Opinion
If our doctors were a little more caring...
Even five years ago I did not think that I would go abroad for medical treatment. But in the end I could not hold onto my resolution.
On May 20, 1999 I had the privilege to participate in a round table meeting on "Why our patients go abroad for treatment and how to reduce this tendency?" -- organized by the Bhorer Kagoj and Public Health Association of Bangladesh -- Forum of Health Care of Financing. In this round table, around 30 renowned speakers expressed their opinions regarding the issue and recommended a number of suggestions for the government, non-government organizations and general practitioners as well as for other public health specialists to overcome the challenge. In that occasion, I was very bold to mention, "I wouldn't go abroad for my treatment if only our doctors show some sincerity, treat the patients with certain dignity and care." The participants of the round table meeting also highlighted the issues of quality and availability of medicines and the reliability of the pathological reports. Doctors also need to be accountable for the treatment they provide and this is seriously lacking in our country, where doctors are not punished for malpractice. If doctors in our country were held accountable for malpractice, if any then maybe they would take more caution and care in their treatments.
Around mid-November 2002, I began experiencing "double vision". As someone who has not yet had the need for glasses except reading glasses, my first conclusion was that I needed to get my vision checked. So I went to our family ophthalmologist, whom my husband and two daughters have regularly seen for the past nine years. Upon examination, he did not find anything wrong with my vision and could not explain the cause of my double vision, and hence referred me to a neurologist.
The neurologist made me take several tests, such as routine blood, urine tests, X- rays of skull, sinuses etc. Based on the test reports he treated me for sinuses, but the double vision still remained.
While I was with the specialist and waiting for my turn to be examined, I had some observation regarding the patient-doctor relationship. The doctor hardly touched the patients or even had an eye-to-eye communication with them. As soon as the patient approached him, he immediately started to prescribe 7-8 medicines (God only knows how many of them were really necessary) and checked for several pathological tests in a sheet/form, while the patient, depending on the level of education or socio-economic ability, tried somehow to describe his or her health problem. The doctor, aware of the long queue of patients, hurried the examination process without any introduction or explanation of the treatment he was prescribing. The lack of communication was very painful. I also observed that even though the doctor was examining/touching some patients, he did not bother to wash his hands in the wash basin which was just half a meter away behind him. The behaviour and attitude of these professors/doctors were totally unacceptable!
Initially, I was impressed with the waiting room, with the seating arrangement, TV and even a junior doctor taking histories of the patients before arrival of the professor or the specialist, in one of the diagnostic centres in Dhaka. The following day, my doctor also consulted another specialist regarding my problem. Even though I felt that the doctor did indeed give me time, and I did feel fortunate, however the doctors did not make an effort to discuss my condition with me. They were discussing my condition in front of me, without including me in the conversation, or acting like I was not there. It was hard not to lose my confidence in them after that. To me, it appeared that both the doctors were taking a shot in the dark. I lost my enthusiasm and faith in their consultation and advice.
Until this moment, I was determined to continue my treatment in Bangladesh. But I was disappointed in the poor patient-doctor relationship, and the attitude/behaviour of the doctors in general.
I talked to several of my colleagues regarding my condition for their suggestions; most of them had skeptical comments about the doctors in our country. Even a colleague of mine, also a doctor, advised me not to go to a well known, reputed doctor, saying that he would not even give me "six seconds of his time". If that is the reputation of even the best of our doctors, then is it a wonder that so many of us are losing faith in them and turning to other countries for our medical needs?
In the meantime, several family members and friends, who had all shared their negative experiences with local medical facilities and doctors, encouraged me to go abroad for a medical check-up. Initially I was hesitant in going abroad for treatment, but after my experience and the continued persuasion by others, I finally decided to go to Bangkok.
My first impression of Bumrungrad Hospital in Bangkok, Thailand, was that of a trust of the doctors, which I had not felt in Dhaka. I began thinking about why I felt this way. It was not hard to attribute my sense of trust and satisfaction to the clean and hygienic facilities and environment of the hospital, but most importantly, the behaviour of the doctors. From the very first day that I was there, the doctors and nurses treated me with much care and consideration. Not only did they perform a thorough medical check-up with comprehensive tests and treatment, but they also explained each procedure to me every step of the way and were extremely attentive listeners. It was unbelievably comforting to being listened to for more than 'six seconds' and have doctors regularly consulting with me, and actually treating me like a patient with genuine need and concern.
During my 10-day stay at the Bumrungrad hospital, I met several Bangladeshi patients who had come to Bangkok because they felt they could not trust the doctors at home or they had suffered from wrong treatment in Dhaka. One female patient who was in the same room with me, suffered from simple urine infection. This was simply embarrassing as the doctors in BG Hospital wondered if in Bangladesh simple urine infection could not be detected! I felt sorry just thinking about these middle class families spending their money for a good treatment! We are spending thousands of dollars abroad just for simple treatment and good behaviour from doctors!
I have returned home with the same problem of double vision as when I left for Bangkok, and the only apparent solution is lots of time and rest. In the end, many of the treatments prescribed by the Bumrungrad doctors were the same as the advice of my Dhaka doctors, but just the manner in which the treatments were provided was enough to secure my trust in the former. I wish I had had the confidence in our own doctors so that I would not have had to make the journey to Bangkok for this treatment.
I would like to reiterate that it is not that I think that our doctors lack in ability or qualifications. It is rather that I think there needs to be an improvement in the patient-doctor relationship, as well as the communication skills of doctors in our country. Doctors need to think of their patients as fellow humans and compatriots who deserve their attention and sincerity.
Nazma Kabir, PhD is a resident of Gulshan.
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