Medical litigations are on a steep rise in recent times. According to Dr RK Sharma, an MD in medicine who has now sub-specialized in “Legal Medicine” (a subject that did not exist till a few years back) by doing a course in law as well, it has risen five fold in the last few years.
Medical wrong doings must certainly be a factor, but doctors could not have suddenly turned criminals en masse, and our life expectancy has contrarily been rising. That patients have become more aware and ‘demanding’ is another factor. And, to be fair, some bit of it may be necessary in society to hold health care providers accountable about what they do.
But a five fold rise in litigations that is making doctors and hospitals appear like the latest class of villains, especially in certain states, must have other factors. And here is Dr Sharma’s list, in the order in which he encounters them.
1. Poor communication is a prima donna factor. A very skilled cardiac surgeon might perform a most challenging procedure and toil in the OT over several hours, but if the patient fails to make it, relatives turn hostile, accusing him of not spending adequate time with them explaining the need, type and risks of the operation, and keeping them synced with the patient’s progress or developments.
The 2-minute consultations of earlier times in government hospitals are all set to go. Every patient, even if poor and illiterate, has the right to know, be heard and concerns addressed by the health care workers.
Doctors often find themselves in a fix. If the list of patients he has to see is around a hundred and the time he has is three hours, what really can be expected of him? I remember that when a new government hospital had opened in Lucknow and was not drawing many patients in its early days, specialists were transported from the nearby postgraduate institute weekly to conduct clinics there. And when 15-30 patients were seen well by each specialist with adequate time and care, the minister had adversely remarked why the score did not touch 100!
2. Doctors are often found lacking in empathy. When a patient visits a doctor, he usually does so in trouble, often in pain and fear. The least that a doctor can do is to be empathetic, even if cannot bring himself to be overtly kind (kindness does not come easily to everyone; doctors should have the trait, but screening and admission requirement do not mandate a personality evaluation). Rude, arrogant behavior does invite hostility, and doctors should realize how their behavior would have been perceived had they been on the other side of the table.
3. Poor documentation. Does your prescription or records reflect what you saw, evaluated and advised? The courts see only the written words and the files. It is important to pay attention to this aspect, no matter how sincerely you attended to your patient.
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