Having practised as a gastroenterologist for over three decades in the USA and with specialization in Internal Medicine, Dr. K. T. Shah of Houston, Texas, took a decision recently to return to his homeland and render social service by attending to health care of rural folk. He was on a brief visit to Mysore a few days ago when our Correspondent interviewed him at the residence of Mysore Grahakara Parishat member Dr. Bhamy V. Shenoy.

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The controversial outsourcing of jobs in the USA has happened on a large scale in IT industry. Has the same happened in healthcare sector?
No, it has not happened yet. Health care is quite different from IT in many ways. In healthcare, a patient desires to have a personal touch with the consultant. Relief can be provided even on the telephone, but that does not result in satisfaction. In contrast, working in IT field or for that matter legal profession, lot of paper work is involved without scope for personal touch. However, if adequate infrastructure is developed, healthcare of high quality can be provided in India. The benefits to patients in money terms will mean, whereas it costs US 30,000 dollars for coronary bypass surgery or knee replacement but only US 5,000 dollars in India. Clean environment, hygiene in public places and good infrastructure for transport to and within cities need to be addressed urgently for providing better healthcare in our country.

Given the rampant quackery in medical practice in India, there is malpractice of one kind. What is the scenario in the US?
Medical profession in the US is highly regulated. Rules have become very strict in the last twenty years. Whenever the doctor indulges in malpractice of any kind and the patient complains, stern action is taken right away. If found guilty, fines are hefty. Doctors have become much aware that they cannot treat heir patients lightly. Thus, quackery in the medical profession in the USA is not significant. It is not at levels that should cause worry. Only Red Indian witch doctors are permitted by the Government to practice their traditional methods. The Government even entertains their claims to meet the costs of their treatment.

Malpractice litigation trends in the USA are mind-boggling. How have the doctors among NRIs fared? Even Non - Returning Indians!
Malpractice litigations in the USA have become a big problem. There are many sides to it. Indian medical practitioners seem to be less affected by the factor of malpractice litigation. Approximately, while nearly 40 per cent of the doctors are affected as a whole, only about 5 per cent of Indian doctors are affected.
That is because; usually they bestow extra time and attention to patients in listening to them about their health problems. They explain to the patients as much as possible about their ailments and the advantages and disadvantages of a particular therapy.

Even family members are given an opportunity to take part in the consultation. The present trend is that even American patients try to consult Indian doctors in certain specializations. In my own 31 years of practice in the USA, My Insurance Company has not paid a single dollar towards a medical malpractice lawsuit.

It is my belief that it is the result of following ethical practices and explaining to the patient the tests to be done and the different options based on the results. I also take care to check side effects of medicines prescribed by me. Earning the trust of patients is very important and that is exactly what Indian doctors try to do.

Drugs banned in the US and European countries are dumped into India. Indian medical profession has lapped them up. Is that not a betrayal?
I don't agree with the statement you have made, more so the way you have made it. It is not the drug companies of USA but our own companies, which are producing generic version of those drugs you are referring to. Therefore it is a case of self - betrayal. Moreover, it is not a serious problem. More than 95 percent of the drugs produced, sold and prescribed here are the same as those produced, sold and prescribed in the West. The bigger problem is, if 100 gram of a component in a particular drug is declared on the label, does it really contain that much? Thus, banned medicines are not a big problem.

American medical lobby have recently said that India's Ayurvedic products are toxic. Is that statement well - founded?
The answer is yes. Research carried out has brought out that Indian Ayurvedic products available in average grocery outlets are highly contaminated. These products do not come under the purview of Federal Drug Control Administration. Many case of patients consuming sub-standard Ayurvedic products and suffering have been reported. Lead, Arsenic and Mercury have been detected in Ayurvedic products sold in many Indian grocery stores in the USA.

Hi - tech healthcare in India has overtones of business rather than service now a day. Is that not an infringement of the oath of Hypocrites?
Yes, indeed, it is an infringement of the oath of Hypocrites. Unfortunately, human beings, with rare exception, are tempted to make some fast buck — businessmen, lawyers and the rest, not just doctors. I am no exception. People tend to cut corners to make money the easy way. The only solution seems to be for the religious heads to impress on practitioners of all trades to adhere to ethics and honesty in their professional life. I feel embarrassed even to repeat Gandhiji's statement: There is enough to meet everyone's need but not everyone's greed.

America is welcoming Indian nurses in a big way. But not Indian doctors. Why?
The answer is very simple. Business all over the world works on the principles of supply and demand. Demand for nurses is very high in the USA. Over the years, American doctors have realized that Indian nurses are efficient and competent in work and communication in English. Indian doctors are also rated well but there seems to be an oversupply of Indian doctors in the USA.

If a medicine does not have side effects, it may not have any effect at all. Is that not a reflection on medical research at large?
Yes and no. Most of the medicines have some side effect. There are some exceptions. Some medicines also have serious side effects. Such medicines will not be permitted to be sold in the market. Side effect of medicines is also related to the genetic make - up of particular patients. Medical researchers are increasingly learning to get the benefits of genomic research in developing safe drugs. Patient - specific drugs are going to be developed in the coming years.

B. R. S.
Courtesy: Star of Mysore

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