It is very common for patients to go from one hospital to another and from one doctor to another to seek guidance regarding illness. As it happens in any field, medicine, law or management, opinions are bound to vary. This leads to more confusion and sometimes panic, leading to even more consultations and even more confusion!! Of course when ones health and life are concerned, this confusion leads to untold misery.
The basic reason for taking several opinions is the lack of trust in the system. Is the doctor recommending an unnecessary test? an unnecessary operation? Is he trying to make money for himself? is he trying to 'feed' the hospital for its laboratory to make more money? While this train of thoughts is understandable, it is at the same time, causing harm to the patient.
The confusion of differing opinions is bad in itself. In addition it encourages several unhealthy practices. It gives an opportunity for the person giving a second opinion
The basic reason for taking several opinions is the lack of trust in the system. Is the doctor recommending an unnecessary test? an unnecessary operation? Is he trying to make money for himself? is he trying to 'feed' the hospital for its laboratory to make more money? While this train of thoughts is understandable, it is at the same time, causing harm to the patient.
The confusion of differing opinions is bad in itself. In addition it encourages several unhealthy practices. It gives an opportunity for the person giving a second opinion
- to create a doubt in the mind of the patient about the first opinion
- to ask for more tests and add costs
One may say that professionals should not do this. But after all, they are a part of society they come from and their behaviour reflects the behaviour of our society.
Instead, one could consider the following:
- Find a family practitioner. Go to him for all your health issues. It is not a good idea to go to a specialist directly unless it is an emergency.
- Go to a specialist directly only in an emergency - e.g., severe headache, chest pain, abdominal pain, collapse, loss of consciousness etc.
- The specialist must be identified when you are healthy and fine; you should not look for a specialist at the time of an emergency!
- How do you find a specialist? Your family doctor may suggest one; your family and friends might have been looked after well - ethically, conscientiously with reasonable charges - by a specialist. Have such a person in mind and keep his contact details.
- For any specialist help call him - if the problem does not pertain to his specialty, he will suggest a like minded specialist in the specialty you need.
- Let him choose the institution; such specialists know where patients get a fair deal and choose the hospital that he/she suggests.
- Another important attribute of an ethical specialist is to seek a second opinion himself, with the consent of the patient, when the progress of treatment is not on expected lines.
The shopping behavior stems from the fact that every one thinks all doctors are here to make money, which is not the case .There are good ones and bad ones. Now the question is how did one arrive at this opinion ?
ReplyDeleteThis is primarily due to collapse of the guidance from the family physician system. Now almost every family has a doctor or a doctor friend and they want an opinion from their preferred person.I encourage second opinions and tell the patients to come back if they are convinced with the management plan. There is nothing wrong in seeking second or third opinion in difficult cases. The great variance in procedure charges in different hospitals is also a reason for "shopping"
ReplyDeleteI agree with the basic tenets of the article.
ReplyDeleteHowever GP ' s as in UK or US are your well wishers and refer you to the appropriate specialist.
In India majority of the Family physicians do so for referral fee and other payments in kind. Hence going by their opinion is also brought with danger of unnecessary investigations and treatment ,whi wh you are trying to avoid in the first place.
Internet explosion and putting knowledge before wisdom is another reason for shopping.
Ultimately patients shop around till they hear what they want to hear.
Ordering investigations in a methodical algorithm should be the prerogative of the specialist,but sadly follows the same principle alluded to above
Patients arriving with a bundle of mostly unnecessary investigations is commonplace
It's also common for you to counsel the patient against surgery based on evidence,only to find out that they have got operated elsewhere.Equally when surgery is advised,they go away and suffer the consequences of inaction
Doctors play but a small part in this scenario.
A note of caution however, even if you disagree with the proposed line of treatment do not be disagreeable to your colleagues
very well stated sir.
ReplyDeleteShopping in Healthcare is not a good sign. Shopping in other field may help the customers to certain extent, but in medical field is not advisable.It depends on the TRUST between the PATIENT and DOCTOR/ HOSPITAL. Treating the patient depends not on one criteria, it depends on the Experience of a Surgeon,type of Hospital, mode of management (Open or Lap)and the type of service rendered by the Surgeon( Elective or Emergency).
ReplyDeleteFor example 1.All the tourist buses charges on routine days will be different i;e; during festival times it will be doubled.
2.Flight Charges changes hourly
3.Petrol and Diesel rates are increasing daily
In these cases are the public doing any shopping.
TRUST IS THE MAIN THING BETWEEN PATIENT AND DOCTOR. If they don't have trust then SHOPPING starts from DOCTOR TO DOCTOR & HOSPITAL TO HOSPITAL.
Dr.V V CHINIWALAR GANGAVATHI KARNATAKA