KOCHI: When a journalist asked a general audience what describe a good doctor, the answers varied but clustered along similar attributes: listener, compassion, commitment, humanity, attentive, patient, competent, teacher, healer, and ethical. One respondent said ‘the one thing I have noticed in those that were great, truly great, were those who were humble, but confident. They would listen quietly to a patient’s story and were never really rushed nor found themselves panicking in a critical situation”.
It is fairly easy to define in a few words what makes a good lawyer, a good architect, or a good writer, by saying that it is one who wins difficult trials, who builds the best construction, or who writes moving novels – no more qualities would be absolutely necessary. In contrast, to define what makes a good doctor is a rather difficult task.
A good doctor is not one who cures the most because in many specialities recovery is not a frequent outcome. It is not one who makes the best diagnosis because in many cases of self-limited or incurable disorders the precise and timely diagnosis doesn’t make a great difference for the patient. It is not one who knows more scientific facts because in medical science ignorance is still rampant in several diseases.
Other professionals can be judged by their end results, but a doctor can be defined as good only when he or she has as many as possible of the above attributes. A good doctor is simultaneously termed honest, kind, humble, optimistic, efficient and God fearing.
What duties do doctors have toward their patients?
In legal terms, doctors have an obligation of means toward their patients, not an obligation of result. This means that they have to take appropriate steps available to make the right diagnosis, provide treatment and follow up on their patients’ progress. Doctors must tell their patients about diagnosis, nature and seriousness of treatment, risks of the treatment and other treatment options. If all the above-mentioned criteria are fulfilled you can definitely say he is a good doctor.
Why are physical attacks on doctors commonplace in India?
Physical assaults on doctors are relatively rare in other countries, but unfortunately commonplace in India. Let us describe a common scenario in the Indian setting. A patient in the emergency room or intensive care unit, in a critical state, succumbs to their illness. The doctor who delivers the bad news is assaulted by the patient’s family members. In September 2013, a lady doctor on call at the Lok Nayak Hospital in Delhi was physically assaulted and apparently threatened with rape by patient’s kin. Her crime: two patients had come in at the same time and she had attended to the sicker patient first, which allegedly upset the other patient’s relatives.
This act is very disheartening and can demoralize the future doctors of our country. Some of the reasons attributed to the violence include misunderstanding between doctors and patients or their families, cost of the medical care and a delay in attending to the patient. The finding of a study by the Indian Medical Association revealed that more than 75 per cent of doctors across the country have faced at least some form of violence. Doctors faced maximum violence when providing emergency services, with as many as 48.8 per cent of such incidents reported from ICUs or after a patient had undergone surgery, the study said.
According to the findings, data from the past 5 years showed that escorts of patients committed 68.33 per cent of the violence. We should understand that medicine is not a smooth road, it is filled with speed breakers and outcomes are not always good. Anger against doctors or health care professionals is justifiable if family members believe that they have been wronged, however resulting in violence is not the solution.
Doctors are demanding tougher laws against assault at workplace and more security in the hospitals. Not long ago having a doctor in the family was a source of significant pride and this tradition was passed down generations. Now, some doctors are actively discouraging their children from a future in medicine. Results of a recent study conducted by the National Health Profile India reveals that the number of doctors is decreasing in India.
A medical disease is becoming more complex, and people are living longer. There has never been a time where patients need to trust their doctors more.. We all need to take a stand against those doctors who are abusing the system for their own gain. Patients should realize that all diseases are not curable A doctor will be close to 40 when he becomes a specialist or super specialist. No other profession has such a long incubation period. Surely he or she is entitled to respect – and understanding if there is a medical error. Every doctor will do only the best for patient.
Dr George Thayil
Senior Consultant Cardiologist
Lourdes Hospital, Kochi
www.drgeorgethayil.com
(The views expressed by the author are his own)