22nd November, 2021
What comes in your mind when you think of Doctors? A smart looking energetic person with formal attire who is calm, composed and someone who deserves respect for selfless service? Or someone who earns hefty amount of money for the work they do? The world needs to know that doctors of Nepal earn less than $400 per month, which happens to be the salary of government doctors of Nepal (for 8th Level Medical Officer and Dental Surgeon), and MD/MS/MDS graduate earns about $30-$40 more per month, And that salary is subject to taxation. Even with incentives for the extra duty hours and procedures performed, median income is below $500 per month. That is the case for government hospital doctors, the scenario is worse for doctors working in a private hospital/medical college/polyclinics (are paid around $250 per month).
This is not in any perspective proportional to the living cost in Nepal. For your reference, here are price of some goods and services in Nepal.
- 1 kg apple = 350 NPR = $3
- Gold Hallmark - 10g ( छापावाल सुन )= Nrs. 80,335.00= $677= more than 1 month salary
- Suzuki Alto 800 STD (796cc) Rs. 19.09 Lakhs = $16080 = (32 months salary of Govt hospital doctor)
- Apple MacBook Air 13-inch M1 chip/512GB - Rs. 189000= $1592 (3 months' salary)
- Median house price = 2 crores = $168467 = (337 months' salary= 28 years' salary)
Which means, if inflation is essentially zero, (which is not, it is 7-8% for Nepal, and the salary doesn't increase proportionally to inflation every year) then a doctor has to work for 28 years and save every penny he earns, just to own a house. If he can manage to save only 50 percent of what he earns, it takes 56 years to own a house.
With private sectors leading the healthcare sector and medical education sector in terms of reach as well as revenue generation, government hospitals in Nepal are known to be understaffed and overcrowded by patients all the time. Old buildings, old equipment that often stops functioning, unavailability of adequate staffs at government hospitals, always irritated and ill mannered staffs are the pictures that come in the general public's mind when they think of government hospitals. Large corporate owned hospitals exploit even harsher making the health professionals work for peanuts charging a hefty fees to the patients which makes it a very alluring business. If you want to make money quickly, you open a polyclinic/hospital or preferably a medical college here in Nepal.
What quality doctors will such institutions produce? Till when the international healthcare industry can rely on quality of Nepalese doctors? What sorts of unethical practices can a doctor be involved in just to make a good living? Is $400 per month a good pay after 5 years of hectic medical school? Not to mention, 5.5 year MBBS course costs $40000-$70000 and BDS course costs $25000-$35000 excluding the educational materials and living costs. Can those doctors be bribed easily by the pharma companies? Can those doctors be bribed easily by surgical items manufacturers? Can they be bribed easily by the owners of nearby private hospitals/laboratories/imaging centers?
What should be the minimum basic salary of a doctor so that his/her integrity cannot be bought easily, so that he/she can choose to live being truly ethical to his self? Please have your say.
Dr. Raman Dhungel
BDS, BPKIHS
Email: raman.dhungel@gmail.com
I agree with current scenario. It is all due to inefficiency of government system combined with unethical practice carried out by paramedics. Most patients that needs an evaluation are still being seen by paramedics. Doctors are not getting enough patients and patients are not getting adequate and optimum treatment. Hence total system needs clean up. We have opened a polyclinic and seen the response. I came to the conclusion that if we can change the system by opening pharmacy with same brand name in many places and funneling patient to one big center. If you are interested in our mission and goal and if you believe we can really work in a disruptive pace to correct the system. Do visit me. Let's move together. After all, someone needs to clean up this whole dysfunct system. Feel free to call me at 9857061631
ReplyDeleteThe so called medical tycoons of Nepal, who have reached powerful positions in both the bureaucratic system created this scenario. The policy makers are those very handful people who own majority of hospitals, have shares in medical colleges, and are influential both academically and politically. They have created a system which only helps and suits their particular needs.
ReplyDeleteFor example: Salary of medical officers, one year extra compulsory "work experience" to appear on PG entrance exams( again since they knew that if this was not mandatory, the necessary "cheap manpower" to run the hospital wouldn't be available and fresh pass out doctors would immediately opt out to do PG), stipend in PG and internship, etc.
The people in power created a problem, so that they can exploit the very problem in various elections for personal gains.
Besides the so called "high profile figures" fail to understand that the world has already changed. They have the mentality of "hamile hamro pala ma eti kamainna thyo....sala yee bharkhar ka bhura-bhuri essai karauchan."
Yes. That's the major issue. This fresh generation should resign from the petty paying jobs and begin practicing independently in remote places rather than being their puppets, (if they are free of government bonds). Mass resignation of Doctors from all hospitals is the need of the hour. You are exploited because they think they can, you cannot break free because they are paying too low to even think of other issues. Why should a doctor be forced to work in 3 different hospitals and seek commissions from pharma companies and labs if he were paid enough for his qualification? What other professionals do the same? If you own a laptop and good internet, and can adjust in remotest parts of Nepal, you can simply run a clinic and make better living than the top paid Doctors. If the nation cannot respect the qualified persons, they are either forced to leave the country or seek their own alternative ways.
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