Lessons from interacting with the medical community

Published: July 8, 2016 at 9:48 am

Last Updated on

My family has had more than its fair share of interaction with the medical community. In this post, I list some of our most important learnings.

Trust is the most important ingredient in the doctor-patient relationship and in spite of all that has happened to us, we still manage to trust our doctors, but not blindly.

I can back up every one of the following statements, both positive and negative, with personal experiences. However, out of respect for the medical community and the kind of selfless service that they provide, I have decided to not mention anything personal here.

THIS IS NOT A HATE POST ABOUT DOCTORS. Just one that tries to be pragmatic.

1. Have a family physician

A family physician – a plain vanilla MBBS doc operating in a little clinic is good enough for most common ailments. They can also help us in multiple other ways:

(a) It would be perfect if their little clinic is close to home (ours and maybe theirs!) and if they also visit a local hospital. They can provide hospital admission slips  (or at least phone it in) any time of the day. This is most useful in case of emergencies. It gives you some measure of control if you can afford to spare a few minutes for it.

(b) They can be persuaded to make a house visit if necessary. Many do, but some refuse as a matter of policy.

(c) If their first/second line of treatments fail, they usually write a decent reference letter to a super specialist “in their circle”. The family doc also helps with a ‘simpler’ interpretation of the super specialists diagnosis/prognosis.

(d) If a super specialist is in charge of a hospitalisation, the family doc is usually consulted for family history and often makes regular visits which can be quite comforting.

2. Do not fall in love with your family physician!

We go to the family doctor so often that we tend to treat them as a trusted family friend and invite them to our social gatherings.

Nothing wrong with the invites but it would be better if the trust between the patient and doctor is more professional. It should be conditional.

If the treatment provided by the “family friend” is not working, we must not hesitate to ask for a super specialist referral. if they are insulted, so be it. It is our body. If they get it wrong (and they can), it could be disastrous in many ways. This is what I mean by professional and conditional trust.

A family physician may simply not be trained enough to treat many conditions. They should be the first to realise that.  Else we are in trouble.

Treatment is not always clinical. Calm and soothing words make a big difference. Family doctors do this better than anyone else. However, if they get used to our mental makeup, it might prejudice them. After all, they are human too.

3. Doctors can go wrong

LIC has a claim settlement ratio of 98.19%. This sounds (falsely) comforting to a person who is about to a buy a term insurance policy. However, what do you the think the 8,689 nominees whose claims were rejected by LIC the same year, feel about ‘how good’ LIC is?

Catch my drift? Yes, doctors are well trained and do not make mistakes often. However, the fact that they can, implies Murphy’s law applies – what can go wrong, will. And for some, it can go wrong so often that they end writing a blog post about it!

And for some, it can go wrong so often that they end writing a blog post about it!

This does not mean we doubt everything that they say. However, we have a right to learn more about our ailments and a duty to go about it the right way.

4. Do not use the internet if you do not know how to process the information.

Search the internet for causes of a headache, and chances are we might believe that we have a tumour and get depressed!

Information about everything is available so freely today that the key is efficient processing. If we do not know what  to ignore, if we do not understand the difference between a possibility and a probability, it is best not to search the net and get scared.

Perhaps a level-headed family member can help.

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5. Learning more about our condition is important!

It is important to understand more about our condition. However, it is better at first to trust doctors at first. Then when things are not developing satisfactorily, state our learnings from the net politely and take it from there.

Older doctors may probably get wild/irritated when some piece of information on the web is shown to them which contradicts their own advice.

The younger and middle-aged docs understand the implications of the internet and do respond politely. In fact, I know a doctor who believes that the patient attender knows more about the patient’s condition than the doctor. So he regularly writes down search phrases and asks me  to read about them and let him know. Respect!

6. Know your medicines first by  active ingredient and then by brand

It is extremely important to know what is the active ingredient that we are consuming. This helps us ask for an alternative brand if the one prescribed is not available.

Does your doctor change brand names and say ‘I am changing medication’ but the active ingredient is the same? I dump them if this happens.

The active ingredient is necessary to search for its uses, side effects and interactions.

7 Beware of drug interactions

This may not apply to short-term drug use. Those who are taking any kind of medication for several months (eg BP or diabetic tables) and are expected to continue them,  should be careful if an additional drug is suggested, especially by another doctor.

Yes, it is important to disclose medical history, but that may not be enough.

Drug interactions can be as dangerous as drinking and driving. It can result in immediate or delayed health issues.

These days I always check for interactions before buying new drugs. If I notice serious interactions, I ask my doctor to change the drug.

Not all doctors may be aware of all possible interactions. So it better to know more about this on our own.

8 Doctors are students too!

Health conditions are extremely personal. The same cause (for example Parkinson’s) can manifest in different individuals in different ways. Not all may be documented and not all may be known to our doctor.

When they first start treatment, they cannot consider outliers in terms of reactions.  They start with a course which ‘on average’ is known to work.

If we are not an average patient, they will suggest course corrections and learn in the process!

We need to keep a log of changes in behaviour when the treatment course changes. This helps the doctor treat better and make a personalised plan for us.

Doctors live hard lives. Safe to say that most of them do their best. Being an informed patient helps us and also them in treatment.

Apologies for speaking in generic terms.

Feel free to share your thoughts. If you are a doctor reading this, would love to know what you think about it.

 

 

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Pattabiraman editor freefincalM. Pattabiraman(PhD) is the founder, managing editor and primary author of freefincal. He is an associate professor at the Indian Institute of Technology, Madras. since Aug 2006. Connect with him via Twitter or Linkedin Pattabiraman has co-authored two print-books, You can be rich too with goal-based investing (CNBC TV18) and Gamechanger and seven other free e-books on various topics of money management. He is a patron and co-founder of “Fee-only India” an organisation to promote unbiased, commission-free investment advice.
He conducts free money management sessions for corporates and associations on the basis of money management. Previous engagements include World Bank, RBI, BHEL, Asian Paints, Cognizant, Madras Atomic Power Station, Honeywell, Tamil Nadu Investors Association. For speaking engagements write to pattu [at] freefincal [dot] com

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8 Comments

  1. Dear Pattu sir ,
    Thanks a lot for writing such a genuine and unbiased article .

    I endorse every word ,what you have already said .

    Nothing really more to add .

    Medical is an imperfect science and it is ever evolving .We do not understand our own body even not 50 % . We still do not completely understand how and when it would react abruptly , which is again very individualistic .

    What we today thought was treatment of choice , becomes obsolete rapidly with some new research.

    Researches again are not flawless , which are relative to each other , and holds good for the moment and not forever .

    Hence the solution lies for us to keep upgrading as much as possible , stick to the best ,evidence based practices ( with some logical variation suitable for local population socio economical status )
    As the society is changing , so are the Doctors and other professionals .

    Still I believe 90% of patients and Doctors are genuine and honest towards each other , Rest 10 % , one need to learn , how to deal with them : Awareness and being cautious is important.

    .Regards.

    Dr Prasoon anand

    Orthopedic Surgeon and your ardent fan ……

  2. Great article indeed. Rarely does some one acknowledge the hard work we do! Got to diagree with this point however: ” Does your doctor change brand names and say ‘I am changing medication’ but the active ingredient is the same? I dump them if this happens.”
    There is, unfortunately, brand to brand Quality differences among the same Generic drugs, not to mention the country to country variation-eg: the same mg dose of plain old Acetaminophen in USA will vary too much on quality vis-a-vis that of an Indian pharma. Not to mention the fact the same old trusted brand might one day go under hammer by the US FDA.
    Then again these are way beyond our control, and we depend on best available, and its very difficult to explain it to public.

  3. Well written and accurate. Doctors cannot be expected to know 100% of latest advances and can make mistakes. And patients asking for a second opinion is not offensive.
    Another fan of your writing..
    Dr. Narayanan, Consultant Physician, Kuwait

  4. times have changed for worse in all fields of life.

    both the society & medical fraternity have to accept this hard core fact.
    un necessarily medical fraternity had been respected,it is simply one more profession-which is subject to all changes ,of course evil ones also.The way you have doubts about every profession,one should have it for medical field as well.
    doctors are simply a small part of health industry,with all features good & bad like any other industry
    For fellow doctors,it is better to accept the change for medical field,& better to stop having grandiose feeling of being in noble profession.
    no profession in isolation is noble.
    all professions followed with integrity are noble,not a profession ,but one’s approach to profession make it noble.

  5. for general information,plain MBBS family physician is endangered species in medical fraternity.
    we will have more specialists & very few MBBS family physicians in years to follow,at least this is 100% true for gujarat where I belong to.
    in my hometown bharuch,for last 28 years I am practising as anaesthesia specialist dr ,& i have not found even 5 MBBS doctors starting family physician practice,while every year we get at least 3-5 specialists

  6. Choosing a doctor : Being a breastfeeding advocate, I would like to say that don’t go blindly with what doctors says. Many doctors plan for unnecessary c sections and top up formula burden when free natural breast milk is easily available. According to WHO less than 3 percent women do not have enough breastmilk due to medical reasons but almost every baby is given formula these days.

    While zeroing in on a doctor, look at the number of cases handled in what way and if it is according to latest findings and recommendations in medical field such as WHO. Also choose a doctor who listens to you and then examine you. Many doctors I’ve met in Chennai do not even listen to patients and the patients are made to wait for several hours in spite of appointments.Choose doctors who treat themselves as human being and not as God!

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