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Sorry Minister Saheb, I Will Continue to Treat Poor Patients from Bihar or Anywhere Else

An AIIMS doctor reacts to minister of state for health Ashwini Kumar Choubey’s call for Bihari patients to be sent back to Patna for treatment.

Ashwini Kumar Choubey

Minister of state for Health & Family Welfare Ashwini Kumar Choubey administers a pledge during Swachhta Hi Sewa Abhiyan at RML Hospital in New Delhi. Credit: Twitter/DD News

I am a doctor, working at AIIMS, New Delhi, for the last 14 years and have been treating all kinds of patients. By all kinds, I literally mean all patients, irrespective of region, caste, religion, gender, social status and even nationality. My specialisation has meant treating patients from Nepal, Bhutan, Bangladesh, Iran, Dubai, Mongolia, Sri Lanka, Pakistan, Nigeria, Iraq, Afghanistan… the list is endless.

I was so bewildered to read and see your recent comments on patients from Bihar that I thought of writing to you. You were quoted as saying:

“I have asked the director of AIIMs that patients who can be treated in Patna AIIMS should be referred there immediately …  There is no need to increase the crowds here…  you know how patients flock here…”

There are certain facts that need to be clarified. Since you took charge as the minister of state for health recently, it is important that someone apprise you of the facts. The following are also important from a legal point of view.

As doctors, we cannot (and should not) refuse treatment to any patient based on their region, caste, creed, religion, gender, social status and nationality. It is not only morally incorrect but actually illegal to do this. So please do not advise doctors from AIIMS, or for that matter any doctor in the country serving under your government, to withdraw treatment to a section of patients. The doctors are morally and legally correct in ignoring your ‘advice’.

AIIMS is the apex referral institute that was formed as part of a visionary thought process by the then policymakers of the country. Being a tertiary institute, it is reasonable if patients from distant states flock to the institute. I agree that at times, there is a loss of gate-keeping in referral practices but then that is not a fault of the patient and they should not be punished for this. Let me tell you that coming to the AIIMS out patient department on a working day, getting yourself registered by standing in long queues and then waiting to be seen by a specialist is no easy task. Your premise that Biharis come to AIIMS for even trivial diseases raises some doubts. I would not waste a day, surrounded by the dying and the diseased, just to be seen for something that could have been treated back home in my hometown. And even if we believe that the diseases for which Biharis come to AIIMS are trivial, the patient’s perception is all that matters. It is the patient’s right to determine how unwell they feel, unless told otherwise. Perception is a matter of behaviour and I do hope that you do not intend to change patient behaviour? If you do, then please don’t, sir. It can be counterproductive in more ways than one.

The problem of overcrowding at AIIMS is not a problem caused by Biharis or even by UPites, Rajasthanis or Chattisgarhis. It is a problem created by the poor infrastructure of healthcare in the country. And who will know this better than you, sir? The serial publications of data on various conditions by your own ministry is a grim reminder of this. The recent data revealed by the Global Burden of Disease Study in The Lancet (which is an important medical journal, sir), should be heartbreaking for all nationalist Indians. I am sure you are aware of that. So in a country with poor health infrastructure, and a shortage of doctors, hospitals and other medical modalities, if there are medical setups that are delivering, patients should not be denied entry due to overcrowding. The poor are reasonably intelligent, they flock to places they trust. Please let them continue to do so.

Finally, sir, a 14-year-old patient of mine who has widespread bone cancer and probably will not be alive to see this winter, visited me yesterday. He is from Bihar. Despite such a serious illness, he hasn’t lost his liveliness. Yesterday, in the light of your statement, he wanted to know if I’ll continue to see patients from Bihar. I asked him to come and see me next week. He kissed my hands with his parched, paper thin lips.

Sorry, sir, I couldn’t obey your orders. He had immense hope in his eyes.

I hope you will understand my dilemma and excuse me.

Shah Alam Khan is a professor in the Department of Orthopaedics at AIIMS, New Delhi. Views are personal.

 

  • Raj

    Excellent and true

  • Anil Sinha

    This man Choubey is a Bihari himself. Now, he says that Bihari patient should be thrown out of AIIMS. These very people are responsible for the sorry state of health service in Bihar.When they get I’ll they rush to foreign countries for treatment.

  • Gohanish

    If only all the doctors were such good people

  • https://babupaedia.blogspot.in Sudhansu Mohanty

    Completely insane remarks by the Minister. This is the problem with this government – talent deficit! No person in his right sense will ever say what he said. The Minister should act in a manner that behoves the high office he holds. Thank you, Dr. Shah Alam Khan, for putting the Minister in his place – your riposte and action is so apt!

    • Anjan Basu

      Along with a huge talent deficit, this govt also suffers from the congenital disease of mindlessness. Common sense and basic human decency are as alien to this dispensation as rain to the arid desert.

      • https://babupaedia.blogspot.in Sudhansu Mohanty

        Fully agree. Apart from commonsense and decency, they lack sensitivity born off their limitless arrogance and the desire to outbid one another in display of their USP – theatrics and histrionics! A test of their DNA will be if the PM, as the Pradhan Sevak as per his own self-claim, takes appropriate remedial action in the shape of public disapproval/reprimand of Choubey’s insensitive remarks.

  • Anjan Basu

    The minister deserved this very well-executed slap on his face. But Prof Shah Alan Khan delivers it with amazing grace. Only question is, will it sink in where it should? Given the unbelievably low levels of sensitiveness and intelligence of the ministers of the Modi govt, even this admonition may go well over Choubey’s head.

  • Amitabha Basu

    A rare breed of doctors in AIIMS, Dr. Shah Alam Khan in particular, who all opposed the diktat of the minister, reaffirms our hope in the medical profession. Unfortunately, the politician breed does not lack maggots, leeches and vile insects.