Dr. R.Kumar www.speakforhealthyindia.com
The majority of the Doctors work hard under very odd and difficult circumstances even at times when they see hundreds of patients with meager facilities. Most of the Public Hospitals lack best practice standards, protocols, uniformity and continuity in care across multiple individuals and levels. Audit from patients perspective whether particular prescribed tests, medication or intervention was really indicated in corporate set ups has become necessary. Was there any conflict of interest in such management?
The physician is no more an angel, but a big trust deficit is eclipsing an altruistic attitude which had identified “medical profession as noble”, so what could be a dream hospital for you, me and any ordinary person who can’t afford five-star hospital but is sensitive to safety and quality of healthcare. In private hospital there is always a fear or suspicion of not being charged fairly. Not many hospitals in private sector escape criticism of ordering unnecessary investigations, consultations, and even interventions. Who can give assurance on these issues of affordability, accessibility, and accountability? When can a patient walk in OPD/emergency of any hospital/clinic/private hospital/nursing home, without introducing on social status, or position and assured that he/she get the same right treatment at right time by the right person by right methodology on the merit of ailment and not because of position or status? Is there any hope for such a system in future?
“Don’t Harm Me – Heal Me – Be Nice to Me, treat me with dignity; with evidence-based practices within an affordable price. That’s what our patients want from the healthcare facility and in that order. Do our patients expect too much from health care providers? In hospitals run by state government; the problem of overcrowding, long waiting lists, lack of safety, infection control issues and quality standards and Quality of care varies dramatically between doctors and hospitals, but those differences are invisible to administrators. Ordinary people have notion unless you are recommended or come from the private clinic of physician you will not get right treatment at right time from right person.
Dilemma of Indian doctors
Only Indian doctors have to justify the money that they charge and have to feel guilty for earning a fair professional fee. Medical care in India is among the cheapest in the world, yet the most criticized! There are several myths.
Myth 1: Doctor fees are high, and they also charge fees on subsequent visits. They will diagnose you and advise treatment and may ask for some investigations if required. You are paying consultation money for his time and medical knowledge acquired after many years of study. Doctors give you a professional service and charge a fee. If one has medical insurance your co-pays should not be more than 20% of the consultation fees and rest should be paid by insurance companies.
Myth 2: Doctors and hospitals have no right to earn money because medicine is a noble profession. Nobility does not feed their families, and does not subsidize any service that they take from other professionals in the society. All of them have to pay the full fee when they want the services of a teacher, a lawyer, an architect, an engineer, an accountant, restaurant etc.
Myth 3: Government is spending so much on medical students. The fact is that government spends less than they spend on IITs, IIMs and every one of the 40+ central institutions in the country. India spends about 1 % of it’s GDP on healthcare which is among the lowest in the world and has been going lower every year. share of medical education in this small pie isn’t much.
Myth 4: There is so much “corruption in healthcare” and “all doctors are rich”
They paint a picture as if doctors and hospitals are the only corrupt entities in India while the rest of the society is honest. This is far from truth; most doctors find it hard to thrive. Despite this many doctors treat patients for free if they cannot afford the fees. I see people complaining of the doctor’s fee being Rs. 300-500, but expect to provide them world class facilities. How does an establishment pay for the land, building, infrastructure, staff salaries and taxes?
As technological advancements in modern medicine increases, the costs are going to rise. It is the same thing all over the world. Making the government invest more of their resources on healthcare is the real answer.
Need to switch to healthcare from Sick Care
Word doctor is derived from the Latin word ‘docere’, which means ‘to teach’. The foremost role of a doctor should be to teach and educate patients about their well-being. Earlier patients used to show highest regards to their treating doctors, and some even considered doctors as next to God. Environment of mistrust is obvious that some corporate hospitals are employing ‘bouncers’ to thwart possible attacks on doctors on duty. Nowadays movies, TV shows and various social media platforms run stories about doctors who are only after commission, as if all doctors are engaged in rampant malpractices, and not to mention, some have even started questioning the competency of doctors to treat patients. Human values are said to be the foundation for any viable life living within a society. It is a collective virtue that guides us to take into account the human element when we interact with another fellow human. Human values are universal and shared by every human being. In medical practice, promoting human values is not a new concept. Human values that should be included by doctors in their clinical practice are empathy, compassion, honesty, integrity and showing respect towards the patients and their families. One must remember though, practicing medicine with human values and without scientific rationale will only be vague caring, but practicing medicine without human values defeats the ultimate goal of holistic healing. This author works in a cancer hospital and has come across patients who gave up all their hope after the diagnosis of cancer. The aspirations and need of these patients over and above the highest standard of treatment and professional care are empathy, compassion and respect from all the hospital staff, right from the person working at the patient registration, nurse, ward boys, janitors, and most importantly from the doctors. Practicing medicine by inculcating human values works as a big morale booster for patients suffering from a dreaded disease like cancer. Studies have shown that practising medicine with human values does lead to a higher level of patient satisfaction and augments early recovery from diseases including fatal diseases like cancer. A cancer patient once told this author about his experience in a corporate hospital outside the State, “The doctor took hold of my hand and listened very carefully about my problems and symptoms. During that short interaction, I felt all my sufferings had vanished into thin air”. Many patients would recall such a gratifying experience with their doctors, and such feelings expressed by patients are the real treasure a doctor can always cherish in their lifetime. These are the real life experiences and narratives that drop by drop will bring about the necessary change in the negative perception towards doctors shown by a section of our society. Adopting human values does not mean to abandon the precincts of science in medicine. Many doctors are not so excited to inculcate human values in their clinical practice, when time and energy are already at stake. Recent medical advancements have opened newer vistas of science for practicing medical professionals, at par with international standards. And sadly, human values in clinical practice have made way for these newer technological advancements. Way back in the 1960s, Dr. Douglas Hubble wrote in the British Medical Journal “the respect for human values is part of our great medical tradition, and neither the demands of medical science nor the claims of society will persuade us to discard it”. The right ways forward for today’s doctor is balancing science and art in doctoring, and provide holistic care at affordable cost to their patients.