The doctor patient relationship is considered fiduciary . Doctor should have only patient’s welfare in mind and the patient is supposed to have faith in doctor’s judgement .
The real picture is very different
There is a deep distrust in the air ,as every where .
As there is no tort reform , doctors have to practice defensive medicine . Patients are sometimes viewed as potential litigators .Doctors have to deal with EMR ,extensive documentation , administrative hassles ,shortage of manpower .
On the other hand , patient are caught unaware about newer regulation about controlled substances .As doctors are the face of these multiple agencies like insurance companies , Corporate hospitals , physicians are viewed as an allies to them . Unfortunately , that is far from truth .
Some times the anger and frustration is so extreme that they would not even stop using cuss words for the doctors
Back home in India , they go a step further .
If there is an unfortunate outcome , they would take law in their own hands . Violence against doctors , arsons at the hospitals are not infrequent
We need to redefine and retrospect on this fiduciary relationship .
A Physician is not God or Santa
Wish lists cannot be always granted
During my last years of residency , not too long ago , when I was job searching , I was made to feel guilty again and again for asking for a decent pay packet as I was inexperienced . I was not supposed to expect much as I was wet behind the ears .On top of that , I was a visa candidate .
Over the years , visa status has not changed . India is the only country languishing in the queue for priority date to become current . But the demand for experienced primary care has gone down .
Fresh MD’s are being welcome with open arms They are ready to book you in your final year of residency with a stipend . All the more better if you are a Nurse practitioner .
After a few years in your job , your job demand does not resemble your old contract any more
In the end , Its Money , Money , Money ;Its the bottom line , Honey ;All that matters to a Compaaa…ny
Drug menace is omnipresent in the world . In America , drug overdose deaths resurface time and again . CNN dedicated its prime news hour to this issue which was moderated by distinguished panel . Thanks , CNN
As physicians , specially as primary care providers , we have a major role to play as most of the time it is in their office where this problem is initiated . Community health centers get to see this cross section of population who use , misuse and may be sell on the streets .
But not too long ago , physicians were answerable to dropping patient satisfaction , decreasing patient numbers and all in all non impressive bottom line . Physicians are sandwiched between patient’s wrath and unaware administration .Even if one of the physicians join administration , they do not take time to change colors .
More public awareness , stricter guidelines , more grants for behavioral health issues are required for this ongoing public menace
In community health centers ,doctors are the pivot around which the whole health care revolves . Most of the decisions need to be run by them . But this is not restricted all the time to health care .
The number of other issues where the doctors have to share the responsibility is incredulous .
Pharmacies which are overworked most of the times after Affordable care act , if unable to fill in medications on time “Your doctor does not want to do it “. Only God knows why suddenly doctor would not want to do it .
Insurance does not want to pay for labs after a certain point .”Your doctor orders too many tests .”
Support staff did not address the issues in time , Blame the doctor .
Housing societies would not let you keep the pet , Ask the doctor .
DMV will not issue disability parking tickets . Take away the license of the doctor with any discrepancy .
The list is endless . Unfortunately patients are too gullible to discern through these excuses .It is a direct recipe for souring patient physician relationship .
But don’t we all need to blame some one ?Does it ring a bell ?
Currently there is an interesting debate going on India about who should be the brand ambassador of Rio Olympics , 2016 .Movie stars are being chosen as they have an insurmountable appeal in Indian society .
It is being argued that brand ambassadors either contribute , participate or promote the product that they are being chosen for and which does not seem justified in the present selection .
Bollywood currently is the largest movie industry in the world .They create magic and sell dreams on screen . Indian masses identify and eulogize them . But off screen they are as human as other distinguished people from other walks of life .
We need introspection and promotion of other achievements in our society .Our young people should chase real dreams not mirages so that the chasm between non credible India and incredible India is little less .