Introduction Healthcare in India has grown by leaps and bounds, gone are the days when the family doctor used to or could handle every ailment. The developments in the healthcare Industry, accessibility and privatization have brought in a new range of specialists and super-specialists. This coupled with the concept of viewing healthcare as a business model had made healthcare the subject of debate and controversies in terms of the standard of care and the cost of treatment.
In India, currently, we have an option of going to our regular family doctor who is known to us or our family members or go to a government institution or a private hospital. Given that India is a land of diversity, healthcare is no exception to this rule. One can have a medical consultation at free or cost or would have to shell out anywhere from Rs 20-50 to Rs 1500-2500 depending on the place and the brand value of the doctor or the hospital. Both extremes are accepted.
Key aspects around a medical consultation Most of us would have visited a doctor in the clinic or the outpatient chambers and would have reached home only to find that there are many aspects of it not clear. Some of us feel that the consultant was not worth the money charged. During November 2017, there was a report published in a popular British medical Journal that primary care doctors in India see patients for around 2 minutes only. This would give a rough idea of how time would be spent during a specialist consultation on an average, not much at least from the patient's viewpoint. One can follow simple but effective steps that can help you get the best out of a medical consultation.
1. Generalist vs. Specialist Many people rush to see a specialist for common colds and fevers that would often be unnecessary in the first place. Please find a good doctor who would be a family physician or a general practitioner whom you can visit for minor ailments. Only if a simple headache, fever, persistent cough does not resolve as expected or worsens then do plan to visit a specialist. If for example there is a lump in the breast or an abnormal swelling that hasn't been adequately addressed or there is a worry that it could be cancer, then, by all means, visit a specialist. Apart from the cost difference, you should bear in mind that the specialist has a focused knowledge of a particular branch and would not be able to manage every common ailment.
2. Government vs. Private There is a never-ending debate on the pros and cons of government and private hospitals. The common factors that would influence your choice would be affordability, accessibility, quality of care, waiting for times and availability of resources including doctors and specialist and sophisticated types of equipment. There are excellent government hospitals and private in the country but all of us would not have access to such quality hospitals and there are bad apples in both sectors. Based on where you are you can choose one of them.
3. Selecting a doctor If you have time and it is a specific complaint, try and find out which hospital or which doctor would be a good choice among the ones that you can potentially visit. This information is now relatively easy to get from the hospital websites, family, and friends, local general practitioners. Every doctor has an area of professional specialization and each has a good reputation based on his or her results over a period of time.
4. Emergency vs. Elective There are certain ailments that cannot wait for you to do a background check. For instance, severe abdominal pain, vomiting, high fever, chest pain or major injuries would need quick attention and appropriate timely care. Please do not waste time, visit the nearest major hospital. Some conditions (Elective) can wait and you have time at disposal to choose a good specialist. For instance, being diagnosed to be a diabetic or high cholesterol levels, stones in the gallbladder by your general practitioner gives you a chance to find out more about your condition and also find the suitable specialist for that.
5. Booking the appointment Many people try and book an appointment based on their convenient time, after office hours, late evening appointments or the last slots. Although this saves you time, there would be delays and other issues that finally mean that you will have a hurried consultation and not able to get a fruitful consultation Imagine going to the bank or the government office just before closing time, then you would understand the scenario and dynamics in the clinic or the outpatient department. If possible try and book one of the first few slots of the day when the doctor is fresh and there isn't a large crowd or delays from previous patients
6. Punctuality A lot of mistakes happen on both sides leading to an unpleasant experience wherein both doctor and patient start off on the wrong foot and do not have a good result in the end. Be on time so that you get a chance to familiarize with the place, calm down and have a few minutes to gather your thoughts. Even if the doctor is late, which happens often, at least, the patients after you would not be delayed because of you.
7. Be prepared and organized. Many patients walk into the consultation room and then have to think about the tablets their mother is taking or the surgery that was done a few years back or don't anything about cancer that was diagnosed in a close relative or a cousin etc. This unnecessarily causes delays and stalls the progress on consultation. Please make a simple list of all the important events that have happened in the medical history (drugs are taken, allergies, thyroid disease, a stent in the heart, stone in the kidney) and write it down neatly or arrange the relevant papers in chronological order. Please try to keep the file as meaningful as possible. Imagine you sitting in the doctor's chair, having to flip through pages of payment recipient, medical shop bills, and hospital bills just to find out what the sugar value or ultrasound report was a few months back. you would certainly be annoyed. Keep things simple and focus on relevance and clarity.
8. Time is short We would like to have all the time in the world to talk to the doctor about everything that crosses our minds. But please remember that the consultation time is limited and in this time the doctor and you should have an exchange of information, an examination, a working plan formulated, an explanation given and a consultant report with a prescription also be issued. All this will give you time only the get a limited number of answers. So, please make a short mental list of questions to be asked, instead of 3-5 relatives speaking to the doctor, let one or two people speak in turns getting all the relevant details, tests to be done, medications to be taken. Before the doctor begins to examine you please mention the allergies or other illnesses for which you have had treatment or currently undergoing treatment.
9. Last minute queries Once you leave the doctor's chamber on the way out or while buying medications, you would have some doubts, some people try to barge into the doctor's room without respecting the privacy or confidentiality of the patient sitting inside, sometimes in the middle of an examination where the patient would not be dressed fully. This lead to embarrassing situations, have patience and try to get help for the doctors assistant or the nurse in charge or the pharmacist to help you. If not, please wait for your turn to get in for a minute for clarifications.
10. Check your belongings
Often, being pre-occupied with the consultation and the information given, people tend to forget important medical documents, previous CT scan films, biopsy reports or mobiles etc. Please check once before you leave the room that you have indeed collected all your belongings.
11. Contact information
Before you leave the reception counter or the premises, please collect contact numbers for the clinic, laboratory and the reports section that would be useful to you. If possible please ask the contact number of one team member of the treating doctor or an emergency contact number for the clinic or the hospital.
A follow-up visit is often frowned upon by some patients as to why should we visit the doctor when everything is well. A follow-up visit would be important in many cases to review the tests ordered, the see if the condition has settled down as excepted. Often new findings emerge after investigations that would need further attention. For example, an Ultrasound to investigate gallstone related illness may throw up a large stone in the kidneys or an abnormality in the uterus or ovaries which would need another referral to a specialist. Certain conditions like cancer and chronic illness need regular follow-up ranging from once in three months to once in a year. If you plan a follow-up visit and it's a busy hospital or clinic, you can book your return visit as you leave the hospital, it saves the hassle of calling back or leaving it for another day.
11. Second opinion
Both doctor and patient are humans, one may not be happy with what has been done so far. Nothing is lost, you can always seek a second opinion provided you have the time and resources.
In summary, the need to visit a doctor or a specialist for something more than a common cold or fever would arise at some point in time. Keeping in mind the cost of consultation and the limited time at hand, if one bears in mind the above, their consultation would be more beneficial and help both the patient and the doctor.
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