In today’s busy life, most doctors do not have time to converse with their patients. First, you need to take an appointment early if you are meeting a specialist. You must ensure that you don’t miss the appointment as sometimes it would well mean a couple of months of wait.
Most senior doctors now a days have “junior” doctors to assist. These junior doctors prepare your case file, take your blood pressure, pulse and check your chest for any congestion. If you have with you reports on your blood chemistry and are carrying X-Ray and MRI scans, then the junior doctor does a summarization and prepares your case file for the “rapid or focused examination” by the senior doctor. The junior doctor asks questions like “Do you sleep well? Or do you frequently pass urine, or do you pant when you walk?” etc. Your responses get recorded.
There is then hardly any need for a conversation that you need to do with the specialist or the senior doctor. The doctor looks at your case file and asks a few snap questions – just to verify perhaps. You are then advised on few general tips like “watch your weight, don’t take too much stress, avoid spicy food, take a morning walk regularly” etc. an advice that you receive from your wife every day and at no fee!
Sometimes you see doctors face a bit worried and puzzled. In this case, the doctor lists a wholly of additional tests that need to be carried out – some of them pretty expensive. “Come and see me with these reports Mr, we will see then” the senior doctor concludes with no conclusion! When you come out of doctor’s cubicle, you see a long queue of patients waiting already for their turn making you feel guilty.
Couple of times, I have tried to open a conversation with the senior doctor but each time my effort was in vain. The doctor pretended as if he never heard me or brushed my question aside saying in an authoritative voice “leave it to us”.
In my young days, we had a family doctor. I still have one who is now 88 years old and still practices. Amazing person. We used to go to his dispensary for any trouble and get checked. Problems were typically fever, cough, indigestion, muscle pain etc. Checking typically consisted of showing the tongue, making the aaaa sound and opening the mouth as wide as possible, followed by checking of the chest with stethoscope. Sometimes if I felt dizzy then the doctor would check my blood pressure with his traditional mercury-based meter asking me to lie down on a tall bench.
We conversed. He used to ask me questions about my views on the Indian politics or where I travelled last and of course what am I doing to check the rising pollution in the cities. I guess this was Doctors diversion technique of taking me away from my problem and talk about the problems of the world. He would typically end our conversation saying – “you won’t need to come back. You will be alright with my medicines”. He had such a confidence that half of my problem used to get cured by his assuring tone.
I would then queue up for collecting medicines next to the compounder’s window. (A compounder is now an extinguished species). I would get a sachet of tablets of different colors and sizes from the compounder from a small window on the counter. We never knew what medicines were prescribed and I don’t think I ever asked about the medicines to my Family doctor.
Now the era of Family doctors is ending or almost over at least in large cities. Everybody now goes to a specialist who may be more qualified but has no time to talk to you.
Conversations are very important in medical diagnostics and treatment. Good doctors who are kind and clever do that as much of the problems we face today are because of the stress, empty feelings and lack of the purpose for living. Sometimes, answers to the simple questions like “is everything else is OK with you? Or do you easily get angry? Or which book did you read recently that you found interesting? when was your last vacation? – open a lot that is buried in the mind of the patient. Mind and body are so much linked. Isn’t it?
These “conversing” doctors may not make as much money compared to the doctors who behave like robots when you see them. But sure, these doctors are most effective in both diagnosis and treatment and are indeed blessed by their patients. They are the angles.
If you know the doctor over sometime, you become friends and then conversations go well beyond those “boring” medical discussions. After the ECG is done, my cardiologist likes to talk to me about meditation and he stresses that mere medication is not the right approach. My nephrologist and his assistants talk to me about statistical analyses of data from dialysis machines and we discuss about the reasons for some of the chronic kidney diseases. But then during these general conversations, my nephrologist has a hawk’s eye on the creatine levels and the GFR of my blood report. After the tooth work is done, my dentist friend describes to me his travels to Africa and the wildlife there. When he finishes showing me the slides he will softly say “don’t eat now for the next hour and take this tablet if it pains too much”. And finally, my amazing acupuncture doctor introduces me to some of the acupuncture books (that I find very intriguing) and gives me a lovely hibiscus tea. That tea sets a conversation.
The secret to above is that I ask these doctors for the last appointment of the day. My experience is that the first part of the day is always crowded even for these kind doctors.
Perhaps, it is the last appointment when the doctor is also looking for some respite before going home. So I make it a point to converse and do my best to relive their stress!
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