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To be a doctor, be patient first

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Does not the patient deserve at least a few more minutes to tell his tale?

A recent study published by the British Medical Journal revealed that the average length of a medical consultation in India is two minutes per patient. This means that on average a doctor in India spends only a couple of minutes attending to a patient.

This figure is very low compared to 20 minutes per patient in the United States, and a little higher compared to an average of 48 seconds per patient in Bangladesh. The report says the primary care consultation lasts less than five minutes for half of the world’s population.

A month back, I had a chance to visit a super-specialty hospital in our city. The out-patient waiting room of our consultant was filled with some 80 patients waiting for their turn. I was told this was for the forenoon and the story would be repeated in the evening.

We have books on the practice of clinical medicine which give guidelines for examining and analysing a case, which when followed, in the least, will need a minimum of 30 minutes for a patient. However keen be the intelligence of a doctor, is it possible for one to assess accurately the actual state of the patient before him within a few minutes?

Our experts are of the opinion that such short-length medical consultations are due to the large number of ailing patients and a shortage of doctors as far as India is concerned. This is evident from the steps taken by the National Rural Health Mission to meet this shortage across country.

In spite of this, is it admissible that the health care services be compromised with low levels of results? No, our busy schedule should never bring down the quality of results doctors are expected to provide.

The hurried process

What happens in those few minutes? The patient hurriedly tries to list down all his sufferings to his saviour, and before he even finishes, the doctor completes writing the prescription. It is as if all the words spoken thereafter have no role in the actual treatment! Does not the patient deserve at least a few more minutes to tell his tale?

Is it not necessary for the doctor to note down all the complaints of the patient for future reference? Is it not true that the doctors, mere humble human beings capable of making errors, should try to spend some more time with the ailing ones?

The reason for such a lacuna, we may aptly attribute to the lowered spirit of research and innovation among the young medical students in the field of pharmacology. Instead of learning the adventurous methods of studying the pathogenesis of drugs, the young students are simply made to memorise the prescription recipe books which simulate the handbooks of a cook.

As per the opinion of most of senior experienced doctors, such handbooks on prescriptions are but the artistic works of the pharmaceutical companies. As long as a doctor is eager to analyse the result produced by the drugs he prescribed, he will be obliged, even without his knowledge, to make a close study of his patients and the state of their disease or condition.

Should we blame only our doctors for this situation? Definitely not! The patients, unfortunately, take their condition for granted, and wait for days or weeks together before they consult a doctor. This consultation is very much like having the darshan of their adored deity. The strangest part is that, these patients are struck by a psychological affliction of fashion. Yeah, it is hard to believe they do it in the name of fashion!

I owe an apology for quoting here the words of truth once told by Dr. C.F. Samuel Hahnemann: “The profession which of all others require actually the most reflection, a conscientious, careful examination of the state of each individual patient and a special treatment founded thereon, was conducted in this manner by persons who called themselves physicians, rational practitioners. The result, as might naturally be expected, was almost invariably bad; and yet patients had to go to them for advice, partly because there were none better to be had, partly for fashion’s sake.”

It is true that the situation has been changing over the years. We do have a section of doctors who are better to get advice from and who really lend an eager ear to all their patients and thereby render greater service to the humanity and to his profession. Still, much distance will need to be covered for our destination to be reached.

eswarang9@gmail.com

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Printable version | Jan 28, 2020 5:51:20 PM | https://www.thehindu.com/opinion/open-page/to-be-a-doctor-be-patient-first/article20917393.ece

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