Sunday, December 2, 2007

Advice unsolicited

I used to know an elderly lady as a patient. She suffered multiple chronic illnesses like severe diabetes, heart disease, skin eczema and she managed her life with these disabilities fairly well. She was a good patient in that she kept her appointments, followed my instructions and paid me well.

She lived alone with a helper but had a large number of relations living in the city, country and abroad and she was popular with all of them and they frequently visited her.

Recently she came to see me and I could see that she was very anxious and agitated. I asked her what the matter was. She said, ‘Doctor my nephew told me that I have Parkinson’s disease. I went to the Internet soon after he left and got very scared, how can I manage with this new disease now?

I could sympathize with her as Parkinson’s disease is an illness which can be very disabling. The sufferer gradually loses control over muscle coordination and becomes stiff and rigid. Worse there is no proper treatment or cure in sight. But she did not have Parkinson’s disease and how could she believe her nephew? I asked her. She said, ‘no doctor, he is a neurosurgeon living in the US and when he saw me shuffling he told me that I have this disease and I should take treatment’

It took me more than half an hour to convince her that merely a shuffling gait is no evidence of this disease and lot of elderly men and women take small steps but have no other signs and she has excellent gait and movement. She went convinced.

This is a problem that I have frequently faced in my practice. Unsolicited advice given on the spur of the moment like this neurosurgeon did. One look at his aunt’s shuffle and he diagnoses Parkinson’s disease. If he had that much concern he could have called me and expressed his concern instead of needlessly frightening his aunt out of her wits. I would have tried convincing him. Weather I would have succeeded or not is a different matter.

My patients receive this kind of unsolicited advice from other doctors at casual social meetings and cause me no end of problem afterwards. I also get asked questions and opinions like this from persons who are not my patients. I have a stock answer. I tell them to see me in my clinic if they are unhappy with their own physician. This usually shuts them up and some times ends the conversation which is to my advantage! because I like to be left alone most of the times!


G.D. said...

Very common these days for our patients with a relative(medical/non-medical) living in the U.S.They quote unattainable,un-practicable U.S. standards over each & every ailment being treated here by the local Doctor for their dear ones, whom they have left & gone in the first place.How I wish they had the common sense to discuss with the Doctor first!!! How I wish they realize that our people still die of mal-nutrition & hunger!!

Anonymous said...

And what about the present day doctors. If a patient goes for a check up even for a small ailment, the suggest we get all types of tests done! There is a sure case of tie up between the doc. & the diagnostic centre! It is so expensive nowadays to just go visit a doc. now. Docs. like Dr. B C Rao are very rare nowadays. His diagnosis is simply super. Well as he himself says, if his patients don't follow some basics he suggests,his temper can be pretty pinching. But all in good intentions! ;)