The Deteriorating Doctor-Patient Relationships – Who is to Blame?

A couple of weeks back, the Sunday edition of Times of India carried a completely one-sided article on how the doctor-patient relationship has changed for the worse with examples of doctors cheating patients, starting with some Calcutta-based physicians who had been sentenced to three-months rigorous imprisonment for some supposed negligence.
A week later, “The Sunset” carried this article.
News Network Service
There is no denying that the doctor-patient relationship is deteriorating. Rank commercialization and deteriorating moral standards in society have had their effect also on the medical profession and the practice of medicine. Doctors have been brought into the ambit of the consumer court and in the last few years, cases involving doctors have gone up significantly. An idea of where things are going can be obtained from some examples of court cases currently up for hearing.
1. Doctor A versus Patient X
Patient X came to Doctor A, a radiologist for a CT examination of the abdomen and pelvis. The cost was Rs. 10,000, which patient X agreed to pay. Proof of this was his signature on the consent form that also listed the charges for the study. Patient X paid half the money and kept the other half balance, saying he would pay while collecting the report. In the meantime, Doctor A called Doctor Y, the patient’s family physician and told him the study was normal. Doctor Y informed patient X about this. Patient X decided not to collect the report. Doctor A’s staff called Patient X at least 10 times, but the patient refused to come to collect the report and to pay the balance amount. He made a police complaint, but to no avail. With no further help forthcoming, the doctor filed a suit in court for recovery of money.
2. Doctor C versus Patient Z
This is a very interesting case. Patient Z took an appointment with Doctor C’s centre for a CT scan, to be scheduled at 7.00AM in the morning. The centre took down the patient’s telephone number and the day before the examination twice called to confirm the appointment. In the meantime, another patient W wanted an urgent CT scan appointment, but could not be adjusted since the day’s bookings were full. Patient W decided to get the scan done elsewhere. On the day of the study, patient Z did not turn up till 7.15AM. The centre called his place only to find that he was still asleep and didn’t feel like getting up to come for the study – his wife said, “he will come at 8.00AM when he wakes up.” The centre cancelled his appointment and the doctor decided to sue the patient for recovery of lost income. As the lawyer puts it. “the patient showed complete disrespect for the system and because of this, the doctor also lost income from another patient who could have been accommodated if patient Z had been more responsible.”

3. The Indian Insurance Company versus Patient M

Patient M had an MRI examination done for the spine and Doctor F’s report mentioned a comparison with a previous scan performed two years ago for the same problem, which was a disc herniation. The patient this time got operated within 20 days of the MRI scan and decided to use his medical insurance, which he had procured just a year and a half ago. The agent told him that the claim would be rejected since the MRI report made it clear that this was a long-standing, two-year old problem. He came back to Doctor F and asked him to change the report so as not to reflect the comparison. Doctor F refused saying that it would not be correct. The patient abused him and also pressurized the operating surgeon to talk to Doctor F. Fed up and fearing future problems, doctor F filed a complaint about patient M with The Indian Insurance Company. In the meantime, patient M had forged the doctor’s signature on another report and submitted the claim. When the insurance company realized this, they filed a suit against the patient for misrepresentation, doctor F being their star witness.

4. Doctor N versus relatives of Patient E

Patient E came to doctor N, an oncologist, with a diagnosis of presumed carcinoma ovary. Since the tumor was big, the patient was explained that the best course would be to take chemotherapy to reduce the tumor size, after which a surgery would be necessary. The relatives were explained this in detail. An uncle of patient E, a very influential individual, pooh-poohed “all this allopathy” and convinced the patient and her husband that chemotherapy itself would kill her. Instead he started them on some “Umerkhadi” medicine. After three months, the patient found her abdomen distending; her cancer had spread into the peritoneum. She went back to the oncologist, who was extremely upset. This had happened once too often and frustrated she decided to file a suit against the uncle who was responsible for converting a potentially treatable situation into a non-treatable disease.
5. Doctor P versus relatives of patient S
Patient S was admitted with acute severe pancreatitis in the ICU of the hospital under doctor P. The relatives were explained in detail that this condition was potentially fatal and worse than having a “heart attack” or “stroke” – the treatment would also cost upwards of around Rs 3 lakhs. The doctor visited the patient at least twice a day, made sure that the necessary investigations were carried out, had him operated for necrosectomy and as his vital organs started failing one by one, made sure that the best specialists for the other organs were available. Despite his best efforts, the patient died after three weeks. He had constantly been in touch with the relatives and appraised them of the situation everyday. When the doctor told them of the patient’s death, the brother and father pushed him around outside the ICU and loudly blamed him for the patient’s death. Doctor P was upset and shocked; assuming this was a reaction to the death, he let it go. However two days after the cremation, they barged into this office and again abused him. Doctor P could not take this any longer; he filed a police complaint for physical harassment and then a suit against them for physical and mental abuse.
6. Doctor O versus The Morning Times
The Morning Times ran a report of how Doctor O had killed a patient during a CT guided biopsy. According to the report, the biopsy needle went into the heart, puncturing it and the patient bled to death. Doctor O was never approached for his side of the story and the entire article was based on the information given by the patients and their relatives. The article went on to blame the doctor and cast aspersions on his method of working and his ethics. What the article did not mention was that the autopsy done two days after the incident had shown a completely coincidental myocardial infarct (heart attack), which had nothing to do with the procedure. When doctor O went to meet the editor of the newspaper with this information, the editor kept him waiting for three hours and was then extremely rude and abusive, the abuse carrying over to the entire medical profession. Doctor O approached the Consultant Doctors Association. When the CDA tried to meet the editor, they were given the same rude treatment and the editor and journalist refused to file a retraction; they refused to even look at the evidence. With no recourse, doctor O with the help of the CDA filed a suit against the relatives of the patient and the Morning Times for a compensation of Rs 5 crores, for slander and resultant loss of practice.
There are many more such cases in the civil and criminal courts.

Doctors are soft targets; they are highly educated and intelligent, but not organized and unionized. Everyone, the patients, the insurance companies, the hospitals and their administrators, the government, the taxmen, etc., tries to take advantage of them. It is time they fought back and it is likely that we will see more cases like these in the future.

One Comment

  • I am trying to write an article in medical journal on Media influence on public. The attacks on doctors and hospitals increased drastically in Andhra pradesh after a Telugu movie ‘Tagore’. This movie will be remade into Hindi movie. I predict this will unleash another flux of attacks on doctors and hospitals in the Hindi belt.

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