“No politician has asked me what problems TUTH is facing”

Dr. Govind Sharma has not only proven to be a good manager but also a doctor with a conscience. A Masters in general surgery and Ph.D in cardio-thoracic surgery, he has been the Director of the Tribhuvan University Teaching Hospital under the Institute of Medicine in Kathmandu for over three years now. Dr. Sharma has been given credit for improving not only the physical infrastructure of the hospital, but also the services provided there. A strict disciplinarian, he leads with example and thus he has forced other workers in the hospital to be efficient and courteous in their service to the people. Heading the most modern hospital and biggest medical college in the country, Dr. Sharma said he believed in work not politics. He expressed similar other views in an interview with Sushma Amatya of The Independent recently. Excerpts below:

Q: It is said that after you started directing this hospital, it has become more efficient. How did you do it?
A: When one heads an institution, one has to priortise team work. For the last three and half years, we have been creating  a good team. One person can not do anything. Whatever positive changes are here are thanks to our team and their services.

Q: How did you infuse the team spirit, a seemingly impossible task in our context?
A: It is quite simple while dealing with educated people - you sit together and talk to them honestly. You tell them that other people like them need their services and that they should do their best.

Q:  What do you have to say about good doctors leaving your institution due to your non-practicing policy?
A: It is true that many doctors left our hospital,  but for the last few years none have left on that account. The doctors who are with us today are very sincere and plan to work with us for a long time.

Q: Is it because you are providing better incentives?
A: We have introduced an in-house practicing system and other allowances that on the whole have made our doctors happy. I do not deny that the practicing system gives a doctor many-fold-income and they would also like to give their children good education and have a better life style, so incentives are a must. But we must not forget our duty to serve the ill as well.

Q: What are the special facilities that this hospital provides?
A: Till recently we were the only hospital in the country that provided open-heart surgery. The poor who cannot go abroad for their treatment have been coming to us. We have very good plastic surgery, neuro surgical, gynaecological, nephrology and urology services; eye and skin department, surgical and medical.....you name it and we have them. They all have been providing good services, yet I agree that we do have to improve in many ways. We are far from being perfect but we are heading in the right direction.

Q: It is said that the strong point of this hospital is the surgical section and its weak point is the medical section. Is it true?
A: I do not think so. All the doctors employed here are all competent and highly qualified. I would not say that one department is better than the other.

Q: What are the major problems that your hospital is facing?
A: We lack funds to do many things that we want to do.

Q: Does our country lack the middle man-power (nurses, technicians) the most?
A: Yes, there is a shortage of nurses, technicians and other helping hands. The private medical colleges who are in the process of producing doctors should also concentrate on producing the middle man power as well.

Q: At what stage are you today, work-wise?
A: Doctors are supposed to work for three decades. In the first ten years, you work very hard as a young doctor, another ten years you train others and teach while continuing with your work; and in the third decade, you do the administrative work. I’m in my third decade now.

Q: What do you have to say about the controversy regarding the doctors who qualified in Russia without having completed their Intermediate in Science level?
A: Both the parties are right from their own point of view. They need to sit down and reach an agreement. My personal opinion is that we should have a qualifying examination for such doctors like they have in many other countries. The capable doctors should be given opportunities like any other doctors.

Q: All the good doctors are concentrated in the Kathmandu valley only. Very few, if at all are willing to go to the rural and the remote areas. How do we tackle this problem?
A: I’m sure the people in the Ministry of Health are aware of this problem and they should know the right answers. But in my opinion, if you create certain working conditions, give proper remuneration and make the doctors happy;  I see no reason why they would not agree to work in those areas. Only ideology will not work.

Q: Medical studies is quite a financial burden, especially the donation system. How could it be made more mass friendly?
A: It is a problem indeed. In our institute, I’m glad to say that we provide a chance to everybody - poor or rich - to compete. We also plan to provide scholarships in future for brilliant students whose parents can not pay the fees.

Q: What do you have to say about the commercial attitude of many doctors here?
A: When people say that doctors have a commercial attitude, it does not sound good for the medical profession.  There are doctors who are not commercial and I hope their number will increase.

Q: What is your opinion on the accountability of doctors - when can patients stand up for their rights when they know they have been wronged by them?
A: A doctor must be accountable. Compared to other countries that I have seen, accountability is lacking here. It is the right of a patient to know all the modalities, outcome and possible complications of a treatment. A doctor has to communicate all these things to his patient and take full responsibility if anything untoward happens to the patient he is going to treat. This issue must be raised and everybody in the medical profession must be made to abide by this code of conduct which is sadly lacking in our country.

Q: What changes would you like to bring about in our medical system?
A: In my experience, we lack good management and good managers. If right people were given right positions and if all managers executed their responsibilities well, we would prosper rapidly. We should also learn to be more sensitive to others problems. None of the politicians or anybody else have come up to me during my tenure here and asked me what problems this institute is facing, or offered any help. Everybody complains of what is lacking but nobody cares why it is lacking.

I’m a small fish trying to my little bit in this hospital; but on the whole as citizens of this country, I think we need an attitudinal change. If everyone of us were to take our duties seriously, honestly and put in our best no matter where we are and what we are doing, we would be a much better nation.

Q: How would you define a good doctor
A: There is a saying that if a patient does not come out feeling better by fifty per cent after meeting with his doctor, then he is not a good doctor. A doctor should remain human and remember that he is not  god.