Thursday, August 11, 2016

How good is your doctor ?



Every patient wants to find the best doctor, but their problem is they can't judge the technical competence of the doctor.  How do they differentiate between an extremely skilled doctor and one
who's a duffer who was at the bottom of his class in medical college , but who camouflages his incompetence with a great bed side manner ?

This is why they are forced take  technical competence for granted . They assume that anyone who has passed his medical examinations and has been certified by the Medical Council to be let loose on an unsuspecting public and start medical practice must be as good as any other doctor .

This is why patients are forced to use the following markers to judge which doctor to select for their treatment.

The size of the bill

For lots of patients, the goodness of a doctor is directly proportional to the size of his bill. They know that better quality stuff is more expensive, which is why they believe that costly doctors must be better than the others. They naively conclude that doctors who charge more must be superior  and that those who charge less mustn't be as good.

Number of tests

They believe that the skills of a doctor is proportional to the number of tests he orders . Their reasoning is simple - the number of tests he orders is an index of how thorough he is . By doing more tests , he is able to probe more deeply into what your exact problem is , and get to the  root cause. They believe that good doctors make the right diagnosis by ordering more tests.

The length of  the prescription

Similarly, a doctor who orders lots of expensive medicines is presumably a better doctor . After all, the medicines must be more expensive  because they are the newest , and have been developed using the most advanced technology based on the fanciest state of the art research . This is in contrast to the old-fashioned doctor , who only prescribes older medicines, presumably because he  doesn't know any better, and has not kept up with the latest advances.

How crowded the waiting room is

If there are a large number of patients who are waiting to see the doctor , and you have to join the queue, this means he must be a  top doctor. If he doesn't make you wait , it's logical to assume he doesn't have many patients to see and this means he mustn't be very good .

The celebrity quotient of his patients

If he attracts lots of high profile celebrity patients, he must be the best - after all, they must have done their due diligence before selecting him, so you can safely follow their lead !

The truth is that all these metrics are completely flawed. Good doctors don't always charge more - they charge what they feel is the right amount. After all, most doctors didn't join medical college to become rich !  Good doctors order only those tests which are required. Often, the newer ( and more expensive) tests are worse, because they provide unreliable information which hasn't been shown to stand the test of time. Similarly, newer drugs have lots of unexpected side effects which we still haven't discovered, and sensible doctors don't use their patients as guinea pigs. The large crowd of patients waiting to see the doctor simply means that he has poor time management skills. If he can't manage his own time well, then how will you manage his patients' problems ?  And celebrity patients aren't always good at selecting good doctors - they just want someone who will fawn over them and treat them as VIPs, while good doctors take pride in treating  all their patients equally well !




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