Monday, February 25, 2013

Why are doctors rude ?

I cringe when I see rude doctors . Sadly, this happens all the time . Typically, the doctor cuts off the patient while he is talking; or is sarcastic about his internet research; or does not respect the patient's need for privacy ; or makes the patient's wait endlessly for no good rhyme or reason , while he's chatting with a medical representative in the consulting room . These are all signs of disrespect , which means that the doctor doesn't really respect the patient , which is why he tends to abuse him . ( In fact, most doctors are blissfully unaware of how rude their own behaviour is, until they are at the receiving end, when they fall ill).

There are many reasons why doctors do this. One is the fact that they have a disproportionate amount of power within the doctor-patient relationship . The patient is dependent on the doctor, and has to rely on the doctor ‘s professional expertise and goodwill. There is often a lack of transparency , and the patient is pretty clueless about what's happening . Doctors sometimes take advantage of this information asymmetry and keep patients in the dark. They use this to establish to the patient that they are the boos; and use this power unfairly to manipulate the patient.

The second reason is because they can get away with it ! A lot of junior doctors see their seniors – their so-called role models – being rude to patients ( especially those who are poor or illiterate ) in the public hospitals, and they pickup these habits. Sometimes this rudeness maybe inadvertent , but it tends to propagate itself , so that it continues down the hierarchy.

Thirdly, being a doctor can make your head swell. Egos can get out of hand  when patients and their relatives hang on to your every word - and when you have a retinue of nurses, assistants and students when you make rounds on your patients in the hospital.

Finally, the most important reason is because patients put up with the doctor’s rudeness – they let them get away with it ! No doctor can survive without patients , and if patients put their foot down and say-  No , this is not acceptable behavior – we expect better from a doctor . We expect our doctor to treat us with the respect which we deserve , I think things will change a lot. Poor patients ( in government hospitals ) don’t have a choice , and have to put up with the doctor dishes out, because they have to depend upon the free medical care the government doles out to them. However, even extremely rich, powerful patients in private hospitals who are paying an arm and a leg for their medical treatment put up with this disrespectful intolerable behavior from doctors . If doctors find they can get away with it , they are that much more likely to do indulge in this rudeness – we all have a streak of petty dictatorship within ourselves.

Some doctors are deliberately rude. They use this as a strategy to intimidate their patients, so that they do not ask too many questions or waste the doctor’s precious time. ( However, this can backfire badly ! If something goes wrong, patients can be vengeful if they feel the doctor was rude, and will go out of their way because they want to teach him a lesson !)  However, I believe most doctors are reasonably nice people , but there is no doubt that when things go wrong , the doctor may forget his manners ! This is true when a doctor is excessively busy ; when is swamped with paperwork; when he is stressed-out because he has been on his feet for over 36 hours; when he has missed his daughter’s school play because he was stuck in the OR: when there is too much going on; and if his patient is not doing well . He may then lose his cool and snap, and take out his anger and frustration on the poor hapless patient who is sitting in front of him. This is such a shame ! If the healthcare system learns to respect doctors a little more ( and not make them waste their time arguing with clerks on the phone or filling out endless forms),doctors in turn will start respecting their patients and not be rude to them.

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  1. Anonymous12:21 AM

    Very nice post! I think the title should have been "Why are Indian doctors rude" and I believe that is what you meant.

  2. Anonymous10:23 AM

    This was very informative. I been trying to figure out why my doc is so rude. As a matter of fact everything you wrote about above,she does it. To add I do have insurance though and I don't rely on the government for that.
    But on my last visit I asked her would she recommend me to someone else. ?
    @Anonymous I agree because my doc is defintely Indian and she talks over me while I try explaining my situation to her.

  3. Anonymous3:10 PM

    We in India have grown up seeing Indian doctors being rude. Now the expectation is set and nobody complains when the older doctors continue to be rude. If we get to see the younger generation doctors not being rude, it is only considered as a one off pleasant experience and not as a new norm. The fact of the matter is that we are at the mercy of the "a very reputed and senior doctor", and we cannot risk to change doctor just because he/she is rude. We patients have no choice but to put up with it or patient must be empowered by means of a law to change this. Only legal enforcement can hope to change certain things in India.

  4. I completely disagree. If a "reputed and senior" doctor is rude, this means he does not deserve to have a good reputation .

    Why do patients think of themselves as being helpless ? You can always find another doctor - there are lots of good, civilised doctors in India !

    The legal system is India is much more broken than the medical system , so expecting legal enforcement to help is a pipe dream, sorry !

  5. Anonymous5:02 PM

    I cannot afford to lose the "number 1" cardiologist my city, for example, if he has agreed to treat me, just because I cannot put up with his mood swings, can I? I need him to treat me. I also don't think it is that simple to find another "good doctor", it usually works by word-of-mouth of other patients who go by his skills and not manners. But yes, I agree that I don't have to put up with it all the time. We just need to break the habit of putting up with rude doctors, at least when I can afford to do it. It is encouraging to see doctors like you do some introspection of the profession. Really appreciate it.

  6. What makes him "number 1" ? You have chosen to give him this title. You can also choose to take it away ! Patients have far more clout than they realise. However, most of us are too lazy to exercise this !

    Hopefully, the ease of getting second opinions online will help to improve the parity in the doctor-patient relationship.

    Medical expertise will no longer become such a scarce resource that patients will feel that they have no choice but to put up with rude behaviour !

  7. Wow Dr.Malpani you are doing an amazing job by addressing issues anyone, especially a doctor himself, would hesitate to see eye to eye into.

    I appreciate your views and topics you chose, which are technically non-medical, to discuss in your blog...


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