Doctors Are So Cruel
"Doctors are just so mean and arrogant," I continue hearing. I somehow have to agree with this assertion considering that every physician-patient experience I have encountered has been nothing but a disaster. I understand that not everyone is a cupcake or rainbow. I also understand that doctors work under loads of pressure but I feel doctors fail to grasp a good understanding of their role. The ultimate role of a doctor is to heal and healing demands loads of patience and empathy.
I once over-heard my friend, who is also a medical doctor, utter that doctors should face the various stages of every disease before continuing to becoming a doctor. I knew what he meant. He meant nothing but empathy! To practice empathy, you have to build an understanding of what the patient is going through. I remember as a pharmacy student, I was required to live the life of a diabetic, hypertensive and hyperlipidemic patient, where I had to inject myself 3 times daily with insulin shots, I had to stick my finger to get sugar readings, and I had to take multiple anti-diabetes, anti-hypertensive and anti-hyperlipidemia tablets. Every day I had to record my compliance and to my surprise my percent compliance by end of the month was 30%. After going through this exercise, I was able to build an understanding toward a patients' non-adherence. Just now I understand what it means to live with multiple chronic conditions, to inject yourself so many times and to take multiple pills. Had I not gone through this exercise, I would not have had built this understanding
Empathy is what doctors are missing in Kurdistan. Empathy is the capacity to recognize and, to some extent, share feelings that are being experienced by the patient. A doctor has to have a certain amount of empathy before they are able to feel compassion. You might wonder like myself if empathy is an innate practice or can it be learned? Of course it can be learned. We have to make this learning available to our students.
One of the by products of lack of empathy is the failure to utilize patient-specific language when it comes to patient interaction. The practice of patient-specific language is also is a learned process that has to be incorporated in the medical curriculums. I recall that though I was providing my instructor with the right answer, points were still taken off because it was not in a language that was feasible for patients to understand. Doctors typically do not have large amounts of time to educate patients, and impersonal, voluminous patient handouts are largely ineffective.Patient compliance is a significant problem and it is strongly correlated with the patients ’ understanding of their condition and prescribed treatment.
Our doctors, like any other doctor elsewhere, fail to practice what they preach to their patients. Almost every other doctor smokes here in Kurdistan. Being part of the faculty at the medical campus myself, it only bothers me to see residents and medical students smoke in-door. It bothers me further when I fail to see a law that strongly abandons the act of smoking in-door. I for once took the initiative to approach a group of residents in the college cafeteria who were smoking. I kindly asked that smoking indoor is not good for my health considering I have an allergic reaction to smoking. I was not only treated with disrespect but also handled bitterly when I was only trying to be professional in my approach. Their reaction makes me question resident’s true intention toward their profession. Why do you want to become a medical doctor when you fail to strive for patient's comfort? Aren’t you wanting to heal a patient?
Arrogance among doctors is an attribute that is impossible to miss. Confronting doctors with a medical error of theirs is blasphemy! I am the kind of soul that loves voluntary and motivational work. I for once decided to help a colleague with his PhD data collection. I decided to help with passing out surveys to medical doctors and acting residents. Filling a survey is completely voluntary. The point of the survey was to grasp the magnitude of our doctor's understanding of methicillin-resistant Staphylococcus aureus, which is a type of Staphylococcus aureus that is resistant to the antibacterial activity of methicillin and other related antibiotics of the penicillin class. I am yet to understand as to why some senior residents took filling the survey so personal, as if we were testing their knowledge. We all know surveys are completely anonymous. We had some doctors look at the survey and intend on correcting the content of the survey while others stated that if the survey was on some cardiology related topic the story would have been far different. I thought to myself, how about just filling that damn survey?
I wish every doctor was as sincere in his/her duty in public hospital hours as they are in their private clinic hours. When we aren't feeling well, which of course is the reason we are paying these individuals a visit, then facing harshness and cruelty may leave us feeling intimidated, angry, frustrated, or a host of other negative emotions, none of which is helpful for improving our health. Confidence and self-assurance are good traits for doctors to have. We want to know that our doctors are confident about their work and are positive about their abilities to help us. But wise patients understand that there is no room for arrogance or narcissism from an egotistical medical professional. Their lack of respect for our needs, and their difficult personalities will prevent the patient-doctor relationship from developing, which will lead to a negative outcome.
I wish every doctor was as sincere in his/her duty in public hospital hours as they are in their private clinic hours. When we aren't feeling well, which of course is the reason we are paying these individuals a visit, then facing harshness and cruelty may leave us feeling intimidated, angry, frustrated, or a host of other negative emotions, none of which is helpful for improving our health. Confidence and self-assurance are good traits for doctors to have. We want to know that our doctors are confident about their work and are positive about their abilities to help us. But wise patients understand that there is no room for arrogance or narcissism from an egotistical medical professional. Their lack of respect for our needs, and their difficult personalities will prevent the patient-doctor relationship from developing, which will lead to a negative outcome.
Glad I haven't worked with any of those doctors lol. Sounds like you have had some bad luck in that department. A majority of the ones I have worked with are amazing people who really care about their patients, and provided a great example to everyone who had the opportunity to round with them. I didn't realize you left the US Helene! Sounds like you are having an amazing time! And congrats on your engagement! Will you be coming back to the US soon?
ReplyDeleteI totally agree with all of what you have mentioned, Helene. It surprises me how you could get all of these deep insights about the bitter situation over there within this relatively short period. I believe this does not only indicate your intelligent and analytical type of thinking, but it also indicates how bad the medical professional reality in Kurdistan is nowadays.
ReplyDeleteIt totally galls me to see these defects in our health system while no serious efforts are being taken to deal with them.
Continuing on what you have mentioned about the survey,I would like to tell you about a similar problem happened to me while I was trying to get the data about the MDR-TB in the country. This topic was suggested by my academic advisor at the University of Nebraska Medical Center as a part of Infectious Disease class requirements and it would have been the first study systemically done about the burden of MDR-TB in the country. Therefore, it was very likely to be published in one of the peer-reviewed epidemiology journals.
However, the Central Laboratory in Baghdad totally refused to give me any kind of data with that regard. They actually wanted me to go personally to Baghdad and get a dozen of papers signed by different health officials. The process was estimated to take at least 6 months to get a final response of approval or refusal!
It was absolutely frustrating to see most of the countries, even the developing ones, have all the "anonymous" health-related data readily accessible online or through formal IRB request processes while we still deal with all kind of data as "top secret" military information that should by no means be unveiled.
Finally, I was asking the same question you were asking about your survey:
It is all about the damned crude anonymous TB data in that damned country!
Agree all the way.
ReplyDeleteYou know what is more, I visit the doctor, I get medication (A bag full) and do the tests but I don't trust a single word they say. I don't even think there is doctor-patient trust here. You feel like the Doctor just wants you out so he get to the next patient, and finish as many as possible in the shortest time that he can. It is unfortunate, as you expect them to have this empathy towards the patient, let them feel their pain etc.. just so the patient can feel secure and know they are getting the right treatment.
You are assigned medication sometimes without even being asked anything about your medical history. As soon as you walk in and take a seat he's writing your prescription! Honestly.
I am going on about this, because it's something I have strong feelings about.
By the way, for some reason I can't comment on your entries in the blog.
xox love your entries
Again I agree that there is patient-doctor distrust. But I think it is not unilateral. The patients have their own "persecutory delusions" as well.
ReplyDeleteI still remember a Kurdish guy I met in Nebraska telling me that he went to a physician in Duhok while he was suffering from a simple sore throat. It seems that the doctor spent along time trying to persuade him that he was suffering from a simple viral infection and that he did not need any antibiotics. Yet, the guy was telling me :The doctor over there thought I am stupid. I have never seen viruses infect human beings. They only infect computers!
Imagine you are meeting 10 of theses patients everyday, what will happen to your mood?
By the way this guy has spent at least 15 years in USA!
Jagar, I just got off from the Diabetes Center and I am completely hypoglycemic. I had to see 200+ patients today, all angry, all impatient, and all needing service right away!
ReplyDeleteThe patient that caught my attention the most was a lady who was yelling at me cos i stopped her from taking metform due to a serum creatinine of 2.5! Your kidney will not tolerate Metformin, hence I'll put you on insulin shots, I said. She was furious topped with 20 other patients in a tiny room looking at me.
Sorry for that Helene!!
ReplyDeleteI wonder what was your reaction?
Majority of patients think that 'insulin' is bad because it causes some sort of dependence or addiction..They think of it like opiates or alcohol!
By the way...I swear I saw u in the dream examining me with another lady...
ReplyDeleteIt was a very tough, long and stressful exam!!
Another interesting blog, Helene. It is very sad to know that this is the reality of healthcare in Kstan. I am still disheartened by what I read in your previous blog, I wasn't ready to be hit by another bitter reality just yet :(. If this is the level of professionalism demonstrated amongst the healthcare professionals, what can we expect from a poor patient? It appears that the crises you mentioned in your previous blog are the cause of this i.e the failure to have professional doctors in Kstan. Doctors are struggling and failing to perform their job properly, failing to educate patients and demonstrate empathy which is, in essence, the core role and duties of a doctor; thus as a result we have a large population of angry, uneducated and unhealthy patients. There is an apparent failure in the system, the whole healthcare system, starting from academic stage. There seems to be a misconception that passing the exam and qualifying to study medicine is enough to show competency to become a qualified doctor, if that is the case then any donkey can be trained to memories the information and pass the exams. The future doctors need to understand the true nature of the job, develop and demonstrate professional communication skills. I personally believe the main reason to why this is happening is the fact that there are no strict rules and regulations for the healthcare providers to follow; patient's death is taken lightly, no laws against misconduct, no laws on negligence etc. Here in the UK we go through a tough system that punishes everyone for any professional misconduct, which makes you appreciate patients' rights and commit to providing the best healthcare service.
ReplyDelete