Tuesday, December 02, 2014

Why doctors get poor medical care


One would assume that doctors would get the best possible medical care . After all, being insiders, they understand the medical system ,and are likely to get VIP care from other doctors, who are their professional colleagues. They understand a lot about medicine, and will know exactly what the best medical treatment is; and who the best specialists are for their illness. Doctors will leverage this “inside” knowledge to get the best treatment when they fall ill.

However, this is not true , and surprisingly doctors often get poor care. One of the reasons for this is the VIP syndrome . Because the doctor is a professional peer,  he is likely to be overtested because the tests are often done free for doctors. Sadly, this then leads to overtreatment, because the treating doctor goes out of his way to do his best for his colleague. Ironically, this also sometimes leads to  shortcuts being taken, because the doctor is given preferential treatment, and allowed to “jump the queue” , rather than being forced to follow the standard protocol.

Also, because it is assumed that a doctor knows what’s happening, the treating doctor may often not provide an explanation for what he is doing, and why he is choosing a particular course of action.

Sometimes doctors suffer from “medical student syndrome” and when  a doctor falls ill, he starts thinking he has the most esoteric illness in the world. Sometimes the pendulum swings to the other side, and because the doctor-patient does not want to rock the boat, or be a “ bad patient” ( because so many doctors have the reputation of being difficult patients) , he does his best to be compliant and passively follows whatever advise the doctor-doctor gives him.

This is why the doctor-patient is hesitant to speak up because he doesn’t want it to appear that he is challenging the authority of the doctor-doctor. He doesn't ask too many questions, and may not express his personal preferences, and he is worried that this can damage the chemistry between the two of them. The treating doctor may also wrongly assume that because his patient is a doctor, he knows and understands everything which is being done, so he may not take the time to provide a complete explanation.

The other problem is that the treating doctor goes out of his way to make sure everything goes like clockwork. Because it’s an honour to treat a colleague, he needs to make sure there is no mishap or oversight. This means that he often adds a lot of unnecessary bells and whistles to his treatment,  to make sure that everything possible which can be done is done, and the patient is getting “state of the art” cutting edge treatment. Thus, doctors will recollect their uncommon complications, and then go out of their way to make sure the same fate  doesn’t befall the doctor sitting in front of them. This can actually make things worse , because more is not always better !

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