Saturday, September 10, 2011

Why don't we treat patients as intelligent adults ?

I treat patients from all over the world. They need to get medical tests done locally in order to check their fertility status before they can fly down to us for their IVF treatment. Sadly, it is very difficult for many of them to do these tests. I can understand this being a problem when they come to us from poor countries like Eritrea , which may not have good medical facilities.
However, this is a huge difficulty, even in developed countries, such as the USA.

It’s very difficult for patients from the US to get even their basic tests done, even if they're willing to pay for them. This is because labs and testing centers insist on prescriptions from local doctors before doing the tests. When the doctor finds out that the patient is planning to fly to India for her treatment, many will refuse to oblige the patient and order the tests.

I find this unwillingness on the part of doctors to help their patients extremely disappointing and I wonder why they take such a dog in the manger attitude. It's very frustrating for patients when they come across this unexpected hurdle, which is very hard for them to cross. They encounter the same kind of resistance after they go back , and need to get their blood tested for hCG to confirm the pregnancy

It still amazes me how hard it can be for patients to get such a simple blood test done ! I sometimes wonder which is the developed world and which is the developing world ? The one which treats its patients as adults who are capable of making their own decisions for themselves ? Or the one which insists that it's only doctors who can make these decisions?

I can't understand why private labs insist on prescriptions from doctors before running tests for patients. This wastes the patient’s time and costs them more money, thus adding to the overall healthcare expenditure. Just like we have OTC ( over-the-counter) drugs which patients can buy themselves without a doctor’s intervention, why can’t we have OTC medical lab tests which patients can order for themselves ? Why should doctors have to get involved at every step , just so that they can extract their pound of flesh ?

Why can't patients refer themselves for simple non-invasive tests ? After all, they are intelligent adults who can look after themselves and who understand what they want. Why do we still treat them as little children ? Why do they have to go running to a doctor for getting every test or scan done, especially if they're willing to pay for them. When patients pay for their tests out of their own pockets, they are going to be very careful about what tests they do for themselves, so there's really little scope for harm. I think a progressive system would allow patients to self refer themselves for noninvasive tests and scans. This particular kind of archaic rule only seems to help doctors because it helps them maintain a monopoly on medical care , where they continue to act as gatekeepers , for no very good rhyme or reason.

I think this is a broken system and it's high time we fixed it.


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