A platonic wish-list for 2022

Just as we were getting euphoric with the prospects of normalcy returning on the Corona pandemic front, comes the disturbing news of Corona virus raising its ugly head once again in Europe and Asia. India too has had its fair share of the roller-coaster ride, but is currently basking in the glory of reduced numbers. However, it would be pragmatic to accept the endemicity of Corona, with occasional exacerbations, and we should learn to live with it, and despite it.

Considering that human memory is short, numero-uno on my wish-list for 2022 is that all we learnt through hard labour and toil, suffering and mayhem, should stay learnt. Despite inherent reticence, medical professionals and the public took to digital technologies, like swan to water, and soon realized their merits.

However, to extend and harness the benefits of digital healthcare delivery for the masses, we need to improve digital literacy and remote connectivity. Vaccines and drugs were developed and approved with warp speed. The inefficiencies and complexities of governance were set right to a large extent and the regulatory bodies became proactive and participatory. Payments were released on time, including clearance of the long-pending dues. The government needs to retain that efficiency moving forward, so that it remains responsive and acts with alacrity, even in routine times. Alas, the same seems to have fallen back into the old mode, with delayed payments from CGHS and other group payers.

Healthcare is not a silo-based speciality; it has social determinants also. Therefore, healthcare needs to be provided holistically and effectively by lateral integration with other streams, like engineering and IT. Architectural design of the hospitals, with the concept of collapsible walls, ready to address the ever-changing needs of healthcare, not only to natural disasters and pandemics, but also to human hubris like wars, confrontations, and terrorist activities too need our attention.

The family physician needs to discover his lost glory so that tertiary care institutions can be decongested. There needs to be an attitudinal change so that we as doctors do not perceive ourselves as the givers and the patients as the takers, but we start partnering and sharing patients’ anxieties and worries, with the attitude of healing rather than just technology-based cure. The mind-set of physicians needs to change to partnership and hand-holding the patients through the disease.

Medical education too needs a relook with introduction of collateral subjects from humanities, art, culture, music, etc., with a view to producing alround development of medical students, who understand the socio-cultural dimensions of health and basic tenets of interpersonal relationships and effective communication, so that the profession reclaims the lost turf of doctor-patient trust and relationship. The four Ms need to be reinforced – not only the knowledge of medicine is important, but also the manners, morals, and even the money, viz., cost of medical education, which needs to be reigned.

Few random rantings for the wish-list – humongous amount of data was generated during the Corona pandemic and there is a need for analysis of this big data on omics, including genomics, pharmacogenomics, and proteomics; artificial intelligence and molecular profiling. Translational research must be the focus area, rather than basic core research. Innovative models of recycling and cost reduction should be developed. They would not only address cost containment, but would also be environmentally friendly and carbon neutral. Relevance and effectiveness of the alternative fields of medicine, especially AYUSH, should not only be professed, but also acted upon by delivery of allopathy with AYUSH services in a complementary manner under a single roof.

To bring up the rear, the conformist in me seeks the quotidian and mundane, viz., increased governmental healthcare spending, reduction in out-of-pocket spending, better financing of the Ayushman Bharat, manufacturing of active pharmaceutical intermediaries (APIs) under Aatam Nirbhar Bharat, increase of the PLI schemes and dedicated MedTech parks. Even medical tourism needs to be reinitiated and incentivized with support from all the stakeholders including the government, tourism, and hospitality industries.

But all these will come to a nought if the health of the healthcare providers themselves was insalubrious. Covid has taken a heavy toll of mental health, and adequate attention should be paid to the medical and paramedical fraternity, so that smiles are returned to their faces, which as a corollary will translate into smiles for the patients and for the public at large. It is estimated that over 450,000 workers moved away from the healthcare and there is a great shortage of manpower. There is thus a felt need for innovations in skilling of healthcare workers, besides developing local supply chains for material resources.

Needless to say, respect for nature and environment will go a long way in restoring the health of all stake holders.