What the doctor prescribes to regain trust of patients

It was a usual busy day in the labour room. A single attending senior doctor was shouting out instructions to her junior colleagues and nurses on duty, and at the same time attending to the patient on the delivery table. In that one fleeting moment of distraction, the baby came out, and straight in the bin below. The catastrophe was met with stunned silence and disbelief. Fear, shock, and guilt paralysed everyone.

Hey viola! The baby announced his arrival with a lusty cry, affirming the adage, “Jaako raakhe saiyaan maar sake na koi.” There was a huge sigh of relief and joy all around. The mother in a drowsy state, raised her folded hands as a sign of gratitude. I dread to think what would have happened if the benign hand of the Almighty had not intervened. This is a true incident revealed to me years later by the senior doctor herself. From this unflinching faith in doctors, to the current situation, where often doctors are regarded with mistrust and suspicion, we have come a long way.

About three decades ago, health care was a government domain. Private hospitals and private medical colleges were few and far between. There used to be a competitive entrance exam to secure admission, which one secured with considerable slogging. Capitation fee was an unheard concept. With the advent of privatisation and liberalisation in the ’90s, many private medical and dental colleges, nursing and physiotherapy institutes and big corporate hospitals sprung up. These offered an attractive investment opportunity to business houses. In the era before this, there used to be the government hospitals, and in the field of private healthcare there were small single doctor clinics, where implicit trust and faith was as much a part of treatment as medicines and surgery.

Rapid advances have taken place in medical science with consequent development of sophisticated gadgetry. It is well-nigh impossible for small healthcare facilities to offer these newer modalities, the cost of which is mindboggling.

A third dimension has crept in with the entry of the insurance sector. Now it is almost mandatory to have some sort of health insurance cover to offset the cost of treatment. Realistically speaking, only a small percentage of our population residing in semi-urban and rural townships can afford private medical care. The social media and information explosion has led to a situation where everyone aspires for the best option for their loved ones.

The involvement of so many stakeholders, the government bodies, health providers, insurance companies and patient themselves results in a complex matrix. This often leads to unsavoury situations like the one we witnessed recently in Rajasthan. Thankfully, the standoff did not drag for long and judicious negotiations led to an amicable solution.

One aspect of this issue that remains paramount is the loss of trust. Trust deficit is as much to blame as other factors. The increasing number of medical negligence cases in consumer courts bears testimony to this development.

Noted physician Dr BM Hegde often quotes Hippocrates who says: “A physician should comfort and console always, treat often and cure sometimes.” To this I add, cheat never. With this principle, we would come to the happy times when a doctor was next to God in the eyes of society.

FROM THIS UNFLINCHING FAITH IN DOCTORS, TO THE PRESENT SITUATION, WHERE OFTEN DOCTORS ARE REGARDED WITH MISTRUST AND SUSPICION, WE HAVE COME A LONG WAY