics on health workers in India are given at this WHO site. Whichever stats you take, they tell you the same thing – India is short of docs.
Indians are not exactly crazy about allopathic medicine
But the figures given above are for allopathic doctors only. More Indians turn to Alternative Medicine (these systems of medicine are approved by the Indian government and also by the WHO) than to allopathic, and this isn’t just because they can’t find any allopathic doctors. They have faith in Homeopathy and Ayurveda. In rural and semi-urban areas this tendency is more pronounced, compounded by the shortage of allopathic doctors. 65 percent of the rural population in India is believed to use alternative medicine for their primary health care needs.
Alternative medicine rules
If you take into account the doctor-per-person ratio of practitioners of both allopathic medicine and alternative medicine, then it’s at 1 doctor to 870 people (Indian government figures). In fact, homeopaths are doing so well in India that the market is expected to increase to over Rs. 26 billion ($650 million) by 2010. Interestingly, alternative medicine is no more the bastion of the east. It is popular in the industrialised nations as well. Here are some interesting faqs from WHO.
- In China, traditional herbal preparations account for 30 percent – 50 percent of the total medicinal consumption.
- In Ghana, Mali, Nigeria and Zambia, the first line of treatment for 60 percent of children with high fever resulting from malaria is the use of herbal medicines at home.
- In Europe, North America and other industrialized regions, over 50 percent of the population have used complementary or alternative medicine at least once.
- 70 percent of the population in Canada have used complementary medicine at least once.
- In Germany, 90 percent of the population have used a natural remedy at some point in their life. Between 1995 and 2000, the number of doctors who had undergone special training in natural remedy medicine had almost doubled to 10 800.
- The global market for herbal medicines currently stands at over US $ 60 billion annually and is growing steadily.
If this seems like an article promoting alternative medicine, well no. What I am trying to say is that the shortage of medical personnel is not being felt as acutely by Indians as much as we are given to believe. Alternative systems of medicine are helping to fill the vacuum.
The quacks are the bad news
Unfortunately, quacks are also rushing in to fill the vacuum. Those with fake degrees. All conmen out to make a fast buck. And what’s scary is that there are more fake doctors in India than genuine ones!
The figures for quacks in just Delhi is estimated to be about 40,000 and I am sure Mumbai beats Delhi due to the sheer volume of its population (13 m at last count, 2001). Many of these ‘doctors’ operate in the slums. They not just misdiagnose, they often prescribe harmful steroids and sell/give away spurious or expired medicine. So if one takes these fake docs into account, then India has plenty of doctors!
Well, some feel that our doctors should stop migrating to foreign shores but what about those in India who choose to practice in the comfort of the city? Anyway, I don’t blame either of the two groups as it’s human nature to want to lead a more comfortable existence and make money. So no judgments here.
But a way out could be to make a year or two of public service mandatory for those who graduate out of government medical school, after taking advantage of the subsidized education in India. It seems reasonable to me, but apparently not to medical students or their parents or even the government. We are moving in the opposite direction. The Maharashtra government has recently “cut down” on the mandatory rural posting due to strong pressure from students and parents.
So does India simply wait until more medical schools are built? We don’t have a shortage of educated people who want to become docs…the problem is that a huge number of students cannot get into government medical schools because of the nerve racking competition and many others cannot afford the high fees of private schools.
The government has this new idea of recognizing graduate medical degrees from Britain, the United States, Canada, Australia, and New Zealand and allowing them to practice here…but how will that help? How many of these students are likely to work in the rural areas? And that’s what we need isn’t it!
The only other way is to give a year of medical training to interested social workers, train them as para-medics. I had read that the government was thinking of implementing such a programme but apparently this idea has been shot down by the medical council.
I hope the government isn’t simply waiting for the problem to sort itself out…waiting for medical schools to increase and plug the shortage…if that is so we are going to have more quacks in the arena… be prepared!
(Both photos are by me. The second one I made in photoshop)
Related Reading: Growth is not leading to development in India
The health scenario in India and medical tourism
Why medical students don’t like to practice in rural areas
Life expectancy and per capita income in India and the world
Shortage of docs leads to high workload and stress
Britain may not want Indian docs but India does