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Patient Rights Awareness in India


Today I had to accompany a relative of mine to CT Scan. This was done in a reputed medical institution. When I was helping fill up the forms, I saw that there was a checkbox for “The side effects have been explained to me and I understand it.”

Most of the people were signing blindly. No side effects were really explained to us, so I asked the desk assistant if she could explain the side effects. Then she did explain the side effects and precautions in brief. I would have liked more explanation, but what she gave me was enough to sign off the and check the box.

I was able to remain polite, but still exercise my right.

What had happened had I not asked it? Is there no structured process? She didn’t have to explain it to every patient. They could have printed a brochure. They had gathered all the patients in a room, so they even could have just explained them all at once.

Advanced medical technology is one thing. But even with the basic technology we have, the quality of medical service can be significantly improved by avoiding the “PAE” or Preventable Adverse Events. What we need is a structured process. Patients must exercise their right of knowing the critical information. If enough patients ask about it, it will result in getting a structured process in place that will significantly reduce PAE.

A great book that deals with this subject is “The Checklist Manifesto“. It talks about an interesting case. A stabbed victim was brought in in a hospital. He seemed ok, people were just doing first aid on him. Suddenly his blood pressure and other vitals dropped for worse. The doctors took him to the operation table and found that his stab wound was far deep and there was lot of internal bleeding. Later when the operation was completed and he regained consciousness, they asked him what was the weapon. ” A bayonet”. A bayonet is far longer and stronger knife than typical stabbing weapons. Had the doctors followed a process, a checklist of some sort, where first thing they do is ask about the weapon, they could have saved a lot of trouble.

Generally we have a culture in India where doctor has status of almost a demi-god. People trust the doctor blindly. This is not to say the doctors are doing a bad job, but the doctor is a human and he/she is bound to make some mistake, or forget to tell you something.

Here are some simple things you can do to help your doctor cure you faster and with more certainty.

1. List down the symptoms on a of paper.

2. List a number of questions to ask the doctor on paper.

3. List all other medicines you are taking on a paper.

4. If the doctor prescribes medicine, ask about three things – side effects, interactions with other medicines, and what to do if you miss a dose. Write down this things, because you might forget later.

5. For a serious illness, do not hesitate to find another doctor and take a second opinion.

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5 Responses

  1. gr8 work kedar… keep thinking.. keep writing

  2. Good article !

  3. I think we all need another perspective; one from the medical professionals side. No doubt; you have rights to ask for what risks are involved; but considering the workload the average diagnostic center has (compared to work force); they barely have time to explain everything to everyone. Yes, they can print brochure; but how many people will bother to read it… they just have wheeled in a patient with an emergency for MRI…. all they care about is getting the work done… the ambulance waiting outside is charging them by the hour. Who cares about brochures then? Waste of resources; right?

    Doctors are no more demi gods they used to be. They have been replaced by Google and Wikipedia. I get patients who know the procedure and complications of Myomectomy; they only need to be referred to the right specialist. Trust towards the GP is the only factor.

    About the example of the stab victim you gave… when we get a stab victim… we do follow certain protocols… but the length of the knife is not a vital criteria. We fix the damage caused…. but its never according to the instrument involved for the damage.
    We had a patient with a penetrating abdominal injury extending into the lung; through the diaphragm. It was caused by a buffalo’s horn; poor female got gored by a buffalo. We did an exploratory laprotomy; went along the stab path fixing ruptured organs; till the aorta. Luckily; that was not perforated. So she lived to see another day. Even if it was caused by a bayonet… we would do the same till we fix up the bleed.
    Just my 2 cents……
    Love to read your blogs…
    Regards
    Ganesh

  4. PS: About the stab victim you mentioned… upon bringing him to the hospital he was apparently ok… He could have very well have told the people treating him how it happened… we always ask that question to rule out attempted suicide or homicide. That’s why it’s called a medico-legal case…. in India. We need to file an MLC with the police station in the area where that injury/ accident occurred.
    In case of victim not being conscious; with no eye witnesses… exploratory laprotomy is performed. Simple. Atul Gawande needs to do a bit more research I guess.

    • One thing a doctor does properly is to use latin medical jargon to confuse the patient.

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