Of Doctors & Patients – Effects and Side Effects !
Columns, Over A Cup of Evening Tea

Of Doctors & Patients – Effects and Side Effects !

By Dr. K. Javeed Nayeem, MD

These are days when one of the greatest relationships that once existed between doctors and patients has become one of the greatest divides. Contrary to what most folks think, this is not just in our country but across the entire world. The reasons for this sad state of affairs are many and they vary from country to country depending on how the medical treatment system works there. Much has been spoken and written about how patients view their doctors as exploiters who advise them to go through unnecessary tests and investigations which are very expensive too. So I will not harp on this issue here.

What I would like to highlight here is the apprehension that a great many patients build up these days when it comes to taking simple drugs which they have been using over many decades without inflicting any harm upon themselves. Because of the internet which has now actually become an extension of the body, thanks to the ubiquitous smart phone, most people who accompany patients to doctors’ chambers begin looking up details of the drugs even as the doctors start writing the prescriptions.

Unfortunately, this seems to be particularly true in my case as I have the habit of writing all my prescriptions slowly in very clear capital letters ! So anyone who decides to know more about the drugs that I prescribe actually types at a faster speed than my writing, pausing to let me to finish. Very often the auto-complete feature in the phone takes over and spares him or her this agony. By the time I decide on the dosage and the frequency of the drug the smart person would have decided whether the drug is worthy of being taken or not !

Before leaving my consulting room they ask me whether all those drugs in my prescription are really necessary and safe too because kind-hearted Google tells them that they are capable of causing much harm by way of side effects. Earlier, when this situation was still more of an exception than a rule I used to take pains to reassure them by explaining that most of those side effects are extremely rare and easily manageable. Then when this problem became more common, I had to come up with a new solution. I now ask them to first look up the side effects of some of the very common ‘over the counter’ medications which they take for their colds, coughs and fevers. That is when they look up at me with panic and say that they never knew that they were exposing themselves to so much danger. I have therefore found this strategy very useful in my practice. You’ll see why.

The most commonly used drug, Paracetamol or Acetaminophen that is present in almost every formulation taken by most people for their aches, pains, fevers and colds can be a killer too. I say this because the internet says so ! At its mildest, it can cause severe itching, rashes, disfiguring dark patches all over the body, mouth ulcers and very painful and ugly blisters that refuse to go away even with years of very expensive treatment. At its worst, it can cause your skin to peel off and all your fingertips to rot and your nails to fall off. It can also cause bloody stools and urine, severe jaundice and a very painful death due to liver failure.

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Now, how is that for a fearful picture of what hell can be? But all this does not have to happen and it does not happen to the millions of paracetamol users across the world. It is only a theoretical possibility. But it is the duty of the internet to give you all the information related to your query. It is up to you to weigh the risks and to sift the grain from the chaff and decide whether to take the drug with the attendant risks or suffer the pain and discomfort of not taking it.

Let me make one thing very loud and clear. The human mind may be capable of doing amazing things. But it also suffers from a very amazing weakness. Once you put a tiny element of doubt into it you can cripple it miserably. That is why people ruin their lives when they begin to suspect the sincerity and honesty of their friends or even the fidelity of their spouses instead of trusting them. That is why people suffer so much when they are unsure of what can happen to them. And, that is also why even the most incapable astrologers are so much in demand even by some of the most educated people !

Your internet information about the drug prescribed to you can nag you like nothing else can. I have seen it driving people nuts by making them lose sleep over the dilemma of whether to take a drug or not. And, even when they do take it, they invariably begin to imagine that they are experiencing all the side effects mentioned by the internet !

But the funniest and perhaps the stupidest thing is that even people who are apprehensive of taking drugs prescribed by fully qualified doctors do not mind eating what can literally be called rubbish on the roadside. They eat fiery, spice-laden chats and street foods and quench the fire in their bellies with water teeming with all kinds of bacteria and viruses. They do not give a second thought to what additives go into their food as long as these give an irresistible taste to it. They smoke and drink without the least restraint and without daring to ask dear Google what these two partners in crime can do to their minds and bodies. They sniff in lethal snuff and also munch on mouthfuls of tobacco, fully aware that they are only inviting a painful death.

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They happily gorge themselves on food served at lavish wedding feasts without checking if it has been prepared hygienically or not. Actually, it is at such feasts where hygiene is compromised most. A simple peep behind the curtains will show you what I mean. Even the most educated and enlightened people will not only gobble up large quantities of processed foods themselves every passing day but also let their children grow up on chemical-laden foods that they should not even be touching in their childhood. This is the bane of leading life on the fast lane where cooking themselves proper meals is near impossible amid their busy schedules.

People smear themselves with layers upon layers of sweet smelling cosmetics and dye their hair with hues that can put a rainbow to shame without bothering to know if they can cause cancers which they actually can. When people go to their doctors with aches and pains most of them are not happy with the reassurance that they are just nuisances and are best left untreated. They expect this reassurance to at least be supported by an accurate diagnosis. So many people, just because they do not mind spending money, insist on getting CT scans done for the most trivial problems. When it comes to scans the CT scan is a hot favourite unlike the MRI which is considerably more expensive and cumbersome although relatively less harmful.

The humble ultrasound scan, the most harmless and yet the most useful of all scans, is something that they relegate to the dustbin because it has been around for too long now and is now found at every street corner. Besides, because it costs just around five hundred rupees or even less they think it is infra dig to go through one ! They think that a CT scan is a magic eye that sees through their bodies and shows up every single malformation and malfunction. It is actually not so. Almost none of them know that in that unnecessary CT scan lurks a great deal of danger because one CT scan exposes their bodies to a dose of radiation equivalent to the radiation from several hundred x-rays.

So, what is the solution to this problem now? Let me tell you that the best approach is to trust your doctor and follow his or her advice as something given in good faith. It may have its inherent dangers no doubt but they are very minimal. They are certainly not as dangerous as the hidden dangers lurking all around you from which there is just no escape !

e-mail: [email protected]

February 16, 2019

11 COMMENTS ON THIS POST To “Of Doctors & Patients – Effects and Side Effects !”

  1. Strangeworld says:

    Trust an Indian doctor, that too some one who usually looks very obese and very sickly and who needs the treatment himself? No wonder, people with money do not waste it on Indian doctors who usually do not have any clue and Indian prescription medicines which have no effect, and go to Singapore.If you see actors like Ambarish going to Singapore, politicians like Jaitley going to America for treatment, you wonder about Indian doctors capability. After all, many of them come through the reservation route based on their caste and not on merit.

  2. Uma says:

    We can’t generalize that an indian Doctor is good or not,! There are exceptionally good doctors and there are the ones who were just earned a degree and a Job on a reservation quota! Now the greedy hospitals who want to convert simple visits to fatal illness that expensive hospitals, the drug industry who bribe the doctors to write unwanted tests and medications., it has made it more complicated ! Politicans go abroad for treatment vacates of 2 reasons! 1. Public money and 2. They don’t want to be the victim of thei evil reservation system they promoted. A reservation Doctor may I’ll them by his stupidity and the merited doctors definitely hate the politicians because of the hurdles and descrimination they have to face because of such scumbags!

    • Strangeworld says:

      Most Indian doctors are worse, rude and greedy. It is not only politicians, even reasonably rich people go to Singapore for treatment. You simply do not want to acknowledge this, perhaps another Indian doctor with an axe to grind? Reservation system came into being because of the agitation of the SC/ST mob and by so called backward class bunch themselves and politicians responded to that. Simply blaming drug industry is sheer wickedness, as if a doctor is honest and sincere, he/she will reject any such bribe Doctors and the private clinics should accept that these tests are a means of earning money.. In Mysuru alone there are a large number of private hospitals and clinics, and each can fleece the poor patients through such tests with the connivance of doctors who work there.
      What is the meaning of this sentence: ” Politicans go abroad for treatment vacates of 2 reasons! ” You need some English tuition, besides thinking well before you reply.

      • Sunil says:

        India is one of the major referred destinations for medical tourism every year tens of thousands of people from USA, Europe and Australia, and from all over the world to get some complicated surgeries like heart, lung, kidney and many other organs! Even in USA, Europe, Singapore, and Australia many successful doctors are Indians who could not survive in the corrupt Indian medical system! The people who come to India for treatments , don’t go to government run hospitals as many doctors are not from the merit quota and many have bribed to be there and collecting the money!
        Even in Bangalore, jayadeva hospital, narayana hridayalaya are world class!
        Yes, you are right, many of the government doctors are rude because if they are nice you may ask more questions for which they don’t know the answer .
        Yes, if you are looking for psychiatric treatment, then, probably India may not be a good option!You may find the doctors very rude and greedy too!
        Many politicians go abroad because it is “Yaarado duddu yellammana jaatre”
        Filthy rich people go there because cleanliness of the hospitals are much better in foreign countries and also what is the amassed wealth for if they can’t spend it?

        • What a World! says:

          Deluded comment, does not merit a reply. Indian hospitals have infection problems on an industrial case. Keep hallucinating, those who go abroad are not fools unlike you!

  3. What a World! says:

    correction: industrial scale.
    Your inclusion of Europe there tells me, you are so ignorant. Pathetic too in your verbose post. In Europe, healthcare is free for its citizens, and is available on demand and it is excellent.
    West European hospitals unlike USA, do not charge to treat emergency problems of tourists. This loop hole is exploited by Indian so called tourists, they are health tourists with severe problems actually, who come to countries like Germany, Belgium, Netherlands and UK, and declare themselves very ill by calling the accident and emergency unit of large hospitals. Many have walked out free with operations performed free of cost by excellent surgeons. have never come across , even a single Indian tourist, who has not approached the accident and emergency care for his /her chronic health problem declaring it as emergency .
    As I said, keep hallucinating.

  4. Manava says:

    @Sunil is blindsided and believes what he hears, which in India is almost propaganda, dished out by very ministers, who go abroad if they get health problems!! Those working in the USA have medical insurance, and those who cannot pay there simply cross to Mexico and get a better healthcare than what they would get in India. No fear of catching MRSA in India! Australia has excellent healthcare, available almost free for its citizens just like in Western Europe. The hapless , Indians and a few Arabs in Gulf States may come to India, but even they who can afford can go to hospitals in Western Europe who charge less and give excellent healthcare- minus MRSA. No stray dogs wandering to bite them adding rabies to he list of ailments! Talking about Singapore, one could see Indian doctors taking their sons or duaghters who have health problems to get treatments from the excellent hospitals there.

  5. Rao says:

    Its just not Indian doctors, its same with engineers/scientists/ administrators/ police etc.
    Its a fact that most likely chances of being treated by an Indian Origin Doctor in Western Countries hospital is high; we probably wont trust the same doctor if at all same doctor treats in one of the Indian hospital. The system cant let him to perform properly. System here includes aam admi as well.
    People thinking that people all over the world are coming to India for treatment are living in denial and seems to be graduated from Whatsapp university.
    People come to India only on cases where their countries treatment is worst (African/ few Middle eastern countries/ South Asian countries).
    Western European countries people come mostly for Surrogacy etc. which is very difficult in their countries due to strict protocols etc.

    • What a World! says:

      Indian-origin doctors coming to Western countries have to prove that they have acquired he required Western standards of education and training by passing the entry exams.in these countries It does not stop there, for most, as there are board certificate exams too in specialities or for general practice. There is no automatic recognition of Indian medical qualifications any more. Thus, there is a set of filtration process.

  6. Raghu says:

    Medical Tourism is one of the most booming tourism sector in India It is currently valued at $3 billion and is expected to touch the 8 billion mark by 2020.
    he government also promoted medical tourism by organizing the promotional campaign and wellness shows. Recently , its reported the government said, that the value of medical tourism in India is likely to touch USD 9 billion by 2020 forecast as compared to the USD 3 billion in 2015
    Medical Tourism is more popular as Patients are seeking better and cheaper options for treatment in India.
    Skilled doctors.
    Low-cost treatment.
    superlative healthcare infrastructure.
    India show exponential growth in medical tourism sector –the next crown jewel–that could shape the future of India’s economy and health care.
    I want to share some of the key highlight factors that contribute towards increasing Medical Tourism in India
    Internationally accredited medical facilities using the latest technologies.
    Highly qualified Physicians/Surgeons and hospital support staff.
    Significant cost savings compared to domestic private healthcare.
    Medical treatment costs in India are lower by at least 60-80% when compared to similar procedures in North America and the UK.
    Options for private room, translator, private chef, dedicated staff during your stay and many other tailor-made services.
    Can easily be combined with a holiday/business trip.
    Low Waiting Periods
    Some of the popular treatments are –
    Cardiology- Cardiological procedures like Non-Invasive Cardiology and Diagnostic, Invasive and Interventional Cardiology, Coronary Artery Bypass Graft (CABG), Heart Valve Replacement and Pediatric Cardiac Surgery are popular in India.
    Oncology – Cancer treatment
    Nephrology -Kidney related problems
    Orthopedics- Treatments like Knee Replacement, Total Hip Replacement/Partial Hip Replacement, Bone Marrow Transplant, etc.
    In India the popular destination for Medical treatment are (Chennai) Tamil Nadu, New Delhi, Maharashtra(Mumbai ), Gujarat(Ahmadabad) Goa, Bangalore, Hyderabad are the places popular with medical tourists traveling to India.
    The splendid combination of world-class technology, modern medical infrastructure, growing hospitality industries, experienced service and good quality medical attention has given impetus to the growth of medical in India. The dual opportunity of vacationing in some of the most tranquil locales, makes India a top choice for medical tourists.

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