I want a female doctor! Well no body is stopping you.

This post on cloud nine blog irked me considerably.  The premise of the post is an important one but the blog author takes it to an illogical extreme.

“India boasts of thousands of qualified doctors- with Indian degrees and the lesser mortals with Russian degrees. So, how does it feel when you end up in a hospital for delivery and the gynecologist about to examine you is a male? Yes, you read it right- a male gynecologist? Or how it would be to consult a male radiologist for a mammogram? A male radiologist who examines female genitalia? Though female gynecologists are aplenty, women often find themselves in tough corners when it comes to taking medical help in extreme cases. India is not a country that has limited medical aid and so why should the women compromise?”

First things first, you just don’t wake up one fine morning and end up in the delivery room of a hospital. There are 40 weeks before that. There is ample time to choose your gynaecologist who will deliver your baby. Same way you can always choose your radiologist. But that’s not the point, the point is what is the problem if a male gynaecologist examines a female patient or for that matter when a male doctor examines a female patient? Surely any one is bound to feel uncomfortable when one’s private’s are examined but note the word “examine” – it’s for the patient’s benefit, not for the doctor’s enjoyment. If at any moment the patient is feeling uncomfortable, they can walkout, complain against the doctor and do what not. But when you refuse to be examined by someone purely on the basis the presence or absence of one chromosome, it amounts to discrimination.

“We are a very conservative society and so it irks me when it comes to women consulting such male doctors in hospitals providing health care, especially in Government run hospitals and departmental health units. You can all it medical ethics, professionalism or anything under the sun, but a MALE IS A MALE! And there are few perverted men who put Hippocrates to shame...You must look at the way they handle their stethoscopes when they check women!”

Again such blatant prejudice against a person based on their chromosome! Ethics, professionalism doesn’t matter right? Well how would it feel if you heard it from a male chauvinist that a FEMALE IS A FEMALE, not point in letting them get a job or education, a FEMALE IS A FEMALE? And it is amusing to hear non-medics referencing Hippocrates! If you read the Hippocratic Oath, you will find that he was not quite the saint you consider him to be (by our present sensibilities of course).

“There are Government hospitals and primary health centers that have a single male/ female doctor taking care of everything starting from a delivery to mammogram. Probably that might be the reason why most rural women shun these hospitals.”

Not familiar with reality, are we? Happens when we make up arguments from thin air to support our preconceived prejudices.

“Let there be no bullshitting saying- this is an insult to doctors of the world and all that blah, blah...How many of you know the unfair advantage doctors take on such unlucky women? Whether there is a chaperone or no chaperone, their sexual apparatus goes on an overdrive, sensing helpless victims. Sexual Boundary Violations ( SBVs) have burgeoned at an alarming rate in India-  which include unnecessary physical examinations, inappropriate touching, sexual jokes with patient, sexual touch and finally there are cases of sexual intercourse too...Read this study published in Indian Journal of Medical Ethics. Unless the doctors try to get their medical ethics right, this problem will be persistent in Indian society. And will the Government bring a bill to say- " Women doctors for women and male doctors for men"??? That is a million dollar question.”

Let’s talk about the study shall we? It is apparent that the blog author has no experience in reading or evaluating medical literature. Happens. If I commented on an Astrophysics article same thing would have happened to me. One point in the study makes the whole study wobbly and unreliable. The authors of the study designed a questionnaire but it was not validated. Why this is important? Let us suppose you want to measure blood pressure and you made your own blood pressure measuring instrument. Unless you validate your instrument by calibrating it with a standard blood pressure measuring device, your instrument is useless.

The most illogical part of the whole post is that of the government bill!! To put the non-sense in perspective consider this example. Some terrorist who were Muslim hijacked a plane and crashed it into the twin towers. Thus the government must bring a bill to prevent all Muslims from flying! Ridiculous you say? Replace some terrorists who were Muslims with some doctors who were male and hijacking a plane with any misdeed you may think and ban them from examining females. That’s how ridiculous and non-sensical the whole premise is.

Will Anna Hazare succeed in curbing corruption?

Everyone has an opinion on Anna Hazare and the anti corruption movement; so I guess why should I be left behind? Being a skeptic I decided to look at the whole thing from a more basic and scientific perspective.

Let’s see what Anna Hazare is proposing – he is asking to pass a bill that will supposedly curb corruption. Here I will not comment on his methods and leave them for a future post may be. I will deal with a much more basic premise; can such a bill reduce corruption? The point that is of utmost importance here is Anna Hazare is following a top down approach, not a bottom up approach. Do we really know if the people of India want such a bill? Even lakhs of supporters in a country of 100 crore does not mean much and I’m being very generous in saying that he has lakhs of supporters.

A look at the science now - why do people bribe? I will leave out extortion by the bribe takers because I feel it will not be a stable system unless people are willing to give bribes. One theory is of “Speed money” or efficiency theory of bribes (see Huntington 1968, Lui 1985). This basically says that in a resource constrained setting people will pay bribe for efficiency. For example, let us suppose that you go to passport office to get a passport. The office can issue a passport within 14 days. But you need the passport in 5 days. So you bribe to get it done. This can be generalized in any resource constrained setting where the act of bribing results in a net profit and I use profit in a very general sense, not only monetary. The act of bribing will only stop when the cost of the bribe exceeds the expected profit, otherwise one will stand to lose by bribing.

This brings me to a very interesting study. Recently a study titled “Greasing the Palm. Can Collectivism Promote Bribery?” published in the July issue of the journal Psychological Science showed that companies which belong to countries with collectivist cultures (East Asian cultures) were more likely to bribe. What does this mean? Say there are 10 people standing in a queue and one of them pays a bribe to get ahead; then one or more others standing in the line will also be tempted to pay bribe to get ahead. They would justify it with the reasoning that everyone else is bribing so why shouldn’t I? The act of bribing thus becomes a collective act. Each act of bribing legitimizes the next act but only in a twisted misguided way.

It has also been shown that companies that make more profits also pay higher bribes. This in effect creates a vicious cycle. The company bribes to make more profit (see the efficiency theory of bribing) and with more profits they bribe even more. And the cycle goes on.

So will a top down bill work? All the evidence shows it won’t. So how can we reduce corruption? We begin at the bottom by eliminating the need for giving and taking a bribe.

Further reading:

• Greasing the Palm, Can Collectivism Promote Bribery?
• Ownership, competition and corruption: Bribe takers versus bribe payers.