Another case of a doctor being manhandled, nay almost murdered. The saga of intolerance continues. (Read)

If a doctor is really negligent, there are ways and means of seeking redemption. There is a legal mechanism- one can approach the professional bodies. So where are we going wrong? Why do relatives of patients resort to violence so frequently?

Let’s get some things clear. Medicine is an imperfect science. Most of what we do when we ‘cure’ depends on hunches, despite practising ‘evidence based’ medicine. Medicine is not mathematics. Not every patient responds like the textbooks say. And there is only so much that a doctor can do. Pain, infirmity and death are all facts of life. Ultimately we all have to succumb. No doctor can prevent that. To expect doctors to have the magic remedy for all that is wrong with this imperfect body is unreasonable. Yet why do some patients perceive doctors as Gods and others as professional murderers?

There can be many arguments and many examples cited by both doctors and patients to substantiate their claims. However I would like to focus on one single aspect- the need for more efficient communication between these two parties.

No one comes to a hospital of their own accord. And it is a traumatic time when stress levels are high. It is imperative that doctors communicate well with their patients. Sadly, the manner in which medical education is imparted in India hardly gives any semblance of training in this essential facet of being a doctor. Outpatient departments in government hospitals in India cater to anywhere between 100-200 patients each day in each speciality- perhaps more. And handling this patient load in a fixed time span means they hardly get to spend a few minutes listening or talking to each patient. I read this scenario been compared somewhere to a cattle factory where patients push past each other like a herd of cattle to be seen first. And the doctor is expected to listen, make up his mind and offer advice within a few minutes. This is unlike the West where each doctor sees very few patients each day with appointments and spends enough time having two-way communication with their patients. One needs to know the difference in the work load we handle in India to appreciate the difficulties doctors here face. 

This is perhaps the real reason why patients and patient’s relatives feel short-charged and betrayed. If a doctor is able to effectively explain a patient’s prognosis and disease to him, a lot of problems can be erased. Communication is a two-way street. And dearth of information or lack of it are prone to multiple misinterpretations.

As a medical student, I do not remember any specific advice being given on how to talk to patients. We simply picked it up from watching our teachers talk to them. If we had a good role model, we picked up the right nuances. If we had an arrogant uptight senior consultant, I don’t know how many of the moldable minds picked up the wrong messages. Breaking bad news to patients was and is one of the toughest jobs we face, and yet, none of us received any training in it. Today, thankfully things are changing. Medical educationists have recognized the need to impart education to young students and communication skills are now an essential part of the curriculum.

Doctors who are confident, able to talk to patients in the language they understand, know how to maintain patient confidentiality and communicate well are likely to win the trust of their patients. And it is here that we can bring about a change in the deteriorating relationship between doctors and patients.

I agree with Dale Carnegie who says that we are evaluated by what we do, how we look, what we say and how we say it.