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?