Devotion, selflessness and dedication are three words always associated with doctors. A doctor is a trustworthy person and a caretaker who has the commitment with his profession more than any other professionals do. However, gone are the days when patient, his family and society granted doctors honour and respect.
Recent increase in violence in hospitals, growing trend of intervention of patient's relatives and physical attacks on doctors on duties reveal the fact that doctors-patient relationship is on the rocks. Once regarded as a noble profession now considered as a job of minting money. On the other hand, frustrations and complaints of doctors are on the rise.
Scores of factors involved in breaching of doctors -patient relationship. Displeased patient and his relatives top the list; they complain that doctors not do their best to save life of the patient. Over the past few months, there is an alarming increase of threatening and violent behaviour of patient's family and relatives. Deceased patient's relatives often get infuriated and take the law into their hands. Recently, in Muzaffargarh, death of a patient enraged his relatives. They blamed Doctors for delaying the treatment. Angry mob injured four doctors, 30 nurses, destroyed hospital's ambulances, and medical equipment. Adverse reaction appeared from doctor side as well; they suspended their duties and handed over resignations to Medical Superintendent of the hospital.
Surgeon Abdul Rasheed, a general surgeon at Sessi Hospital, says; "the authoritative behaviours of patient's relatives often exert pressure on medical professionals to work in accordance with their will especially in emergency and outside patient department. They embarrass doctors on duty by verbal threats and physical assaults. They more than often forget that life and death do not lie in the human hands."
"Often patient brought to casualty department in a critical condition. Some even breathe their last in hospitals because of negligence at home or self-medications. Provision of correct treatment is doctor's duty while it is attendant's responsibility to pay close and continuous attention to patient's condition at home and bring them to hospital as soon as the disease makes it appearances. Doctors are human beings they can do medical errors but usually they do not do it intentionally.
Inappropriate diagnoses before operating the patient often create pandemonium and chaos for the doctor, patient and his family." He suggests, "To avoid mishaps it is important to have informed consent before the operation." He further adds, "It happens that sometimes for the sake of compensation money patient's relatives exaggerate the situation."
Patient's unrealistic expectation is another factor of mounting distance between doctor and patient. No doubt, it is a doctor's responsibility to specify the seriousness of patient's medical condition before starting of the treatment. However, even a well-informed patient suspects doctors ability and efficacy of his prescriptions. Dr: Zahid says, "Patients often hide pertinent information such as use of self medicines and alternative treatments which makes it difficult for a doctor to diagnose the disease correctly."
Lack of communication between doctors and patients often cause disappointments and frustrations. Unfortunately, busy schedules of doctors do not let them to share patient's miseries. Many doctors are overconfident of their professional skills and deny their role as good listeners. Therefore, patients feel dissatisfied and devalued when doctors treat mechanically suggesting tablets and syrups without feeling their pains. Such way of treatment is opposite of medical ethics.
At the start of a career, the doctor aims to help, heal and save the lives of those suffering from illnesses. A doctor is therefore deserves high level of respect. A good doctor knows that his patient needs his sympathy and attention. It is his charismatic personality which brings the patient back in normal and healthy life. Besides, without having consideration of disrupted feelings and frustration of the patient it is almost impossible for a doctor to ask respect and honour from the person lying in front of him in bed.
Dr: Faraz, runs a private clinic, argues, "Some patients are too difficult to manage. Some want instant cure while other like to spend hours with doctors. Some have long list of illnesses and want to discuss all in one visit. It is difficult for me to give patient more than half an hour because I have long queue of patients outside waiting for their turn."
Dr David H. Newman, an emergency room physician at St. Luke's-Roosevelt Hospital Center in Manhattan, says there is a disconnect between the way doctors and patients view medicine. Doctors are trained to diagnose disease and treat it, he said, while "patients are interested in being tended to and being listened to and being well."
Outside patient department or OPD serves as a first communication between doctor and patient. Overcrowded OPD of hospitals is a headache for both patients and doctors. Patients dissatisfied with the services of OPD. They have to wait long hours for their turn. Senior doctors vanish from the OPD leaving patients on the mercy of inexperienced junior doctors who lack medical knowledge. Doctors argue that shortage of medical professionals, and unavailability of medical equipment makes it difficult to give quality service to each patient in OPD. Junior Doctors have another story to tell, they complaints that they receive low salaries and work long hours without discretion of day and night.
Degrading moral values also badly affected the noble profession of medicine. Many private hospitals and healthcare centers run for the money. These hospitals and clinics badly reputed for taking excessive fees and extra charges beyond the reach of low-income patients. There has been severe criticism on Doctors for over prescriptions, unnecessary diagnostic tests and conditional favouritism to various pharmaceutical companies which results commercialism of medical practice.
The grade of service is painfully low in government hospitals where most patients come from suburb and poor localities for treatment. A Poor patient has to tolerate disrespectful behaviour and lackadaisical attitude of medical staff. According to A study of doctor-patient relationship "Serving a customer who arrives with some combination of illness, pain, anxiety, and fear presents a distinct service challenge to physicians compared with other services. "
Recently, in different regions of the country doctors went on strike for the demand of raising salaries. According to the media reports, patients suffered badly during the strike. At least 34 patients have died for not receiving medical treatment due to doctors' strike in Punjab. Another report quoted Lady Willington Hospital (LWH) sources that more than 250 pregnant patients visited the outdoor patients department (OPD) per day and about 50 to 55 new-born babies had delivered in the hospital. However, owing to the strike announced by YDA, a large number of gynecology patients faced many problems.
In many countries, concerned people provide online facilities to patients and their families to share their experiences in hospitals. These websites are online forum to put forward complaints of doctors and their attitudes. Such online forums are effective in overcoming tension between doctor-patient relationship. Unfortunately, in Pakistan low rate of literacy is main hindrance in promoting online complaint centers.
No doubt, a good number of doctors enter the field with the aim of serving the humanity, but eventually they caught in the web of pathological jealousy, and lust for money. A small number of doctors are committed to their professional skills and clinical excellence. Nevertheless, their professional skills and good will highly abused by their own colleagues, administration, and patients attendants. Amin A. Muhammad Gadit in one of his articles wrote that" In the public and private sector, their promotions were blocked, they were defamed, their credentials were questioned, wrong information about them was given to the press and media with the intention of sabotaging their image, they were threatened and abused both verbally and emotionally...". Finally, it is important for doctors to realise their knowledge with care and responsibility, whilst patient should admit and trust doctor's abilities and hardwork.