By Dr. K. Javeed Nayeem, MD

After I wrote my last article about the many fake doctors who were exposed and apprehended by the Police at Kolkata, I have received a spate of letters and phone calls from my readers asking me to write a follow up article guiding people about how they can ensure that they do not end up entrusting their health into the wrong hands, especially when it comes to selecting specialists. Many people have narrated seemingly harrowing experiences of how they were taken on very expensive and painful rides by some so-called reputed doctors which made me feel a little distressed myself. If what some of them have said is even partially true, I feel that we doctors have to do some soul searching to see on which side of the fence of ethics we are standing. 

Most of their grouses relate to what they felt was overcharging while some have talked of inappropriately or insufficiently qualified doctors embarking on treatment procedures which they were incapable of handling. They have talked of messed up outcomes of these procedures that proved very painful and expensive to them. Well, selecting the right doctor is not rocket science, especially for an educated person and it is therefore not very difficult. All it needs is some common sense. But sometimes common sense as we all know very well, can be very uncommon which is why we find many people making some very wrong choices and landing into trouble.

If you are not very averse to going to a very well-known and reputed hospital looking for the specialist you need, you are generally very safe. I say this because almost invariably, all reputed hospitals recruit their in-house consultants and duty doctors only after verifying their antecedents and qualifications thoroughly. They also ensure that every one of their visiting consultants too goes through this screening process before being empanelled with them. This ensures that inappropriately qualified or inadequately trained people do not end up bungling with the treatment of the patients who go there, trusting their own reputation.

But there are many members of the public who are very wary of visiting large hospitals. They fear that these are places which are inherently very expensive and which also order a large number of unnecessary tests and investigations to sustain their working costs and also to recover their huge investments. They are not entirely wrong as most large hospitals these days are self-contained, having all specialties under one roof and doing all their investigations themselves, not just to earn more but also to make things easy for themselves and their patients too.

But to do this they need to invest very heavily on their equipment and infrastructure. And, mind you when I say very heavily, I really mean it, as medical equipment is among the most short-lived and costliest things anyone can buy or maintain with its astronomical annual maintenance contracts. Moreover, to have a team of very good and capable specialists and retain them against the attractions of fiercely competing establishments, they have to pay them very well, which again adds to what their patients end up paying.

But the icing on the expensive cake is that patients do not have to run from pillar to post while getting treated and they can be sure that they are being treated by really competent doctors and not any black sheep in white coats! It may be interesting to note here that all these large hospitals, with their periodic internal audits, have perfected the subtle art of retaining only the star performing horses and tactfully showing the door to even the slightly lame ones in a remarkably short time! The additional advantage of going to large hospitals in these days of medical insurance is that most large hospitals honour the medical insurance policies of most reputed insurance companies. And, when it is the insurance company that settles the bills, patients too would prefer to have the best service without minding what clearly looks like a case of excess billing. It is a different matter that while discussing their treatment with their friends and relatives later the topic of their discussion always revolves only around how high the bill was! 

The next and certainly less expensive way of ensuring that you see a good doctor is to ensure that you check his or her reputation from your friends, relatives and acquaintances before embarking on your quest for medical treatment. You will find that reputations are usually right, especially if they are long standing ones. If everything goes well, the bonds between patients and their doctors are usually very strong and long-lasting and so the good word of mouth is usually worth trusting. 

But if you are in the least bit of doubt about what your doctor has studied or where he has acquired his or her training and experience, it is always best to open your mouth and ask the necessary questions without squirming with any embarrassment which can cost you dearly. The slightly tricky part here, while separating the grain from the chaff, is finding out if the doctor is appropriately qualified to treat the ailment you are going with. 

I say this because these days it has sadly become very common for some slightly unscrupulous real doctors to deliberately withhold some vital information while mentioning their qualifications. It is very rightly said that half the truth is often a very great lie! These are the grey sheep in the profession who bring a bad name to it and although they are armed with impressive looking postgraduate degrees after their names, they may not really be so appropriately qualified in the area of their practice. 

Although the Karnataka Private Medical Establishments Act (KPMEA) makes it mandatory for all doctors registered under it to mention the subjects in which they have earned their degrees, it almost never enforces this stipulation. It will not be an exaggeration if I say that this legislation is largely a toothless tiger which is only being misused by the government agencies to hound and harass honest and law-abiding private doctors and medical establishments. The best defence against all kinds of unscrupulous medical practice is to have a government maintained online medical registry, accessible to anyone and everyone and which at the click of a button makes everything, the good the bad and the ugly, about any doctor, known to everyone! This is how things are in most other countries today and that is why we do not find any wolves in sheep’s clothing there!

Note: Health, like climate is unpredictable, says a wag. It is like English weather, everybody complains about it but nobody does anything about it. Luck matters much. If you are lucky you don’t get sick and do not get life-threatening illness. If you are lucky, you get good doctors, if you are lucky you get properly diagnosed in time and get cured also. Money or expense is secondary even for a poor man in distress, says a reader. —Editor

e-mail: [email protected]