Basically my favourite lawyer character was called on an "acute emergency " . The patient a big industrialist is on the table and a sigmoidoscope /colonoscope ( an instrument to view the back passage ) is inserted . And he is calling the lawyer from the table . Basically he wants to sue the doctor for medical malpractice and the doctor is in a dilemma whether to withdraw the scope or not . It was a sarcastic look at the dilemmas of a doctor practising in a litigant soceity . And the example was the apt sarcasm . Of course after the episode and lot of arbitrations by multiple lawyers the doctor and patient agreed to get the scope out of his back passage .
That legal drama gets acted out in the hospital (somewhat like an out of court arbitration ) but the ethical points raised were very relevant in current times ... mainly in the western world but increasingly in india .
I am not going to the arguments and counterarguments of medical negligence as having read extensively and seen medicine from different aspects and speaking to a reasonable number of people both doctors and public . To make a long story short .. just like in soceity 5 percent of doctors as well as patients are very bad ..(because they too are taken from the same soceity ) . All the mistrust is because there is a lot of lack of knowledge (even among the educated ) and also there is a general expectation that most diseases can be cured and course predicted especially when technology is growing at a very fast pace .
In addition "consumerism " with all its good and bad aspects has increased tremendously over recent years . And of course many doctors have not taken the time to understand the changing expectations of the soceity or as few of them say they have given up on the overexpectations of many people in the soceity . I have blogged on Dr X who is thriving extremely well , has a good name in soceity but who is paying back to the soceity in his own way ...But this sigmoidoscope episode is a must watch in "The practice " as it sarcastically shows where medical field is heading and though solutions are very simple like most things instead of endless arguments .
PS : A note about me .. for last many years i am in medical teaching and since my students of all ages do not represent "the ignorant arrogant " category and dont have overexpectations i am very happy in my role . And as a patient ( i too need my repairs once in a while ) i choose my doctors carefully and i ask them relevant questions , never throw my "attitude" at them and on my part read up especially the limitations of each disease condition .
After all i dont want a sigmoidoscope stuck in my back passage . I love my doctors and though i dont say they are Gods (thats outdated ) i respect them and trust them and forgive them for their humanness . And regarding the "black sheep " i strongly believe both the soceity as well as the medical community identify the real black sheep and isolate them ... Its possible , believe me ..
Also till we find a 100 percent cure for all diseases lets keep our attitude at home as no amount of money or attitude helps to fight most diseases except a trusting partnership between a doctor and patient ..That will prevent diseases from making the last laugh . Comments , arguments , welcome ..
Think about thousands of patients who cannot Google, and trust the doctors. Implicitly. Agreed there are limitatiobe. But subjecting laymen to unnecessary tests and examinations just because a lot of money has been spent on donations,.infrastructure and equipment is unforgivable in a noble profession like medicine. I am sorry to say the number of black sheep are steadily.increasing. One does not expect magic cures. But the doctors.should deserve the trust. Easy to ask the layman to choose carefully. Most people do.that. What is worse.ignorance or lack of ethics?
ReplyDeleteCan vibe with the feelings expressed in the above comment. And i also agree that the number of black sheep are steadily increasing . But after talking to countless people on both sides of the "no trust zone " i sincerely believe the trust can at least be partially regained if soceity (doctors included ) take a meaningful and realistic look at the "problem " of lack of trust . The "unnecessary " test is the classic case .On one side there are doctors ordering unnecessary test for commission . Also there are doctors ordering tests to prevent litigation . And on the other side there are laymen who themselves decide when a test is necessary when even evidence based medicine is trying hard to decide when a given test is necessary . And lastly inspite of all the commissions and unnecessary tests and lack of trust the lifespan and quality of life is improving . And for that i thank the few white sheep that remain .
ReplyDelete