One leading scientist remarked at a local conference, ‘When we were growing as children or youth, we were fed by the tender and loving hands of our parents and that now when we have become doctors, we are fed by patients’. Doctors must remember that their only earning comes from the patient. They should reciprocate with love and affection that they got from their parents, to their patients. Doctors must strive to make each rupee of that money count for the patient. A better waiting room, more efficient patient management, transparency and education, everything counts for the patient, and they would actually like paying for it. There is no place to be unethical for the doctor or patient.
There are often patients who present with a symptom that could be because of several different conditions. Doctor A, is cautious, ill trained and afraid of failure. He would investigate heavily, and when that too doesn’t give him enough clues, gives the patient plethora of medications for all the conditions. The patient may get better, yes, but the doctor would never know which medicine has made him so. The spiral begins, and patients get investigated more and more, medicated more and more, side effects of treatment spirals and skill acquisition is minimal. The patient may be a victim of toxic effects of the medicine, besides paying heavily for avoidable tests and medicines. Let us look now a doctor B. He is shrewd, well trained and is not afraid to experiment. He, by using an analytical brain and clinical acumen, thinks in favor of one possibility. He doesn’t investigate much because he trusts his instincts. If the patient gets better, he is elated- he is proven right. If he doesn’t, there’s always second option. To prevent the discomfiture of an irate patient irked by the delay in treatment, he uses kind words and counseling to reassure the patient that he is only trying to avoid unnecessary medications and investigations. Over time, doctor B gets more and more skilled. He now has acquired that sixth sense which tells him what the patient might be having instead of over investigating. However, doctors deal with uncertainties and changing patterns of ever increasing knowledge that rival most other professions. But they cannot, under the cloak of that nebulousness, neither wallow in self pity, nor puff out in artificial pride.
The public has become over-critical of the medical profession. They make persistent attempts to belittle and undermine a physician’s work. More the hype is being made to sullen doctors’ image more the community is going to suffer. When a patient comes gasping to emergency ward the doctor on duty never wastes time to ask the history and based on his third eye and experience he will take emergency measures. Trying to start an intravenous line, putting oxygen and keeping the airway clean and after monitoring the vitals then only he proceeds to take the history and decide to investigate further. If the doctor is hesitant due to fears he may refer him to a big hospital. Already this has started happening in accidental cases where the public never bother to shift the patient to hospital to avoid being listed as witness. Media has become a tool to defame this profession. Without verifying the facts they just make it sensational. The small mistakes become headlines. Judiciary has also been sensitized to make the doctors as a whipping horse. However, doctors are the real heroes, who change the course of life! No matter how bad things get, doctors make something good happen! One in pain already starts to feel better when they see a doctor’s smile or get a pat on the shoulder! No medicine can do this wonder better than this tenuous tether of compassion between a doctor and a patient.
Business culture spread its tentacles
Affordable, health services have gone beyond the reach of a large majority, with life-threatening consequences. One can appreciate that corporate hospitals with their latest equipment and medical talent meet a growing need of rich class that can afford to buy their five-star comforts. Since society itself is in the grip of moral decay and greed, can doctors be left behind? With business culture creeping into the noble profession, trust in the doctor’s word has been given a goby. Doctors can no longer expect a sense of gratitude. Medicine being a specialized field a patient does not know whether the prescribed drug, test or line of treatment is correct or is required at all. Besides greed, insensitivity, negligence and carelessness seem to have become professional traits. A few months ago, Delhi’s top Hospital was asked by the State Consumer Commission to pay Rs 75 lakh for “doing unwanted treatment on the patients who are not easily identifiable by the commission”. The highest-ever compensation in a case of medical negligence in India, however, was awarded on October 25, 2013, when the Supreme Court directed the Kolkata-based AMRI Hospital to pay over 11 crores compensation in case of an NRI patient. In a recent book, ‘Dissenting Diagnosis’ authors have made recommendations about how the situation can be modulated. There is need for greater regulation of medical services by a calibrated cap on procedures; standardized treatment protocols; patients made aware of their rights and doctors of their duties. Regulation is what is required, not criminalization. This is indeed a wake-up call, though some are not sure whether the conscience that it wants to rouse is not already dead. Let us all try to bring it back to life. The onus for that lies on the community as well to be fair to the doctor.