A recent case in Bihar saw a staggering 194 medicos disciplined after they were not present during a Medical Council of India (MCI) inspection – casting a spotlight again on the issue of doctor absenteeism in India.
The MCI was inspecting a number of medical colleges in the state in which a number of staff were absent without reporting a reason why. Penalties issued by the state health department include cutting a week’s honorarium and a salary increment, affecting professors in medical colleges and doctors in public hospitals.
This is not the first instance this year of doctors being penalised for absenteeism in Bihar. Earlier this year, 33 doctors at the Jawaharlal Nehru Medical College and Hospital were absent without cause during an MCI visit and punished with salary deductions. Doctor absenteeism exacerbates doctor shortages in the state. There is an 86 percent shortfall of specialist doctor positions in the state and an overall doctor-patient ratio of one physician for every 17,685 people. Inadequate public health infrastructure and staffing levels in the state were flagged as one factor behind the deaths of numerous children in the Muzaffarpur district due to outbreaks of hypoglycaemia and acute encephalitis syndrome.
Doctor absenteeism is a national issue. Nationally, there is one doctor for every 11,082 people. This influences subpar standards of healthcare responsible for 1.6 million deaths annually. Absence of doctors compounds this issue. A 2011 study indicated that forty percent of medicos are absent from work on a typical day. More recent data suggests the situation has not improved to a great degree.
The example of 194 doctors in Bihar is a reminder that the provision of adequate healthcare depends on a trained and present workforce. When patients visit hospitals and are unable to avail treatment because of the lack of a doctor, it represents a failing of healthcare providers to guarantee access to treatment. As such, it is vital in the interest of public health to counter issues such as doctor absenteeism to mitigate existing accessibility issues in Indian public healthcare.