Compassion is dying. Doctors are forgetting the Hippocratic Oath of keeping patients’ interests first. In 21st Century Delhi, doctors are concerned only about revenue per patient.
A young doctor came to me after having been to a doctor in a prestigious private hospital. He paid the fees, but was ‘seen’ among a group of 2-3 patients, all talking to the doctor at the same time. Having narrated his symptoms, he was told that he suffered from Depression and he needed to get a CT scan and some blood tests done before a prescription could be given. He tried discussing why he felt he did not have Depression, but the doctor, a neurologist, insisted that only a CT scan would help clarify the diagnosis.
Empathy and rapport building: NIL.
Professional courtesy: NIL.
Keeping patients interests first: What patient; I want my moolah and not only my consultation but more!
The frustrated but worried doctor came to me for a second opinion and I advised him the correct diagnosis and the futility of a CT scan or blood tests. His lament of the way he was dismissed and misguided is not a one off as I keep getting patients from across the city who have been mistreated, misinformed, and at times financially exploited.
If this is the approach towards a medical professional, think of what the attitude would be to those who are not aware of any clinical knowledge.
Some instances really make my blood boil.
A 70 yr old lady was brought to me in a wheelchair by her husband and son. She was very restless, shouting intermittently and was not having any solids for the last 3 months. She complained of an obstruction in her throat that prevented her from eating or drinking. She felt she was dying and would not get better. Over the last 4 months she had been admitted to private hospitals 3 times, once for over 15 days, and never had doctors suggested that she should be seen by a Psychiatrist. At each instance of hospitalization, IV fluids were administered, a battery of blood tests done, and a multispecialty panel of doctors evaluated her ‘in detail’ (Laryngoscopy, Endoscopy, Ultrasound, CT Abdomen)!! Result: NIL. The patient had been deteriorating and all the health professionals involved in her treatment were blind to her mental health problem! I find that hard to believe. I wanted to shame these people who had allowed a frail lady to get unwell and become weaker.
The lack of ability to call or refer to a Psychiatrist is an epidemic afflicting thousands of doctors across the city. They prefer to admit, investigate, evaluate and assess until some ‘body’ diagnosis provides them a lifeline to justify the expenses and the suffering of the hospitalization. Yet, at discharge, such patients always have a benzodiazepine added to their list of medicines. A Psychiatrist would have identified the ‘mind’ diagnosis by talking to the patient and the family members in a comfortable, patient, and reassuring manner. No hospitalization would have been required and of course no blood tests. Revenue from the patient would have been a few hundreds only. Is that the reason of this epidemic of specific blindness which is afflicting health professionals in Delhi?
Until such doctors are held accountable, can things change? No, not at all!
Do I have hope of accountability of doctors? No, not at all!