NEW DELHI: Even as governments cite shortage of
doctors to allow more private medical colleges, six
states — Delhi, Karnataka, Kerala, Tamil Nadu, Punjab and Goa — have more doctors than the
WHO norm of one for 1,000 people. Yet, some can’t find enough doctors for rural public health system. Also, most doctors from these states are unwilling to move to states like Bihar or UP that suffer from an acute shortage. This again raises the question of whether merely producing more doctors can address the crunch in public health and in rural areas.
The density of doctors per 1,000 people in Tamil Nadu is as high as 4, almost at the same level as countries like Norway and Sweden, where it is 4.3 and 4.2 respectively. In Delhi, the density is 3, higher than the UK, US, Canada and Japan, where it ranges from 2.3 to 2.8. In Kerala and Karnataka, the density is about 1.5 and it is about 1.3 in Punjab and Goa.
TOI calculated these densities after deducting 20% from the number of registered doctors, as is done by the Medical Council of India to estimate the number of doctors available, since many state councils have not updated their registries. In states that have updated them through periodic reregistration, as in Delhi, the 20% reduction was not applied.
Since India’s doctors are largely concentrated in urban areas, it is possible that even some states with doctor population ratios better than 1:1,000 may have shortages in rural areas. However, Tamil Nadu and Kerala boast that they have no vacancies in their rural public health systems.
According to Dr Prabhakar DN, former president of the Karnataka branch of the Indian Medical Association, 40% of doctors in Karnataka are in Bangalore. “In rural areas, there is still a shortage. Bangalore is saturated, even for specialists. So they don’t get jobs. Doctor salaries are coming down... We need to focus on producing doctors for the periphery. Just producing more doctors won’t work,” he added.
“Unlike engineers, who typically need to find jobs, doctors can be self-employed. If there are too many in a geographical area, they resort to unethical practices on the few patients they get to make ends meet. That’s why there is a need to calibrate the number being produced. We have told the state government to stop allowing the opening of more private colleges. They should shut down many of those that are in a bad shape, with no patients and no money to pay their faculty. The IMA is having to intervene each time to help them as they are not paid for six to eight months,” said Dr N Sulphi, secretary of the Kerala IMA.
File photo used for representation
