Why do most Indian doctors only spend about two minutes with their patients?
By Isaac James Manayath | Express News Service | Published: 11th November 2017 11:05 AM |
When you went to your doctor the last time, how much time did he give you? Chances are it was no more than two minutes, for that’s what the average consultation time in India is, according to a study published in the British Journal of Medicine (BMJ).
The researchers studied 2.8 crore doctors’ consultations in 67 countries, using techniques ranging from calculating the number of patients seen in a given time to assessing data from multiple surveys.
Where does India stand?
India ranked rather poorly, 62nd among 67 countries in fact. At the top of the heap were Sweden, USA and Bulgaria where doctors see their patients for an average of at least 20 minutes. Sweden (22 minutes) topped the chart. The Swedish healthcare system has for long been the envy of the world. A recent
research by the Organisation for Economic Cooperation and Development (OECD) found that healthcare in Sweden is among the best in the world. Pakistan is the the worst country to be a patient in. You’d be dismissed in 48 seconds. According to the BMJ data, doctors in Asia are busier than their African or European counterparts. Eight out of the 10 lowest-ranking countries are in Asia. Doctors spend more time with patients in Europe and North America. In fact, all countries where doctors spent more than 15 minutes seeing patients are either in Europe or North America. Interestingly, most of these countries also have a high per capita spending on healthcare.
Why are docs in such a hurry in India?
A number of factors explain why doctors spend less time with patients in India. India’s low physician density could be a major factor. According to the CIA World Factbook, India has 0.73 physicians per 1,000 people. The United States and the United Kingdom have 2.55 and 2.73 doctors respectively. Austria has five, which is the hisghest among the countries studied. One thing that stands out is that in countries with better a physician-to-patient ratio, doctors end up spending more time with patients.
Five of the top 10 countries in terms of consultation time have a physician density of more than four. A country with high health parameters may cope with low physician density. But in a country like India, where health standards are low and the patient population is high, it places heavy stress on the system.
Another reason why doctors tend to hurry in India could do with the commercialisation of healthcare in the form of corporate hospitals. More patients translates into more money for such hospitals and a better ratings for the doctor in such hospitals. Thus, a doctor may hurriedly end his/her session with a patient so as to call in the next.
What are the consequences?
Studies have found that short consultation times correlates with prescription of multiple medications, overuse of antibiotics and poor communication with patients. Doctors who spent less time seeing patients tend to prescribe more medicines, including antibiotics, the BMJ study says.
When consultation time is limited, doctors tend to quickly gloss over the symptoms and prescribe medicines rather than tackle the root causes of illness. It may lead to impropoer diagnoisis. According to the Institute of Medical Science and Law, cases of improper diagnosis doubled in India between 2013
and 2014. Also, when consultation time is short, it may not be possible for doctors to advise patients on preventive tips. As a result, patients may get ill again, leading to additional stress on the system.