Treat your doc as god, but for heaven's sake ask questions
Seema Singh -
Monday, February 23, 2009 11:05 AM
Let me start with an anecdote.
Some three years ago, while researching for a story on clinical trials, I visited some hospitals in the city meeting doctors who ran human trials of new (also some old drugs for new indications) drugs. In each case I found several patients, not necessarily poor but visibly uninformed, relying totally on their doctors and soaking in their words as gospel truth. "You know the best," was the clichéd patient response.
Today, a new report in the journal Cancer (April 1 issue) says that when cancer (colorectal) patients seek out health information from the Internet and news media, they are better off in getting the latest, and by some stretch, the right treatment. I wonder what happens to people who don't have the (right) information?
Colon cancer is a good example where over screening and diagnosis can do more harm than good. "These findings emphasize the importance of exploring patient influence on physician prescribing patterns and understanding the impact of information seeking on cancer outcomes," the authors from the Dana-Farber Cancer Institute. Boston, and Universty of Pennsylvania write.
The findings can apply to breast cancer treatment in India. We are witnessing an explosion of screening centres, along with most existing diagnostics centres and hospitals providing "Women's executive health check up" or some such scheme, which invariably offer an X-ray without a physical examination. (A simple examination can rule out the need for an X-ray in normal cases with no family history.)
So, what's the way out? Does the onus lie on patients to be more informed or does it lie with the medical fraternity to spend more time and money on patient education and counseling?
For obvious reasons, it's difficult to expect the latter. Here's an example:
I once went to a doctor seeking medication for an allergy. To my mind, I explained everything reasonably well: "I am allergic to heat and chill. I get rashes. If you want to see I can climb stairs to the third floor, rashes would come; alternately, I can put my hand in front of the AC outlet in your cabin." Even before he could think, I did the latter and, wow! red rashes were all there for his close examination.
I elaborated further: "If I take Allegra-180 mg, I am fine for a week; if I take 120 mg, the effect lasts only 2 days. And I know I am not allergic to milk products, as I stopped them for five months and found no relief."
He gave me a weird look, as if saying, ‘you know a tad too much about your allergy'. "Here are some medicines (just a mix of anti-histamines), try them," he said, looking pretty unsure. I, though, was sure not to try them.
I walked out thinking, I did know a bit about my disease but I knew nothing about its treatment. And that's why I went to him!
"Allergy is Allah-ki-marzi" had said a family doc and I thought it better to leave it at that.
Bottomline: Not all diseases can be left entirely to God or doc, so, if possible, please go informed (to the doc, of course) and ask questions!
PS: What does your experience say?