Conversion rate

This heading should not lead you to think that I have suddenly become an economist and have started thinking about conversion rate of rupee against the dollar or have become an evangelist counting number of heathens I have managed to convert. I am writing about what a doctor friend told me about conversion rates related to a corporate hospital.

My friend is one of those rare birds who tries to follow medical ethics. His hospital outpatient work is fairly busy as he is good in his job and in his approach to the patients. He and I have become friends over years and he occasionally confides in me and seeks counsel.

Recently his hospital’s chief called him over for a chat and during the course of the talk gently reminded him of his conversion rates! He had a chart in front of him which gave him the year’s figures of the number of patients he has seen as out patients and the number of admissions he has made. Compared to the previous year the admission rate had come down and this from his point of view is not good and my friend was gently reminded to improve his admission rate.

I have grown old watching the changing medical scenario in urban India. Thirty odd years ago it was doctors who were hospital chiefs which were the beginning years of corporatization of health. Now it is the finance mangers with MBA qualification who become hospital chiefs and their method of management is how much profit a particular input shows at the end of year. The input may be a respected physician or a Sonography machine. The hospital chief is likely to be a much younger person than the doctor who is responsible for patient care. If I were in his position I would congratulate the doctor for having reduced the admissions while seeing more number of outpatients.

Hospitals are not factories which produce consumer products. These are institutions that mange sick patients and if a sick patient can be managed as outpatient at much less cost it is a service to the patient and indirectly to the community. If the same patient were to be admitted and treated when he could have been managed without admitting him, it may be beneficial to the hospital but it is very unethical.

 This is not an uncommon practice and there have been many occasions when I have given contrary advice to that of the hospital consultant who had advised intervention and very rarely such advice has been proved wrong.

What should doctors, who are at the mercy of the hospital owners to do in such a situation? Many are forced to compromise values and stay on, as quitting the job often means a major drop in the income.

What did my friend do?

He quit.

IPL 3

The slam bang veriety of cricket which goes by the name Twenty Twenty Cricket is back. It is sad that in this format where it is designed to badger the hapless bowler, the viewership seems to be good though not as it was last year. Most that pay exorbitant amounts of money to see this murder of cricket are young and I feel sad to see their hysterical behavior in the stands. Then there are the cheer girls with their skimpy dress or undress gyrating whenever a four or six is hit. What a weird spectacle!

A gentleman’s game to be enjoyed in leisure over five days has been reduced to this Jamboree of instant gratification!

 Are we seeing the last days of test cricket? I am afraid so.

Identity Crisis

We, Indians are called so by others. But those living inside the borders of the country called India have no single identity. We have many identities especially those of us who are grouped under a religion which goes by the name of Hindu. Followers of Islam and Christianity when asked their nationality if they are living in India are likely to say they are Christians or Muslims but ask a Hindu, he will confuse you by saying he is a Jat or Yadav or Curmi or a Reddy or a Gouda or a Vanniar etc, depending on where he lives and practices his caste. For this group of so called Hindus, their caste identity is more important than his Hindu let alone his Indian identity. 

We also suffer from afflictions of language. A person is likely to identify with the language he speaks and say he is Tamil, Telgu, Punjabi, Bengali etc. Again here, the Hindu is more likely to identify himself thus than others. This love of language can take extreme forms to be downright ridiculous. Considering we have twenty or so major and some thousand minor languages this attachment further divides us. I have seen people who speak a dialect, group together and from social clubs and exclude others and take great pride in doing so. This allegiance to language and caste is not only prevalent inside the country but is exported abroad too. Where ever there are a sizeable number of Indians living, you and be sure to find Guajarati, Bengali or Punjabi Association of [Indians]

When a human being decides to associate with another human being because he or she belongs to same caste and speaks the same language and not because of qualities of head and or heart, how do you expect progress?

To a great extent the ills we in present day India are facing is because of these strong multiple loyalties which blind us to the recognition of talent in those who don’t belong.

Rule of Geriatrics

Most countries retire those at sixty. Rightly so. Physical and mental decay begins about this age and the above sixty cannot perform as the below sixty. Brain degeneration makes them slow to react and they become indecisive. They tire easily their hearing and vision deteriorate. They have to go to the loo more frequently. They are more prone to arthritis, heart and lung ailments, cancer and auto immune disease. Therefore it is best they don’t work in responsible positions and endanger others. They can however contribute by being advisors to the younger decision makers.

This, at least in India, does not seem to apply to our politicians. Here Gerontocracy rules the roost. We have an eighty year old Prime minister, a seventy eight year old finance minster and an equally old foreign minister. Our defense minister is only slightly younger. The results of these tired old [not necessarily wise] men ruling the country is there for all to see. Their inefficiency is leading us from one scam to the other.

When they were moving from one scam to the other, on the way sweeping the other scams under the carpet, our army chief did not want to retire without bringing out the truth about the state of affairs in our defense forces. You can ignore any one else and get away with it but not an honest soldier who refuses to be bribed and adding insult to injury, wants to bring it into the open.

Our geriatrics are now stuck in a deeper mire.

Rise of field Hockey

There was a time we reigned supreme in this game. For over 50 years till the sixties we were unbeatable. Then started the era of decline. Slowly and gradually Cricket took over and Indians switched their loyalty and showered money, love and adoration to this game. But there were a few like me who continued to nurture our love for the game of Hockey. Hockey has some features which Cricket can’t have. It needs skill, speed and stamina. You cannot afford to loll at first slip or mid on and while away your time even if you are past 35 and your only qualification is that you are a good batter and the country loves you. I wrote about how the short form of Cricket, The so called Indian Premier League has sounded the death knell of the real Cricket, the Test Cricket. That this shorter version played in the IPL is hugely popular does not make my statement less true. Over the years we had to bear this pain of popularity at the cost of talent and merit. One look at our politicians and their popularity will make us wonder how these people can be popular. Look at the likes of Yeddyappa, Mulyamsingh and the Dalit Queen Mayawati, and you will understand what I say. This is also true to some extent as far as the twenty twenty form of cricket is concerned.

While I intensely dislike the abridged form of cricket, there is no chance of this happening to Hockey. Hockey, unlike Cricket has no abridged version. It is played over a period of 60 to 90 minutes and the result is guaranteed. India over the past ten years had a dismal record both the quality ofplay and its administration. We did not even qualify for the last Olympics. This time however we did qualify by beating France. I watched that game and it brought back memories of the golden era of Indian Hockey. This was followed by two weeks of scintillating Hockey which went by the name of World league of Hockey.

Taking the cue from the IPL the organizers of the World Hockey league divided the teams based on Urban centers and called the teams with fancy names. There were players from Australia, Canada, Pakistan, and Malaysia in this league along with Indians. It was a spectator’s delight.

That the Indians who played were not the best [as the top 20 who played for the country were not allowed to play in this league for the fear of injury keeping in view the forthcoming Olympics] did not matter. There were so many young Indian players with so much talent who played in this tournament that I felt the future of Hockey is bright.

That the league was a huge admin and financial success means a lot for the players who were treated so shabbily hither to. It is high time this happened to Indian hockey and the money and fame will surely lure our school children away from Cricket to this wonderful game.

Flock of sheep

MCI has recommended an increase in the number of seats in the medical colleges and this will help to meet the need for doctors in the country. The human resources ministry also seems to think that by allowing or forcing the IITs to double their intake they will meet the demands of the industry and also will help the socially and economically weaker sections to get access to these premier institutions.

Is increasing the numbers without caring to increase the infrastructure [buildings, equipment, and personnel] bring about the desired result? Answer is no and one can see this happening in post independent India. There is definitely an increase in the number of professionals of all types but their quality has suffered over the years as evidenced by the calamities we hear every day in the media [collapsed bridges, train accidents, fires, buildings giving way, patients dying because of wrong treatment]

Some twenty five odd years ago Late lamented Prof B.G.L.Swamy wrote more out of sorrow than anger, ‘I was forced to take double the number of students for the course, this and the number of repeaters made the work of conducting examinations in a decent manner nearly impossible. When I brought this to the notice of the principal of the college and the director of education, the common answer was ‘Swamy, you have to manage somehow’ this somehow resulted in students taking examination, spilling over to the pavement. The principal who came to inspect, seeing students sitting on the pavement, tried taking his ire on me. I said,’ sir, what you see inside the room is any and the one you see on the pavement is how’

This over flowing ill trained students become tomorrow’s professionals and what we are seeing all around is the handiwork of these. A flock of sheep incapable of original thought and deed, capable only of incompetent repetition and blunder.

Who can save this country full to the brim with incompetence?

Cult of violence

The incident of a 15 year old student stabbing his school teacher to death should come as an eye opener to most of us. While not condoning the student who was driven to this, one should consider why he did this. The teacher who was concerned with the poor performance of the boy reported it to his parents who in turn took the boy to task and the enraged boy took out his frustration on his teacher. For many students, the present day schooling and the methods of learning are worse than spending time in jail. A society which puts scholastic performance as the acme of achievement places enormous pressure on parents and indirectly on school teachers who in turn pass on this burden of performance on school going children.

In post independence India there have been two primary casualties. One is health and the other is education. The government has gradually withdrawn its responsibility of providing these two to its citizens and has allowed the private players to enter the field. I wrote some time back on corporatization of health and the aftermath. The same is happening in the field of education. All sorts of player whose motive is to make money are entering this arena across the board from primary education up to post graduate level. This has not come cheap. These institutions are prohibitively expensive education shops. A situation has arisen in this country where in an average parent is finding it difficult to foot the education bill of his or her children. I know of many who are either stopping at one child or not having children at all for this reason!

Those who do send their children to these privately run schools are under considerable financial strain and to get a report that their ward is poorly performing and thus a poor return on investment must be indeed galling. They will vent their anger on the child and he in turn will resort to violence either on himself or on others, in this instance on the hapless teacher. Suicides are not uncommon during exam time and at the time the results are made known.
To add fuel to fire is the general atmosphere of violence in which we are living. Our media, TV serials and movies, Computer games that children play, glorify violence. A child who grows in this kind of atmosphere can easily justify violence [a la Taliban].

In this land M.K. Gandhi. We are slowly and inexorably slipping into a land of himsa [violence].