Thursday, November 26, 2009

A patient provides feedback to help doctors to improve

This is a guest post from a patient whom I respect.


I am writing in about something that happened with me and my gynecologist in Chennai. I know that you write a great deal about positive doctor-patient relationships. I am not writing in to complain, crib or even ruin this doctor's reputation but a lot about what she said and did left a lot to be desired.

My parents live in Chennai and I spent my first trimester with them, because my husband was traveling a great deal and he did not want me to be alone in Mumbai. In Chennai, I went to a very well-known gynecologist. She was quite approachable and friendly in person, so I had no reason to expect the volte face that I saw today.

For my second trimester, I am back in Mumbai, because my husband is back. I plan to go back to Chennai for my third trimester, because my husband might have to travel again then. The Chennai gynecologist asked me to call her in case of doubts and queries. To be honest, this is the first time that I am even calling her ever, because she does not check her mail regularly and she is very busy so I did not want to trouble her with calls. I had done a urine analysis and wanted a clarification about the report, which said that the PH level was very high (the normal range was given in the report and my PH level was 8.5). This part was the only highlighted part of the report.

I am no doctor but as a patient, I did have a doubt about this and wanted to ask the doctor. In fact, it is precisely the fact that we patients do not know what is important and what is not in a report that prompts us to ask these questions, which may seem silly or irritating to a doctor but like doctors, we are human after all and it is my body, which we do not want to take for granted just because we are afraid to ask stupid questions.

I asked the doctor about the PH level and she told me that I had not gone to a medical school and that my knowledge of other things may be great but I knew nothing about medicine, so I had no right to second guess a doctor by using a piece of paper. First off, I was not trying to second guess her. I merely wanted to *clarify* something in a report and I did so with humility about my ignorance and faith in her judgment. She then asked me what PH was, as if I was a student in a class, and when I said that I did not know, she told me that I had no right to ask such questions as if I knew everything about medicine. She continued to grill me about what PH was with sarcasm and malice. Finally she asked me to drink a lot of water and said that I will be fine. She also said that I should not dabble in anything I had no knowledge about, although my knowledge in other things might be 'great'. She is right, of course. My knowledge of manners is far superior to hers.

When I proceeded to ask her about hair loss during pregnancy, she said that that was an intelligent and 'valid' question. I felt like I was back in school, dealing with a malicious teacher who was pulling me up for asking the 'wrong' questions, whatever those may be.

I know that we patients can get on doctors' nerves. We have a tendency to think that we know it all or we want to know it all. We want answers for everything when in fact, things are a bit more complicated than they appear. We know that doctors work very hard and I know that it is next to impossible to be patient with us.

However, the fact is, I know that I know nothing about medicine, let alone pregnancy, but this does not mean that we are empty mugs to be filled. It is my body and I do have a right to ask questions. If I do ask questions, it does not mean that I think I know more than the doctor does. I have met doctors who have snapped at, chided or pulled me up for being stupidly worried about trivial things and they were right in being upset but they were never malicious, personal or sarcastic in their anger.

All I want to stress on is that patients are possibly ignorant about many things but it is our body. And it is my child. My husband and I did conceive with a certain amount of difficulty, and the child is all the more precious to us. I know that our struggle is nothing compared to couples who try so many years and so many attempts before they get successful. I can only imagine how gynecologists are to them. In no way did I adopt a superior tone to this gynecologist. In fact, I was so taken aback by her behavior that I did not even react strongly to it. I was, however, extremely upset and saddened. My husband has written a polite but firm email to her. I simply do not want to write or communicate with her again because the relationship has obviously soured to a point that it is not fair to the doctor that the patient dislikes her but still goes to her.

I thank you for your time in hearing me out. Hopefully, I will, as a patient, be one step closer to understanding the doctor-patient relationship. I do respect it a great deal and the challenges that miscommunication poses. We have known some truly wonderful doctors - Dr KK Raja who performed my dental surgery, Dr VC Bose who performed two hip resurfacing surgeries on my husband, Dr Ananthapadmanabahan our GP in Chennai, Dr Prathima Reddy my gynaecologist in Bangalore for over three years, and of course, you, doctor.

1 comment:

  1. You absolutely have the right to ask, and indeed should ask questions. Ask, Ask, Ask, and keep asking.


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