Physician , Heal Thyself

As children, we all think of our doctors as nothing short of magicians. You’re down with fever and feeling terrible, you gulp down that strawberry flavored medicine your doctor gave you and lo and behold, the fever’s gone and you are back to your cartwheeling ways!! If that is not magic, what is!! Most of us retain a bit of this awe, wonder and implicit faith in our doctors well into adulthood, until we inevitably run into some unscruplous doctor who makes a mockery of that faith and makes us eye every other doctor thereafter with suspicion.

Satyamev Jayate’s episode on corruption in the world of medicine raised many hackles.  A number of doctors’ groups were up in arms against Aamir Khan for daring to put doctors under the spotlight. Social networking sites were agog with vicious and frequently personal assaults against Aamir and his show and the Indian Medical Association went as far as to threaten him with legal action if he did not apologize for ‘showing only one side of the story’. It was heartening to see Aamir call their bluff by refusing to apologize, and the IMA ended up with more egg on it’s face than before.

Such a sorry state of affairs for a profession held in such esteem, particularly in our country which is so woefully short of doctors that they are kind of revered as divinity incarnate!

My first personal experience of patent medical malpractice came four years ago when I was pregnant with my second kid. I had gone to my doctor, one of the top gynecologists in the city, for a routine check-up. When I took a look at the prescription, I found that I had been advised to take, apart from the mandatory iron and calcium supplements, a drug named Gestin, twice daily for twenty days. Gestin? It sounded suspiciously like the group of hormones known as progestins! I  asked the doctor what that was for.

It’s good for the baby, she said curtly, giving me the annoyed look which doctors in India tend to give you if you question anything they’ve prescribed. Many of them seem to consider it a personal affront.

I looked up the net as soon as I reached home and found that I had not been off the mark, after all. Allylestrenol( the generic name of the drug) was indeed a synthetic progesterone used purportedly to treat cases of threatened miscarriages or pre-term labor although its usefulness even in those conditions had not been completely established yet. It was banned in the USA, the UK and Canada but was very much in use in Russia, Japan and India. Allylestrenol was aggressively marketed, and hence widely prescribed, in India, said article after article.

I remember feeling shocked and outraged as I read all this. The doctor had had no earthly reason to suspect that I could be having a pre-term labor or a miscarriage–there were absolutely no such indications for her to justify prescribing this drug that was not just unnecessary but potentially harmful too . How could anyone stoop to such levels to make a little money on the side?

Now, it wasn’t as if I had been unaware of the fact that doctors in India were given to overprescribing–go to any doctor anywhere in India with the common flu or even the common cold and you run a fifty-fifty chance of being prescribed antibiotics –but I had so far tended to give them the benefit of doubt. I thought it was more due to the exigencies of practising in our cramped cities where epidemics were common, or maybe even a certain amount of  incompetence in some cases, than genuine malpractice. But this!! Didn’t this amount to a wanton disregard for the well-being of an unsuspecting patient who has put so much trust in you? All because some godforsaken pharmaceutical company wants you to push their pills, for a good fee of course!

Needless to say, I didn’t touch those darned pills and found myself a new doctor the very next day. I so wanted to take my former doctor to court for malpractice  but I was thirty weeks along at the time and found that I just did not have the stamina, and my husband did not have the time, to run around courts. It was simply more convenient to forget about it and move on.

Nevertheless I still fumed when I thought about it, when I thought of all those pregnant women in her care who were being made to take pills they should not be taking.

A couple of months after the delivery, I got myself an appointment with my former doctor with the sole intention of letting her know what I thought of her and her little scam. I couldn’t sue her but I could surely berate her for the unpardonable breach of trust! I could surely let her know that she had been caught at it!

And so I told her that even if it didn’t prick her canvas-like conscience, pushing questionable pills to unsuspecting patients could land her in big-time trouble in this age of unlimited access to information  (ah, how the likes of her must hate the internet for it) when even a layperson like me could find out at the press of a button what a particular drug was meant for.  She was lucky that one patient who did catch her at it did not press charges–she might not always be so lucky.

My little lecture was over in just two minutes and I walked out of the doctor’s chamber feeling oddly light. I don’t remember what she said–or if she said anything at all. I don’t know if it had any effect on her or if it even registered in her brain. Probably not. But it definitely made me feel a lot better about the whole thing.

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17 Responses to Physician , Heal Thyself

  1. I can empathize.
    I have had only pleasant experiences with my doctors till I hit 40.
    Those were doctors of the previous generation and I would like to put them on a pedestal.
    They did not have the benefits of modern technology, but they had competence and integrity.

    After 40 ( I am now 63), I have had fifty – fifty luck with doctors.
    Half of them were either incompetent or lacked integrity.
    I can recount at least three unpleasant experiences with doctors but that would need three blog posts each and it would not be fair to you write an ultra long comment here.

    I agree with your observation about doctors probably hating the internet!

    My wife is an expert at this. She knows how to look up information on ailments, treatments and drugs and their usefulness or otherwise by “Googling” or “Wikying” them and she often confronts doctors after preparing well in advance. Some doctors have merely hummed and hawed when she exhibited her knowledge during consultations and they could not stand by their initial drug recommendations during the last three years when I have had more visits to doctors, hospitals and ICU’s then in my entire lifetime.

    I am now wary of doctors and specialists. I have a doctor friend of the same age as me who has now retired and I often consult him over the telephone when I suspect that that the advice of a specialist is not motivated by concern for my health and cure but by monetary considerations.

    I too loved that program on Satyameva Jayate on medical malpractices.
    Regards
    GV

    • Long time, GVji 🙂

      Doctors of the previous generations were indeed a class apart for the most part. My dad’s father was a doctor posted somewhere in northern Bihar in the fifties. Once a patient’s relative arrived at his home in the dead of the night, quite like in the movies, pleading with him to visit his place as the patient was not in a condition to be moved. Grandfather took out his bicycle and was following the man when he had a fall on the dark, bumpy road and badly fractured his left hand. The bone could not be set properly and he ended up having a permanent bony bump midway between the elbow and the wrist. It looked awkward but did not bother him otherwise, fortunately.

      My grandfather was very critical of the younger crop of doctors for their tendency to overprescribe . I wonder what he’d have to say, had he been alive, about doctors such as the one I wrote about.

      Like you, my father too has a doctor friend his age in whom he has great faith and whom he consults whenever he has any query regarding any medicine 🙂

      We do fortunately still have some great doctors around–my daughters’ paediatrician is a gem of a fellow–just that one has to look out for them with a magnifying glass.

  2. Jas says:

    Bravo. You did a commendable job by going back and actually telling her what she had been doing. I remember all that propaganda on Facebook and I felt didn’t they see that it was only some doctors who were pointing out the anomalies in the system in the episode.

    • I guess those doctors have been branded as traitors for speaking out.

      I also wonder if they noticed that the only people ‘liking’ their propaganda on fb were doctors themselves–which says something about the lack of support for ‘their side of the story’ amongst the general public.

  3. Bindu says:

    Absolutely loved this post. On one side we rue the fact that the cost of healthcare is going up and run after insurance coverage and what not, on the other side such rip offs!!
    Good old family doctor days were so much better!

  4. It’s actually scary to think that some doctors prescribe pills without being bothered about the negative effect it may have on their patients.
    I guess the personal touch and trust which doctors of an earlier generation had, is slowly vanishing- it’s becoming more and more business like. With this change, even we need to rethink our blind faith in doctors.
    Personally, I need a lot of coaxing even to take a normal pain killer, so any doctor prescribing me any medicine has to put up with a lot of questions!

    • Medical care has certainly become more like business ventures. I guess it is a sign of the times–we as a society have become a lot more materialistic than the previous generations and our doctors too are part of this very society. The problem really arises when doctors lose sight of the ethics of their profession in their bid to make more money. It becomes a scary scenario because it directly affects the well-being of patients . Small wonder then that people should no longer have the kind of faith they used to have in their doctors.
      Welcome here Gaori 🙂

  5. R's Mom says:

    you are awesome SH! I dont think I would have done that…

    RD was really pissed off with my gynac in Baroda after my horrible delivery..we didnt blame anyone at that time (I guess the family was thankful that I was alive etc) but what you did is really amazing…going back and telling the doctor…I learnt a lesson today…may be she may think twice before prescribing the drug to anyone again?

    • RM, I’d like to believe that she would think twice before prescribing the drug to anyone again but I am not sure. Maybe she will be more cautious with women who appear to be well-educated but not with women who don’t look like they read their prescriptions and can be taken for a ride easily 😦

  6. Zephyr says:

    I know how they hate it if you question their ‘wisdom’. I am extremely wary of going to a doctor and do so only when there is some kind of emergency like an injury or my eye problems. It is heartening to read that you went back and told her off. If nothing, it would at least make her fearful of a malpractice case — even by you!

  7. Scribby says:

    I’m honestly happy that you did what you did! Going back to the person who did you wrong or intended to do you wrong…especially the doctors on whom we put all our trust! Not everyone would think of doing this or even if someone thought of doing this would not have given it a serious thought…so there!

    When I was pregnant, me and Husby, the inquisitive minds that we carry in our heads, used to Google for every little thing that my gyneac suggested,spoke about and all those sonologist’s reports that described the condition of my little baby inside me….it not only felt secured that we have a sane doctor around but it also gave a sense of pleasure to understand things on our own about our baby 🙂 thanks to Google aunt for that 🙂

    Also, I must mention that at no point in time in those 9 months,did my gyneac ever raised an eyebrow to the questions and doubts that we raised and the information that we sought for…in every meeting,she herself asked us ‘what else do you have on your mind regarding so and so’ cause from the very first meeting she understood that we do our homework and then come to her 🙂 we consider ourselves lucky to have found such a doctor who is not only knowledgeable, experienced but also patient enough to chat with me endlessly till I felt satisfied..in spite of she being the cities best and busiest doctors.. ….of course such doctors are seldom found !

    • We have a lot to thank Aunt Google for, that’s for sure 🙂

      However sometimes it becomes a double edged sword. Having access to too much information during pregnancy may at times give rise to needless anxiety , because in the absence of a training in medicine we might not view it in the right perspective. On the whole, of course, it is a boon, particularly in our country where doctors tend to be apathetic and indifferent.

      //but also patient enough to chat with me endlessly till I felt satisfied.//
      Now that is rare! You were really lucky to have found such a doctor!

  8. starsinmeyes says:

    My God! How dangerous. I’m glad you went back and gave her that piece of her mind. I’ve had similar scary experiences wtih docs and dentists and thank my stars that my background is Biology, and shudder at what ‘laypeople’ re vulnerable to,

    • Good to see you here, Starry 🙂

      Yeah, most people have had such experiences with with one doc or another. And dentists–ah dentists– they’re another story altogether!!

      I too have a background in Biology, which is why the name Gestin rang a bell. I agree, the laypeople are truly vulnerable 😦

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