Should doctors be made more accountable?
Dungarshi bhai Kapdia, 82 is old, partially disabled as he underwent two hip surgeries and speaks only Gujrati. For the last one month he is in one of the corporate hospitals in Banjara Hills. Nobody knows why he is there since a month. Prognosis and diagnosis nobody is sure, in the hospital. The doctors, nurses have poked every inch of his 5’ 3” body till he feels worse. He closes his eyes, tries to sleep but tears roll down his anxious eyes. He tries to find out, what is wrong with him but no correct answers. He is visited by many important looking people who stand beside his bed and gesticulate. They look at the charts and monitors adjust the various tubes, poke him, draw blood but nobody touches him (his feelings) or make an attempt to communicate to him. His sons are in USA, both sons are NRIs. The nurses and ward boys keep him clean. He feels lonely and small. He wants to get back home to taste “Dhokla” and sit with his friends in the big verandah of his five stored bungalow and sip tea.
He feels helpless, in this country of abundant health care systems. For three days he was kept fasting and bottles of glucose and tubes connecting him. He knows the word “scan”, x-ray. He is under the belief that scan is some sort of a medical order to feed a patient. I need a scan he requests the nurse helplessly parched he eyes the water tap but they don’t understand. The nurse points to the nil orally sign but he cannot decipher the language. He wonders how long he will have to remain in this hospital with the ambience of a star hotel.
A junior doctor finds him crying and tries communicating in his mother tongue. He begs to go home as he knows nothing is wrong with him. He would rather die with his friends than stay here. She assures him that he is not dying and he was admitted for a simple gastric problem which got cured the next day. Then why is he still in the hospital? He forces her to help, the doctor fights her way, does paper work and let him get discharged. She knew she lost her job but she has a sense of satisfaction.
Most of us put doctors on pedestals because they are exceedingly smart, skilled, and let’s face it, special. Not everyone can become a doctor. It takes someone who is resilient and with a quick and practical mind to make it in this profession. And we venerate them not just because of how good they are. It is also because we trust them with the one thing that is most sacred to us: our health. Why wouldn’t we put them on pedestals? They have the training, the knowledge, and the experience to help us when we are helpless. So, does that mean it’s okay for them to not let us know just how good at their job they really are?
I don’t think so!
When I asked her about the risk of the job she smiled pleasantly and said, I just couldn’t leave him I am accountable. I felt accountable.
Accountability in health care seems an omnipresent term these days but it sounds like a nebulous idea, it looks like corporate hospitals which draw heavily from the purses of the patients do not feel accountable.
Did we do a right surgery? How many patients spent more than three hours on a trolley? Was it needed? Could we have completed the surgery with two doctors? Was there a need of 6 nurses?
“In a hospital setting, all employees and medical staff members have a Social responsibility for the healthcare given to the patients and community.
Like the junior doctor personal accountability cannot be legislated. Like the junior doctor you must feel it weather you are under scrutiny or not. (medical fraternity)
The good news is most doctors reassure that if you begin with the belief that you are personally accountable to your patients chances are” all is well”.