Listening to: To Be With you - Mr. Big
Mood: Productive
Hello Internets. It's me, the blogger who just has too much shit going on. Well, not literal shit, but definitely stuff. I've been wanting to get back into writing for a while now and I definitely have a lot to say. So here we are.
I've talked a lot about the medical system in India. In some ways, it's absolutely amazing. Medical care and medicine is very easily and quickly accessible, affordable, and can be top notch. Doctors, are a little more complex, and not always amazing. They do not always act in the best interest of the patient, and they aren't always transparent or factual about aspects of care.
I considered for a while if I even wanted to speak (figuratively) about this topic. While a great deal of India is after "Reviews", mostly what they want are gold stickers and positive feedback. I agree completely that positive feedback and credit where due is important so I'm going to try to balance the issue that way. I guess what I'm getting after here is that positive aspects and individuals do not excuse negative patterns, behaviors, and individuals. It's not a scale - at least not for me. I'm also planning to write a review though I do not anticipate a positive response from the medical testing facility.
I've spoken at length as well about India and the allergy here to accountability. The group interest outweighs the interest of individuals, and usually, something dramatically bad (think death) has to happen before anything is done to remedy a situation. If that does happen, it's also used as a political and posturing tool for political parties to wrangle for power. It's disgusting, but believe it or not, you get use to it.
Background: My doctor recommended a test for me recently - I don't want to mention which one for privacy's sake. I happened to know that this particular test can be painful. The doctor also mentioned that it may be slightly uncomfortable (the only honesty I've found in this situation!) and mentioned it to be similar to a pap smear (absolutely not). For this reason, I pursued other options for as long as possible, but the test became necessary. My doctor had mentioned a diagnostic center that offered a "painless service". Again, knowing it can be painful, I decided to try that diagnostic center. When I spoke to the person, they informed that they used "gel" to make it painless. After I reached the facility, I was given a muscle relaxer, a Tylenol, and an injection "that specifically relaxes the muscles in the area". The clinic specifically used the word "painless," and both the doctor/radiologist and nurse assured me it was. They also assured me they would talk me through the procedure so I would know what was happening. I'll spare you further details on the actual procedure. Not only was it painful, but the doctor also did not tell me before doing the painful part that she had assured me she would. This is medical violence. When I spoke up, I was gaslit and told that it was not what she did. She also told me that for the amount of medication I received (which was less, by the way, due to my blood pressure being WAY up due to anxiety), I should not be feeling any discomfort. After I informed her that what I "should" be feeling was irrelevant if I explicitly told her what I was feeling, she left the room, opening the door while I was still in a state of undress, facing the door. Whew. My BP is going up again just thinking about it. It was traumatizing and unnecessary.
I've found that this isn't rare. Doctors do not feel the need or compulsion to establish rapport, maintain honesty, or do what is necessarily in the best interest of patients. I did some research as to what the expectations are in India. Generally, it's agreed upon that honesty (outside of certain, extreme cases) is the best strategy when dealing with patients. In fact, I wouldn't have been quite so upset had the doctor and staff been honest about a bit of pain. But that would have ruined the marketing of a "painless" procedure.
India doesn't always have continuity of care. Over my years here, my primary doctor and specialists have changed over the years. When you see a new doctor (especially in large, money-driven private hospitals), you aren't always seen as a person by the doctor. They both see far, far too many patients to maintain individual relationships, and don't always figure there will be any consequences later on.
Unfortunately, I've found that this creates a profound sense of distrust about the medical system. Instead of trusting a doctor to help me feel better, I wonder what I'll run into, what I need to look out for, and if I'm asking ALL the questions I need to. It sets up a combative relationship before you even seek care, which isn't optimal for anyone. It also seems extremely unethical, which creates a lot of dissonance in a country where doctors are revered almost next to God.
I also feel that not having all the correct information interferes with an individual's choice and autonomy in medical decisions. Most of the doctors that I've run across feel that patients cannot make their own medical decisions due to a lack of knowledge or empowerment. While I do understand why that thinking exists, I don't agree with it at all. Medical autonomy is crucial. Medical violence and the ends justifying the means are not healthy for anyone. Women in particular are subject to this infantilization/withholding information, and it needs to stop.
I'm sure this isn't going to change. I imagine this is a part of the indoctrination (pun intended) for Doctors here as patient management skills. I find it a shame.
~Becky~
