Coronavirus | Opeds and editorials

We need social physicians

Doctors and medical staff attend residents at a COVID-19 coronavirus community clinic in Mumbai on May 19, 2020.

Doctors and medical staff attend residents at a COVID-19 coronavirus community clinic in Mumbai on May 19, 2020.   | Photo Credit: AFP

A deficient social emphasis still remains a stark feature of India’s medical curriculum

While medicine remains central to public health, medical academia has never been a torch-bearer for the public health cause. Apart from the inherently individualistic character of medicine, part of the reason can also be located in Indian medical education originally “carrying the cultural accretions of the West”, as D. Banerjee puts it. Multiple policy deliberations have upheld the idea of training a socially oriented physician responsive to community and public health needs. However, a deficient social emphasis is still a stark feature of India’s medical curriculum.

This orthodox edifice of medicine has come under attack thanks to the COVID-19 pandemic, which is both a medical and a social calamity. The pandemic has served to water down the elitist and individualistic barriers of medicine that have hitherto kept apart the private and the public, the rich and the poor, and the individual patient and the community. COVID-19 has delivered one strong message: when it comes to a nation’s health, private care is of public concern, and public health is of medicine’s concern.

Comment | Where is health in the stimulus package?

Creating ripples at the societal level

Early this year, there were debates on why elite professional institutions such as top medical colleges rarely become the centre of political ruckus and remain free of strong ideological leanings, unlike many of their humanities counterparts. The perception about medical academia is that it is too preoccupied with cultivating scientific and professional excellence to cast an eye upon politics. One reason given to explain leftist dominance in humanities academia is the keen social orientation that humanities education inculcates. By the very virtue of their education, humanities students feel strongly about inequity, stratification, and deprivation. This element remains missing in technically oriented, competition-driven professional fields such as engineering and medicine. But while engineering is irredeemable in this respect, the same cannot be said for medicine. Both the number and profundity of emotional experiences that medical college-hospitals see on a regular basis can scarcely be fathomed in any other category of educational institution. The Competency-based Undergraduate Curriculum applicable since 2019 emphasises on inculcating communication skills and empathy in medical students to improve clinical practice. However, that such empathy can create stronger positive ripples at the societal level has been given little attention.

This is not to suggest that medical colleges must be modelled after the highly politicised humanities institutions. The idea is to emulate purely the ‘social orientation’ element. The same empathy shown at the singular-patient level, and which improves clinical practice, can manifest at the societal level to confront the inequalities and deficiencies of public health. It is common knowledge that public health has perennially been one of our highly neglected items. It is also a concern that cuts across party lines and stands little chance of being viciously contended and politicised. Besides, a deficient social orientation among physicians has significantly contributed to their maldistribution.

Remodelling the foundation

For this, the foundation of India’s medical education would need to be radically remodelled along bio-social lines. There is need of radically enhancing community exposure during both undergraduate and postgraduate years. For this, medical training will need to shift a considerable part of its base away from medical colleges in cities to lower-level health facilities and the community, along with seamless integration of medical colleges with the health services system. Also, there is need to pep up the community medicine curriculum and teach health policy to medical students emphasising particularly the sociological and political-economic aspects. All of this should confer the ability to critically analyse how health and medicine function in the bigger picture — creating a socially oriented physician capable of relating with macro-level challenges in public health apart from practising social medicine.

Also read | The pandemic and the contours of a health response

Some might say that that the biggest stumbling block to realising socially oriented physicians is the commercialisation of the medical profession. But commercialisation is something that has largely arisen from within the profession. Given this, corrective measures will also need to be effected from within. The aforementioned measures can actually help us combat commercialisation among multiple others, given an environment conducive for the same. In the wake of the pandemic, we have started entertaining ideas such as private hospital nationalisation and mainstreaming of alternative medicine. A push for any reform cannot do without acknowledging the imperative of social physicians for better public health.

Dr. Soham D. Bhaduri is a Mumbai-based doctor, healthcare commentator, and editor of ‘The Indian Practitioner’

A letter from the Editor


Dear reader,

We have been keeping you up-to-date with information on the developments in India and the world that have a bearing on our health and wellbeing, our lives and livelihoods, during these difficult times. To enable wide dissemination of news that is in public interest, we have increased the number of articles that can be read free, and extended free trial periods. However, we have a request for those who can afford to subscribe: please do. As we fight disinformation and misinformation, and keep apace with the happenings, we need to commit greater resources to news gathering operations. We promise to deliver quality journalism that stays away from vested interest and political propaganda.

Support Quality Journalism
This article is closed for comments.
Please Email the Editor

Printable version | Jun 1, 2020 3:14:54 PM | https://www.thehindu.com/opinion/op-ed/we-need-social-physicians/article31625933.ece

In This Package
Open with caution: On Unlock 1
It’s time for a universal basic income programme in India
The waning of subaltern solidarity for Hindutva
Export blocks: On India’s trade amid the pandemic
A moment to trust the teacher
The echo of migrant footfalls and the silence on policy
Enjoying the fruits of their labour
Helping supply chains recover
The heavy burden of social suffering
An effective lockdown
The lockdown has highlighted stark inequalities
Will sport be the same in empty stadia?
Cinema after COVID-19
The eternal longing for the distant home
Working safely: On workplaces during the pandemic
A hole in the whole: On health sector woes
China, better prepared for the post-COVID world
How public health boosts an economy
Keep it retrospective
Backing the ‘angels in white coats’
Standstill: On opening of stadia for training
Flawed stimulus is justice denied
You are reading
We need social physicians
A callous response
Peaking: On India’s coronavirus tally
Farm gate in focus: On amending Essential Commodities Act
A question of quarantine: On migrant workers and other travellers
TASMAC tribulations: On Tamil Nadu liquor sale
The pandemic and the challenge of behaviour change
One for the poor: On Centre’s corona package
Lockdown syndrome: On virus-induced economic crisis
Are India’s labour laws too restrictive?
Stop the return to laissez-faire
States cannot be left to the Centre’s mercy
Local motif: On Modi’s call for self-reliance
Liquidity lifeline: On Nirmala’s MSME package
A plan to revive a broken economy
Provide income support, restore jobs
Perilous state: On State finances
COVID-19 and the path ahead
Reaffirm cooperative federalism
Riding roughshod over State governments
Tragedy on the tracks: On the killing of 16 migrant workers
Coming to terms: On India refusing to admit community transmission
The trends shaping the post-COVID-19 world
The epidemic and ensuring safety in courts
Responding to COVID-19 at the grassroots
The face of exploitation
Contempt for labour: On dilution of labour laws
Slower growth and a tighter fiscal
Back home: On return of Indian expatriates
Blame game: On Donald Trump’s anti-China rhetoric over COVID-19
Resuscitating multilateralism with India’s help
A war-like state and a bond to the rescue
Fear and loathing in the land of the free
Everyone wants a good stimulus
Rent control amidst pandemic
Slow release: On lockdown 3.0
No comfort in numbers: On Bengal’s coronavirus cases
Pandemics without borders, South Asia’s evolution
India’s disease surveillance system needs a reboot
No relief for the nowhere people
BRICS against COVID-19
Recovering early: On India’s COVID-19 patients
It’s about food, nutrition and livelihood security
Taiwan’s coronavirus protocol shows how it is done
Needed: a pandemic patent pool
Getty Images/iStockphoto
Plasma therapy is no silver bullet
Take care of yourself too, fellow journalists
Strategic shift: On home isolation of mild coronavirus cases
Coping with today, planning for tomorrow
No end in sight: On India’s coronavirus strategy
Vividly imagining the life of migrant workers
A task for South Asia
Privacy concerns during a pandemic
Unlocking justice in the lockdown
Safe return: On migrant worker distress
The outline of another pandemic combat strategy
Pandemic and panic: On Tamil Nadu’s five-city lockdown
Protecting the poor from becoming poorer
Did SARS-CoV-2 begin from a lab?
Protection for protectors: On safety of healthcare workers
Rapid failures: On antibody testing kits
The COVID-19 paradox in South Asia
Fishing in troubled waters during a pandemic
How will India emerge out of the lockdown?
Making doctors wash hands
Locked out of cities, homes and livelihoods
Script of unity: On coronavirus and social prejudices
Exploiting a pandemic: On Trump’s immigration policy
The village is still relevant
A time for planetary solidarity
There may be no going back
No transparency in West Bengal
Focus on the curve: On India’s COVID-19 numbers
Economy in lockdown: On India’s worst case scenario
A shot of hope with a game changing vaccine
Caught in the heightened arc of communal polemics
Singing the corona tune
Helping a lending hand: On RBI’s second lockdown stimulus
A season of change: On IMD forecast system
A virus, social democracy, and dividends for Kerala
Across the gulf: On stranded Indian workers
Virtual reality: On telemedicine
A blueprint to revive the economy
A case to use JEE-Main instead of JEE-Advanced this year
Will the aviation industry recover from the pandemic?
Data-driven reporting during COVID-19
Stress test: On revised lockdown guidelines
Disastrous decision: On Trump halting funds to WHO
Cease the distractions, seize the moment
Getting the containment strategy in India right
In India’s response, a communications failure
Harmonising with nature
End the harassment of farmers now
A narrowing window: On extension of lockdown
Corona bond: On Eurozone COVID-19 rescue package
Halting the march of rumours
Polls during a pandemic
The pandemic and the contours of a health response
Economic liberalisation and its faults
Invasive, alien, most fearsome
Trade in tatters: On the global slump
Wanted, a collective national endeavour
Disingenuous and no antidote
COVID-19 and the crumbling world order
Women’s safety during lockdown
Lives and livelihoods: On economy after lockdown
Stage fright: On denying community transmission
Team India and winning the pandemic battle
In time of need: On hydroxychloroquine export
Will COVID-19 affect the course of globalisation?
Finding a scapegoat in WHO
Curating news for children during pandemic
A time for extraordinary action
For better use: On MPLADS funds
Needed, greater decentralisation of power
A key arsenal in rural India’s pandemic fight
Preparing for exit: On lifting the lockdown
Sanctions and pandemic: On America’s Iran policy
‘A script of action, responsibility and compassion’: Chief Minister Ashok Gehlot writes on Rajasthan’s fight against COVID-19
Taking a long view of the pandemic fight
Ten questions posed by the virus
A different economic approach
Why healthcare workers above 60 should be ‘benched’
Enemy at the gates: On Kerala-Karnataka border row
Reducing farm distress during a pandemic
Why everyone should wear masks
The criticality of community engagement
A niggardliness that is economically unwarranted
The spectre of a post-COVID-19 world
Light and sound: On Narendra Modi’s 9-minute light ceremony
A million and counting: On global coronavirus spread
Safe forests, safe people: On diseases of animal origin
Quarantine and the law
Making the private sector care for public health
Looking east to contain COVID-19
Limits to rugged individualism
Uncritical endorsement: On exodus of migrant workers and the Supreme Court
Beyond the blame game: On the Tablighi Jamaat episode
A long road: On India’s 21-day coronavirus lockdown
The missing notes: On politics and the fight against COVID-19
China’s zero: On China’s lead in containing coronavirus
Unprecedented step: On Wuhan lockdown
The return of the expert
Lessons from Hubei
A pandemic in an unequal India
Faith can’t override public health
Devising a people-centric response to COVID-19
Karnataka CM writes on how the State is fighting the pandemic
Tamil Nadu CM writes on how the State is stopping the pandemic in its tracks
The hunt for a cure begins with telling the truth
COVID-19 and a city’s anatomy
Long live the nation-state
The COVID cycle
Coronavirus | The worst of times, the best of times
It’s also a fight against punitive measures
The age of the neoliberal virus
The deep void in global leadership
Thinking national, acting local
Every man is a part of the main
Beyond social distancing to fight COVID-19
Next Story