Medical Misfortunes

This week has been filled with trips to doctors' offices and hospitals, for both me and my husband. That being said, even though the US health care system has many faults (such as being really expensive) I will appriciate it a lot more now that I've seen some of India's health care system.

So first off I've been having "women's problems" for about a week. I'm not going to go into too much detail, all I'll say is that I wanted to go see an OBGYN. So we started to search for one in Mumbai that I would be comfortable going to. Apoorva asked his cousin, who is in the health care field, and she provided us with a list of doctors, one of which is some distant relation. So we called this 2nd cousin once removed and she had an opening the next morning.

I'm not exactly sure how it works here, but it seems as if many doctors practice right out of hospitals, and during part of the day will hold outpatient office hours right in the hospital. So that is where we went for my appointment. The hospital itself, while considered to be one of the better ones in the city, was dirty and run down. I would have never guessed it was a hospital unless someone told me (or if it had not been for the nurses who were dressed in a somewhat more conservative version of the old-fashioned white nurses uniform). But I guess some would argue that US hospitals and Dr.'s offices are unnaturally sterile, so I could forgive a little dirt and grime. What really skeived me out though was that table dressings were not changed in between patients, and many times the door was not closed (and this is an OBGYN we're talking about... not a podiatrist)

But what really bothers me is how patient care itself is delivered. No matter what the setting you would expect care to be delivered in much the same way. But there are glaring differences between the US and India in this department. First of all, you don't see a nurse, no patient history is taken, you are not asked what medications you are on, in some cases your weight is not checked, or blood pressure. The doctor spends about 2 or 3 minutes with you asking about your specific ailment and then gives you a diagnosis and sends you on your way with about 10 different prescriptions (none of which are checked against any medicines you are currently taking, and the pharmacy doesn't do this either). And what really shocked and surprised me is that no medical records are kept. If you want to keep a record of your medical history you have to do it yourself. And even if you did a doctor probably wouldn't look at it before examining and diagnosing you.

Don't get me wrong, the doctors themselves are nice and professional and do everything they can to figure out what's wrong with you and what they can do to help (in a timely fashion considering the patient load is probably 3 or 4 times what a doctor in the US would have). The OBGYN I saw was concerned about some pain I was having, so ordered an immediate ultrasound and was there while I was having it done (which is unheard of in the US). And doctors still do house calls here, and will give out their cellphone numbers. And of course they are just as educated as doctors in the US. It's just that the system is all messed up. I don't want to even think of how many people have reactions because of problems with medications. The fact is that here, you have to be on top of your own health care.

I of course am not basing my opinion on one doctors visit. The same can be said for Apoorva's visit to the clinic today with some sort of viral infection. I've also been to the doctors twice before now (once for a wrist injury and once for a sinus infection) and had one doctor make a house call when I had food poisoning. Yes, it is cheap and easy to get health care here, but there is just something about it that leaves me a little worried that the doctor couldn't have gotten all the information, or than one of the prescribed medicines will interact with something else I'm taking. I definitely feel like I have to be more aware about my own health care while I'm here, because no one else is!