What if patients start advising the doctor

As we all know, it is the physician who advises his patient to take the treatment as prescribed by him. But it was the other way about in parts of western Uttar Pradesh where a few decades back some patients from middle and lower middle class families would often “advise” their physician on the mode of treatment they wanted.

Of course, such brazenness invited rebuke from the offended doctor. Nevertheless, the trend continued in the region for a long time, though in small measure. I witnessed it in my younger days when I used to spend some time at the private clinics of my uncle and my first cousin, both doctors.

After the initial physical examination, some patient would say, “Doctor, give me an injection. I tell you, it will cure me faster.”

In those days, Penicillin was vogue because of its efficacy in treating quite a few ailments. So some enthusiast would blatantly demand that he be administered “this wonderful medicine”. Some others would plainly tell the doctor to prescribe only those medicines that tasted good.

My elderly uncle would dismiss such unwarranted ‘advice’ coolly. But my cousin would lose his temper.

I noticed that the ordinary patient believed that an injected medicine gave quick results vis-à-vis tablets, capsules or a liquid mixture that took time to act.

On one occasion, I found another brand of “patient”, a middle-aged woman, who was not sick at all. Coming from an affluent family she complained of “suffering from anaemia for a long time”.

The fact was that her pink cheeks and arms were glowing and appeared to be on the verge of oozing blood. But she insisted that she was feeling weak due to anaemia.

“Who told you so?” asked my uncle. “All the women in our neighbourhood. They say I will be all right if given some injections and fruits like apples, grapes etc” she replied. It turned out that her stingy husband was not meeting her craving for fruits and some other delectable food items. Ironically, there were patients who really needed both medication and nutrition but did not have the requisite financial resources.

The scenario is totally different today. The pattern of medicare has changed, and so has the people’s attitude. The level of literacy and awareness rose due to the advent of television. As a result of sustained government campaigns and TV channels’ own initiative, the idiot box took illustrative tips on health, nutritive food and the need for change in the lifestyle right into the most modest homes.

The industry that responded to the needs of the changing times also contributed in a big way in spreading awareness, of course with an eye on its commercial concerns.

The enlightened patient of today knows that cooperating with the doctor is in his/interest. Of course, this is not the case with everyone.

Happily, the average patient is slowly but steadily becoming conscious of his right to know details of the treatment he is proposed to be given or being given. This is not to suggest that all is well on the health front. Of course, things are getting better but it will take a lot of time to change the mindset of patients, paramedical staff and even doctors.

There is no doubt that doctors, nurses and the lower staff in state-run and municipal hospitals that cater to the largest segment of India’s ailing population, are working under immense pressure. Among the reasons are the country’s ever growing population, lack of resources and inadequate governance.

I don’t propose to discuss these but would only mention two cases to illustrate my points. In the first, a junior doctor had a cursory look at a case file and started examining the patient’s right knee. On being pointed out by the patient, a teacher, that the problem was with his left knee the doctor felt offended. He curtly told the patient “I know my job”. He then examined the left knee.

Now about a nurse who came on night duty. Going through the patients’ case files, she woke up a woman patient who was deep asleep. Chiding her she said, “Hey, you are sleeping? Take this sleeping tablet and then go to sleep”.

That was mechanical, but faithful, implementation of instructions even though it amounted to absurdity.

Lalit Raizada is a journalist based in India.