Every condition does not have a drug to be given for relief. A lot of medical conditions just require patient listening and firm reassurance. After Ayurveda when the gift of western medicine was thrusted on Indians, somewhere down the line it created a notion that each and every symptom can be treated with a specific concoction. This has been specifically observed during doctor training programs known as residencies formally. During out patient hours, personal issues are regarded trivial and unimportant and questions only regarding the disease are asked as if the person needs to be ill with a disease having manifest symptoms. Other than that anything else is deemed unsatisfactory to the diagnostic interests of the doctor and deferred for an unknown period.
Keeping in mind that in such a huge population condition, sitting in a tertiary care hospital, trivial details of patients behavior or life cannot always be entertained by doctors, the concern rather appears to be regarding the training of young doctors in such institutions. Currently tertiary care hospitals are the main focal points of medical education in the country. Not all personal complains are psychiatric in nature. Not all symptoms can be organically explained. The divide between systemic illness and psychiatric illness has remained very shady considering the almost non existence of communication and empathy awareness training during medical school.
The after effect is that we create doctors who can elicit extremely good medical histories but do not understand the Socio economic importance of such histories. We impart treatment grim facedly in a copy book manner but consider to ignore the look of confusion in the patient’s face regarding the same. This is one of the many reasons public health has suffered so much in this part of the world. Health care delivery has ideologically come to be imparted from apex centers only. Even mental health has not been given its due importance. Counseling during patient handling has received the minimum attention too. Why has it been so? Simply because counseling does not command as much monetary benefits as a coronary artery stenting. A medical system which disregards the status of counseling is dangerous for everybody as it leaves opportunity for unnecessary medical procedures and interventions done on patients, nothing short of extortion.
Moreover learning tenets of counseling and conversations do not guarantee a single question correct in mcq exams. Orienting oneself with these other sides of the profession would very popularly be considered a namesake of suicide only, delaying one’s rise in the academic scale and professional ladder, considering that the markers of this rise are purely dependent on representation of well known facts.
Until next time,
Peace to the departed souls at Peshawar.
Restless Wanderer 