Cast & Curious

Tag: Physician

  • Should new technologies in medicine threaten one’s (old) practice?

    In one community where I practice, no hospitals offered diagnostic procedures like CT Scans or MRI (Magnetic Resonance Imaging). Thus the current practice is to immediately transfer the patient to a nearby hospital with such capabilities. This, in spite of the fact that medical professionals here can actually perform the needed medical procedure after the CT was done. This practice went on for so long as I can remember and physicians bothered less and less about honing their skills managing ill patients diagnosed with the help of  a CT Scan.

    Until one day, one hospital invested in a cat scan. Many physicians suddenly find themselves in a dilemma. That despite, the availability of a ct scan now, many physicians lacked or simply forgot to learn or re-learn how to manage patients that was diagnosed with the help of a CT scan.

    Many physicians view new medical technologies as a threat, simply because they lose patients in the process.  Somehow though, there’s this lukewarm acceptance for re-learning of skills. The quandary is not about what you don’t know, but about how confident are you in managing those that you now knew because there’s a CT. Should they still refer the patient to another city for treatment despite the fact that the diagnostic technology is available here already? Would you see this as an opportunity for re-learning or would you simply refer the patient and free yourself the hassle of it?

    This is just an example of technologies that threaten conventional practice. Many physicians view it as a threat, simply because they lose patients in the process but somehow, there’s this lukewarm acceptance for re-learning of skills. For some, this an opportune moment for seizing the timing for creating value added services (like ICUs and neurosurgery) in the hospital. For patients, this is totally a welcome development and improvement. Lower costs and convenience for both the diagnostic procedure and the value added service cannot be simply ignored. New technology, if indeed necessary, is here to stay.

    So are you going to just ignore it and go on with your old practice or re-learn skills to adequately manage the influx of patients as a result of new technologies? Put your comment below.

  • What should a dissatisfied patient do regarding their physician’s “bad” service

    Recently, I’ve been receiving   complaints from patients regarding some attending physician’s “quality” of service. Complaints like, “the doc saw me late already” or “my waiting time is far longer than my physician encounter time”  or “this was not explained to me” or  the difficulty of some patients (or relatives) to talk to their physicians. In most cases, the attending physician’s technical competence is unquestionable, but the patients or relatives sometimes felt they still didn’t receive adequate care or service from their physicians. What must they do?

    a patient unhappy with the physician services rendered to him (Photo credits from http://www.art-of-patient-care.com/doctor-patient.html)

    I always tell these “complainants’ that any doctor-patient relationship is contractual by nature. Meaning both parties has to agree and deliver their end of the deal to consummate the “contract”. The contract is of course the delivery of health services required by the patient’s current health needs.(Read my perspective of this here.) This may sound simplistic but for purposes of discussion, this “understanding” of a contract should suffice. If one party, does not agree or adhere to the contract, then the relationship could be terminated after due process.

    In non- emergent situation,  and if the service is available, patients have the choice on who will be their doctor or what type of service they could avail. That by choosing or agreeing to be under the service of a particular physician, the patient also has the responsibility of paying the services of that physician. That is the contract, no matter how business like it sounds.   In cases where one party felt that other party did not deliver the expected service , he or she may choose to end the contract after duly informing and after paying the services rendered by the physician. (By the way, the physician under certain circumstances and on valid grounds, may opt to terminate a patient-physician relationship too but let’s leave that discussion in my future posts.)  In my practice, I always offer this option to all my patients even prior to our patient-physician relationship.

    Problem comes in when patients just change physician services without adequately informing their previous and frequently, their succeeding physicians. Far worse is the situation  wherein patients  “leave” their previous physicians without paying their bills on the pretext of a “bad” service.  This is not good practice either and probably will only harm patient’s reputation also.  In the first place and except in emergency situations or some government health training facilities,  the choice of  any physician is really the patient’s responsibility. Health is the business not just of the physicians and institutions but of the patients as well. If you don’t know any of your physicians in the community, then you cannot blame someone else for receiving a bad service. Remember, that physician  gave his or her professional service and in the context of a contractual form of relationship, that has to be duly paid even if you’ll change physicians.

    Patient doctor relationship is based on trust (photo from http://harvardmedicine.hms.harvard.edu/doctoring/patient-doctor/index.php)

    So if you want to change your attending physicians for a valid reason, inform your physician of the transfer. Pay your end of the  contract, meaning the services rendered. Cultivate the habit on talking to your doctors. Pour in your concerns on them and seek necessary answers to lingering questions.   But don’t forget to inform the physician if there’s something good also about his or her service that you liked. I always believe no doctor would want any patient to feel bad about their brand of service. Just be honest. If those physicians do not change for whatever reason, that’s their catch. Remember that health community is far more sensitive than we thought on issues like this. These type of service screw ups always catches up someone else ears. If you don’t like them, then do not patronize them. That way, you won’t complain at the end of your contract. That simple.

    Or is it? What do you think?

    “The essential quality of the clinician is an interest
    in humanity, for the secret of the care of the patient is in caring
    for the patient.”    – Francis Peabody Class of 1907, Harvard Medicine