Friday, November 2, 2007

Doctors of Doom





Ok, so its a long time since I cribbed...not that i've had nothing to crib about, but i've just been lazy. Something that I was browsing through today made me post this.

For the first time, I looked up reviews of hospitals in Bangalore, and I was pretty shocked to read that nobody had anything nice to say about their experiences there. Most of the complaints seem to be about hospitals in the corporate sector. I observed a few common complaints..

1) Misdiagnosis
2) Surgery recommended in the hospital when it wasn't required
3) High costs
4) Doctor not listening to the patient's problems
5) Unnecessary tests


While no doctor likes to be wrong in his diagnosis, mistakes do occur and the serious ones tend to be fatal on rare occasions. One must understand that medicine is a vast science and is constantly evolving. While other professions allow for mistakes to be easily rectified without much loss to life or property, it is hard to expect that sort of cushion in medicine. There are a huge number of probabilities in everything we do. I cant even think of listing them here. A patient who comes with fever could probably be just suffering from a minor throat infection that would go away in a couple of days, or he may be suffering from something as serious as dengue fever that may kill him in the next few days if untreated. That is why even simple symptoms are sometimes subjected to a battery of tests which may not make sense to someone out of the medical field. They are quick to blame the doctor for unnecessary tests if it is a simple problem and are quick to sue the doctor if it turns out to be something serious.

There is however no excuse for negligence by a doctor. Negligence does occur, but is rarely seen in larger hospitals. Most of the cases of negligence I have seen occur in government run setups and small nursing homes. These places do not have doctors with the required expertise, equipment and backup to handle problems and are usually the source of mismanaged patients.

High costs by corporate hospitals are mainly due to the money invested in infrastructure and equipment. To put it in perspective, to furnish a single ICU bed with basic equipment (ventilators, monitors, etc) would cost the hospital a minimum of 10 lakhs. The maximum price for ICU rental per day in Bangalore would be about Rs 5000. Nobody seems to complain when they pay 3 times that price for a hotel room in this city which would have cost the hotel far less to furnish!

Doctor not listening? Doctors usually listen to a point till they have sufficient information to make a diagnosis. Sometimes, the clinical picture is good enough to make a diagnosis. Many times the patient or his relative provides facts that are irrelevant.

Like any other field, nobody in the medical profession wants to be bad. We all work very hard to provide medical care to the best of our ability. Most of the patients we see improve and go home happy. Some people are so distraught about the thought of losing a loved one, that they fail to accept that some conditions (like cancer) cannot be cured. In their ability to accept reality, such individuals are quick to blame medical care as the cause of a patient's death, but not the disease itself. Some reassure themselves that the patient would be ok in a day, when the truth is, he would be dead in a day. In short, people sometimes expect miracles. Miracles in medicine do occur, but not to everyone and not every day.

I'm not making excuses for doctors in this post. Amidst the thousands who do a great job, there are a few who are Grade 'A' scoundrels. However, good hospitals tend to filter out these weeds.



How do you get good medical care in Bangalore? I would suggest you follow some stuff that I have mentioned below.


* Get a health insurance policy. It will help you cover large hospital bills.

* Avoid small nursing homes for surgical procedures and deliveries. Most of these places are not well equipped. Many choose them to cut costs. Its not worth it. They are ok for a medical consultation... but not for surgeries.

* Larger hospitals have better trained doctors & staff. They also have better backup facilities if an emergency arises.

* If you are unhappy with the care you are getting at a hospital, approach the management with your problem. Hospitals such as the one I work in take complaints like this seriously and we deal with it efficiently. If the hospital management is not willing to discuss the problem (if it is legitimate) with you, then you would be justified in moving to another hospital.

* If in doubt, you are free to get a second opinion. However, keep in mind that even if the second opinion sounds better than the first, it has an equal possibility of being wrong.

* If possible, have a doctor as a friend. He may be able to guide you when you need some help.

* Do not tell the doctor how he must treat the patient and what medications he should get. Not only does this thoroughly annoy the doctor, it makes you look like a complete idiot.

* Most of all, stay healthy and avoid hospitals!