BENGALURU: Gone are the days when doctors would be considered near equivalent to God, and their word, ultimate truth. With corporatisation of the medical field over the past two decades, a communication gap, has been created between the medical fraternity and those who come for treatment of their aliments.
In the process, quite unfortunately, the perception about the ‘doctor’ has changed. From unquestioned respect and faith to some kind of malice often buttresssed by lack of trust amongst patients, is rampant. The younger doctors particularly, bare the brunt of the altered equation. The legendary practioners, however, prove there can be exceptions.
There are two sorts of doctors — “those who practice with their brains and those who practice with their tongue. The world deserves both of them. There are two kinds of patients too --those who always trust their doctors and those who always have doubts. The world requires more of the first and less of the latter,” says Dr Naresh Shetty, President, Ramaiah Hospital.
The problem, however, arises from the manner in which health care, has to be accessed in today’s world. The lack of sensitivity that the ailing or their families sometimes face in trying to get medical attention in health care centers. A common complain among patients: when they go to a hospital seeking treatment, the first question they’re face is — “Do you have insurance?” Not about the ailment. Another common grouse among the middle class patients, is that they are ‘fleeced’ by private hospitals which, on finding that he/she is insured, instruct them to undergo a series of ‘unnecessary’ tests. Which the patient, later realises had served little real purpose in their diagnosis.
Take this case, for instance: A one-and-a-half-year-old child in Jayanagar in Bengaluru, stumbled and fell, smashing his face onto the edge of the bed which slit his lower lip. When his parents rushed the child (insured) to a reputed hospital, they were asked to admit the child. A slew of tests, including an MRI scan, were conducted. The three-day stay at the hospital, including the tests and suturing, came to a whopping Rs 78,000.
Unheard of in the days when the general practitioner would simply stitch up the cut and send the kid back home, the parents felt. In another case, a child damaged her finger when it got jammed in a door. A private hospital said the surgical procedure would cost Rs 45,000-50,000. “When I consulted a trusted doctor for my client’s daughter, they said this surgery was not needed. When we admitted her in Indira Gandhi Institute of Child Health, the procedure cost just Rs1,000,” says Suresh Ramegowda, an independent insurance advisor.
Ramegowda adds: “A patient who is diagnosed with dengue and wants to be admitted to a hospital, often has to go through unnecessary medical tests for malaria, typhoid and other illnesses. When our clients send us the bills to claim insurance, we realise they have been over-charged through unnecessary tests.”
In addition to this, the package rates set by General Insurance Public Sector Association (GIPSA), a group of four public sector insurance companies, are often bypassed by some private hospitals to overcharge the patients. “For example, a cataract package costs Rs 40,000 as set by GIPSA ... that is payable by the insurance company. Our clients do not know about this. Some hospitals loot them by giving open bills where they are charged separately for nursing charge, bed charge, doctor charge, etc. The bill comes up to Rs 60,000 - 70,000,” he says.
When asked why patients are made to pay through their nose, Ramegowda claims, most hospitals give doctors targets to meet which force them to charge double or triple the normal amount.
Other techniques, patients now has to watch out for is quoting excessively under the non-medical expenses section for gloves, soap, syringe, scissors, blade, etc -- things that are not covered by insurance. “Insurance policies cover patients who are admitted for high fever in 103 to 104 degrees Celsius range and not lesser. Despite this, hospitals admit patients with even 99 degrees Celsius fever and make them pay more,” Ramegowda says.
Simran (name changed), a young working professional, says, “I went to a private hospital with a minor gastric problem. Doctors began forcing me to get an appendicitis surgery done for Rs 30,000. I did not have the money at hand and decided to wait for a day. They next day the ache disappeared.” In another instance, she says, “A doctor in a private hospital diagnosed me with urinary tract infection and kept giving me medicines for three months which did not help. When I consulted another doctor, he saw my reports and said I never had UTI. He said there was an issue with a nerve and gave me medicines which worked. I realised I was being fleeced earlier only then.”
What many patients do not know is that they can approach the consumer court in cases of medical negligence and if they win, the doctors pay up through their Indemnity Insurance for Doctors. This is a professional insurance all medical practitioners have to safeguard themselves against legal claims made for compensation by patients. “Instead of looking for legal/pecuniary redressal, patients resort to violence which does not help them in the end,” adds Ramegowda.
HOW TO BRIDGE THE GAP
One way to bridge the gap between patients and doctors is, for doctors to be more compassionate and empathetic with patients, use counselling methods. Inculcating soft skills, while dealing with patients and the family right from the training days, may be a solution to the growing problem. “Be honest, transparent and ethical in dealing with patients,” says Dr Sudarshan Ballal, Chairman, Manipal Hospitals.
“There is always a communication gap between doctors and patients. The patient party at times fails to understand what they are told, when things get worse. The doctors also should have the capability to explain the treatment procedure or the ailment to the patient in detail,” Dr Govindaiah Yatheesh, Unit Head, Apollo Speciality Hospital and Secretary of Private Hospitals and Nursing Home Association.
DOCTORS’ DEFENCE
“There was definitely a time when doctors were seen as God, a friend , philosopher and guide. But now, it is sad to see they are considered as devils. Many a time it is thought that patients are fleeced at private hospitals but the truth is, with advances in technology, infrastructure, consumable costs and drug costs have shot through the roof. The patients feel we ask them to go ahead with medical tests because we get a good profit from the medical insurance companies, that is not true. The tests are done in order to check for/rule out additional illnesses. It is always ordered based on the needs of the case. Most of the doctors do not get into thinking about profits because our job is to treat our patients and we are already getting paid for our profession,” says Dr Sudarshan Ballal.