HEALTH CARE - A SERVICE, AN ENTITLEMENT OR AN OPPORTUNITY FOR DISPLAY OF POWER?


I am writing this post after a particularly awful experience yesterday. I had gone to this place called                 “ Sankar Nethralaya” -  a very well known ophthalmic destination in Chennai to get my eyes tested. This was  their new branch which was about 5 minutes down the road from my house.  After an  hour’s wait I was referred to the optometric an-  a particularly nasty young woman who disproved the theory that you need to be loud to be rude. She proceeded in a very soft voice to take nastiness to a very high level of perfection. She asked me close one of my eyes with my palm. Now, folks, try holding your palm over your eye for about a minute and you will find that it has a tendency to slip down- something involuntary which seemed to anger her no end.  She then proceeded to check the pressure in my eyes after putting some drops into them. I had no clue what these drops were for and neither did she inform me why she was putting them. It was suddenly a scary experience to find a machine coming towards me and being asked to open my eyes wide to allow a protuberance come very close into my eye. The involuntary reaction of any human being is to close their eyes. Again, anger! “ Keep your  eyes wide open. I cannot check your pressure otherwise”  she said sharply.  Enough was enough!! I got up and told her if she wanted to be rude like this she and her institution could keep their Rs 350 with them. I was going. This seemed to worry her and she said that she had put an anesthetic into my eyes and so why was I getting scared? This was news to me that I had anesthetic in my eyes- then I realized those drops that went in….!!  Finally, I completed this session with her and went back to the waiting area when suddenly a girl appeared , caught hold of my eyes and put drops into them. This was repeated twice after which I saw the doctor who informed me about  the new glasses that I would need and  as I staggered out blindly the girls at the reception came running out at me and thrust a paper in my hand saying – “ you cannot go without filling up the feedback form” . I looked at that form and could see nothing! The letters were floating about on the paper.. My dilated pupils could make out nothing. “ I am sorry . I can hardly see anything on this”  I told her. But she was busy with the next patient and paid no attention to me. I managed to scrawl on the form “ Sorry I cannot give you any feedback because my eyes are dilated. If you really want feedback call me at….”  

This folks, is the story of health care in India -in a reportedly well known private health care centre.  I began thinking what must be the plight of all those who use public health care systems?

I remember nearly fifteen years back when my mother had to undergo a laser treatment for her glaucoma. Her eyes were similarly dilated and suddenly someone thrust a consent form in front of her asking her to sign. I refused to let her sign because she was in no condition to read what was written on it. The nurse in question told me that since I was there I could read it out to her- again something I refused because, I don’t see why I should do something like this when they could jolly well have given her the form before dilating her eyes? My mother ofcourse was terribly embarrassed by all this especially when a doctor came to ask what was going on. “ See you should not fight with a doctor” she whispered to me when he was gone. Now that is exactly what people feel about doctors – that they are some supreme beings and one should not question them.

While I do not discount the fact that doctors are healers and often life savers, I think there are some rights that we as patients have that needs to be respected. We ought to be explained about whatever procedure is being done on us – even if it means putting two drops of medicine into our eyes. Without our permission no one has the right to touch our bodies – healer or not!!!

There is also something called pleasant behavior when we deal with any kind of service delivery which doctors and other health care workers seem to forget.  I remember taking my daughter to a so called “reputed”  pediatrician ( who in those easy times in 1998 used to charge Rs 150 per consultation). He used to be so rude whenever the child cried ( and she used to cry the moment she set her eyes on him because she had figured out that this was the guy who used to poke her with injections) asking me to get the child to stop crying..! A highly unapproachable person, once when I called him in panic after I I found that my daughter had developed rashes across her face on taking a medicine prescribed by him, he told me to take her to the emergency room in The Child’s Trust hospital if I could not wait till the next morning to see him. Now this is the guy who was charging heavy fees for each consultation !!

In a  country where a large number of people are poor and uneducated, doctors and other medical professionals are treated like Gods. So, over the years they begin to feel like God . One of the simple things that a doctor is expected to do is to provide information to the patient and answer all questions.  It is the patient’s right! But the entire health care system today is designed in such a way as to intimidate the average patient.  In a public health care system no one really cares about service delivery while in a private health care there is an appearance of  efficiency but the attitude of the health care workers is the same. I would like to destroy this myth that “ quality of health care improves with paying capacity of the patient”

Health care is neither seen as an entitlement nor a service that the sector provides to the public. It is seen as a sort of “ favour”  that is bestowed on you and don’t you dare question what the doctor or health care worker says.  If you are paying them then they pocket your money and are rude to you. If you are not paying then you get rudeness for free.

Doctors and other health care professionals of Indian origin I am told are some of the best in this world.  I am very curious to know if they  behave like this  when they work in developed countries or is this         “ special”  treatment reserved only for their fellow country men/ women?

Comments

  1. Meera,I am sorry I am not in agreement with you.I do not know about the one doctor you had interacted with.One swallow does not make a summer and it would not be correct to paint all the doctors with the same brush.The institution you referred to is doing yeoman service and is driven by the concept of service and not profit.The inspiration for this comes from the top.It is one of the finest institution where patients from all over India,particularly Eastern part throng.
    We have to keep in mind the hordes of patients waiting to be seen and the doctors are highly skilled professionals who know what they are doing.It is just not practical to answer every question and explain what medicines they are putting in the eye and what they intend to achieve by such tests.Time is the essence in a crowded hospital.
    My experience is that they are all efficient, businesslike,courteous and quick in getting the examination done, be the patient rich or poor,educated or unlettered,Indian or otherwise.

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  2. Meera I share your anger and frustration.

    It seems that often health care providers in India, do not provide information before doing any medical intervention. This is something that may not taught in medical school or if it is taught, it is soon forgotten.

    Most of the time my friends in health care justify it by saying that they have so much to do that there is not enough time to sit and explain.

    I think that India's very hierarchical and class-based society is also to be blamed for general attitudes. If behaviour towards educated persons in urban areas can be bad, it is even worse towards poor and illiterate persons. On the other hand, you have to see the feet licking of VIPs.

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  3. @ KP thanks for the comments. I would like you to know that this post is about health care delivery in India, the Sankar Nethralaya experience is only an example . Whhile I am not disputing the huge numbers that they deal with and the subsidised rates at which they provide their care- my entire argument is that this is not an excuse for poor quality of service anywhere!
    @ Sunil Deepak you are spot on- about the hierarchies! Science as a body of knowledge as it is practiced in India is a very hierarchial one- you dont question that knowledge and the knowledge holder...

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  4. Every word is true- Healthcare is only for the rich and famous- VIPs. For aam admi, it is forms, forms and fees. The most unprofessional and unethical sector in India is probably the Healthcare sector. But have a look at Apollo's Medical Tourism division- Courteous, Kind and Condescending! What about us- wait for a room from eight in the morning to 12 noon! What double standards...

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  5. well, i think its not about any particular Hospital or the Nursing home for that matter, in fact by n large its almost at all the places in India we can find these type of Doctors who are so rude n money minded that they seldom have the medical ethics left into them anymore...its unfortunate, really.....

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  6. Thanks for a nice share you have given to us with such an large collection of information. Great work you have done by sharing them to all. simply superb. Photo Recovery

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  7. Same applies in health services in Nigeria, esp the Govt hospitals...they are soooo, saucy & rude! I feel your pain becox my friend lost her baby after delivery due to the negligence of the nurses. She told the nurse that it looks the baby had Jaundice & but the nurse asked her IF SHE WANTED TO TEACH HER, HER JOB! By the time she was about to be discharged 2 days later, that was when the doctor noticed it!..the baby died that same day!

    I ONLY attend private hospitals becox of these problems...the GOVERNOR OF LAGOS STATE disguised himself and went to LUTH {Lagos state teaching Hospital} after observing for a long time, he revealed himself to the shock of people & he sacked some of them, & made changes, thus they had been on their toes since , but a leopard cannot change it's spots. likewise, a head nurse was called as she was about to close for the day that an emergency accident victim was rushed in, she should come to administer first aid before the doctor was called, she refused, in the usual I DON'T CARE MANNER, she left & when she got home, she received a call that her hubby was involved in an accident & should come down immediately. She went back to the hospital but it was too late...as she was crying, she was told that, he was the man they were calling her to come & administer first aid to ..her inlaws made her saw hell when the news spread out like wild fire...IF she had hearkened to the call do the necessary, he MIGHT had been alive today!

    HEALTH CARE should be a RIGHT to everyone with RESPECT.

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  8. My god, and then when your eyes became normal again?..yes, people, not only who work in service sector, but also, every one irrespective of the profession, should learn the art of pleasant behavior..

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  9. Ibhade government hospitals in India are the worst in terms of care. What I have written about is paid private care.So you can imagine how free care would be. We always use quantity as an excuse for poor quality. Nivedita you are right India and Chennai is emerging as a medical tourism destination- our health care system is only bothered about the people who can pay in dollars. And Tomz, yes pleasantness should be part of every profession

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  10. Medical practitioners seem to forget about the 'CARE' in health care. I remember this horrible cardiac physician who was so callous in telling that my mother needed a by pass surgery. The idea of a surgery was so scary and he was using such tough medical terms. Lucky for us that the surgeon turned out to be a more empathetic person and took the trouble to explain the situation to us and patiently answered all our questions.

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