Putting Doctors to the Test

Even the Court has expressed concern about doctors performing too many tests on patients

This time, we put doctors, instead of lawyers, under the lens. And we have the tacit backing of the court.

As this is being typed, the author is recovering from a serious illness. It requires trips to the hospital and a series of tests; rather costly, but necessary to be put on the road to recovery. Friends phone or visit. Most have some advice or the other. They want to know the reason why many other tests ‘were not taken’.

A couple of days ago, the court remarked on how medical treatment is getting out of hand—with one test after the other. There is also talk about kickbacks from diagnostic centres encouraging doctors to recommend unnecessary tests. And, if you seek a second opinion, you will have to do the same tests all over again. True, very true. But the flip side needs be considered. Audi alteram partem.

Part of the reason for mounting expenses is the rise in instances of medical malpractice litigation. While, no doubt, people are being killed left, right and centre, and doctors are attacked at the drop of a hat, the issues are deeper. We will analyse them and then…

You be the judge

A day after the court’s observation came news of forced sterilisation that snuffed out many lives. There can be no excuse for that. Malpractice is a mild term for this type of manslaughter. Were preliminary tests taken? Doubtful; especially when the process was almost on an assembly-line basis. Some reports suggest the quality of antibiotics and pain-killers is under investigation.

Should not tests have been taken? In hindsight, most patients would have wanted them. But, at that particular moment, the women would have baulked. There would always be the burden of extra charges. The women had come for free tubectomy.

The problem with tests is this. Until a positive result is obtained, that is, until a disease, or some problem, is identified, tests have to continue. The doctor wants to be sure. He is fully aware of the Damocles’ sword hanging over him. He does not want to take risks. In other words, he does not want to be sued. Even though he has acted in good faith, he can be dragged over the coals and with a sensationalism-obsessed media barking at his heels, he wants to be doubly sure. Ergo, tests.

The past few weeks have been educative. The author is out of action and so is his lawyer.

A doctor’s son, the advocate, had to undergo many tests before he was on recovery street.

His assistant, a young newly-minted advocate, was down with dengue. Tests had to be performed to determine if it was not a run-of-the-mill fever. Without the tests, the boy and his doctor would have been in deep trouble.

You be the judge.

The court had bemoaned the lack of the family physician’s touch. Reminiscing about the time when the corner doctor seemed to cure all with a few coloured and foul-tasting ‘mixtures’, one wonders what happened to that world.

There were no malpractice suits, in those days. Docs did not get hammered by relatives venting their frustrations, often misplaced, on them. Hospitals were not overburdened.

The cities were cleaner and epidemics not rampant. Quinine and penicillin were enough to eliminate the most persistent bugs. Rifampicin v/s TB was in favour of the former.

Drug resistance was unheard of. Today, it is different.

So, should tests be taken or not? Yes and no, would be the best answer that we can come up with. Yet, a modicum of measured approach by doctors may well be needed. In the case of this sick author, only those tests that were deemed absolutely necessary were carried out. It was a step-by-step approach. In spite of the many tests that the friends recommended, the faith in the doctor was justified.

It’s a dicey situation.

You be the judge. When and how does one cross the thin red line?

Bapoo Malcolm is a practising lawyer in Mumbai. Please email your comments to mail@moneylife.in

Courtesy: Moneylife