Choice of Doctor and Hospital

I do not think that the existing system prevailing in our country is lagging behind but more easily we can approach a specialised doctor of our own choice at any point of time. As far as hospitals are concerned, one can have his treatment from a specialised doctor thereat as an outdoor patient by paying only his consultation fees and one needs to pays other charges of the hospitals only on becoming an indoor patient. As I saw in Canada. my son with his broken index finger while playing cricket had to wait for a couple of week to get it operated and bandaged. When he was suffering from acute headache continuously for a few months, without proper diagnosis, he was prescribed a medicine dangerously harmful to cardiac systems on its continuous use. In the meantime, luckily he visited home and saw a local Neurologist, who first of all stopped the medicine prescribed in Canada, prescribed a simple tablet for stress releasing and referred him to a Cardiologist, who diagnosed him a patient of hyper-tension. The medicine prescribed by the neurologist did the miracle and the headache vanished on using it for a few days. Moreover, medical services in western countries including medicines, as referred to in the post, are at least 10 to 20 times costlier than in India Above two examples are comparable with the prevailing systems of any country but what we need is to restrict the greed for money of our corporate hospitals, which results in depriving majority of our people from proper & good treatment by renowned specialised doctors generally available in those hospitals. more  

DON T DECORATE DOCTORS LIKE THEY ARE NEXT TO GOD TREAT THEM LIKE A SKILLED COMMON PERSON WORKING FOR SICK PEOPLE AND GIVING HIS BEST IN ALL ODD CIRCUMSTANCES.HE IS SERVING SICKNESS AND NOT FOR YOUR EXPECTATIONS. more  

http://www.thehindu.com/data/WHO-report-sounds-alarm-on-%E2%80%98doctors%E2%80%99-in-India/article14495884.ece When you have less number of seats available for Medical Institution and the amount of fees one has to pay in private Institutions, and the kind of doctors coming out of these institutions are businessman and most of them cannot even show their human side as they are under lots of pressure to collect the capitation fees paid and some are not even worth becoming doctors and charge a huge amount of fees for their practices. Once every thing is streamlined we can expect better doctors and services like in the west. more  

Dear Ms. Sanjana, I am not aware whether this happens in Western countries as you seem to think but unlike what our friend, Dr. Mahesh thinks, in USA (my first hand experience), you have extremely wide choice of health care units covered by majority of the insurance companies (I understd this to be generally true as my insurance cover & choice of dispensary is of my son). As human beings, irrespective of the profession, they practise, average US citizen is far superior to average Indian. I, therefore, think that subject to availability at the given hour, you can possibly have choice of the Doctor, provided you are acquainted with them. Unlike the superiority of Indian Doctors, that Dr. Mahesh seems to claim, the Doctors in US (irrespective of their origins) are far far superior and systematic than majority of the Indian (domicile) Doctors. In fact, they are generally, more brash & high handed when they work in so called Corporate hospitals. Even in India (my experience is restricted to Pune, Hyderabad, generally Andhra Pradesh) Doctors in Govt. hospitals are far more competent and better behaved but if they appear to be irritable at times, it should be because they were overburdened with patients on that day. The reason for competence of Govt. Doctors is due to the fact that they see a variety of deceases and complications. This is exactly the reason why an Indian Doctor or Indian medical treatment is preferred by many westerners in addition to cost effectiveness of the persons and systems Vis-a-Vis dollar parity. Lest some one like our friend Physician may raise a point that medical tourist prefers private hospitals only, let it be understood that it is due to better hygiene achieved by driving out majority of Indians (due to gross overcharging), where as however well intentioned the Hospital superintendent might be and however hard, he may try, he/ she can't achieve that with overflowing unhygienic patients. Please note that mere cost break-up is not going to help as you think. Even the looting hospitals will provide you break-up if you seek. To visit a private hospital and get treated with reasonable cost to yourself, you need to know some influential Doctor in that unit. 2. Since it is your intention to understand why affordable hygeinically maintained hospital treatment can/ not be provided to all citizen, let us look at what was the system 50 years ago, when I was an adolescent. For anything and everything (except for very minor ailments like Fever, URTI! UTI, cold & cough, for which family doctors used to treat at consulting room or dispensary as required) in big towns, our parents used to send us to Govt. hospitals. For eg. I was tested for my eye sight at Sarojini Devi Hospital, HYD. by none other than Padmashree Dr. Shiva Reddy (Presidents Ophthalmologist later), when I ripped open my wrist in heavy cyclone in IIT, Madras in 1967, I was attended to in midnight by Royapettah General Hospital, Chennai. A decade later, Govt. started recognising some private large nursing homes, where many a time, experts from Govt. hospitals were called in. Govt. Doctors were permitted to have private patients and were treating them either in small nursing homes or admitting them in Govt. hospitals. This was when the health care systems started deteriorating in India and medical ethics started going to Dogs as population started bulging out without commensurate increase in health care facilities. 3. Some enterprising but more money minded (less ethical) people started so called corporate hospitals, which were only glorified money churning large nursing homes. Around this time, diagnosis has undergone change from "Symptomatic" to "quantitative analytics" (test based). Requirement of expertise and experience took a rear seat and testing became more rampant. This further lead to progress of medical mints as they could afford purchase of machines where-as Govt. hospitals are starved of funds. Some of it, if not all, of this fraud called global standard Medicare is with the blessings of governing politicians. 4. Today, with reasonable financial standing, two insurances, Oriental & Aarogya Raksha (GOAP) and CGHS (payband IV member), we, me & my wife are most afraid to go to any Doctor & most of the time depend on family doctors (luckily I have Doctor friends since 1974 whether in Pune or here) and get treatment at home or even on telephone. Please note that Insurance claims are very difficult to realise, CGHS dispensary In Vizag is overburdened with waiting time anywhere between 4 to 6 hours (coupled with specialist (only of Govt. )consultation time of another 4 hours and both these routes are quite cumbersome. 5. The only way forward is 1. Increase health care facilities in public domain enormously 2. Make it absolutely compulsory to Govt. College Educated Doctors (highly subsidised in AP, if not in other states it should be made so). This should be enforced under essential services act with military discipline, given the temptation of Doctors to unethical practices. 3. Leave the high cost private College students to private sector, since most of them are poor qwality lacking first hand experience of patients & deceases, enforcing expeditious criminal action for medical negligence & incompetence. 4. Fixing charges for all and sundry activities in hospital and making individual Doctors responsible for every entry in the bill and every patient will have one Doctor as in-charge for each patient. 6. Enacting a law to keep a lien of Govt. over assets and immovable assets of hospitals in the event of insolvency (India can not afford to lose facilities already created) 5. Promptly bring such hospitals in public domain after insolvency. 6. This should possibly help in over a long time, as many of the incompetent and unethical hospitals will wither away (similar phenomenon has already set in engineering educational shops) but those facilities will come in public domain. There should be simultaneous effort to augment medical infrastructure by Govt. and it should be well distributed. 7. My thoughts may look utopian but they are worth a try for posterity. Nevertheless, I conceed Dr. Mahesh's point that Indian educated Doctors from Govt. colleges (mostly) are preferred even in USA (of course further trained for systematic treatment by Senior specialists) over many of the locals. I understand that in New York & New Jersey states, many of the facilities are manned by us. more  

I am sorry but your information is wrong. In Western countries, patients can choose their doctors only in private practise when they pay out of their own pocket. It is the same in India. In Western countries, if the patient has health insurance, they are given a limited choice of clinics and doctors among which they have to chose. After consulting the primary doctor, only if the doctor refers them to the higher centres, then only they can go to the higher referral centre, that too, to the centre that the primary doctor refers, not wherever the patient wishes. This second system is similar to the system in ESI Hospitals in India. In India, patients paying out of the their pockets or those having health insurance have the choice to go to any hospital they want if it is empanelled but then, they do not have the choice of doctors. They have to consult whichever doctor is in the specialy there. For example, if I would like to have a surgery and am paying out of my pocket, I can go to any surgeon that I want. If I do have health insurance, then I can choose a surgeon from among any of the hospitals empanelled with my insurance company. There is a very wide variety of choices in India and that is why Westerners are very happy coming over here. Basically, you are highly misinformed about how Indian health system works and how health systems works in various other countries. There is a documentary by Michael Moore called "SICKO". Why don't you go through it? Secondly, consider the following factors - Why are Westerners so happy to have Indian doctors working in there countries if Indian trained doctors are not competent? Why are people from all over the world so happy in coming over to our country to get surgeries and cancer therapy done in our hospitals if our hospitals are infact extorting exorbitant fees from patients?. Third, please understand that treatment protocols and procedures are standard all over the world and do not change according to the affordability of the patient. Maybe, the problem here is not that the hospital bills are high but that the per capita income, literacy level, doctor to patient ratio as well as basic common sense is very low in India. more