We are indeed living in hostile times. There is violence not only at the war front, but also in our homes, on the roads and even in hospitals. It seems as if each of these places has become a battlefield. Hospital rage is increasingly becoming a common phenomenon. Every day, we hear about patients’ relatives creating a ruckus in hospital premises, protesting against doctors’ apathy—either treatment is not given timely or it is wrong treatment. Sometimes doctors also retaliate in self defense to show that they are above reproach like Caesar’s wife.
Gone are the days of the family physician who used to be not only a healer of the body but also of the mind—a friend, guide and curer, all rolled into one. But this is the era of modern economic theories where the patient is a customer who buys the services of the doctor. So where is the scope for any love being lost between them?
Dr Rajesh C Shah, a renowned surgeon and medico legal expert of Ahmedabad was recently in Lucknow for the Foundation Day celebrations of CSM Medical University. In an exclusive interview to CNS he spoke about the steady erosion in patient- doctor relationships.
He reminiscenced, “During my student days, we were taught that a doctor should consider the patient as god. He should treat him as a family member. Unfortunately that relationship is no more—chiefly because of the Consumer Protection Act which brought into its purview the medical profession also, way back in 1993. This Act has gone a long way in creating consumerism in the profession, and this has eroded its nobility due to the law of the land.”
He said, “In the past if a patient complained of a headache problem, I would prescribe a simple analgesic, and ask him to report back after 3 or 4 days. Only if the ache persisted, would I go for other tests. But my present duty is to explain to the patient all the possibilities at the first instance only. Obviously, then the patient wants to know all possible lines of treatment/ diagnostic tests available. Suppose I suggest a CT scan to a poor labourer, then what will happen to him? His headache may be cured by a simple tablet, but to save my own skin, I have to mention CT Scans and thus create a bigger headache of doubts in his mind, and also the desire to go for the best treatment, which may be out of his reach. Ultimately the result is a rise in treatment costs, and this has created dissatisfaction in society. The format of the present Consumer Act, as applied to the medical profession, needs some changes. Either the cases should go to civil court only, or there should be some judiciary from the medical profession to help.”
He agreed that there should be accountability on part of the doctors, and they should be punished if found guilty. But in 99% of the Consumer Court cases, the verdict has been in favour of the doctors. Yet, the trial faced by a doctor is no less a punishment as it sullies his reputation and makes him suspect of misconduct, even though he has not been negligent. So winning the case loses its sheen.
Unfortunately, there is a lot of turbulence in patient-doctor relationship these days. The ethical, moral and monetary values of society have changed drastically in recent times. This is reflected in the medical profession also. Consumerism has eroded the nobility of this profession, because of the law of the land. Also, patients have become more informed and knowledgeable these days and this has created a lot of friction. Dr Shah was of the opinion that if doctors spend more time in their consulting room, then they will never have to spend time in the courtroom.
In a majority of cases it is improper understanding between the patient and the doctor that creates conflicts. Doctors are so busy that they have no time to counsel the patient or the relatives. This is especially true of government hospitals, where inhumanly long working hours, poor compensation and a skewed up doctor-patient ratio worsen the situation. There is also an acute shortage of trained and polite nurses/ward boys/ care providers. Obviously this affects the quality of services. Things are no better in private nursing homes, where the services rendered generally do not match the exorbitant charges. All this makes the patients a disgruntled lot, and hospitals a fighting arena. Hospital violence which is becoming increasingly common, affects not only the doctors, but creates problems for other patients as well. So it is a no win situation for all.
It is time the healer and the sick started respecting and trusting each other. Both should understand that human beings can make mistakes. Doctors should implement the Hippocrates oath in their daily practice and patients should understand the constraints under which doctors work at times. let the doctor be more sincere in his/her profession and not treat the patient merely as a case-file. at the same time the patient needs to cooperate with the doctor and have faith.
The ultimate goal should be the betterment of all.
(The author is the Editor of Citizen News Service (CNS) and also serves as the Director of CNS Diabetes Media Initiative (CNS-DMI).She is a J2J Fellow of National Press Foundation (NPF) USA. She has worked earlier with State Planning Institute, UP. Email: firstname.lastname@example.org, website: www.citizen-news.org)