The Death of Empathy in Medicine. Health; MEDICAL PRACTICE |

Health; MEDICAL PRACTICE | The Death of Empathy in Medicine. Diagnosing the malady, where do things go wrong? Our Identity as Noble Professional sets certain morals, values, behavior’s, ethics, and relationships that underpins the trusted public has put in doctors as “healers. "Today, looking back at the most profound part of my identity and purpose, I find medicine at crossroads due to the indiscretion and the dishonest ways how consumerism, commercialization, moral degradation has engulfed the medical profession." DR FAIZ FAZILI-Published on: 26 Jan 2022, 1:32 am Greater Kashmir Why health care is an exceptionally different profession: Why does it matter to reclaim its nobility in a commercialized healthcare market. To be a Doctor in medicine is a dream to be achieved and a goal to be cherished. It was a real enthusiasm and joy when I joined the medical college being one amongst the privileged ones to be selected from several thousand aspirants to be a part of the noble profession. An opportunity for contact with humanity, the ability to understand the pain and human suffering, and a motivation to address it create the positive in your career. Today, looking back at the most profound part of my identity and purpose, I find medicine at crossroads due to the indiscretion and the dishonest ways how consumerism, commercialization, moral degradation has engulfed the medical profession. The term healing has taken a big hit, hospitals are no more called “Shifa Khana’s" (places of cure ), or doctor is considered as “messiah.” In the first place, from times immemorial medicine is not a money-minting profession but in their day-to-day practice Doctors are committed to integrity, compassion, altruism, continuous improvement, excellence working in partnership, and empathy with patients and families, members of the society. Has those oath practiced professionals kept the Hippocratic in abeyance? Where do you say ” yes “and where you refuse to compromise on conflicts of interest in exploitations of name, fame, finances and say, “No, this is my limit of what I can /can’t do.?” Diagnosing the malady, where do things go wrong? Our Identity as Noble Professional sets certain morals, values, behavior’s, ethics, and relationships that underpins the trusted public has put in doctors as “healers”. The commercial forces have steadily encroached into our understanding of medicine and health, the moral foundations of the medical profession losing their influence on the behavior of physicians. Awareness about things that most people have an inkling of the nexus between pharmaceutical companies, diagnostic centers, and corporate hospitals; the pressure on doctors to prescribe as many costly investigations and tests as possible, do (indicated or not indicated )interventions to earn a pre-specified revenue for their hospitals; at times, such spicy stories pile up one atop another, and some of these can read like stray gossip which, even if true, I found it hard to swallow. The idea that senior doctors who we regarded as our icons (names withheld) are indulging in such unethical practices is shocking to me. How many doctors working in x rated -star hospitals shortchange patients to keep their management happy and enrich their own pockets. Involving healthcare workers in malpractices has long been an area of concern and importance. However, we still need to understand how patients perceive undesirable events of exploitation during their hospital stay; getting cut (% ) on total hospital charges, kickbacks for when a doctor prescribes tests the laboratory conducting those tests gives commissions, some tests (sink tests) prescribed by doctors are not needed unnecessary surgeries, emergency interventions on the virtual dead body. Charging patients, a fat amount for ICU bed charges, consumables that were not even used, prescribing drugs that are not under price control to claim higher margins, unnecessary frequent visiting doctor’s fees and to be on the panel of a prestigious hospital, there is give-and-take involved, separate billing code is applied for the procedure and adhesion’s they are there to inflate bills and commissions like allegations have surfaced in media Any Hope? Though our land has a long way to go, the attitude toward malpractice is slowly changing us there are many honest doctors and private hospitals from the valley with impeccable ethical records. Sadly, many of the present-day doctors after putting a long period of labor and money in achieving degrees and expertise’s yearn for becoming rich overnight. Be it by fair or foul means enter in league with the private hospitals, labs, and diagnostic centers especially across the tunnel shortchange patients to keep their greedy management happy and enrich their own pockets. Although I am not generalizing doctors for crass commercialism, many of them behave so, earning disrepute for the profession. No doubt, corruption is everywhere in all professions, but medical corruption literally means the death of empathy & trust deficit involving decisions of life and death. What fails our doctors is a lack of QPS (Quality & Patient Safety accountability)in our healthcare system, and the State’s vigilance on such corporate exploitation, giving the patient or families a distorted version of the pattern of illness for all the unnecessary tests and over interventions. Trust is an essential part of healthcare. When we feel poorly, we visit our doctor with our hopes high, trusting that he or she will help us heal. We bring Doctors our concerns, our list of symptoms, our history, and our questions. In exchange, we expect answers, or at the very least an effort to find answers. What if we feel like our trust isn’t returned? What if our symptoms are dismissed or our story considered unlikely? What do we do if we feel strongly in our gut that something is wrong despite the medical expert who says we’re fine and we can go home? Or we’re told it’s just stress, or a touch of the flu, or a common childhood illness? Or the worst dismissal heard by so many: it’s all in your head, overthinking & prescribe anxiolytic? Being ignored by your healthcare professional is one of the most common complaints heard by patient advocates, healthcare reporters, and now social media. Most patients (Seventy-six percent) of respondents said they don't leave their physician's office on a positive note, feeling disappointed by questions and answers exchanged, confused about their health, according to a 2021 October report by the AHIMA Foundation. Eighty percent are likely to research their medical recommendations online after an appointment with their physician. Twenty-two percent of respondents said they don't feel comfortable asking their physician certain health questions. Four in 10 respondents reported being dissatisfied with the questions they could ask and the answers they received.Twenty-four percent of respondents said they didn't get clear answers to questions they asked their physician, while 17 percent said they didn't have the opportunity to ask any questions at all. Twenty-four percent of respondents don't understand the medical information their physician provides. Fifteen percent said they are more confused after a visit than they were before visiting a doctor. Are doctors Losing their touch? The disappearance of the primary care physical examination, auscultation by stethoscope, and palpation by hands are scarcely used. Feeling dismissed and ignored by Your Doctor especially with the healthcare care delivery system, State health-run institutions, people are compelled to seek a second opinion locally or outside with lot of hardships. Unarguably many of our doctors need a refresher course in communication skills. Opening of full-fledged state of art hospitals under a single roof (or a Medical city ) with treatment accessible & affordable even for a common person. The PMJAY or Ayushman Golden card e Ayushman scheme intended to be a 'game changer' in healthcare has not been relatively problem-free some hospitals are shying away from treating patients entitled to the scheme, in some cases, hospital patients had to pay for COVID Management “high-cost cocktail- monoclonal antibody therapy and that the project could be running up against non-compliance in terms of its implementation on the ground. Now the doctor-patient relationship is that of a service provider-consumer. Initiating the cure Medicine must change from business-centric care to patient-centric care. What Needs to be Done? Public-private partnerships or PPP model in healthcare scenario in India has seen a growing trend from reputed or multispecialty brands of health care instead of multistory hotels on our land instead of catering outlet shops for transparent affordable provision of care. The skills, talent, competency of our own doctors is no less than those who come from outside, our hospitals including private ones are still cheaper and are resisting profiteering through unfair means try them first before venturing outside, belief, me there is much exploitation outside, which most of us don’t understand till one becomes a victim of exploitation of buying health, the costs of commercialism as an alternative philosophy which most of us don’t understand till one becomes a victim of exploitation of buying health. In the end, we cannot outsource or buy our way to the answer, our identity as noble professionals sets some moral values, behavior’s, ethics, and relationships that underpin the trust the public has put in doctors as care providers or healers. I am a doctor, but I am also a patient I was born in this land, will continue fighting in a collective responsibility so we can make it an honest and fair trustworthy system to restore lost mobility and trustworthiness in me and my profession. How soon? The choice is ours. (The author,Dr .Fiaz Fazili is Senior Consultant surgeon and an expert on Healthcare Policy, planning to improve patient care in low and middle income states.)