specialisation and missions
I am an ardent supporter of specialisation.There was once a time when specialisation was abhorred saying it was deterrent to the growth and sustenance of mission hospitals.The fear was normal considering the message of their times when a single doctor who would be the sole savior of a community would be the one available.Imagine if he is absolutely clueless about basic management of disease what would happen to the plight of the community!In that setting the antispecialisation supporters had a point.However What was ignored was the failure of the medical schools in making the person fit for medical practice after 5 years of training in learning and managing disease!
Things are rapidly changing in the healthcare scenario.Now there has been an ever increasing trend for specialisation and superspecialisation in both the secular world and in missions.What has happened to us?
As we see there has been significant leaps in the knowledge of disease and management which had led to the expansion of various specialisation branches.Health professionals feel the inadequacy of the knowledge they have acquired or they feel tempted by the new wellsprings of technology and sophistication.Moreover a cultural shift in the mental makeup of the health professionals leading to the acquisition of a "degree" an indispensable part of their life has been a major influential factor in pursuing a specialization.
At this juncture i asked myself why did i chose a specialty for my work in missions.For a start i do concede the fact that mission is primarily a spiritual enterprise and knowledge is just a pie in the big picture.In this context specialisation not only ignites a passion for the disease and management within a person , it also helps in revealing the mental makeup of the person.The choice a person makes in their specialization is one of the defining factor of his framework of thoughts and physical make up.Though not a blanket statement ,more often than not people are not attuned to the areas of healthcare for which their mind is not compatible.The current craze for specialisation in the immediate post MBBS period among graduates is just a symptom of willing to "adapt" to the course they get into to fulfill the void they feel within rather than making a active choice to elicit the "passion" of their heart for which they are destined to be.People with a passion to care for the suffering of the person should also have a complementary mental make up and passion for the cause of their suffering.This is the major reason which prompted me to support specialisation.
Secondly in a mission hospital setting though primary care is key to the health of a community most of the mission hospital have moved on to provide secondary level care and some to even tertiary care.The query from the villager for his conjunctivitis is "is there an "eye" specialist available for my problem"!We can chose to ignore these innocent queries but we cannot deny the fact that currently mission hospitals are mostly known for "saving a life who was almost dead/dead elsewhere" rather than a simple treatment for a cough and headache which can be treated by anybody though both carry equal importance from the perspective of the suffering person.Till health care inequalities in delivery exists there will always be quacks who would be willing to provide simple and economical remedies to the ailments of the community.Only the unmanageable are referred.In this setting when more and more complicated illness reach the footsteps of the mission hospital long term qualitative services of the mission hospital will take a back seat without specialisation. in a secondary hospital setting.
Thirdly considering the hostile scenario we encounter progressively by health care laws such as the clinical establishment act which has no mercy for the rural healthcare scenario specialisation is essential.These laws are detrimental to the long term objectives of equitable healthcare in the country.Till the laws are revamped leading to the recognition of reasonable multitasking by a qualified doctor in the absence of specialists,specialisation is here to stay .It is also required to get a buy in period for christian healthcare institutions to give a concerted response to this act.
Having said this , in no way i have disregard for the primary health care/ primary health care providers which is the backbone of health care of our country. I am speaking purely from the context of my work and also after observing like minded institution i serve.There may come a day when laws will be enacted which says only a "cardiologist" can treat a chest pain or a gastrointestinal surgeon should do a appendicectomy!I dread to see that day .Nor it is right for a specialist to look down upon the general practitioner nor to ignore the basic medical skills obtained along the course of the medical life.A skilled general practitioner can prevent a visit to a specialist and cut cost to the patient.
Only I do believe and hope that passionate people will rise for the cause of injustice and inequality and not just qualified people!May be specialisation may aid in igniting it if used in the right way.
As we see there has been significant leaps in the knowledge of disease and management which had led to the expansion of various specialisation branches.Health professionals feel the inadequacy of the knowledge they have acquired or they feel tempted by the new wellsprings of technology and sophistication.Moreover a cultural shift in the mental makeup of the health professionals leading to the acquisition of a "degree" an indispensable part of their life has been a major influential factor in pursuing a specialization.
At this juncture i asked myself why did i chose a specialty for my work in missions.For a start i do concede the fact that mission is primarily a spiritual enterprise and knowledge is just a pie in the big picture.In this context specialisation not only ignites a passion for the disease and management within a person , it also helps in revealing the mental makeup of the person.The choice a person makes in their specialization is one of the defining factor of his framework of thoughts and physical make up.Though not a blanket statement ,more often than not people are not attuned to the areas of healthcare for which their mind is not compatible.The current craze for specialisation in the immediate post MBBS period among graduates is just a symptom of willing to "adapt" to the course they get into to fulfill the void they feel within rather than making a active choice to elicit the "passion" of their heart for which they are destined to be.People with a passion to care for the suffering of the person should also have a complementary mental make up and passion for the cause of their suffering.This is the major reason which prompted me to support specialisation.
Secondly in a mission hospital setting though primary care is key to the health of a community most of the mission hospital have moved on to provide secondary level care and some to even tertiary care.The query from the villager for his conjunctivitis is "is there an "eye" specialist available for my problem"!We can chose to ignore these innocent queries but we cannot deny the fact that currently mission hospitals are mostly known for "saving a life who was almost dead/dead elsewhere" rather than a simple treatment for a cough and headache which can be treated by anybody though both carry equal importance from the perspective of the suffering person.Till health care inequalities in delivery exists there will always be quacks who would be willing to provide simple and economical remedies to the ailments of the community.Only the unmanageable are referred.In this setting when more and more complicated illness reach the footsteps of the mission hospital long term qualitative services of the mission hospital will take a back seat without specialisation. in a secondary hospital setting.
Thirdly considering the hostile scenario we encounter progressively by health care laws such as the clinical establishment act which has no mercy for the rural healthcare scenario specialisation is essential.These laws are detrimental to the long term objectives of equitable healthcare in the country.Till the laws are revamped leading to the recognition of reasonable multitasking by a qualified doctor in the absence of specialists,specialisation is here to stay .It is also required to get a buy in period for christian healthcare institutions to give a concerted response to this act.
Having said this , in no way i have disregard for the primary health care/ primary health care providers which is the backbone of health care of our country. I am speaking purely from the context of my work and also after observing like minded institution i serve.There may come a day when laws will be enacted which says only a "cardiologist" can treat a chest pain or a gastrointestinal surgeon should do a appendicectomy!I dread to see that day .Nor it is right for a specialist to look down upon the general practitioner nor to ignore the basic medical skills obtained along the course of the medical life.A skilled general practitioner can prevent a visit to a specialist and cut cost to the patient.
Only I do believe and hope that passionate people will rise for the cause of injustice and inequality and not just qualified people!May be specialisation may aid in igniting it if used in the right way.
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