September 15, 2008

What ails the medical profession?

He was a family physician, consultant and, above all, a caring friend.
There was a time, not long ago, when patients considered doctors as demigods. The doc was so much a part of the patient’s family that even personal matters were discussed and advice sought. He was part of get-togethers and his opinion mattered, on almost every issue.

The reasons were the three ‘A’s: Affordability, Accessibility and Amiability. In simple terms, the doctor was easily approachable, the best of treatment was not beyond the patient’s means and the doctor’s empathetic stance gave a consoling touch to the suffering person. He was a family physician, consultant and, above all, a caring friend.

In the same breath, one must add that medical care in India three decades ago consisted mostly of primary care at the villages and two-tier cities, and secondary care in the metros. Sophisticated gadgets for diagnosis didn’t exist and the pharmaceutical industry was in its nascent stage — even lifesaving drugs had to be imported and were a privilege of the elite and the powerful. ‘Corporate hospital’ was unknown terminology.

Changing times
However, in the past two decades. things have changed. We are proud that our doctors are second to none in their ability and clinical acumen. The hospital industry is booming and medical treatment attracts patients from South East Asia and the Middle East, adding to the economy boom.

Today a coronary by-pass or renal transplant is within the reach of the upper middle class, and thanks to the enterprise of both medical and non medical entrepreneurs, life-saving equipment and tertiary hospitals are now available even in two-tier cities.

But these advancements have also ushered in certain problems. Patients don’t find the three important ‘A’s in the medical profession any more.

Safeguarding interests
Doctors are confined to their air conditioned chambers, and to reach them one has to pass through a secretary or the reception crew at the hospital. Not an easy proposition for an uneducated person!

In an era of growing awareness of consumer protection among patients and fears of litigation, doctors view every patient with suspicion — in other words as a potential litigant. Therefore, in a bid to safeguard his interest, the doctors go for opinions from super-specialities and order a battery of investigations before starting treatment or suggesting surgery. Naturally cost escalates and, when things go wrong, the doctor in question is cursed and vilified. In a fast developing country like ours, it is imperative on the part of the government and medical community to promote the latest in the field of medicine. At the same time a delicate balance is the need of the hour.

The solution lies in the hands of the doctor. He has to spend enough time explaining the pros and cons of treatment, maintain a sympathetic approach and explain in detail every procedure, the cost and the pitfalls. Adopting these measures alone will place the medical profession on a pedestal again.

Dr. Ashraf was awarded the B.C. Roy national award for 2006 for Medico-Social Relief. E-mail:

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