Spice Route

Interview with Senior Physician

Dr Ajay Kumar

Dr Ajay Kumar presently serving as the President of IMA Bihar chapter has worked in different posts from the rural area to the secretariat in the health department of Bihar. He has been an inspiring leader throughout his medical career. He always fought for the cause & welfare of his patients as well as medical professionals without fearing the consequences. He established his clinic in the year 1980 in Maner, on the outskirts of Patna & continues to practice here till date. Since his early days he has established a good rapport with his patients and that remains over the years. He has shown us that a Family physician can be a good social leader.

Q1: What motivated you to choose medicine as your profession? How has your journey been?

It was decided well in advance by my father when I was in class 8. My father and his family were indebted to the medical profession, which saved my mother's life in 1959 (her 7th pregnancy). I was inspired to be a doctor. I did my higher secondary schooling at the age of 16 with very good marks and was admitted to the Prince of Wales Medical College, Patna (5 1/2 years integrated MBBS course). Had it not been for the National merit scholarship awarded to me it would have been very difficult for me to carry on my medical education.

Q2: How did you start your medical practice? What difficulties did you face during your initial years?

I joined Bihar Health service in 1979 while doing my MD (medicine) and was granted study leave. After completing MD, I intentionally joined rural posting at Maner, Patna. The rural PHC (Primary Health Centre) was very poor in infrastructure (an old state dispensary) without any quarters for doctors. The hospital was connected to the main road by a dilapidated road. There was no electricity (for most hours), washroom or water. I lived there for many years in a thatched house sleeping on a hospital bed. It was a very difficult time. It was my passion to work in rural areas that kept me going. I started my private practice. The catchment area had poor villages and no doctor could have a relatively good practice there. But I was happy with a small 80 - 100 Rs earning per day. I could take my wife and 2year old son to live with me only after 5 years when I got a small pucca house on rent leaving my little daughter (7 years old at the time) who got admission at Notre Dame Academy under the care of my mother at Patna. The area was full of quacks, and I had to struggle hard to convince people about the difference between a qualified doctor and a quack. After a few years I became the CMO and I had to take some strong actions including some legal ones against some of those quacks. They feared me but I never got any referrals from them. But I remained there for a long time by managing my transfer in nearby hospitals. And I am still practicing there for the last 41 yrs.

Q3: In the current trend towards super specialization & corporate based medical practice, how have you sustained your practice?

Super specialisation and corporate based medical practice have done more harm than good. They have encouraged quackery in rural areas and tried to weaken family doctors and small specialized clinics. Many specialists post MD/ MS are practicing as specialists/ super specialists. I never took that path but used my specialist knowledge as a general and family practitioner. I believed in sober earning that helped me to sustain my practice.

Q4: What are the changes you find in medical practice now as opposed to previous years?

Now medical professionals depend more on investigations and machines and less on their clinical skills. This has made health care unaffordable. This has created a mistrust between doctors and patients. Advances in medical technology certainly help in diagnosis and treatment. But it should be used cautiously not to fleece patients. I believe that medical students must be taught about ethical practice and management of health care in their medical curriculum.

Q5: Doctor Patient relationship has been facing serious troubles in recent times. Can Family physicians play an important role in improving this?

I never faced any serious problem with my patients as I practiced with honesty and empathy which are key to solving problems of distrust. Family physicians’ role is paramount. This can help patients to get the right referral and proper treatment free of exploitations.

Q6: You have been the leader of BHSA (Bihar Health Service Associations) & presently President IMA Bihar, how do you convey the importance of an organization among medical professionals?

When I found medical professionals becoming victims of government apathy and injustice, I rose against it, revived a dormant organization like BHSA. We fought and got a lot which could not have been achieved without a strong organization. An organization helps a doctor to grow personally as well as professionally. In IMA, the situation is different due to the heterogeneous composition of its members. Unless it works on a common minimum programme representing all sections of professionals, we cannot be strong enough to be heard by the Government.

Q7: Spice Route India Movement which is a part of WONCA (World Organisation of Family Physicians) is motivating young doctors across India to grow as family physicians. As a senior physician what's your advice to this movement and for the young & aspiring members?

Family Medicine is a specialty and family physicians can only bring universal health care to reality. Any organization representing family physicians must keep these in their agenda. I would like to be a part of this movement. The young and aspiring doctors must achieve the best in their medical training. Striving for specialisation or super specialisation is not bad but one should not forget whatsoever, what they learnt during MBBS. Quackery must be opposed for the good of the profession and society. Believe and respect your science.