National Doctors day is celebrated on 1st of July on the birth anniversary of the famous physician of India Bharat Ratna Dr. Bidhan Chandra Roy.
There is trust deficit- India has a little over one million modern medicine doctors to treat its 1.3 billion people. Health care has been sick for decades, but the illness has progressed rapidly in recent years.
Doctors day is an opportunity to rededicate ourselves to the practice of medicine, a time for us to reflect on the responsibility we bear and redirect ourselves onto ethical path of healing those in need.
In my mind, the doctor-patient relationship is sacrosanct. There is no relationship where the bond of trust should be so strong. Trust has many components. Compassion, Communication, Consistency, and Competency: are four drivers of true trust.
Doctors: Reestablish the trust!
Don't we all believe that death is a natural event and it is pre-destined? Then, why are doctors blamed if the patient dies even after they do everything to save? Believe me; the death of a patient hurts us as well.
The patient is not just a group of symptoms, damaged organs and altered emotions. The patient is a human being, worried and hopeful, searching for relief, help and trust.
Medicine is a hot mess of human anatomy, physiology, sociology, psychopathology, drugs, hope, and compassion. The patient narrates a story- his perception, for you to make a diagnosis. Never forget that some diseases are incurable and you will not have much to offer. We are human; we use our expertise to reach a cure with the help of modern technology. Our purposes are humble: "To cure sometimes, to heal often, to console always."
Why the trust deficit?
There has been so much talk on the unethical practices among doctors. Bad apples are there in every profession. Lack of transparency, lack of communication, unethical practices and low quality of service has all contributed to the trust deficit.
The basic function of the doctor, to diagnose and treat, has been called into question by the Mayo Clinic article with stories such as over-prescribing, doctors taking money from drug companies, the guy who performed illegal and unsanitary abortions, doctors turning down poor patients, etc.
Today's society is run by money, everybody is after money. The greed for money is overwhelming! Doctors are no exception. There is no denying that doctors are afflicted today by the same corrupt practices that have permeated every aspect of our public lives.
Irrational prescriptions, bribes for referrals and unnecessary investigations are the most common forms of deceptions in India's health sector. Hospitals are 74% the least trusted, followed by pharmaceutical and insurance companies 62%, Medical clinics 52%, doctors50% and diagnostic laboratories(46%) were other healthcare players whom people don't trust as blindly as they did.
There is a Crisis of Compassion! I say this with a great deal of sadness. But the humane, compassionate, caring doctor, who worries about patients' welfare, who treats them with a "holistic approach," is a relic of the past.
Today's doctor is in a predicament. Medicine is a science which has many probabilities and possibilities. A patient places what is most valuable to him-his very life in the hands of the doctor. It increases the responsibility of the doctor and is expected to exercise a very high degree of skill and care.
There has been unprecedented violence against doctors. If hostile relatives take centre stage, the poor doctor is a sitting duck. The violence and abuse against doctors, both verbal and physical, is illogical, and the malady is fast becoming pandemic. It isn't easy being a doctor, it never has been. Today, the Indian Doctor is Isolated, Defensive & Vulnerable.
The New York Times did a piece that contained a great deal of doctor-bashing. "It's not hatred, its fear."- I was told! If people are starting to fear physicians then we've got a real problem. Trust has always been the basis of the doctor-patient relationship. If you can't trust us then we're done. If you can't trust us then our relationship becomes adversarial: you against me. If you can't trust us, you won't tell us things, you won't do what we say, you will constantly doubt our motives. Actually the doctor-patient relationship becomes basically that of teenager-parent.
The media has always looked at doctors with a jaundiced vision. While a doctor is expected to be altruistic, above temptation, he is not above suspicion, reproach and ridicule. Certainly, the relentless negative press coverage of physicians sets the tone. Often media blames physicians for things the doctor has no control over.
Doctors trust patients less too due to fear of litigation. Doctors are forced to practice Defensive medicine- With increasing lawsuits and violence, doctors will be forced to practice where you document more than you diagnose and treat.
The need of the hour is a sincere, upright, concerned, kind, ethical doctor, whose primary interest is the patient; who is available, affordable, and empathetic; who touches them, holds their hands, examines them, cares for them, and treats them like human beings.
(Prof. Dr. N. Prabhudev, Former Director, Sri Jayadeva Institute of Cardiology)
