Last Friday saw a number of public demonstrations in Lahore that successfully clogged up traffic all over town. All of them were important in their own way but the one that ordinary citizens should perhaps be most concerned about is the ongoing agitation by the Young Doctors Association (YDA) for better pay. The reason why I say that is because after the Raymond Davis affair is long forgotten, people of this province — including our political bosses — will still need doctors to take care of them. Most of these young physicians out in the streets are the ones who are indeed the ‘future’ of the healthcare system of this province. More importantly, the agitation by the YDA has also closed down most public hospitals in many major cities of the Punjab and this is obviously of much greater consequence to the ordinary public than the traffic mess in city streets. How these young men and women of the YDA are treated today will in some way decide the future of medical care in Punjab and possibly the rest of Pakistan. What is being determined right now is whether these young physicians out in the streets agitating for better pay will eventually develop into cynical physicians without any trust in the government and its promises or will they instead become solid citizens who trust the institutions of state. Sadly the present government of Punjab has not treated the medical community too well and at times seems to have a thing against them. Perhaps it might be worth remembering that the YDA became prominent a few years ago when the present Punjab government arrested physicians involved in a medical malpractice case at a public hospital in Lahore and charged them with murder. After that episode, physicians in different situations were again and again charged with criminal activity for medical errors. All this created considerable distrust between physicians and the present government of Punjab. More recently, the YDA started asking for increased pays for young physicians in training. Some of their demands were a trifle excessive but essentially junior physicians in government service are indeed underpaid considering the fact that many of them put in excessive hours of work under extremely demanding situations. Over the last year or so, the Punjab government played the YDA like a bunch of fools. It kept promising imminent pay increases but kept dithering about this decision. This finally led to a situation where the young physicians came to the obvious conclusion that the Punjab government was not serious about their demands. If the Punjab government had told the young physicians from the very beginning that there were just not enough funds available to provide major pay increases but in time their demand would be addressed, then all this could have been avoided. Indeed there could have been a common ground worth striving for and some sort of a deal could have been worked out. However, the Punjab government clearly never had any intention to make any deals and this became obvious when the latest secretary of health took over. He was brought in not as an administrator but rather as an enforcer of the writ of the provincial government. No wonder the YDA in their protests burnt an effigy of the secretary of health in Rawalpindi/Islamabad. The anti-physician attitude of the present political government in Punjab is not limited to their antipathy towards young physicians but extends to the entire spectrum of physicians working in the public sector. One of the first official efforts concerning medical institutions made by this government was to try and revert King Edward Medical University (KEMU) to the status of a medical college and but for the opposition of the then Chancellor of the University, Mr Salmaan Taseer, it might just have happened.Since that time KE has been treated quite shabbily. A few months ago a very junior member of the academic staff was appointed by the secretary of health as the acting Vice Chancellor (VC) of KEMU and for the first time in the history of this ‘august’ institution such a junior physician was put in a position that was always occupied by the most senior physician in the hierarchy of physicians in Punjab. The person now working as the acting ‘VC’ of KEMU, instead of representing the faculty or the students essentially, represents the bureaucracy and the political government and for all practical purposes has one goal and that is to please his ‘appointing authority’ at all costs. As a consequence, during the 150th anniversary celebrations of KEMU in December of last year the son of the chief minister of Punjab turned up as the ‘chief guest’ during the inaugural ceremonies and the secretary of health came as the chief guest at the official dinner hosted by KEMU. Fifty years ago at the centenary celebrations of KE and then at the 125th anniversary, the heads of state of Pakistan were the chief guests. Fortunately, at least at the dinner hosted at a local hotel in Lahore by the visiting physicians from the US to celebrate the 150th anniversary the Governor of Punjab Salmaan Taseer was invited as the chief guest. All this suggests that the PML-N government has an intrinsic antipathy towards physicians working in the public sector. This is perhaps typical of a centre-right political party that supports business and private enterprises often at the expense of the public sector employees. It is, therefore, highly unlikely that the Punjab government will make any voluntary attempt to calm the young physicians and respond favourably to their demands. Unfortunately, even if the Punjab government suddenly becomes sympathetic to YDA, it still does not have the money to give them the pay raises they want. So where are we headed? Frankly, I do not see a way out of this impasse unless one side or the other gives in. The writer has practised and taught medicine in the US. He can be reached at smhmbbs70@yahoo.com