Friday, June 19, 2009

Primary Care

India today is at cross roads.We are fast developing people.It is like being neither here nor there,I mean we are educationally quite advanced in pockets like southern Karnataka.But unfortunately we are only literates,not all,though.Many people with no college education are more sensible that they know when to consult professionals.Many with postgraduate qualifications think they know something about everything and mess things up.
Medicine is one field where one will regret such action because what is good for me need not be so for the other person.
Every one of us have visited a doctor in our life. In the past,it used to be a local GP.Whatever he used to advise was like scripture.He used to be a friend,philosopher and guide as described in text books of medicine. Slowly we advanced and had all types of specialist doctors in our midst,that lay public started deciding whom to consult,which in the past used to be decided by the local family doctor.This is when things started to go wrong.
I am not suggesting one should not go to a specialist but before that his local doctor should be consulted and preferably give a reference so that you go to the right person and he has some idea as to from where to start,else if you approach a wrong specialist he may not be in a position to do justice to the case.
For example take a case of pain abdomen(stomach ache).It may just be just an ordinary pain or serious ailment like appendicitis where early intervention by a surgeon will save lot of complications,both physical,psychological and financial.
I get all types of questions,from people who have been coming to me for all their health needs. Children become adults and take a job in a new place where they feel lost.They find it difficult in a new place when it comes to the selection of a primary care physician.It is easy really.You may be wondering how so.Let me explain-when you need to see a doctor,go to any qualified person and explain your problem,on the other hand you can ask your previous doctor for a recommendation(many a times it so happens that your family doctor knows someone there).Make it very clear to him that you do not expect any miracles,that you are ready to undergo required tests to felicitate diagnosis and that you are ready to spend reasonably.Because we doctors encounter all sorts of people in day to day practice(it has been my experience-many people simply do not want to pay the doctor assuming he has made enough to need anything more!)Many diseases can not be clinically diagnosed and need some clinical tests.And when a doctor orders those tests people think they are being fleeced.Hardly so,because the doctor expects the patients back!And finally when he does prescribe something ask him whether you really need those medicines.Now you will tell me the doctor is awfully busy to explain,never so.On the other hand he will and should be pleased because too much expectation by the patients make the doctors to overprescribe.And if the doctor concerned is really annoyed please tell him politely that it is your health you are worried about.It is your right and his duty.And never go to him again.There are bad apples in every barrel.
One thing every one of us should understand is that there is no fast cure.It depends on the disease,and one particular doctor can't do any better than the the other.And remember there is no medicine that is "strong",medicines are either necessary or not.If necessary,however strong it may look, it is not.
You may be busy but so is the doctor.If you are in a hurry and tell the the doctor that you have no time to rest, he may not be able to help you.If you want proper care you got to spend some time and money,after all it your health.
Think about it.(dos and don'ts with doctors in the next post)

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About Me

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Puttur, Karnataka, India
Medical doctor,arrogant,self centred,can be very helping. Concerned about the falling standards in ethics.Advocate discretion in lifestyle instead of regretting after the fact