If a child kid fails or
performs poorly in exams, nobody raises a finger on the teacher’s
capability. But if a patient does not respond to treatment, one starts doubting
the doctor. Emotional stress, coupled with the financial distress of the
relatives waiting outside the hospital is very high.
It needs to be understood
that a human being is not immortal. No doctor intentionally kills or
deteriorates a patient. Relatives of patients ask the same question to
different doctors to extract some positive feedback. It is both for their mental
satisfaction as well as a plan to set a trap to catch doctors in their own
words as if they are some CID officers.
People ignore the warning
signs of their illnesses, go for cheap remedies, are not compliant to
treatment, but expect magic pellets from doctors. If a doctor tells the
relatives about the general condition of patient that he is on ventilator,
requiring support for blood pressure, with dropping urine output and an
increase in the cell count is high, the next query propping up is whether the
rest is fine. The meaning of this “rest" cannot be comprehended.
In the past, a doctor’s life
was pretty simple. When somebody fell ill, he would first try home remedies,
and if these didn't work, would go to the family doctor. The doctor would make
a diagnosis, and since most medical problems are self-limiting, majority of the
patients would get better. Because of the natural history of most diseases,
where the body heals itself, the most important role of the doctor was to rule
out serious problems, reassuring the patient and hold his hand till he got
better.
Life has become much more
complicated now as the knowledge achieved by doctors after numerous years of
study and years of experience is interpreted by relatives using their own logic
or consulting the internet, which means in a few minutes, they are quite likely
to know more about the possible diagnosis and treatment options. The trouble is
that they then start thinking of themselves as being well-informed, whereas
often they are misinformed, as so many sites are unreliable and even plain
wrong. There problem with internet is that each case is a different one and often,
particularly in complex illness, the information given is not quite about a
particular patient’s situation, and may not reflect encouraging details of the
case or peculiarities in the diagnosis. Also, good doctors are busy most of the
times and do not have the time to answer the queries online, and those who do
spend a lot of time answering the patients’ doubts might be the ones who do not
practice full time and/or have less current experience.
When patients start assuming
that they know more about their problem than their doctor does, they are quite
likely to lose confidence in the doctor’s expertise. They then want to use the
doctor purely as a sounding board, to get a “second opinion” and confirm that they
are on the right track.
Internet has
made a doctor’s life much harder, and that is why many doctors get irritated by
patients who come to them with the results of their internet search. The truth
is that a lot of these search results are complete nonsense, because a layman
is not sophisticated enough to separate the wheat from the chaff. While they
can acquire the information easily, making sense of it requires a lot of
sophistication which many patients lack, because they do not have the ability
interpret it in the right context.
While the internet is great
at providing knowledge, to transmute that knowledge into wisdom and then
convert it into actionable advice still requires the maturity of a doctor. The
problem arises if patients don’t trust the doctor, because it takes trust to
develop a healthy doctor-patient relationship. If this is missing, then this only
creates friction and unhappiness, for both doctor and patient.
It is understandable that
5-10 % doctors might be doing wrong practice for their financial gains or inadequate
knowledge, but it is not right to doubt each and everyone.
If some doctor advices a
thorough investigation, the bills soar up tremendously and the person starts
blaming the doctor. But if the diagnosis is missed, the doctor would be grabbed
hold medico legally for negligence.
Up and above this, a doctor
needs to get permission from various authorities, viz. the municipal
corporation, waste disposal, fire department, water supply department and many
others. Then a patient expects concession, bills are doubted and services are blamed.
People can spend thousands in celebrations, cinemas, malls etc. without even
bothering about the expenses, but try to act like yellow ration card holders in
front of a doctor.
Don't know where our health
system is going but the current scenario is compelling doctors to be a crude doctor
and not a good doctor.
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