Med profession not a paymaster, doctors turn gig workers in TN

CHENNAI: Once celebrated as a noble calling, the medical profession in Tamil Nadu has today become a story of despair, disillusionment, and survival. The State, long hailed for its robust public healthcare system and high medical literacy, is now witnessing an alarming exodus of young doctors, not to foreign lands, but to gig platforms.

Burdened by corporatisation, stagnant wages, and shrinking job opportunities, many physicians have traded their stethoscopes for steering wheels and delivery bags.

“After five and a half years of MBBS and internships, many graduates begin with just Rs 15,000 to Rs 30,000 a month. By the time they reach 30, they barely touch Rs 30,000. For someone who spent nearly a decade studying to save lives, it’s heartbreaking,” a senior doctor told DT Next.

The last decade has seen this crisis deepen, transforming what was once an admired medical ecosystem into one marked by frustration and fatigue. While popular culture continues to romanticise doctors, thanks to shows on OTT platforms, the real-life pulse of Tamil Nadu’s medical community tells a bleak story – of qualified doctors, postgraduates, and even superspecialists left unemployed, underpaid, or forced to abandon the profession altogether.

“When government jobs are scarce and private practice is unaffordable, they turn to gig jobs – food delivery, driving taxi, or courier services. It’s tragic to see that doctors who once wore stethoscopes are now wearing helmets,” the doctor added.

Veteran surgeon Dr Jaison Philip, who has served in Tamil Nadu’s government hospitals for over three decades, paints a grim picture. “When I was young, family doctors like Dr Saravanamuthu and Dr Prabhakar were pillars of their neighbourhoods. They diagnosed, treated, and cared for entire communities with just an MBBS degree. People trusted them. Today, medicine has become an industry where profit takes precedence over patients,” he said in a social media post that went viral.

Dr Philip, who has also served on hospital boards, said that boardroom discussions now revolve around revenue instead of recovery. “They talk about identifying ‘rich’ patients, about increasing profits through unnecessary tests or procedures. Compassion has vanished,” he said.

He also highlighted how the doctor–patient ratio, a traditional benchmark of health infrastructure, has lost its meaning. “The WHO recommends a 1:1000 ratio. In Tamil Nadu, it’s 1:250. But the irony is that even superspecialists can’t find jobs. MBBS graduates work as Swiggy riders, specialists earn Rs 60,000, superspecialists Rs 90,000, if they’re lucky to get placed.”

Dr Philip’s revelations didn’t stop there. Sharing his payslip online, he disclosed that after nearly 30 years of service and 275 kidney transplants, his gross salary stands at Rs 1.6 lakh, with a take-home of Rs 1.3 lakh. “It should be higher, but corruption in systems holds it down. I don’t bribe, so I suffer,” he wrote, later alleging that he received threats from higher-ups for “speaking against the system.”

Former IAS officer Dr PV Ramesh, who once chaired REC Limited, supported Dr Philip’s concerns. “A senior superspecialist earning Rs 1.3 lakh a month after decades of service exposes a structurally broken system. In pay grade, we equate highly trained doctors with clerks. The health pay structure must be realigned with market realities and indexed to inflation and private sector standards,” he said.

The former CMD at REC Limited added, “Many doctors continue to serve out of professional commitment, not money. But the real disease is clerical dictatorship; honest doctors are penalised for not paying bribes. Automation could fix this, but there’s political reluctance.”

According to Dr Shanthi, secretary of the Doctors Association for Social Equality, the situation has reached “a point of collapse.” “There are thousands of doctors and dentists in distress. Tamil Nadu has increased medical colleges and infrastructure but not the number of jobs,” she pointed out. “Two decades ago, there were 19,000 government medical posts. The number remains the same, even though 5,000 new doctors graduate every year. Where will they go?” she asked.

Regulatory roadblocks, she said, are making things worse. “The Tamil Nadu Private Clinical Establishments (Regulation) Amendment Act, 2018, and the Consumer Protection Act, 2019, have made it extremely difficult for small clinics to survive. With no access to insurance tie-ups or advanced diagnostics, young doctors simply can’t compete with corporate hospitals,” she told this newspaper.

One 28-year-old MBBS graduate, now working as a food delivery agent in the city, shared his anguish. “I studied under management quota, my parents took huge loans. After graduating, there were no jobs and I couldn’t afford a clinic. So I began delivering food and driving a bike taxi. My parents think I’m a junior doctor. I can’t tell them the truth, it would break their hearts,” he said. “Three years have gone. Sometimes I regret choosing medicine. I’m now preparing for higher studies, still hoping for a future,” the doctor-turned-gig worker told this correspondent.

Even senior doctors are feeling the pressure. A government medical couple in the city said they had to shut their private clinic. “Fifteen years ago, we had a loyal patient base. Today, corporate hospitals and insurance networks have destroyed independent practice. We now work as consultants. We have told our son not to choose medicine, the profession has lost its dignity,” the doctor said.

Health and Family Welfare Minister Ma Subramanian, however, downplayed the crisis. “There are only limited vacancies in government hospitals,” he told DT Next. “Under Chief Minister MK Stalin, Tamil Nadu has achieved zero-vacancy status. We increase government vacancies every year, but we can’t absorb all graduates, no country can. I don’t see any doctor working as a gig worker. Most pursue higher studies and earn well later,” he said.

Medical seats to job ratio, dilution of profession, put doctors in peril

The doctor-patient ratio, a traditional benchmark of health infrastructure, has lost its meaning, rued Dr Phillip. "The WHO recommends a 1:1,000 ratio. In Tamil Nadu, it is 1:250. Every citizen thinks they're a doctor. But the irony is that even superspecialists can't find jobs. MBBS graduates work as Swiggy riders, specialists earn Rs 60,000, superspecialists Rs 90,000, if they’re lucky to get placed."

His revelations didn’t stop there. Sharing his payslip online, he disclosed that after nearly 30 years of service and 275 kidney transplants, his gross salary stands at Rs 1.6 lakh, with a take-home of Rs 1.3 lakh. "It should be higher, but corruption in clerical systems holds it down. I don't bribe, so I suffer," he wrote, later alleging that he received threats from higher-ups for "speaking against the system".

Former IAS officer Dr PV Ramesh, who once chaired REC Limited, supported Dr Philip’s concerns.

"A senior super-specialist earning Rs 1.3 lakh a month after decades of service exposes a structurally broken system. We equate highly trained doctors with clerks in the same pay grade. The health pay structure must be realigned with market realities and indexed to inflation and private sector standards," he said.

The former REC Limited CMD added, "Many doctors continue to serve out of professional commitment, not money. But the real disease is clerical dictatorship. Honest doctors are penalised for not paying bribes. Automation could fix this, but there's political reluctance."

According to Dr Shanthi, secretary, Doctors Association for Social Equality, the situation has reached "a point of collapse".

"There are thousands of doctors and dentists in distress. Tamil Nadu has increased medical colleges and infrastructure but not the number of jobs," she pointed out. She questions, "Two decades ago, there were 19,000 government medical posts. The number remains the same, even though 5,000 new doctors graduate every year. Where will they go?"

Regulatory roadblocks, she said, are making things worse. "The Tamil Nadu Private Clinical Establishments (Regulation) Amendment Act, 2018, and the Consumer Protection Act, 2019, have made it extremely difficult for small clinics to survive. With no access to insurance tie-ups or advanced diagnostics, young doctors simply can’t compete with corporate hospitals," she told DT Next.

One 28-year-old MBBS graduate, now working as a food delivery agent in the city, shared his anguish, "I studied under the management quota. My parents took huge loans. After graduating, there were no jobs, and I couldn't afford a clinic. So I began delivering food and driving a bike taxi. My parents think I'm a junior doctor. I don't tell them the truth, it would break their hearts.

He says that he regrets choosing medicine, at times, and three years have rolled on like that. "I’m now preparing for higher studies, still hoping for a future," the doctor-turned-gig worker told this correspondent.

Even senior doctors are feeling the pressure. A government medical couple in the city said they had to shut their private clinic. "Fifteen years ago, we had a loyal patient base. Today, corporate hospitals and insurance networks have destroyed independent practice. We now work as consultants. We've told our son not to choose medicine. The profession has lost its dignity," they said.

Health and Family Welfare Minister Ma Subramanian, however, downplayed the crisis. "There are only limited vacancies in government hospitals," he told DT Next.

"Under Chief Minister MK Stalin, Tamil Nadu has achieved zero-vacancy status. We increase government vacancies every year, but we can't absorb all graduates. No country can. I don't see any doctor working as a gig-worker. Most pursue higher studies and earn well later," he said.