A doctor talking about salary has been an issue which has always been frowned upon in a country like India where public wants to see healthcare as a free social service.
On the contrary, instead of asking the government, the political class and the policy makers for the free status of healthcare, the brunt of this expectation has to be borne by the doctors.
Hardly a few people from the general public actually have an idea about the money their elected government spend on them in a year.
As per WHO's Global healthcare expenditure database, the healthcare expenditure by India per capita per year was just 5 dollars ( Just Rs. 369/ year/person !!) which is just barely above the expenditure by Pakistan and Bangladesh.
India has one of the lowest expenditures on healthcare among 36 other OECD countries.
Sri Lanka's per capita expenditure on healthcare is 3-4 times higher than that of India.
The table below shows the US$ per capita Health Expenditure of USA, UK, Sri Lanka, India, Pakistan and Bangladesh.
|
Countries |
Indicators |
Unit |
2016
US$ per capita Health Expenditure |
|
United States of America |
Capital health expenditure |
in current US$ per capita |
343 |
|
United Kingdom |
Capital health expenditure |
in current US$ per capita |
124 |
|
Sri Lanka |
Capital health expenditure |
in current US$ per capita |
15 |
|
India |
Capital health expenditure |
in current US$ per capita |
5 |
|
Pakistan |
Capital health expenditure |
in current US$ per capita |
4 |
|
Bangladesh |
Capital health expenditure |
in current US$ per capita |
1 |
This per capita health spending has wide disparities even within the country with Tamil Nadu having highest per capita expenditure of Rs 447/year/person and Bihar having lowest per capita expenditure of Rs 100/year/person (NIPFP, 2005).
Owing to this gross under funding of healthcare sector by the government, it translates into poor quality healthcare and very low pay scales for doctors and other health workers.
Apart from the problem of low Government expenditures in health, other issue that affects the doctors is the gross disparity in the salaries of Government doctors amongst different states of India.
State wise sample salaries of Indian Resident doctors
Below are the state wise sample salaries of resident doctors- post MBBS, during PG and Super specialisation along with the institute review based on the survey conducted by WorldSurgeryForum.net.
- Delhi NCR
- Haryana
- Uttar Pradesh
- Madhya Pradesh
- Puducherry
- Punjab
- Rajasthan
- Maharashtra
- Chhattisgarh
- Uttarakhand
- Jammu and Kashmir
- Gujarat
- Kerala
- West Bengal
- Telangana
- Andhra Pradesh
- Karnataka
- Tamil Nadu
Why Low salaries for Doctors are not justified?
The gross disparities between states and unjustifiably low salaries in some states are obvious by few of the examples below:
- An Assistant Professor with a postgraduate qualification in a Medical College in Tamil Nadu having 20-30k lesser salary than a Junior resident post MBBS doctor in Delhi NCR.
- An Assistant Professor in a Government Medical college in Tamil Nadu doing 50-60 hrs of duties along with night duties with many emergency surgeries and procedures per week having a lower salary than a Professor in arts/ science government college doing 30-40 hrs of duties in a week in the same city.
- A doctor in mid 30s working as a senior resident in a superspecialty department in a Medical college with post doctorate degrees giving 100-120 hrs of duties per week in Tamil Nadu having a lower salary than a graduate Call centre employee in the same city.
These issues start pinching manifold when a person has spent 50 lacs to 1 crore on his education or has been bonded with a government bond of Rs. 20 lacs to Rs. 2 crore for a period of 1-10 years!
Also read: WHY INDIAN MEDICAL AND SURGICAL SUPERSPECIALTY SEATS ARE GOING EMPTY?
These examples have become a big source of demotivation for a majority of doctors as these financial issues are compounded by not being able to give enough time to family leading to marital problems which are on the rise in the medical fraternity.
Everybody is aware that the family life of young doctors goes for a toss as the duty hours for young resident Indian doctors can go upto 100-120 hours per week. Each doctor has to go through this heavy duty schedule in the starting 6-7 years of the career.
Another issue is that of unjust and unruly demonic bonds by various state governments. The government has taken the model of apprenticeship followed in Medical education in a very wrong way.
In an apprenticeship model, where a trainee doctor is a valued component of the hospital workforce while he is also learning and improving his skills on the job. He is not like a post graduate engineering or humanities student who is just exclusively learning and is liable to pay a hefty fee. He is an apprentice; he is contributing much more to the system than he is learning on the job.
The bond structure in our country has its origin in the premise that a trainee doctor is a student and is liable to pay full fee for his training. And if he is not paying the fee at par with a private sold or sponsored NRI seat, he is liable for a bond lasting for up to 10 years breaking which he is asked to pay an amount upto 2 crore rupees. This mind set has to be changed and requires a strong opposition from the medical fraternity!
Conclusion
Though discussing about salaries may not be considered good, but this is one issue that actually matters to each and every person who has old parents and a family to take care of, like people in all other professions. We should be open in discussing them because of these unjust and grave disparities in the pay structure across our country.
