Welcome to another session of DocScopy. We present the motivating life story of Prof. Surya Kant, one of the Top 2% of scientists worldwide (Stanford Top Scientists, 2022), and currently Head of Respiratory Medicine at King George's Medical University, UP, India.
He has 20 fellowships and over 625 publications in both national and international journals. He is an excellent orator, a strategic manager, an exemplary physician, and a professional leader.
Talking to him was transformative, personally, and professionally, he inspires through his words and emanates competence.
Let us dive into his world!
Dr. Purnoor: Kindly provide a brief introduction of yourself for our audience and elaborate on your current professional role.
Dr. Surya Kant: I am, of course, Dr. Surya Kant, Professor and Head Department of Respiratory Medicine at King George's Medical University, Uttar Pradesh, Lucknow. This institute is a pioneer institute that was established in 1905. The first MBBS batch came in 1911. So we are a more than 100 years old institution and I am fortunate enough to say that I did my MBBS from this institute. Then, of course, post-graduation in MD Respiratory medicine, and then I did three years of senior residency and later on became a faculty member here. Currently, for the last more than eleven years I am heading the department.
Other than this I am also the professional leader in our fraternity. So I have been the National President of all three important respiratory and chest societies. I have been the National President of the Indian Chest Society in the year 2016-17. I have been the President of the National College of Chest Physicians from 2018-19, and I have been the National President of the Indian College of Allergy, Asthma, and Applied Immunology from 2018 to 2020. I am also professionally active in the largest medical professional society in India as well as the world, the Indian Medical Association which has a membership of around four lakh doctors in this country's modern medicine. And I have been the National Vice Chairman of this body also for a specialist wing.
Dr. Purnoor: Looking back, how do you reflect on your professional journey?
Dr. Surya Kant: If you see my journey, I would say that after graduation I did my post-graduation from this college and the journey was very smooth. I was an ambitious student when I was selected for MBBS in 1983 and of course, till 1996 there was no problem.
Except for a time I would say 1996 to 1998. Why? Because for these three years, I worked as a temporary lecturer. Once the advertisement was made in 1996, it was canceled, and another advertisement was made in 1997. Ultimately interviews for the post of Assistant Professor were held in December 1998 and I joined as regular faculty on the post of Assistant Professor on 28th January 1999.
These three years were a challenge for me. When I got married in 1994, my parents as well as my in-laws were asking me to join regular services and I had appointments at 3-4 types of services. But I insisted that I would apply for a faculty post at King George's Medical College. At that time it was medical college and ultimately I got it.
So I think my decision was right. Although I was criticized by my family members, my in-laws, and everyone. Everyone will criticize your choice if you are newlywed, have a young boy, and are not receiving a full salary or you are not in a sound financial situation at the time.
Although those were difficult days, I remained steadfast in my choice and believe I made the right choice overall. All of my family members and relatives are now quite happy and recognize that criticizing me at the time was wrong.
So this is the history, I would say the professional history of the professional journey.
Dr. Purnoor: What inspired you to become a doctor and specialize in Respiratory Medicine?
Dr. Surya Kant: Oh, you see, my dadi (paternal grandmother) passed away in 1976 when I was ten years old and no cause of death could be determined. What illness specifically? Given the symptoms, she had at the time and the fact that a diagnosis could not be established before her condition worsened, it is likely that she was battling cancer of the intestine or a similar condition. So this was the first time when I realized the importance of medicine, the importance of the medical profession. After that, my nani (maternal grandmother), died of a respiratory illness, now, I can probably say she had asthma. These were the two examples of how I started to appreciate the medical field.
To further explain, I may draw on my own experience. When I was three years old, I experienced severe pneumonia, which likely made me critically ill. Due to the fact that I am from a small, Tier-3 Uttar Pradesh city, Etawah, doctors did not hold out much hope for me. With this rural background, there were no medical colleges in the region at the time, nor were there any good hospitals. I do not remember everything. But I do recall a few details: I was on the bed, and everyone was anxious and everyone was desperate. Fortunately, I made it.
I kept getting repeated infections, but nobody understood why. I later discovered that I was born as a premature child: at the intrauterine life of seven months, I was delivered. The management of the premature child was not in place at that time. I was normally delivered, and immediate management was like any other typical delivery. This is why, I did not receive proper care, and was not kept in a hospital. The safety measures that need to be implemented for a premature baby, were not taken.
I would believe I was 13 and a half years old when I started experiencing a lot of breathlessness again, after ten years. Finally, a senior physician at the district hospital in Etawah named Dr. Gupta made the diagnosis of tropical pulmonary eosinophilia for me. "Your eosinophils are 72%," he added. "I've never noticed an eosinophil count this high. I will, therefore, refer you to the Patel Chest Institute, Delhi." My family members were quite scared of my condition. Ultimately, I responded to his treatment.
Dr. Purnoor: What do you think are the current challenges in front of the medical fraternity?
Dr. Surya Kant: Now the biggest challenge, which has emerged in the last 30 years, the last few decades I would say, is the emerging intolerance and violence against healthcare workers. This is the biggest challenge that we never faced, before 30 years. Why is this timeline of 30 years, because 30 years back, I was under the category of a junior doctor. And as a junior doctor, I never faced this situation. And even my teachers, who were, of course, the senior ones, also never faced this situation.
But gradually with time, especially this recent decade, I would say, violence, intolerance, misbehavior, arrogance, and high expectations have increased.
I often say we are doctors, not God, and no doctor should consider himself one. You see, God is the source of your life and the source of your death. We can only facilitate the treatment process, we can facilitate the relief from your anxieties, stresses, and any poor health ailments that fall. But, we are helpless in either giving life or ending it.
The second aspect is that society has to understand that doctors, according to their ability, their skill, and experience, try to give the maximum to a patient. Why would a doctor give you treatment that is not according to his knowledge and his experience? According to his wisdom, every doctor wants the patient to be cured. No doctor wants that any patient ends up in treatment failure or dies. Why should you cast doubt on a doctor's integrity and intent? This would mean business personnel trying to shut their own business.
There are two things, one, in the last three decades, society has become aggressive. The second thing is there is a lot of information available through Google. Everyone then looks up the disease process and its various treatments. And they themselves, without a degree or any formal training, become masters of medicine by conducting a Google search.
When we were residents, patients had complete faith in the doctor, who may have been a young doctor or a senior doctor. Furthermore, there was no question; the most they could have said was, "Doctor Sahab, how is my patient?" Just that. People now want to argue why this procedure has to take place, sir, why this test was not done, and so on. This is not the proper way to seek medical care from your doctors. You also have a choice if you're not happy. You can change your doctor and your hospital.
Another thing, the mentality of the society is that they go to a five-star hotel, and will pay whatever amount of the food they eat, or their accommodation charges whatever it is, and they will also give tips to the waiter. When a patient is hospitalized, there will be a bill from the hospital. If you are not economically competent to bear the costs of a costly hospital, there are alternatives, you can go to a public hospital or a government hospital. By choice, you are going to a certain hospital, and then, you raise questions about the bill in order to settle the bill at a lower rate.
The truth is that if you compare the medical expenditure from the developed countries or even from the poor neighboring countries like Pakistan, Bangladesh, and Nepal, the cost of medical expenditure here in this country is very less. One study says, if you compare the US or most of the developed European world, the cost of medical expenditure in this country is only 10 percent.
The highest fee in this country for any doctor is up to 5000 rupees.
But, if you just compare the fees of a leading advocate of this country, the fees per visit or per hearing are more than 10 lakhs rupees. Is there any comparison? But nobody will. I'm not against any professional community.
Yet the issue is that you happily pay this much to an advocate and you don't realize any issues. You want to compromise a doctor's fee.
Most hospitals and doctors, organize free charitable camps and do a lot by giving services to poor patients. They try to give other concessions to poor patients. Even the government is providing schemes like Ayushman Bharat Card, Mukhyamantri Arogya Yojana, and so many other things for BPL card holders (Below the poverty line), etc.
Again, I'm repeating that I'm not against any professional community. But you expect a good quality of treatment, you also expect less charges and you expect charity. Why are there so many expectations?
Before 1994, the medical profession was not under the Consumer Act, however, the government included it in the Act in 1994. If a profession comes under the Consumer Act, it is of course a commercial service. Everyone providing a service is charging. Why should we expect charity from doctors? After 1994, nobody should expect charity from medical healthcare workers.
Doctors pay income taxes, they are paying so many things when they open a new hospital. There is a lot of investment. Gone are the days when doctors were tagged as second Gods. It would be better if people can let us be humans.
Three decades back there were fewer private medical colleges and less corporate hospitals. The fee of a doctor was very less. Even medical services were provided in exchange for a corn cob brought by patients coming from a village. I agree, this was there.
Still, 20% of charity is done by doctors.
With mushrooming of a lot of private medical colleges, doctors even bear an expenditure of crores and crores of rupees, now, how can they be expected to do charity in society? A doctor who has invested crores in a corporate hospital, how is charity possible?
I'm not saying, all doctors are very good by heart and very pure sanctums, maybe 4 or 5% of doctors, may indulge in malpractices also. And that is true for all professional sections; the relative percentage may be higher.
Whatever changes are occurring in society, they are occurring in the medical fraternity also. So, don't expect through your mental image that a doctor should practice like he is practicing in the 90s but demand services of the 21st century. If services of the 21st century are to be provided by a doctor, then of course, his fees will also be at par with the 21st century.
These are the five factors that are raising the incidence of respiratory diseases, and these are the real challenges for a respiratory physician.
And not only this, but some diseases—they say some people leave, but their footprints are left behind. So there are some diseases that you have cured and successfully treated. However, people have now developed lung damage. So you have treated a TB patient, and now the patient is TB-negative. TB has been cured, but the patient has wounds or cavities in his lungs now. When they heal, they lead to fibrosis, bronchiectasis, collapse, etc., the post-tubercular sequelae.
Dr. Surya Kant: I think these questions were very close to my heart. I have specialized in discussing these questions, thus, the long answers! (chuckles)
The story hasn't ended yet. Stay tuned for Part 2 to know the challenges faced by Dr. Surya Kant and how he tackled them gracefully.
(HN)
