Don’t Become a Government Doctor, Please…!!!

Challenges in Public Healthcare and the Declining Trust in Government Doctors

Published on 28 August 2025

In recent times, public trust in government doctors and government hospitals seems to have declined. Likewise, doctors are often unwilling to take up government service in rural areas. Neither the administration nor any political party’s government has paid attention to this so far. How important government doctors are—and how crucial government health centres, rural hospitals, and government medical colleges are— became clear to everyone for the first time during the Covid period. A few years earlier, this was not the case: about 20 years ago, people had complete faith in government hospitals and government doctors.

Specialist doctors from renowned medical colleges used to come to their home districts and start serving in government hospitals. They were fully dedicated to the entire district, taluka, or village. Many doctors also saw patients at their homes in the evenings. In some places, senior villagers even provided space so they could run a small private clinic in their spare time. As a result, most Medical Officers stayed at headquarters and offered 24×7 service. Thus, at every level, MOs were available and enjoyed immense goodwill. In many places, MOs who had come from other districts settled permanently where they were posted. Because of the medical profession’s standing, local representatives and villagers provided whatever help was needed—food, even a place to live.

Generally, students from poor backgrounds studied MBBS in government medical colleges; therefore, after becoming doctors, their expectations were modest. Private clinics were fewer then, so Maharashtra’s public health system was excellent and capable. We could overcome epidemics that appeared from time to time. But the number of private medical colleges rose; paying lakhs and crores in capitation fees for MBBS and MD became common. Doctors graduating from such colleges found it easier to open private clinics on their own and maximise profits than to join the government system. With corporate multispecialty hospitals also coming up—attracting investments from many non-doctor businesspeople—government doctors, too, were gradually hired there at double or triple the government pay. Consequently, services once provided free within the government system started costing ordinary people money.

For nearly 15–20 years, why has no one paid attention to the steadily declining number of doctors in the government system? Who is responsible for this serious issue? During the global pandemic, there were very few doctors in the government setup—who is responsible for that? Why have government policies given so little attention to the health sector? Perhaps, had the 2020 pandemic not occurred, no one would have realized that government doctors are in short supply.

There are countless difficulties and problems, but I wish to shed light on why doctors are not joining the government system.

Very low salaries for Medical Officers. Even after the 7th Pay Commission, a newly joined MO gets only ₹65,000–₹69,000, and even that is rarely regular. Corrupt and obstructive clerical staff in district offices do not cooperate with new MOs; tired of the harassment, about 30–40% resign. No one helps or consoles them. In private practice, an MBBS doctor can earn well over ₹2,00,000, while the Non-Private-Practice Allowance for MOs is barely around ₹8,000 (though as per government resolution it should be 33% of basic pay). The MO post is Group-A, yet probation seems endless; for 5 to as many as 15 years, an MO can remain stuck at basic pay, without regular increments. No decision has been taken, so the younger generation hesitates to join. Other allowances come only if ‘babus’ push the files (which means greasing palms).
No fixed working hours (should be 8 hours). Village politics often swirls around PHC services and the doctor’s name; new MOs face this often. Disputes among local office-bearers should be resolved via the Zilla Parishad or Panchayat Samiti, but it is expected that the MO will solve everything: treat as directed, issue certificates as told, refer particular patients, conduct normal deliveries on demand, and avoid assigning tasks to favoured staff. In such a scenario, the MO is confused about what exactly to do; plain, straightforward speech leads to complaints and transfers. Because of such cases, many PHCs run without doctors. The association has raised this repeatedly, but working hours are still not fixed. With only one MO (sometimes none) at PHC level, there is no defined end time after OPD and field visits. If 24×7 service is expected at PHC level, at least three doctors must be posted at each PHC and a separate doctor assigned for field work. Instead, the honest MO who stays at headquarters can’t even get leave for personal work; local expectations from that one doctor keep rising. If the doctor is unavailable on some occasion, complaints are filed and transfers forced—after which the PHC post remains vacant for years, directly hurting the poor.
No administrative training before joining. Even IAS officers receive about a year of administrative training after they pass, and other departments also train recruits before posting. But immediately after MBBS, MOs are posted as gazetted officers in charge of PHCs, with full financial and administrative responsibility. With zero experience, a couple of legal cases or RTI applications can push them to quit—because they lack information and receive no guidance from seniors. Why aren’t these untrained MOs, who must also handle patient care and national programs, given financial and administrative training? No decision has been taken on this so far.
The ‘headquarters’ sword hanging overhead. Appointment orders in all departments say officers and staff must serve from headquarters, yet talathis, gram sevaks, teachers, and even senior taluka-level officers often do not stay at HQ. Only MOs are strictly required to remain at HQ 24×7. Why is it expected that any MBBS doctor must live in the village? Even permanent villagers move to towns for their children’s education; then why complain that MOs don’t reside at HQ? Aren’t other officers also absent for village-level work? Fearing such complaints, new doctors are reluctant to serve in villages.
Local village politics. At the village level, politics often revolves around PHC services and the doctor’s name; new MOs face this repeatedly. Disputes among local leaders should be resolved by the Zilla Parishad or Panchayat Samiti, but the expectation is that the MO should fix everything—treat as instructed, issue certificates, make referrals, conduct normal deliveries for specified patients, and avoid assigning tasks to favoured staff. Consequently, many PHCs end up without doctors, directly harming poor villagers.

Medical Officers who enter the government system often do so because of their circumstances; they are usually doctors who studied despite poverty and lack prior experience—so they deserve understanding. After one or two years, they grasp local dynamics and the health system. If people and the government resolve the above difficulties in the first 2–3 years, vacant posts will soon be filled. Not all MOs are perfect in every way, but if the government promptly and on priority solves these simple, basic issues, our health system will certainly regain its former strength. At least in this Corona period, the government must understand this serious matter and resolve it—otherwise these problems will never be solved.

A poem dedicated to all the doctors and their subordinates who worked during COVID. They are working selflessly, putting aside their own families, to save the world. Salute to your work.

...बायको..... मला थोड तरी सिरीयसली घेत जा !

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