The doctor’s not in anymore
These days, we often end up seeing doctors to whom a patient is a number, not even a name, writes Namita Bhandare.india Updated: Mar 06, 2011 12:32 IST
I’m a bit of a doctor junkie. Listed in my phone book are numbers for various specialists. I could direct you to a cardiologist, endocrinologist, oncologist, pediatrician, gastroenterologist, gynaecologist. But ask me for a family doctor and I will draw a blank.
Growing up, most middle class Indians had one; some lucky ones still do. Mine was genial old Dr Vibhakar who literally had his finger on the family’s pulse. When one of us fell ill, he would drive across in his Fiat with his battered brown leather bag that held a treasure of forbidden instruments: stethoscope, thermometer and that hammer thing to tap on your knees. He’d peer down throats, dilate pupils, palpate stomachs and pronounce both prognosis and remedy. Then, tea would be brought and he would stretch his legs and catch up with the family he cared for.
The family doctor went beyond fixing the odd ailment. He knew you. He knew the family, its genetic history, the way it thought, its beliefs and values. He knew, for instance, that the mother was stressed because the son had failed his exams again and, so, that spike in blood pressure needed to be cured by both pill and pep talk. He knew that your dad was diabetic and, therefore, unfailingly nagged you about diet and exercise. He knew when your kids’ inoculations were due. You didn’t have to remember the year you had your tonsils removed; he had been there, holding your hand as you were being wheeled into the operating theatre. He knew which pain killer was kindest to your stomach because it was his business to know these things. And because he knew you, you were always assured of an appointment at his clinic.
When exactly the family doctor disappeared from our lives, I cannot say. It’s not as if the practice wound up. General physicians (GPs) continue to flourish and are often regarded as the first line of defence in medical care. They conduct screening, counselling and analysis and in most cases manage chronic conditions just as well as a specialist would. But that man who was an integral part of your family, that man who listened and cajoled and bullied and advised, he’s gone.
What happened? Perhaps the information available to us on the internet made us believe we didn’t need doctors; we could fix ourselves — at least for the small stuff.
Or perhaps it was the onset of specialist diseases — diabetes, blood pressure, cardiac disease — that demanded specialist treatment and specialist doctors. The GP stopped becoming our first port of call; we began sailing straight to super-specialists and a battery of tests, some invasive, most exorbitant. The calm hand on your forehead gave way to scans and probes and the physical examination is now in danger of becoming a lost art; instinct giving way to equipment.
The house visit itself is nearly extinct. Cities have grown, traffic has grown even madder. House visits are a luxury — most of all for the doctor himself. Corporate, ‘super-speciality’ hospitals that, not unlike modern shopping malls, promise a fix for every need came up in big cities and smaller ones. For the stand-alone family doctor, newer and often more lucrative employment opportunities beckoned. Easier to simply close shop.
Too often we end up seeing doctors for the first (and perhaps last) time; doctors who never keep records because they aren’t sure if they are ever going to see you again. Doctors to whom is the patient is a number, not even a name.
Last week, my mother needed to get a routine medical check-up. Her doctor for several years had moved miles away, to another hospital in faraway Gurgaon. Not practical, I argued. We have to find a new doctor, someone more convenient, somebody closer. But my mother would not budge. That trek halfway across Delhi to see a familiar face — a face that knew her, would recollect her last visit and which tests were now due — was a small price to pay for knowing that everything was all right.
Because when it comes to health, we need reassurance more than prescription, familiarity rather than fame.
Namita Bhandare is a Delhi-based writer. The views expressed by the author are personal