Scene 1: My grandmother complains of incontinence and a burning sensation during micturition. Since our family doctor is out of town, we call another doctor, let’s call him Dr. A, home to examine her. He orders a urine analysis and a urine culture test. Both tests clearly indicate a Urinary Tract Infection (UTI). Based on the urine culture, Dr. A prescribes an antibiotic X. When our family physician returns, we decide to show him my grandmother’s reports and take his opinion. Thank God, we did too! The antibiotic X, which was prescribed by Dr. A, apparently had a history of causing the platelet count to plunge and therefore, had been discarded by majority of the practising physicians. Add to that the fact that my grandmother was a hypertensive patient and her BP had been known to shoot up to 200/90 mmHg, a point that had been conveyed to the visiting doctor.
Scene 2: In the interim period before the results of the urine tests were available, my grandmother’s condition worsened and we had to call Dr. A home several times. Owing to reasons only known to him, he concluded that she was probably suffering from malaria and decided to administer three doses of an anti-malarial drug to her. Seeing her debilitated state, we were too worried and anxious to oppose his decision. She improved marginally after these administrations. Once the urine test results were out, it was evident that she had not been suffering from malaria and that these injections were entirely unnecessary. As a result, what could have been cured in a matter of ten days, took more than a month. The anti-malarial injections weakened her to such an extent that she required shots of vitamin B12 to recover.
The above scenarios point at the doctor’s skill and expertise. The first event may be attributed to Dr. A’s ignorance involving current developments in drugs and patient care while the second could be a case of lack of experience. However, in my opinion, he cannot be blamed for either of these instances. Correction: He cannot be blamed entirely. In urban areas, there is no dearth of doctors. There are atleast five practising physicians in my locale alone! Not to forget, the horde of young doctors that medical institutions churn out every year, each of whom is trying to secure a stronghold in the healthcare business. In such a scenario, existing doctors who are yet struggling to establish a flourishing medical profession, would resort to alternative means to bring food to the table, such as, working in the Out-Patient Department (OPD) of several hospitals all over the city, visiting patients at home, among others. This leaves little time to keep abreast of the latest advances in the field of healthcare. Ironically, leading a life as hectic as this, it is no wonder that so many doctors suffer from heart problems.
The issue with such a situation is the humongous burden that these poor doctors have to carry. Not only is their academic training demanding and arduous but their work life is exhausting and stressful, as well. At such a time, there is a need to divide the onus, a need to involve more healthcare professionals. In the United States, the task of diagnosis falls to the physician while the job of prescribing medicines is undertaken by the community or hospital pharmacist, depending on the setting. In contrast, a pharmacist’s line of work is limited to that of a shopkeeper in India. Furthermore, in view of the hectic work hours a doctor has to put in, it seems rational to hire physician assistants who can look over aspects such as, taking a patient’s history, explaining the directions of use of a medicine, resolving any doubts, etc.
A doctor’s job is tough and crucial. Reducing their work load by engaging more healthcare professionals will not only aid doctors in providing better treatment to patients but will also open up more career opportunities in our country. In totality, it would add up to enhanced patient and health care.