Too Scared to Visit the Doctors?
In India, we are scared to go to the doctor. Why?
I know the answer why we do not like to go to doctors for years, and literally suffer in silence.
- You are scared because the doctor may tell you, you are going to die soon. That is the worst scenario.
- You are scared because the doctor’s fee is Rs. 300. That is okay, but you are worried that it will not stop at Rs. 300, he will end up costing you Rs. 30,000.
- It could be even okay if it is Rs. 30,000 also, but then you are not sure that Rs. 30,000 is getting you management worth your money.
- If you go to another doctor, he will tell you, “hey, everything was wrong”. You paid Rs. 30,000 for nothing and that is when resentment and frustration comes in and you pay Rs. 30,000 again.
What if we bring a revolution and change this scenario and make all 4 reasons above obsolete. That is the concept behind our Add15Years series of books. I, (Prof.) Dr. S Om Goel, trained from top medical schools in India and USA being the author of these books, focuses on maximizing your lifespan and predicting health crises before it happens in your life. I am asking, can we predict the future in relation to our health? Of course, we can. Just like we can tell you today, when it is going to rain, or a hurricane is approaching so that you vacate towns in the USA. Ignorance used to be a blessing in the past, not anymore. Today we have resources and can make you live longer and healthier and with “ No More Crisis”.
Today, there is a segregation of two classes, the upper middle prosperous class and the poor. When we came out of medical schools in the 1980s, healthcare was 100% government based whether one was rich or poor (actually nobody had any money). Today, the poor go to government based public hospitals and rich go to the corporation owned private hospitals. The contrast is very dramatic. Because of mismanagement, although public hospitals have all the funding and lots of money, poor people end up waiting and suffering. While private hospitals, because of the very smart professional and financial management, are becoming richer and at the same time they try to give everyone a very VIP treatment. The more money anyone has, the more VIP treatment he or she gets. There is a belief today that our life these days is very stressful, and we are having more medical issues in present times. To be honest, the fact is we are living actually healthier and longer despite being more incidence of diabetes, or blood pressure, or arthritis. This is for one simple fact that we are getting better access and better medical care, especially in big cities.
There is no question that our doctors in government hospitals are very experienced and renowned. The professors are very experienced, very renowned and very talented, and some of them are the best senior doctors. But, the only way people for the upper middle-class society to approach them is through connections. It is stupid for any self-respecting person to go to government hospital in today’s times without connections. As I did the pilot project in Gurgaon/NCR, it became more and more obvious to me that in these modern times, Indian medicine still focuses on crisis medicines and we are not taking advantage of the resources available in the modern medicines. Maybe we want to, but then we do not trust our medical community.
Our medical community has a very bad reputation. But, why is that?
- Because there is no control over expenses. There are no fixed costs.
- There is no one to verify the judgment of our colleagues. Even if you seek the help of law, it will take several years and a lot more money.
Result is we trust only 300 to 400 top renowned doctors in NCR, India who achieved fame by practicing for 20 to 25 years in the community, waiting for hours and hours to see the same doctor, paying Rs. 2000 for consultation when it should cost Rs.300 to Rs. 500 . If we had a choice, we would all go to them. Money and time become restrictive factors, of course.
Ideally, both senior doctors and not so senior doctors should get the same amount of money. I am not saying that a senior doctor should not get the benefit of their knowledge and experience, but that knowledge and experience should bring a larger number of patients rather than more money per visit just like we do in the United States. To be very honest, any specialist (not MBBS in India), who once finishes his or her studies should mature within five years of starting medical practice and this should apply to the surgeons also.
Indian medical system is based on seniority and name. If you are senior and you have a good name in the community, you can charge for a consultation from Rs. 1200 to Rs. 2000, for which specialist in the community will charge around Rs. 400.
One major difference between the internet and doctors is when things go wrong somebody needs to take responsibility. Doctors are highly trained to anticipate and look down at the future because we deal with 5 years old, 10 years old, 50 years old, 80 years old. So, we see the progress in life and every day we are reminded of what is going to happen to anyone down the road.
Second thing, modern medicine is fast changing, the technology and new medicines are marketed every few months. Only doctors are aware of that (it is our obligation to be aware of recent advances). There may be a new revolutionary treatment, so the internet is not the right place to bring it to your attention.
The question is can we wait as long as we can, to visit the doctors, be happy with normal blood tests, exercise, take vitamins and go to the doctor only when medicine/treatment by a local chemist, or treatment by a doctor in our family (by phone) is not working or failed?
The answer to your above question is “No we cannot “. Not in today’s environment. We have no choice but to visit a doctor in this day and age. Whether we are going to live or die either way we want to know. There is no sense in running away from the truth. Let me now tell you two of my clinical experiences pertaining to this scenario.
One day I was sitting in my Asha USA medical office, a husband came with his wife and he said, “she is having a big tumor on her head and it has been there for four years. So, he fears that she has cancer, Dr. Goel”. So I said, “wait a minute, let us not jump to any conclusion”.
I saw the wife and assessed her. I looked through her hair, and looked at around 3 cm big mass. The wife admitted that for the last four years she had been constantly worried that she had cancer, and something is going to go wrong. I asked her, “But, why did not see a doctor for that?” For whatever reason they did not have any good answer for that.
So, I examined her. I looked at her and to me it was a simple hair follicle which got infected and what we call a ‘sebaceous cyst’. After taking history and talking to her in detail, how things had been over the last four years, and it became obvious to me that it could not be a cancer at all. I gave them my opinion; it was a simple infection. Let us treat it with antibiotics, or may be with incision and drainage, but it was not a cancer.
I could not convince the wife and I could not convince the husband, so I treated her, managed it, and for the next couple of days of follow ups, the wife was still worried about the cancer. So, the only thing I could do and convince them ultimately was to drain the fluid and send it for a pathology examination, although it would cost another Rs. 5000 and I discussed that scenario with them. They wanted to go ahead and paid Rs. 5000. So, finally the report came out and obviously as I had no doubt, the report said it was just a simple infection in pathology.
Finally, the couple was highly relieved that there was no cancer. She waited for four years and worried about cancer pretty much every day and was scared to find out the truth. But really, I can tell you that any cancer we can diagnose at the first stage is 100% curable.
(There are usually four stages of cancer).Before I set up the Asha USA Mini Medicine Citi project in Gurgaon, I had set up Koman Savitri Hospitals, (2009-2012) in different sectors of Gurgaon. I have come back from the USA and I was working there. This lady walked in and since besides being a medicine specialist, I am also diabetic, blood pressure, and kidney specialist. So, the lady came to consult me about her kidneys and said that for the last four years everybody has been telling her that her kidneys are weak and for the last few months she has developed swelling in both the feet. Her kidneys have failed, and she is going to die within six months
I was totally taken aback. Anyway, one good thing was she had all the records for the last four years. She had all the blood tests in relation to all the kidney function tests for the last several years. I went through them and I realized that kidney function throughout was normal, they remained very stable and nothing has changed over the last three or four years. She was taking medications for blood pressure. She was taking calcium channel blocker. It became very obvious to me that her leg swelling was because of the blood pressure medication which is a very well-known medication to cause leg swelling. So that mystery was solved, and the second mystery was what she probably had or could have.
The only answer was that she had IgA nephropathy which is one of the most common medical condition but she was clinically very, very stable, so I told her that, “you are doing absolutely fine and the only explanation I have for your so called diagnosis of weak kidneys is that sometimes you might have little protein in your urine and it happens in IgA nephropathy but only way to prove this is by doing kidney biopsy. I can do a kidney biopsy and prove my diagnosis, but thing is, what am I going to do with the biopsy results? Even if I prove it, am I going to treat you?” Of course not, because her kidneys were functioning absolutely normal.
They are working absolutely fine. They have been working fine for the last four years. There had been no change. So, I decided that I am not going to give her a single medication and I am not going to touch that balance of relatively healthy kidneys at that time.
So, when I talked to her again and everything pointed out to me, she actually was in very good health except for swelling of the feet and I asked her again. She said, “no doctor, I have been told again and again for the last 4 years that my kidneys are weak, my kidneys are weak.”
So, it took me almost two hours to convince her, but what was painful for me to see what she had gone through for the last four years and she said , she has spent almost Rs. 4 to Rs. 5 lakhs over the last three years and she was not a rich woman at all. She did not even have a very good income