When people learn that I’m a doctor, they often ask me about doctors’ behaviors which they find unreasonable or objectionable. Which of the following sound familiar to you?
Clinical practice
• Doctors come later than their posted clinic hours, making patients wait, sometimes for hours. Some doctors have multiple clinics and may not allocate enough time to travel from one clinic to the next.
• Doctors institute the “first come, first served” rule at their clinics. This benefits only those who can arrive early or those who can send people to wait on their behalf. Whatever happened to making and keeping appointments?
• When doctors are out of the country, their clinic secretaries also go on leave. This makes it difficult for patients to schedule appointments or to make further inquiries.
• Clinic secretaries sometimes allow medical representatives to pitch to doctors during clinic hours while patients wait.
Hospital practice
• Some doctors do not sign discharge papers ahead and advise regarding their corresponding professional fees, and must be chased down so that the patient can be discharged.
• Some doctors charge for daily rounds even if they do not make daily rounds to see in-patients.
Consultation fees
• Doctors may refuse to discuss the costs of consultation, only to charge more than the patient expected.
• Doctors may charge patients a full consultation fee even if they are only requesting for a prescription to refill their maintenance medicines, and are not given a proper medical consult.
• Some doctors charge foreign patients a higher fee simply because they are foreign.
• Doctors sometimes require patients to pay the professional fee directly to the clinic secretary, even charging a lower price if the patient foregoes an official receipt.
Labs and meds
• Some doctors perennially prescribe specific medicines so that the industry will offer them perquisites such as trips abroad.
• Some doctors do not trust the laboratory of other hospitals and require patients to repeat a battery of lab tests even if they have just recently had the tests done.
• Many doctors do not make a practice of disclosing the risks and contra-indications of medicines they prescribe. And yet, they often get irritated at patients who ask many questions.
In a Lancet article entitled “What Patients Say, What Doctors Hear,” Dr. Danielle Ofri posited that the primary diagnostic tool is the patient-doctor conversation. She studied communication patterns between doctors and their patients, and found instances of miscommunication even in high-quality consultations among well-educated patients and caring physicians. She observed that doctors tended to interrupt the patient’s narrative after 12 seconds and, if left uninterrupted, the patient would only take an average of two minutes to describe his/her condition. Dr. Ofri recommended that doctors consciously develop the ability to treat each patient as a unique individual, put themselves in the patient’s place, and listen attentively, in order to improve their practice.
The doctor-patient relationship is just like any relationship, in need of mutual respect and two-way communication. Like any profession, the field of medicine is filled with many types of doctors, and I am certain that each patient can find a doctor to meet his/her needs. For prospective patients, do not hesitate to discuss your needs, questions, and expectations with your doctors. For doctors like me, the list above is a reminder that our profession is a call to serve. If not for patients, where would we doctors be?
Incidentally, I have noted that a majority of the people who would approach me belong to the privileged classes, used to asserting their rights. I wonder whether average Filipinos will speak up about their observations, and whether doctors would listen if they did.
Illustration by Paul Fabila
This article originally appeared on Asian Dragon Magazine’s June-July 2017 issue, available for download on Magzter.
