The last five decades have been one of change. We have travelled from the black and white TV to the curved LEDs, the wired big black telephone has been replaced by mobile phones which disappear into the palm, the mobile wallets have replaced paper money; the list is endless.
These 50 years have also seen exponential medical development. The advancements have been phenomenal - the introduction of antibiotics beginning with penicillin in 1940 to the introduction of imaging technology like CT and MRI which have revolutionised the way in which the body is scanned to detect disease, anti-TB therapy, anti-viral therapy for HIV, kidney dialysis, angioplasty, endoscopy and laparoscopic work, inhaled therapy, organ transplantation etc.
With new developments, we encountered new challenges. Medical professionals have moved away from practising traditional medicine. There was a need to stay abreast of the developments, the need to invest time and money in specialising, acquiring new skill sets and finding ways to introduce a new methodology.
Many travelled overseas to work with pioneers in the field. They returned with knowledge and skills which they shared with their colleagues. The journey has not been easy. The treatment options, diagnostic tools and skills that are taken for granted today, are the result of perseverance and hard work.
Karl Marx said: “Medicines heal doubts as well as diseases.” Unfortunately, the progress in medicine has been coupled with growing distrust of the medical profession and professionals. This was formalised when doctors were brought under the Consumer Protection Act (CPA) 1986. Though they say that doctors practising ethically and honestly should not have any reason to fear, the fact is today most doctors are being driven towards defensive practice.
Following inclusion in the CPA, the number of litigations against doctors went up. Think about it, once a doctor advises investigations, the speculations begin: doctor is getting a cut, so sue him. If there is a delay in diagnosis: the doctor should have advised the investigations on my first visit. Doctor messed up, so sue him. The doctor did not answer my phone at three in the morning, so I suffered mental agony, sue him. The call was made at three in the morning, I wonder. Are doctors not human? Do they not have a family? Can they not be going through a personal crisis - a loss, a member of their family unwell, and hospitalised, too? Do they deserve the work life balance that everyone talks about? Where are we headed?
The patients visiting the doctor generally have underlying health problems which can predispose to and/or compound health issues. Especially today, every family has a member suffering from diabetes, hypertension, a problem with the heart, kidney etc. The newer issues like Dengue or H1N1 are taking their toll, purely because of either the aggressive nature of the infection or underlying health condition. The doctor can do just so much.
All a doctor wants to do is diagnose correctly and advise the appropriate treatment. No doctor would like any complication in his patient. He only wants his patient to get well and go home. Results are sometimes beyond the control of the doctor. He can only give his best. Retrospectively, every job can always be done better or in a different way.
Trends are changing. The doctor is no longer going to advise what he feels is medically best. He will give options. It will be up to the patient and the family to choose and commit their choice on paper. To cite a case, a friend’s five-year-old daughter had a fall and sustained a cut on the scalp. She was advised that she could let it be and it would close naturally, or get stitches put or have staples put.
On questioning as to what was the best option, she was advised that he could only offer options, the decision had to be hers. The doctor has obviously had a problem with a patient before. This is what we are pushing the medical profession to do.
Action and reaction are equal and opposite. Today, parents are questioning their decision to enrol their children for medicine. They calculate the investment in terms of long years of study, wherein some institutions do not even have habitable quarters, the long gruelling work hours, meagre pay and most importantly the safety of their child while at work. Where is our next generation of doctors? We are nipping them in the bud. Before assaulting a doctor, breaking up a hospital, maligning or suing a doctor- pause, think and refrain.
(The writer is medical director, Fortis Hospitals, Bannerghatta Road, Bengaluru)
Published 03 August 2017, 19:47 IST