‘Trust deficit between doctors, patients taking toll on healthcare system’
Srinagar, Jul 10: The Managing Committee of Amar Singh Club, Srinagar held a seminar under its ‘Common Interest Conversations’ program on the topic of ‘Healing With Honor – Ethics & Empathy in Medical Practices’.
The event was presided over by Senior Advocate Zaffer A Shah and chaired by renowned Neurologist Dr Sushil Razdan. Other eminent speakers included Dr Mustaq Margoob, Dr Abdul Wahid and Dr Naveed Nazir.
Nasir Hamid Khan, Secretary of Amar Singh Club gave a brief outline about the program ‘Common Interest Conversations’ initiated by the Club Managing Committee which had held in-depth discussions on various common interest issues like Digital Addiction, Drug Abuse, Mental Health, Women Wellness, and Eldercare.
Khan stated that “healing the human body and preservation of life is a divine command for all faiths with a clear and well-defined code of medical ethics. “Doctors are often referred to as God’s Hands whose profession is not just a job but a service to humanity. I placed on record society’s gratitude to Dr Sushil Razdan for suggesting the holding of this event and I congratulated him for following his faith in letter and spirit by dedicating his life to promoting the culture of humanity, serving and healing the people of Kashmir without discrimination and for feeling their pain as his own,” Khan added.
Khan stated that a recent petition in the Supreme Court highlighted the nexus between some doctors, distributors and pharma companies “raising pertinent questions like what is the real basis for doctors to prescribe certain brands of medicine?” “How much influence do pharma companies have on doctors? And how true are the allegations of fantastic bribes like cruises, expensive holidays and gifts?,” he asked.
Zaffar A Shah in his opening remarks highlighted the immense contribution of doctors to the society. He said that the sheer number of patients visiting the Government Hospitals was so large that it was impossible for the doctors to pay full attention to all. He said that this is one area which needs to be addressed as to whether the number of doctors can be increased so that ratio of doctors to patients is balanced as the doctors are under tremendous pressure to work.
He said that this reflected on the quality of healthcare as the doctor is not able to apply his mind fully to the problems of his patients. He highlighted that due to the sanctity of the doctor-patient relation, how many cases have been filed for negligence or carelessness. Quoting the recent news about a doctor getting a government job with the help of a fake degree and treating patients, he said “it was shocking to learn that even such doctors can get away.” He said that there are a number of good doctors but not all doctors are good. He said that the Caesarian Section surgeries were being encouraged more due to economic reasons rather than medical reasons. Quoting from personal experience, he stated that he had witnessed that in Australia, doctors do not allow C-Section surgeries unless medical indicated. He said that on a human angle, doctors must have self-realisation as they take an oath, they have the 2002 ethic guidelines to which the Secretary referred but practically it doesn’t so happen.
Dr Sushil Razdan sharing his views on the subject said that “we doctors as well as patients are at cross-roads.” Patients think they are not heard when they are being investigated, lots of tests are done, they are referred to too many specialists and the outcomes are not good, costs have risen. There are extreme differences in Corporate Hospitals and the Government run hospitals where the difference in costs, facilities is quite big,” he said.
‘The doctors think they are overworked, we have been bureaucratised and mostly do managerial work. In the corporate structure, doctors are under high stress due to the targets given. They are no longer the bosses but the relationship has changed from the simple doctor-patient form to a team-patient form of shared responsibility. There had been tremendous success and progress in modern medicine where we have beautiful new drugs to treat cancer, rare degenerative diseases, we have vaccines that changed life,” Razdan said.
Dr Abdul Wahid stated that “there are bad doctors, bad people and bad lawyers also.” He said Dr Ali Jan was in the habit of prescribing one particular brand and suddenly switched over to the second brand. “When asked about it by the representative of the pharma company, Dr Ali Jan told him that it was because the medicine he now prescribed was 20 paise cheaper than the other one,” he said.
Dr Wahid said “today, doctors tend to prescribe only those medicines which are available only at their clinics or in close vicinity. Speaking about the legal aspect.”
Dr Mustaq Margoob stated, “when we talk about increasing the number of doctors we need to look at the times of Dr Ali Jan and Dr Naseer Sb who were still a miniscule ratio in comparison to their patients. The difference was in approach and how they connected with their patients.” He said that upon entering their clinics, patients would be greeted and patiently listened to which had a huge.
Dr Naveed Nazir stated that speaking as a common man, “we need to see the reason behind the trust deficit which was emerging as the biggest issue in patient care.” Citing examples, he stated that the patient today is more likely to trust his mohalla chemist more than the doctor treating him as patients have an impression that the doctors are not treating them but doing it for their own benefit.
He said that if you see statistics, Kashmir is number two in quality of public sector patient care in the whole country after Kerala. He said the question which then comes to mind is where does the deficit in our healthcare system lie. He said that “we do not have a proper healthcare referral system in place. It had led to a huge burden on the main hospitals as patients with milder conditions who can easily by treated in the peripheral medical facilities also land up in the main hospitals and occupy space next to patients suffering from serious conditions.”
Speaking about the Caesarian Section surgeries, he said that doctors needed to counsel patients for not opting for the C-Section surgeries. He said speaking as a pulmonologist, a normal delivery is the best because there are no anesthetics, there is no effect on the lungs and there is no risk of any exacerbation of existing pulmonary conditions.
He said that he does counsel his patients not to go for the C-Section surgery “but today it is not always the doctor who is to blame as patients most often opt for these procedures out of the fear of pain.”
He said that adding to this fear is the impatience of the doctors to go through the grind of clinical and theoretical side of medicine. He said that from day one their focus is on obtaining degrees of Specialization and Super-specialization which has a telling effect on healthcare. After the preliminary session, the participants posed several questions to the panelists.
