Doctor-patient relationship

Prof. (Dr.) Dharmakanta Kumbhakar

(drkdharmakanta1@gmail.com)  

Nowadays, it has become fashionable to say that doctors are not noble and dedicated to their profession. Most of the time, people are too judgmental and biassed in their opinions about doctors. People are becoming increasingly intolerant and appear to be in a mood to pick a quarrel with doctors over petty matters. It has become increasingly common for doctors in India to be jostled, roughed up, harassed, and abused physically and mentally by angry relatives of patients on the slightest pretext for alleged medical negligence without going into the merits of a case. When a patient dies, assault on doctors has become the norm in India. Surveys by the Indian Medical Association reveal that about 75 percent of doctors have complained of verbal abuse and 12 percent of physical violence. Acts of assault on doctors for alleged medical negligence in Assam have also registered a spurt in recent years.

. There is no room for disagreement when it comes to medical negligence. There are instances where some doctors may be guilty to some extent. As medical practice falls under the Consumer Protection Act, if any doctor resorts to malpractice or medical negligence, he or she can be prosecuted under the law. As statistics reveal, a large number of medical injuries and deaths in Assam are due to medical negligence, so it is important to create awareness amongst people about the same. In developed countries, the authorities meticulously examine the data in relation to medical negligence. But, in Assam, there is no such medical tribunal (or a similar platform) to deal with cases of medical negligence. The authorities concerned with the state should take steps to reduce the incidence of medical negligence. There is a need for a medical tribunal in Assam to deal with such cases properly and rationally. Many a time, a fatal situation may not be due to a doctor’s negligence. Therefore, a medical tribunal is the need of the hour to ensure the safety of both doctors and patients. The doctors of Assam should not be defensive about their negligence or errors being examined and recorded.

Unfortunately, a large section of our society does not understand the philosophy of the medical profession. Medicine bridges the gap between science and society. Doctors are an important agent through whom that scientific understanding is expressed. No one can deny the services and contributions of doctors dealing with health issues. Doctors do their best to save human lives. Nowadays, most patients and their relatives come to doctors with unreasonable expectations that they fail to meet, which leads to assaults on doctors. Doctors are also as human as the patients they treat. They are not magicians or wizards. No one should be under the delusion that doctors are capable of fixing any illness that patients bring to them. A doctor never causes injury to a patient for his or her own benefit. No doctor has any personal interest in seeking their patient’s death.  Doctors look forward to filling out a discharge card, not signing a death certificate. However, doctors may commit mistakes as they too are humans. If any doctor commits malpractice or medical negligence, the doctor should be prosecuted under the law instead of the public taking the laws into their own hands. If the perverse trend of assault on doctors continues, very soon it will become impossible to render medical services to the needy. This entire situation needs to change.

No doubt, there are a few rotten fish that do charge excessive fees, prescribe unnecessary and costlier medicines, advise unnecessary investigations, have an unholy nexus with diagnostic set-ups and pharmaceutical companies, mislead patients for their own benefit, take advantage of the helplessness of patients or their families, misbehave with patients and their relatives, refuse to admit their mistakes, neglect the duty of care, and do inhuman acts of illegal abortions after prenatal sex determinations. These rotten fishblic, however, should avoid developing a negative perception of the entire community of doctors based on the actions of a few black sheep.  are degrading this noble profession and tarniabout theing the doctor’s money-But still, the priority of doctors is the well-being of their patients. The public should be aware and cautious about the future of these money-minded, selfish doctors. Such doctors are a disgrace to the entire doctor fraternity. The general public should avoid developing a demoralising perception of the entire community of doctors based on the actions of a few black sheep. Such generalised negative views can have a demoralising and discouraging effect on dedicated medical personnel. People’s appreciation acts as fuel for doctors to work hard and improve their services. Dedicated doctors must be given a fair chance and a safe work environment to serve people better. Doctors are not trained for combat; they are trained to save lives. They need security and support from everybody so that they can perform their duty without fear.

The doctors and the public should try to avoid the triggers (rude behaviour of doctors, intolerance of the public, etc.) that can destroy the relationship between them. Trust is the single most vital ingredient in doctor-patient relationships. This relationship is in itself therapeutic. A successful consultation with a trusted and respected practitioner will therefore have beneficial effects, irrespective of any other therapy given to the patient. For this to happen, doctors must pursue ‘good medical practice (GMP)’ as a set of values, behaviours, and elationships. GMP includes medical professionalism, good communication, judicious use of investigations and medicines, and practising within medical ethics. Medical professionalism (sharing disease information and management options with patients and their families, taking appropriate ethical decisions, fostering continuous professional development, etc.) underpins the trust the public has in doctors. Good communication helps doctors identify patients’s problems and expectations quickly and clearly, which establishes trust between the clinician and patient. Failure in communication leads to poor health outcomes, strained relations, litigation, anger, and dissatisfaction among patients, their families, and doctors. Poor communication is the root cause of most complaints.

The best possible GMP is that where compassionate health care can be provided to patients or a community within the available resources in a specific setting, doing justice to the profession, staying within ethics, respecting people and their autonomy, telling the truth with informed consent, keeping confidentiality, and giving maximum benefits to the patient with no malfeasance. To end the conflict with the public, we, the doctors, should be a little more patient in dealing with patients and answering their queries. A tolerant, forbearing, and polite approach can go a long way towards restoring the lost faith in doctors.