Saturday, January 23, 2010

I never got a chance to talk to the consultant !

An unhappy patient who had failed an IVF cycle at another clinic was ventilating her pent up anger. Her major grievance was that she never got a chance to talk to the senior doctor and that all the clinical care was provided by her juniors, most of whom were inexperienced.

It seems to have become the norm that as a doctor gets busier and more senior , he starts employing assistants whose job seems to be to improve his productivity, so that he can treat even more patients. The senior surgeon then does only the operations, while his juniors do the consultations and the counselling. Most senior surgeons take pride in having fully booked operating rooms and month long waiting lists. To my mind, this seems to be poor time management.

I think this is an unhealthy trend . While it's important to improve the "star surgeon's" productivity and throughput, this should not be at the expense of the quality of care provided to the patient. Taking a patient history and doing a consultation is the heart of clinical medicine - and "outsourcing" this to an assistant is poor clinical practise.

Busy surgeons will always be very busy - but doing so at the expense of not having time to talk to patients is a recipe for disaster in my opinion ! It's not possible for him to establish a rapport , and such super busy clinics become assembly line " patient processing units" . Not only is this bad for the patient, it's equally bad for the star doctor, who then no longer gets a chance to get his batteries recharged by connecting with and empathising with his patients.

However, it's not fair to blame the surgeon. After all, he is being perfectly rational and doing what makes a lot of economic sense - maximising his revenue. Part of the blame has to be shared by patients who are willing to put up with this kind of neglect and inattention !

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