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Of Docs and Quacks

Recently there was an article at Sulekha written by a doctor about the legal troubles and high insurance problems faced by doctors which affects their practice the quality of health care in USA. Another article in the Times of India also exposed the dearth of doctors in my current home-state Pennsylvania to attend ob-gyn cases due to the fear of malpractice suits. Most people [as evidence by the comments on the above mentioned article in Sulekha] immediately point out that this situation is brought about by the greed and negligence of the doctors and that they can very well afford to pay those insurance premiums.

Well, that may very well be. I know, as many horror stories about doctors as the next person, may be even more. I also happen to work at a Cancer hospital as a Biomedical engineer. During the course of my work, I meet several patients, interact with doctors and work together with nurses and technologists. And I have found that most doctors are pretty committed individuals who genuinely care about the patients. I have seen docs discuss cases enthusiastically late into the evening to confirm a doubtful diagnosis. I have seen doctors plan a course of treatment carefully weighing the pros and cons of the prescribed course to determine what is best for the patient.

But then again most doctors are scared people. They live under the terror of speaking a wrong word or inadvertently giving a wrong impression, either by word or expression, that might cause the patient to sue him. The golden rule while dealing with patients, I soon learnt was “Don’t say anything!!”. No wonder it is frustrating for patients who go to a doc suffering from aches and pains to get a disjointed or a vague response. Most doctors live under the threat of a lawsuit and the hassle and the cost of it soon make the number 1 priority of doctors to avoid the lawsuit. The treatment offered to the patient immediately becomes defensive.
In the United States, physicians and other medical professionals pay insurance premiums to cover payments for awards resulting from lawsuits. This liability insurance is a must[in several places it is a law] while practicing medicine ,similar to the fact that you need an auto insurance for your vehicle prior to buying or driving a car. If you work in a hospital, in most cases your hospital covers a part [or most ] of your insurance. However if you have an independent organisation or are into private practice that you pay this premium yourselves. The liability insurance rates for ob-gyns with a clean record in Philadelphia is approximately 100K a year as compared to the National average of ~ 60K. [Well, that does put my car insurance into perspective!!!]
The dearth of doctors in this area means that waiting for months before scheduling an appointment with your doctor. At times, even emergency cases get attended to only after a month or sometimes more. I have known cases that to get a regular x-ray one has to wait for 7 months in Philadelphia. This certainly compromises patient care. High insurance rates in a city cause the doctors to look elsewhere for setting up a clinic or if not charge prohibitive rates to the patients. In any case it is the patient who suffers.

I do not mean to condone the behaviours of greedy or lazy doctors but isn’t this also worth a thought that if patient care needs to be of the highest quality then docs should treat in an atmosphere where the first priority of the doctor is to treat their patients rather than cover their rear ends.

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