Medicine is neither holy nor physician a divine being

Medicine is neither holy nor physician a divine being.

“Medicine is sacred and doctor is equal to divine incarnate”, were generationally held beliefs.

Times are changing and so are people and their thought processes.
It’s not possible to treat patients with herbs, lotions and potions.

Populace would reject it.

However modern medical technology might be some ailments are beyond remedies.

Some might last a life time.
Some cause suffering for months and years, and leave mental and physical scars.

This is the nature of illnesses.

Surgical cases require not just the surgeon’s expertise from admission till discharge.

Recovery is dictated by severity of illness, patient response, drugs and their impact on the patient, overall medicare, and the quality of care patient can afford.

While this is the real world, patient’s understanding and expectations might be different.

There is of course a need for first class health care.

There must be well equipped setups to provide prompt care when the patient steps in to the hospital.

There must be no delay in treating a patient in distress, and the disease must go away soon.

These are common expectations of an average patient.

Only an expert physician can meet patient’s demands.

He must have received the best training, and update with the current developments in the field.

One must be attending conferences, and be in touch with the latest medical literature, text books, journals and online resources.

A physician’s education never ends, and he/she is a lifelong student.

Any deficiency in knowledge might attract an invitation to the consumer court.

“Having expended so many resources should I not recoup it through patient’s fees?”, is the comment from an average doctor.

Society definitely expects doctors to have a social responsibility.

It is not so explicit with engineers, teachers, lawyers, charters accountants and so many others.

People leave them scotfree.

Those trained in IITs and IIMs with huge public expense, are never asked about their duty to the society.

Don’t they expend public money?

Is it only the doctors trained with public purse?

Is it only the medical profession that must be engaged in public service for salvation?

These questions parade before us whenever our profession is discussed.

We must notice a few things.

Patients who consider doctors as demigods do not keep quite when things go wrong in treatment.

The same god is abused and even assaulted and hospitals targeted.

A law abiding patient takes to legal recourse for monetary compensation, and the doctor has to go round the courts.

The divegence of opinions between the physician and patient, is a result of the misunderstandings in their relationship, objectively.

Though medicine, society, medical techniques and many other issues have changed, the traditional view about a doctor haven’t moved a lot.

They still remain old fashioned, and this is leading to a huge disparity between them.

Fiscal, societal, and cultural issues change with time inevitably.

Human relationships too change.

Good Samaritan dwellings are replaced by hotels, just as free food houses turned to restaurants.

But society is still not able to recognise changing character of medicine.

How is it possible to consider a physician as a self-sacrificing, compassionate, tranquil messiah born to provide medical care to the suffering poor without expecting monetary returns, in this current society in which a lot of transformation has happened in virtually every area?

Though people, medicine, medical procedures, technology and all aspects of medicine have change, society’s expectations of doctors hasn’t changed and remains old-fashioned.

This duplicity is widening the distance between medical profession and its users.

As time moves on physicians and their methods of managing illnesses too change.

Expenses too drive upward proportionately.

All these changes are parts of the whole.

A holistic view of the society permits an objective evaluation of doctor-patient relationship, and promotes greater understanding between the stake holders.

If not there would be mutual suspicion.

One more angle ‘not so obvious’, as to why doctors alone are targeted as to their social duties.

This is because a disease directly causes suffering to the patient, that only a doctor can intervene effectively.

This requires a direct payment to the treating doctor as well.

Let’s analyse how this payment towards medical expenses leaves an unpleasant taste in patient’s psyche.

No one likes to be ill, but disease is inevitable, and treatment becomes a must.

Whether one likes it or not one has to go to a doctor or get admitted to a hospital.

Let’s leave aside doctor-patient relationship for now.

Human needs are of two types.

First type are those which give happiness on parting with our wealth.

We chase them.

We love to buy an expensive television or buy a cinema ticket in black paying many times over a normal rate, or buy an expensive carbonated drink like coke to quench our thirst, or enjoy an expensive wine. We love them a lot. So we spend without hesitation and pain.

Second type are compulsive expenditures, that we must spend whether we like them or not.

Bribes, court cases, medical expenses belong to this category.

These expenses were thrust upon us and therefore they don’t yield happiness.

As we lack an in depth knowledge of these and only an expert can guide us for a fee, we feel that the money went down the drain.

A guy who spends ten thousand rupees without batting an eyelid, for an intoxicating drink, thinks a lot to pay five thousand rupees towards doctor’s bills.

He gets a moral dilemma, “does it really cost so much?”

It keeps aching inside that the fee is too much.

“Physicians earn far too much”, is a common abuse.

“Doctors have no humanity”, is a popular comment.

When hurt seriously in an accident, and when life is in danger, a patient yearns for a saviour doctor out of fear.

“Where is our doctor?”, is the only thought at the time.

Doctor attends and treats and reassures.

Patient’s mind shifts to “how much might be the bill?”

Patient gets better and the bill lands in the patient’s hands.

The bill might be small or big!

“Oh lord! These doctors have no pity. They are plundering mercilessly. What great thing did this doctor do?” are the
post-treatment thoughts in a patient after recovery.
This is because health expenses are considered to be avoidable.
A modern proverb has come to life

“A doctor appears to a patient like divinity in a life threatening crisis, a friend during recovery and as a devil after a bill.”

While paying the bill a patient applies the yardstick of pleasured or pressured expenditure.

In the changing social norms a doctor expects proportional remuneration for his/her services. Remuneration= Service.

The greater the disparity between patients’ and physician’s logic, greater the strain on their professional relationship.

Even after bringing in patient-doctor relationship under the purview of consumer courts, it is not fair to expect a doctor to work in the ancient principles of service and compassion.

A patient must pay for the services received.

Similarly a physician must provide honest quality proportionate to the fee earned.

Patient must be a quality conscious customer and physician a quality provider.

When a patient is reluctant to pay a doctor for the services received, the physician adapts a variety of techniques to collect the fee.

Doctor and patient are the rails on which the train of medicine runs.

One can’t expect one rail to make up for the deficiency of the other.

In this context the patient consumer must change his attitude towards the provider doctor.

Medicine is not a holy profession.

It is a service purchased with money.

A doctor is not a noble soul.

He is simply an expert in a variety of areas.