Doctors are soft target of politicians, press, and public. Yes, we agree some of the doctors are corrupt like other professional of the society but not all. When a MP, MLA, Film Star, Model or a Player endorses a particular product no one objects. We should not forget the 21st century is moved by brands. from soft drinks to skin whitening.
Coming to our generic product, let’s analyse this simple situation. Ravi goes to a bar and asks for a peg of whiskey. He can’t ask for his favourite brand (100 Pipers) because it has been lifted by the government. The bar boy gives him whiskey of his choice from which the bar owner will get maximum profit. Similarly you go to super market and ask for shaving blade and you get some blade without brand name but written over the packet—blade. Another lady asks for washing powder and the person at counter hands her a packet where it’s written washing powder nothing else—no brands nothing. Imagine the situation if that customer happens to be from Bihar.
My learned friends, you must remember when a doctor prescribes a particular brand of medicine there are certain factors for which he or she has written the name of the medicine (like you choice of hard drinks)–his experience with that product, research product of certain firm mentioned in textbook of medicine, price factor, patients’ status, little bit of commission if he is having his own clinic or hospital and bioavailability of the product.
When we swallow a tablet or capsule some are supposed to be released in stomach, some in duodenum and some inside intestine. The release of contents from the drug depends on the coating and capsule technology. Certain inferior quality medicines of certain firms get released in large gut or not at all instead of stomach! The patient would come back to doctor and blame him for not getting a cure with his prescribed medicines; will the CM or PM come to his rescue?
I will narrate one simple example. In SAIL hospitals we were almost forced to write government run drug company’s medicines because that company was in red and certain minister got some kickbacks for revival of that company. So the medicines were procured but union people caught hold of the substandard medicine indented as P1 product. The director and the store in charge doctor were harassed by the consumers and branded products were intended once again. Because doctors are building house after house or going on foreign trips or staying in star hotels abroad is not the look out of the political party. There is an income tax department, vigilance or other department to check the corrupt practice of all professionals. Around 30% of apartments and house in Bhubaneswar belong to persons attached to education system or chartered accountants but very few are doctors. I am a retired SAIL doctor but I doubt whether some Hindi film actors’ driver would stay in my house, even if given free.
With present directives of government, instead of doctor the unqualified pharmacists would get the option of dispensing medicine of his or her choice. After sometimes instead of doctors pharmacists will go for foreign visits, then? A drug quality depends on its bioavailability and quality control which are deficient in millions of small pharmaceutical companies of India. A particular antibiotic of these unknown companies are very cheap but no doctor is sure about its efficacy. Say a tablet of ciprofloxacilin from a branded company is costlier than another branded company because the other company is a copy master and the particular medicine is not its research product.
If only cost factor is the concern of the government then let all the central and state government doctors prescribe products in generic name. Regarding hand writing of doctors the medical council must look into it before giving the registration number. Compulsory one month hand ‘writing is polishing’ class for students with illegible handwriting after they pass out their MBBS examination should be introduced?
Like wearing helmet and changing of car number plates from white with black digits to black with white digits or yellow digits this wave of generic versus brand names debate will continue in India as long as we allow MPs and MLAs to advertise products in each and every news papers, TV channels and hoardings on the high ways. A time may come when our politicians and courts would prescribe a particular directive for doctors, when they can go to washrooms or temples or go to bed. We must remember the whole world moves on different branded product, or sponsors from Haldiram mixture to Bofors gun, you accept it or perish.
PS: Remember, not all branded medicines are costly; some are even cheaper than generic drugs. What should the doctor do when the patient requests for a branded medicine which he has been using for last ten years?
By Sanjoy Kumar Satpathy
Joint Director,Health services.
RSP,Steel Authority of India(SAIL)
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