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CHOOSE YOUR DOCTOR - II, (February, 2005)

Apart from having requisite accredited qualification and experience and specifically registration with The Medical Council, with a Registration Number, there are many other more important attributes needed for a good medical professional. Delivering "quality medical care" consistent with the currently accepted standards is probably the most important attribute you should look for in your doctor.

 

Delivering quality:
As a lay person, it is not easy to decide if your doctor is delivering quality medical care. Generally a doctor's competency is decided by his "reputation" which is merely the words of satisfied clients over a period of time. It is appreciation spread by word of mouth by the clients of a doctor. If the client happens to be a socially or politically important person the "reputation" a doctor earns is considerable. Over a period of time his reputation builds up like a tower. But in any doctor's life, while treating his patients, complications do set in; rarely an error of judgement may result in a serious complication or even fatality. This mishap may occur in spite of taking all possible measures and precautions. And this one single episode is sometimes enough to destroy a reputation built over a lifetime! Hence obviously this more or less accepted method - his reputation, in deciding on one's doctor is not good.

Let us now see, how else we can choose our doctor. If specialist medical care is needed, like a cardiologist or a surgeon, the family doctor is generally the best person to assist you, provided you have a good family doctor. The family doctor, who usually has information on and interaction with his professional colleagues can critically assess other specialists and direct and refer you to a good specialist doctor. You may even discuss the professional competence and any other information about the specialist with your family doctor who usually is expected to be like a family friend to you.

Guidelines to directly evaluate your doctor :
Your consultation with the doctor: A doctor who talks to you unhurriedly, examines you in detail and peruses all your previous medical records is considered to be systematic and thorough in his clinical examination. Such a doctor is more likely to be able to make the correct "diagnosis" - which means he can conclude what exactly is your ailment or the disease you are suffering from. Apart from making "diagnosis', he often makes "differential diagnosis" , which means other possibilities, in case further tests reveal that his " diagnosis" was not quite correct. Depending on his diagnosis and differential diagnosis a good doctor will order for "relevant " tests or investigations. These tests like blood tests, x-rays, scans etc will help to finalise and decide the final and correct diagnosis. Only when the doctor is sure what the diagnosis is, he can give specific and correct treatment. A bad or inefficient doctor does not examine you thoroughly, has no time to listen to all your "stories" and does not arrive at any specific diagnosis or differential diagnosis and orders a long list of tests and investigations which may not have any bearing on the disease/suspected diseases or conditions that you may be suffering from. Some of these tests are quite expensive and unnecessary. Some of them are ordered with a view to benefit himself or his friends financially. You as a patient have every right to ask your doctor to tell you what you are suffering from and why he is ordering any tests. Sometimes the doctor may get angry with you, when you ask these questions. But a good doctor is usually willing to answer all your questions, unless you are impolite.

Treatment - medicines, diet, other measures, surgery etc.

Correct treatment is based on precise diagnosis. But quite often, the doctor may not be able to pinpoint the diagnosis at the first consultation. He may have to wait for the results of the tests & investigations. However, if the situation demands that he start immediate treatment, he would do so based on his "provisional diagnosis" and subject to modifications after seeing the results of tests. In situations where there is no urgency to start immediate therapy, treatment would start only after arriving at a "final" diagnosis. Often, non emergency surgeries are performed after completing all investigations and fixing up a mutually convenient (sometimes auspicious) date and time.

A good doctor will discuss with you the diagnosis as well as treatment plan and give you precise instructions to follow. In cases of medical treatment, his written prescriptions should be clear and legible; dosage and frequency and method of taking medications ( eg. before or after food or at bedtime & so on). It is also his duty to warn you of any possible side effects or complications and what to do in such situation. The doctor or his competent assistant/associate should be available in case of any emergency. Any do's and don't's, particularly regarding diet and work or bed rest are also essential information needed to be given by the physician.

If at the conclusion of treatment, whether you have fully recovered or not, you are also "satisfied" with the overall care given, you have possibly been treated by a "good doctor". But even though you recovered from your illness, "in spite of" your doctor's treatment/surgery or whatever, if you are quite unhappy with some aspects of your interaction with your doctor, it is possible that your doctor was not quite good. Apart from technical competency and skill as a doctor/specialist, his personal rapport with the patient and his family members are important factors in "delivering quality service". You recover from disease/ illness to some extent by the medications given; but to a considerable extent by the overall kindness, concern shown by the doctor!

So, apart from proper certified qualification and experience a good doctor should be able to deliver quality medical service.

Some more attributes of a "good doctor" will be described in forthcoming newsletters.

Be Healthy; be well informed and get treated by good doctors!

Dr. M.Mohan Rao, MBBS,MS,FICS,MCH,

Surgeon (Retired) & Director,Dr. U Mohan Rau Memorial Hospital.
E-mail: mmr@mohanraohospital.com




 

  

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