Not Another Utopian Dream!
My mother was suffering from persistent lethargy and slight intermittent chest pain for a couple of weeks, while having a very busy schedule at her office. Being a first year medical student, I felt a surge of responsibility and checking her pressure, I found that she was suffering from persistent hypertension with a BP ranging around 160/100. Getting pretty concerned, we visited a doctor at a reputed nursing home.
After a good two hours of wait, the meeting with the doctor persisted for less than two minutes and we were left baffled with a list of four medicines (a Calcium channel blocker, a beta blocker, a costly vitamin and a sleeping pill as I found out later) to be taken every day, from now onwards, and a battery of clinical examinations including even a Trans Esophageal Echo!
Bamboozled by the whole event, we felt like consulting someone else. The visit to the next doctor was likeably different. Though the initial waiting was almost equivalent, but at least this time, we felt that someone was listening to us. After about 5 minutes of patient listening to the patient, he checked the pressure and said, “You really don’t need to start a drug against hypertension right now. Have this sleeping pill for a week and take some rest. You will be alright. ” And amazingly, my mother did get well with a few sleeping pills instead of four stupendously costly drugs.
Events like this are not rare. And thus creeps in the concept of a ‘better doctor’. Both the doctors, whom I mentioned above, had respectable degrees from respectable institutes. But their method of dealing with the patient was so remarkably different. While one of them was just able to make the patient feel how irrecoverably ill she was, the other one gave her the confidence to get well, simply with the warmth in his voice.
To quote Dr. William Osler, who has a quite interesting take on this ‘good doctor-better doctor’ concept, “It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.”
In my small experience in the medical environment, I have felt, time and again, that our method of education is pretty deficient. Getting to know the diseases and their medicines by heart can only produce an efficient database, but, for treating ill people, a few more things are absolutely necessary. Before writing this essay, I asked some people about their opinions about a ‘better doctor’ and irrespective of any situation, the following points were talked about by every one of them.
This apparently mundane thing can be the most useful tool for a doctor. Proper communication can make the patient comfortable, satisfied and willing to co-operate. Explaining the whole course of treatment in brief saves the patient’s family a lot of tension and also decreases the chances of a vehement reaction against the doctors when the patient deteriorates. If they are told that the patient is doing well (as most doctors tell, carelessly), it is pretty obvious that they would erupt in angry violence when they are suddenly notified about the patient’s death!
While gnawing through the huge medical textbooks, most of us lose our normal social behaviors. However, the last thing that the society can call for is a sociopath doctor! A sweet smile, a small handshake, a few random questions to show the patient that you care are some of the things that shows the better doctor from the good one. Lingering through my memory I still remember this particular pediatrician who used to give me a toffee every time I visited her… I still want to visit her sometimes!
For a doctor, the patients are like a flowing stream of different diseases (and money, of course) but for each patient, their diseases are of extreme concern. They feel much better if the doctor can reflect at least a bit of that concern. After all, as Osler aptly said “The good physician treats the disease; the great physician treats the patient who has the disease.” This can be so easily done by taking the history in a friendlier way, instead of following the mechanical pattern as given in the ‘bedside technique’ books and showing some respect and love in the procedure.
A major complaint against doctors is that they are becoming money making machines instead of being the saintly care-givers. Hot debates can be made on this topic but as much as I understand, it is important for the doctor to take into consideration the patient’s socio-economic status while prescribing drugs or suggesting clinical examinations. It is simply painful to see people who can’t even get a square meal a day being prescribed ultra-expensive drugs (while cheaper ones are available) just because the doctor owes that company for supporting his overseas family vacations!
Examples of corruption and malpractices can make the essay lengthier. But, discussing them doesn’t solve anything. It is obvious that the challenges that we get to face as doctors are quite unimaginable to most of the common people, but it is by choice that we have taken up such a huge responsibility. While the complexities of the health care system is growing by leaps and bounds with the most unbelievable progress in technology and astronomical number of researches going on, everywhere. But, if only a miracle drug or a wonderfully efficient diagnostic technique was the definition of a better treatment, then, I can say, it won’t be long before the doctors are replaced entirely by intelligently programmed robots.
But, I believe in the idea of a ‘healing touch’. Doctors matter. That is why, even above the general dissatisfied squabbles against the medicine-man, the names of a few doctors are chanted as that of God. We can all be that ‘better doctor’ if we give it a try. All we need to do is, ‘care’.
All these babblings can be summarized by quoting Dr. Osler, once again! So, I would simply wind up repeating his words, “Observe, record, tabulate, communicate. Use your five senses. Learn to see, learn to hear, learn to feel, learn to smell, and know that by practice alone you can become expert.”
About the Author : Chandrima Naskar isa 2nd year student at Medical College and Hospital, Kolkata, India. She can be reached at : [email protected]
About this article: This article is competing for the JPMS International Medical Writing Contest 2012 for the theme: Becoming Better Doctors.
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