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Monday, May 23, 2016

Those evil hospitals and their vampire doctors

Seemed like an apt title for this post. Now that everyone is climbing on the doctor bashing bandwagon in India, the surefire way to get people to read on would be to toe the line and badmouth the hospitals and doctors.

Reality Check: Most of what is written is true!

A corporate hospital is one run by a corporation who intends to expand the hospital chain like it had expanded itself into a corporate entity. By virtue of this simple statement, it is understood that they will run the entity like a business, and why not?

We consumers are a fickle minded people. We want the best hospital every time, with the cleanest floors and the best service with the best staff and the best care with possibly the best food ever tasted in a hospital along with possibly the best views on offer along with the best amenities with of course the best possible and cheapest tariff known to mankind!

Let's take a pause here since at this point a whole bunch of you are saying, hang on, we don't mind paying for quality!! Sure you don't, but you aren't the one's complaining are you?? Also, that's kind of not the point is it? 

Everyone seems up in arms about hospitals pushing doctors to make a profit and how unethical it is! 

Reality Check: There is nothing unethical about hospitals pushing their doctors!

The thing is, every business out there, is out to make a profit. You would be lying to yourself if you thought otherwise. Anyone who thinks hospitals and doctors should be more charitable, please head on over to the number of government and municipal run hospitals there are. Even better, move to the UK and face the NHS!

Even today, India continues to be at the top of the healthcare chain and is one of the cheapest destinations for quick healthcare the world over. We must be doing something right!

Coming back to the point of this post, corporate hospital management is correct to push it's doctors. The only problem is that they seem to be pushing without direction. This could be attributed to people in high places with no healthcare experience whatsoever. Which is where the need for trained post medicine admins come in, but that is another post.

The ethics debate which is where this is blowing up, lies and should lie solely with the Doctors! It is up to them to decide whether they do what the management asks without regard to their medical training or continue ethical practice of medicine and be the best doctor that they can be!

If the Doctor is as good as he/she should be, the patient load and revenue will come in anyway. Once the doctor has a roaring practice, the management will have no choice but the accept the terms he works with, otherwise, there are enough private hospitals out there poaching good doctors.

The ethical dilemma, in my opinion, is only with those Doctors, who either can't bring in patients on their own merit, or the newbies who were drafted into the big hospitals, and want to prove themselves. Either way, the load of ethics still stays on the doctors shoulders.

An illustration to help understand this better. A recent newspaper article cited a hospital as suggestion to its cardiologist to perform angioplasties on at least 40% of his out patient visitors. A negative look on this suggests the hospital deciding for the doctor how many procedures his patients should undergo. A positive outlook is that the management is informing the Doctor about the average turnover of cardiac patients that a busy established cardiologist may have as industry standard.  

At the end of the day, every doctor gives the patient a choice. If you choose to believe in your Doctor, you would undergo a procedure. If you have less faith, you would get a second opinion. Either way, the doctor is acutely aware that he/she is being scrutinized, more by the patients than the management. Believe me, we doctors care more about what our patients think than what anyone else does.

The Doctors who do push patients for uncalled for surgeries and procedures are few and far between and must be pulled up. However, writing articles in the newspaper about the entire healthcare system being bad isn't cutting it. The book dissenting diagnosis is getting a lot of publicity with this and I wouldn't be surprised if the doctors who wrote the book aren't laughing all the way to the bank about this, but I wonder.....

The crux of the matter is, the book interviews a couple of hundred doctors. They got a few positive answers. They haven't mentioned all the others that they did not interview or those who gave them negative responses to what they were looking for.

Bottom line. Find a Doctor you can trust and stick with them until given reason not to. If you can't find one you can trust, always take a second opinion. The best way to do this is not Google, but going to a second doctor without telling him about visiting one before hand. This gets you the best unbiased consult. Once you are convinced about your condition, decide where you want to go by reading about the hospitals suggested. I'm in the process of launching a website that gives honest, first hand user related ratings and reviews of hospitals. Visit the site at Best Hospital Reviews and learn about the place. Then make your decision on an informed basis. You would never need to criticise a doctor or hospital again since you'll have done your due diligence. Yes YOUR due diligence. You play a part in this as much as the ethical doctor you want does!! Any views and critique are welcome and will be replied to in the same tone as this post!

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