Doctor rounds


By Chitra Ahanthem
Once upon a time, a trip to a doctor meant a pretty decent time interval where the doctor would take patient history and then follow it up only with required medication instructions. Looking at those times, it is also a matter of great irony that though there were lesser doctors then and few private clinics, there would never be a rush of people waiting for their turns to be medically examined. But they say changes are the only constant of life and the scene has changed and how! For one, the number of doctors and specialized ones has increased and so has the number of private clinics and hospitals and doctors on private service. But along with the number of doctors increasing (and we are talking mainly of urban centers), there is also an ever growing number of people who are becoming inclined towards seeking health services.

There are interesting insights into the phenomenon of seeking health care. There is of course, the fact that people are becoming more aware about the need to be concerned about their health and to take medical opinion. But on the other end of the spectrum is also the fact that urban life styles have added to new medical ailments. Over and above these areas, there is a disquieting tendency for doctors to treat their patients like money spinning enterprises. There is rarely any doctor (doing private practice) in Imphal or for that matter, in the district headquarters who do not charge a set patient consultation fee. Most of these doctors have a family member or a relative manning a sort of ticket table. They allocate serial numbers and take the consultation charge. The going rate at present is Rs. 200 on the first consultation and Rs. 100 for every follow up medical check up. 99.99 per cent of the time, the doctor will give a list of medicines that you have to buy and the ticket attendant will lead you to the in house pharmacy. Chances are also that you will find free doctor samples of medicines being sold.

This piece today is certainly not a chest beating or vitriolic rant against the medical community in Imphal but a mere mirror image of the practices that has become totally normal. It is certainly not a stand-alone practice for the same situation exists in urban areas and cities. But one wishes that there was a standard set of rules or code of conduct and ethics that the medical fraternity here would stick to. Most private clinics that I have seen functioning outside the state have a social responsibility program where they give subsidized health care to senior citizens and people with poor economic backgrounds. I happened to take my son for a surgery for plugging his leaking tear sac at the Nethralaya Eye Institute and was very impressed by the standard of health care and quality that justified with the amount of money they were charging. They had a patient counseling session where they explained the operation and what would follow later on. But what impressed me most was the fact that they had free surgery and medication policy for senior citizens and people from poor backgrounds. For the later, they checked with BPL cards and when I asked what would happen in cases where people do not come with any official documentation specifying that so and so is poor, I was told that the one thumb rule to check such cases was the desperation of people seeking services and the state of their appearance. I was told that it was as simple as that!

Personally, I have nothing against doctors on private practice so long as they are not shirking their Government work timings. It is I as a consumer, and customer and patient party who is aware that I can also seek his service at a subsidized rate at the government hospital where he/she is practicing. And if this “I” feel that waiting at a hospital is not in the order of things, it is only fair that “I” pay for the time that the doctor has devoted to me. But having said that, there are many areas that need to be considered from the doctor’s viewpoint that justifies the money that is being charged for his consultation. For one, it would do well to have a strict order of who gets in first. Very often, doctors have a set consultation time, which is known or announced. Patients troop in and an attendant, who allocates a serial number, takes down their names. But mostly, the serial numbers do not matter because someone they know or some one in their social circle drops in unannounced for a check up. Also, there are certain doctors who will give first priority towards the patients they have been administering at his/her government hospital set up but who follow up with him later on a private consultation basis. This would mean that they would jump the waiting list and ruffle up a few feathers.

They say that an apple a day keeps the doctor away but either, something is wrong with the apples or the doctors have become indispensible for on an average basis, about 4 people out of 10 would most definitely be seeking medical attention or consultation at any given time: if not for his own self, for a family member, for a child etc.

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