It's extremely important that a patient be able to trust his own personal physician . When you are ill, you are extremely vulnerable, and need someone whom you can trust implicitly . You want to be sure that he's looking after your best interests , and understands that your needs come first. This is why the family doctor of the past was held with such high regard. He was respected as a family member, and thought of himself as part of your family. He felt he has a fiduciary responsibility , and made decisions which were right for you , because he knew so much about you, and was invested in cultivating a long-term relationship, based on mutual trust and respect.
Sadly, this has changed today, and we no longer have long term continuing relationships with our doctors. Because of the technical advances in modern medicine , we have to deal with lots of specialists , as a result of which our care gets fragmented . We often find that our doctors treat us as cases, rather than as human beings . The trust has started to evaporate, because our contact with our doctors has become so transactional.
This is true, not just on a personal level, but on a societal level as well . Most people don't trust the medical profession anymore , because we think they have become too commercial. We feel that doctors have started to put their own personal mercenary interests first, because they have so many masters to answer to. Thus, specialists employed in corporate hospitals have to keep the hospital management happy - and they are far more interested in profits rather than patients. This is creating a huge trust deficit , and this gap between the doctor and the patient is actually widening .
A negative, vicious cycle has been set up. Patients don't trust doctors, as a result of which doctors get beaten up when the outcome is bad; or dragged to courts and sued for alleged negligence. Doctors have started to practise defensive to protect themselves, and have started treating patients as potential adversaries.
We need to bring the trust back - for the sake of both doctors and patients ! One way of doing this is to ensure that patients feel that doctors are accountable to them . Today, many patients feel that doctors can literally get away with murder , because they are unapproachable and inaccessible.
So far, society has relied on Medical Councils to self-regulate the profession, so that errant doctors can be taken to task. However, this hasn't worked well in India, and this is why we depend upon a trusted intermediary (a friend or a family member who is a doctor ) to refer us to the right doctor - someone whose integrity is beyond reproach, and who will behave as a trusted professional, and do what's right for us .
A better way of getting doctors to be more accountable to their patients would be to use technology. Every doctor should have their own website - and perhaps this could be provided to them by the Medical Council when they graduate. Once doctors have a mandatory online presence, they will understand the importance of guarding their digital reputation, because this is freely accessible to everyone . They will therefore treat each patient with care and respect , because they know that if something goes wrong, the patient can post negative reviews , which will harm their practice.
Online patient reviews carry a lot of weight , and give more power to patients , so that they don't feel helpless when talking to their doctors. Once doctors understand that patients have the power to retaliate if they behave badly with them, they will start respecting their patients , and treating them better.
Doctors would develop their websites further, and use these as tools to educate their patients , so that patients have realistic expectations of medical treatment. Patients also feel secure that their doctor is an expert, and feel comforted that the doctor is willing to share information with them. Having a website will encourage doctors to be open and transparent, and this will help them become more productive as well, because they'll need to spend less time educating their patients in the clinic itself . They will be able to focus on establishing a personal relationship one on one with their patients , so they can work on creating trust. Finally, this kind of transparency will also help to reduce medical costs , because doctors are competitive , and patients can pick the doctor who offers them the best value !
I am a consultant IVF specialist, who runs one of India’s leading IVF clinics at www.drmalpani.com, along with my wife, Dr Anjali Malpani. We have founded HELP, the Health Education Library for People (www.healthlibrary.com), which is India’s first Patient Education Resource Center. I have authored many books, including: How to Get the Best Medical Care; Successful Medical Practise; Using Information Therapy to Put Patients First; and Patient Safety - Protect yourself from Medical Errors which are available free at www.thebestmedicalcare.com . My passion is patient empowerment; and I believe that using Information Technology to deliver Information Therapy to patients can heal a sick healthcare system. I am an active angel investor ( www.malpaniventures.com)