M*-powered patients & Fearsome doctors !
December 4, 2024 by dr s venkatesan
The following thought, is in response to a spate of violent attacks by patients on the doctors in my state. One of my ex-colleagues, an Oncologist was stabbed with a knife by a son of an elderly mother in his clinic room, apparently agitated with the side effects of the chemotherapeutic drugs she was receiving for end-stage Hodgkin’s lymphoma. The other case was a young gynecologist attacked for the loss of a newborn baby due to obstructed labor, again alleging wrong care.
A chilling concern and a confession
While doctors work day in and day out for the welfare of the patients, it is inevitable that forces beyond their control and some systemic issues do bring some adverse impact. Critical decisions are taken on a moment to moment basis, guided by their experience ,Intuition, trust, and belief, of course with learned skill and expertise. It is estimated that doctors work with a knowledge base calculated at best 20 % for most illnesses. ( BMJ 2022;376:o702) So, we primarily work with what we don’t know, rather than what we know. Unfortunately, no doctor would like to tell this, and no patient wants to hear this. But one thing is certain. No doctor can ever harm a patient intentionally, even in dreams.
However, errors in judgment and negligence, along with some casualness due to physical and mental stress, do happen. To be honest, it is more common than anyone can guess. Fortunately, the bulk of these errors are not reported and either self-heal or are rectified internally without reporting. I can also say with conviction that doctors are humble souls, and most of them carry the guilt of a true error lifelong and take every step to prevent it from recurring. (Recalling the tragic story of an honest gynecologist Dr Archana sharma who committed suicide due to mob shaming)
Minimizing such harm is one of the major goal of every doctor and institutions. However, it can not be eliminated completely at any state of imagination.(It is like climate change in environment or corruption in politics) To repeat this statement ,No doctors can harm a patient intentionally, complications, and errors are like high way accidents .Request the patients to please understand this simple truth. Many patients do, many don’t.
The problem with many patients are ,they are unaware, that doctors often practice medicine with incomplete knowledge. To be very frank, many times it turns out to be , sort of therapeutic experiment with inherent risk at every stage .The present day patients want to know ,what the doctors themselves do not know.
There is new emerging issue. the current generation of patients in our part of the world ,carry a huge and unrealistic expectation along with lowest level of tolerance. Armed with artificial ignorance fed by digital doctors ,they think if you have money power, we can cure any disease. . It has gone to the extent , they are not able to accept even the natural history of untreatable and end-stage diseases. Some of them harbor a dangerous thought ,that no patient dies in a hospital instead ,he gets killed by mis-management.
“One of the important reasons for this miscommunication, squarely lies with us. We need to admit, un-intentional errors is indeed a big problem in medical profession, as in any other field”
Final message
Even serious errors in other public departments like transport, economics , Judiciary , police ( even intentional criminal acts by individuals ) are casually taken by the public and readily forgotten or forgiven. While ,the tragic truth in our profession is, patients are never ready to forgive even small errors by doctors who have dedicated their entire life for patient welfare. Unless something dramatically happen that change people’s perception about medical profession ,we are heading towards very tough times.
Reference
*Money (Empowered)
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- Source: https://drsvenkatesan.com/2024/12/04/m-powered-patients-fearsome-doctors/