Dear doctors, what happened to your bedside manner?

Published: June 29, 2013
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Why do you take such extreme offence if I dare to make a simple inquiry, dear doctor? DESIGN: EMA ANIS

Why do so many doctors here treat their patients like mindless cattle?

Yes, I understand that doctors regularly treat relatively uneducated patients who may not be able to follow procedures or understand information. However, when a person comes along, clearly literate enough to make sense of what is happening, it is beyond me as to why doctors treat their questions or opinions with careless disdain, as if we have foregone the right to ask and respond by stepping into their domain.

Fine, you find it difficult to keep me in the loop about what you are doing and how you arrived at your diagnosis, but why do you take such extreme offence if I dare to part my lips to make a simple inquiry, dear doctor?

I’ll elaborate by narrating a recent experience:

“Why is there blood on your hand?”

Does this sound like a reasonable question to you? I think so. However, it was too much to take for my doctor at The Aga Khan University Hospital.

In response, she pursed her lips in indignation and snapped:

“It’s very normal. Why are you worrying so much? You could get killed by a bus tomorrow. Worrying won’t get you anywhere.”

Gee thanks! If the procedure wasn’t intimidating enough, this rude, flippant answer horrified me. To top it all, the wound bled for two days after – which on doing some research, I realised, was far from normal.

It seems as though several doctors in Pakistan are on a strange sort of egotistical trip. Their prevailing attitude is “question me not for I am the all-knowing, all wise.” The minute you let on that you might be able to understand what they’re doing and why (thanks to the Anatomy classes you took in college), they will condescendingly reply:

“Oh, so you are one of those who Googles everything and then freaks out about it.”

No Dr Sahab, just because I asked you what I can do to avoid getting Shigella again does not make me a hypochondriac who will “Google” everything.

It comes down to this. We must all be yes-men and wordlessly accept the verdict scribbled on to a piece of paper by the doctor. Worries, apprehensions, questions are a waste of time; in fact they are offensive to many doctors here.

Forgive me if I am wrong, but I thought doctors were meant to provide a much needed service – to take care of their patients and to reassure when needed. Nowadays, however, it seems that regardless of exorbitant amounts of money we spend on doctors’ fees, we are indebted to them. They act as though they are doing us the grandest favour possible, merely by doing the job we pay generously to perform.

Let me shed more light on this attitude via another terrible experience at The Aga Khan University Hospital.

I recently went for a gynecology exam. My appointment was for 9:30 am – I specifically requested this time because I have to be in at work at 10:00 am and I hate being late. It seems, however, as if my doctor did not reflect the same sentiment. She sauntered in to The Aga Khan at 10:00 am and took her time in calling me into her clinic. Once I was in there, she asked me,

“What’s your problem?,” without even looking at me and you guessed it, without a word of apology!

“I don’t have a problem, I just came in for a check-up,” I replied, quite taken aback.

This was followed by a few instructions. Long story short, I was on a table in a compromising position, pretty much just waiting. And I waited and waited and waited.

My doctor had vanished.

10 minutes, 15 minutes 20 minutes …

She is back. Holding a cup of tea. She went to make herself tea while I was on the table waiting.

Mind you, I paid just under Rs1,500 for this very special treatment. After much poking and prodding I was done and very happy to leave. The next day, I was called in for another test with a different doctor at the same hospital. I was alone and scared, and I expressed as much to the doctor, asking her,

“Will this hurt?”

She looked at me as tough I had said something as outrageous as “Michael Jackson is alive”.

“No,” was her curt and abrupt reply.

Then without any warning whatsoever, I felt a jab – an unexpected jab – and I clenched. I really couldn’t help it, I was so surprised, that I half sat up.

“Don’t clench!” She yelled at me.

At the time, I was too frightened, but a furious me wants to ask her right now, why she didn’t warn me about what she was about to do and how on earth did she expect me not to clench if I was taken by surprise?

I discussed the incident later with my friend – who is also a doctor. She said that maybe the doctor thought you knew what was going to happen and so she didn’t warn you. To this all I have to say is, no I didn’t and I made this clear by asking her if it was going to hurt. If I knew, why would I even ask?

I have been for medical exams in Canada and the doctors have always been so polite, reassuring me and holding my hand every step of the way. Whatever it was, whether a shot or an X-ray, they always told me that I was going to feel a pinch, this is going to sting a bit or that this will feel cold. Isn’t this how doctors are supposed to be, or should we expect the unexpected when we go to see a doctor in Pakistan?

I was absolutely dumbfounded at the lack of patient care coming from doctors in what is arguably the best hospital of Karachi. Doctors are meant to be the most educated rung of society, but after the way I have been treated, I am beginning to doubt this.

Now, after my terrible experiences here I am curious to know, dear doctors, did they not teach you any bedside manner in med school?

Note: If The Aga Khan hospital requires details pertaining to the names of doctors I saw and the procedures I was in for, please feel free to email me. 

Read more by Zahra here or follow her on Twitter @ZahraPeer

Zahra Peer Mohammed

Zahra Peer Mohammed

Former Blogs Desk Head and Senior Sub-Editor at The Express Tribune. She is a business graduate from the Queen's School of Business who tweets @ZahraPeer (twitter.com/ZahraPeer). She blogs at zahrapeer.wordpress.com

The views expressed by the writer and the reader comments do not necessarily reflect the views and policies of The Express Tribune.

  • Arain

    You should go to my mom for check up. She takes like 1/3 the amount, and even though you would have to wait that much, you would certainly not be treated like an animal. :PRecommend

  • Doctor who

    I’m sorry you had to go through this. Most doctors and students of AKU have this superiority complex how they’re working in the best hospital in Pakistan and all when they don’t even know squat. Recommend

  • Insaan

    You are expecting Pakistani doctors to behave like Canadian or American doctors. I guess Pakistani doctors are not used to explaining things to patients. Answering patients questions and making patient feel comfortable is an important part of treating a sickness.

    Your doctors may be suffering from depression. A normal doctor will not behave bad.Recommend

  • MNA

    Sorry to hear ..but the fact of the matter is that the hospital in discussion is working at full throttle. At the end of day it is a charity hospital where you are getting with patients from as afar ( routinely) as Badakhshan, Kabul and Kandahar.Unfortunately for expats it is not a boutique hospital where you could avail a professional advice and a gourmet hospitality for a princely sum of 15 dollars!
    A large chunk of us have western passports in our back pockets but we sweat it out on the streets of Karachi ourselves to come to work and offer our services at the hospital. Too bad, it ain’t up to scratch but these are miserable times we are all living in . It reflects on everything that we interact with.
    Perhaps you should indeed go back to Canada for a better experience, because I can assure nothing will change short of well spun lip service over here.Recommend

  • AKU Alumni

    This is a fact that AKU doctors are getting worse and worse. I saw it during my 5 years at AKU.
    And the “chai” wala part is so TRUE OMG!!!Recommend

  • gp65

    Author: Very real description. Sadly this could have been your experience in many reputed Indian hospitals too – barring a few 5 star hopitals for foreigners and filmstars. These doctors are not always highly paid, they have 3 to 4 times the caseload of a typical doctor in Canada/US ,much more difficult operational environment to function in and as you correctly stated a large percentage of patient group that is poorly informed. This is not an excuse for rudeness but certainly an explanation.Recommend

  • Zain

    Do us all a favor and post their names please.

    Recommend

  • SAL

    Very truly narrated. Our doctors are money hungry, they don.t care what happens to there patients. Now, Agha Khan Hospital doctors have joined the ranks. Have faith in Almighty Allah Sister.Recommend

  • wsd

    Well first of all this is an attitude prevalent in the whole society. Callousness, rudeness is seen every where and doctors are not exception. The treatment that author talked about is still much better than what happens in govt hospitals.
    The author questioned the medical training and whether bed side manners are taught to these doctors. I can assure her that the doctors who treated her were most likely foreign trained. The interesting thing is that if the same doctors go abroad, in a matter of few days they will be as gentle and courteous to every one that if the author sees them she will not believe her eyes.

    The problem, as i mentioned, above is on our society as a whole. Our values have changed in a negative manner and we have no accountability what so ever. We have neither the deisre ot get better nor fear of being disciplined…….Recommend

  • New

    Dear Writer: Although I agree to your argument regarding the general not-so-friendly attitude of Pakistani doctors but Aga Khan Hospital has got a very efficient Patient Feedback System. You just need to lodge a complain and they will get back to you on anything that made you feel bad at the hospital. You may also fill the complain/feedback online through their website.Recommend

  • Luciferous

    Sorry to hear your story.
    We teach medical students “medical science” but not the “art of medicine.” The culture in medical colleges on wards and during training is “what you should do to the patient” rather “what you can do for the patient.” We do not teach medical professionals that medical science has it’s limitations and their mistakes have consequences.
    It behooves senior physicians to demonstrate what a clinical practice out to be be.
    Great professor Hutchison pointed out how a physical exam could feel like as assault.
    Some how rudeness is seen as an essential element of competence by senior physicians in Pakistan.
    It is important that patients let their doctors know abaout their feelings.
    Culture needs to change at the top.
    Recommend

  • Dr Said

    The simple answer to your question is “no”. We are not taught bedside manners nor are they empathized as extremely important in Pakistan as they are here in the West. Heck, the US had to invent a clinical exam just so foreign grads could learn mannerisms when dealing with patients and various clinical scenarios. Recommend

  • A. Khan

    No surprises here. Doctors in Pakistan do not consider their patients as humans or at least as equivalent human beings. They don’t see them as patients but as walking cash machines. I have yet to visit a doctor in Pakistan who I can say gave me value for money, in terms of the advice and diagnosis. If this, as an educated professional, is your experience at a place like Aga Khan Hospital, considered one of the premiere hospitals in Pakistan, just imagine what happens to the poor folks at sarkari hospitals.Recommend

  • http://blogs.tribune.com.pk/author/430/faraz-talat/ Faraz Talat

    The problem is, the older generation of doctors received no training in behavioral science, or medical ethics as we now know it. This subject has been introduced fairly recently in college curriculum. The good ones learned the art of patient management on their own.

    While the newer generation, mine, has received this training, they still prefer to imitate the older, senior doctors in dealing with patients.

    It will take a few more years before the introduction of behavioral science begins to truly serve its purpose. Patients need to be treated as actual people, and not just diseases on legs.Recommend

  • p

    doctor are most rude and self centered people in our society….i tell u my story one day i had a toothache i went to the doctor,,instead of calming me down he said beta u know wasim akram’s (cricket) wife also died due to this tooth infection..i mean this is the bottom line how majority our doctor treat patients, they demoralize themRecommend

  • donny darko

    ahhh, they just want to make money. i avoid this hospital, their doctors are not trained and they have no idea that theres something called “post operative care”.Recommend

  • Canadian Doctor

    Several lengthy articles can be written about how the average Pakistan-origin patient behaves in Brampton and Mississauga, but then that would be both unpatriotic and unrelated to this topic.Recommend

  • asad shaikh

    You went to the wrong hospital ma’am. Aga Khan is famous for its carelessness. I’m a doctor I know that. Liaquat Khan Hospital is much better, and no I dont work for either of these hospitals.Recommend

  • Sajjad

    This is ‘patient abuse’ and cannot be justified. But kindly consider the following issues, Are our doctors paid as much as doctors in Canada? Do we have a health system like Canada? Do we have politicians, bureaucrats, policemen, journalists like in Canada? When society is in a decline as a whole, you can’t expect anything different from doctors. They are part of this intolerant and inconsiderate society and we should not expect them to be perfect.Recommend

  • 357

    @asad shaikh:
    Liaquat Khan Hospital? Weekend already, Doc?Recommend

  • 357

    @Sajjad:
    Absolutely… For example, if you treat a hundred Japanese a day for a year, your conduct eventually ends up being somewhat like theirs. Similarly, if you treat a hundred Pakistanis a day for a year, I guess we all know where that goes.Recommend

  • dr. Farhad

    i dnt knw abt Agha khan bt u need to look at other side of pic.. Patients r gaurded by at least 4 attendants, the doctor explains da whole story to patient n attendants aftr 10 mints another atndant needs to inquire abt whole situation then doctor repeats whole saga of situation.. Aftr 30 mint sm of their wel educated relative or friend arrives to knw abt cndition.. N most of da times doctors r on duty 4 last 12 to 14 hrs, for God sake doctors r also human n v knw patients expect alot frm them bt u shd keep in mind this side of picture also, i m talkhng abt gov hsptls..God bles pakistanRecommend

  • Siddiqui

    Attitudes of physicians still remain indifferent towards patients all around the world. Perhaps, it is not just in Pakistan but almost everywhere. The only problem is that in most of the countries, laws are strict and that is why such things do not appear over the surface. On this note we need to understand that if only we could: a) promote research in healthcare systems and b) stricken our laws; then only can we see a change.

    I found this article really interesting, and it reminds me of qualitative research in health. Qualitative research includes interviews with all stakeholders involved as well as observations around a particular phenomenon. And then a proper analysis is done to identify major themes that were raised in the data collected (observations and interviews). Such results then go the policy makers who then have research based evidence which not only allows them to take concrete, but rightly-directed actions to cause a change. This is how nations progress in this era.

    I, with a heavy heart really can not see that happening in Pakistan! Recommend

  • Minerwa Tahir

    This attitude of doctors is perhaps because of the high regard most of the people give to the doctors by addressing them with the title ‘Doctor Sahib‘. This should stop now, at least among the literate; a doctor is no superior being to you. It’s high time we should realize the importance of equality of all humans irrespective of their gender, race or profession, etc.Recommend

  • Ali S

    @gp65:

    I can assure you the work environment of Aga Khan University Hospital are not difficult at all – they have top-notch facilities and all the consultants are ridiculously well paid. It’s simply a matter of ego and lack of respect for the patient.Recommend

  • http://syedaabidabokhari.wordpress.com The Only Normal Person Here.

    GOOD Blog, everything I always wanted to say, to our not so dear docs.Recommend

  • leela

    Surprisingly, quite a few docs end up being obnoxious TV personalities discussing geo politics. Could that be a reflection of the competence of doctors? Recommend

  • alepo

    the ruthless ‘entrance test’ and extreme sense of competition(accompained with hatred off course) makes them rude and insensitive and when they make to medical schools, its superiority complex and lack of education of patient’s pschology and ethics which worsens the situation!Recommend

  • hema

    my experience with doctors in aga khan was not so bad. but yes, there are good doctors and there are bad doctors. my doctor friend has told me that hospitals are running out of employees. most take their usmles. therefore, the posts are limited, where there should be 5 resudents there is just one who has to do all the work.
    i can imagine why docs in canada are nice. most of them come from india and pakistan, and they would be deported immediately back if they were rude to their white patients.Recommend

  • Parvez

    Doctor stories are like air travel stories…………they can go on and on and on.
    My guess is you just got a bad doctor. My family physician used to encourage us to ask questions so that he could explain what was wrong and how he’d fix it., saying that once the patient understood this his work was half done.
    Recommend

  • http://blogs.tribune.com.pk/author/430/faraz-talat/ Faraz Talat

    As a doctor, it’s hard not to take some of these comments personally.

    No, I don’t think doctors are the “most rude and self-centered people in the society”. That’s a pretty big judgement against an entire workforce that you know very little about.

    I admit that doctors need to be trained better when it comes to patient management (see last comment), but I also know that doctors get piled on and cursed at more often than they deserve; often for things that are beyond their capacity to affect.Recommend

  • Aamna

    this is so true…u went to AGA KHAN hosp…imagine the docs in govt hospitals….and the nurses…why do they behave so? if they don’t like to interact with people or are too annoyed why did they become doctors anyway knowing that they have to deal with people…they r v.rude…u might b experienced doc sahab but we r not..doctors must be nice!!Recommend

  • Mohammad Hamza

    To be fair and objective to AKUH , I would like to say based upon first hand experience, that doctors qualifying from AKU Medical College are definitely trained comprehensively on exemplary patient interaction with care and politeness.

    Unfortunately though almost all AKU grads leave Pakistan and work abroad in the best hospitals.
    Hence, the doctors staffing AKUH are mostly grads from other medical colleges and their training or inadequacies ( or professional hatred for AKUH ) thereof are reflected in their performance bringing a bad name to the Hospital.

    The patient feedback system is in place and I encourage people to use it extensively to enable AKUH take corrective action in recruitment and followup ( Did the author do that ? )

    My elder son is a AKU alumnus and now works as Consultant / Faculty at Harvard. In process is my daughter at AKU in her clinical years.Alhamdolillah and hence Iam in the know to put the record straightRecommend

  • Mohammad Hamza

    Just to add , I understand that surgeries and other procedures where the patient is normally under anaesthesia are remotely recorded on video as on ongoing audit on the operational performance of both the medical and para medical staff for review and compliance of SOPs and professional conduct.

    Mohammad HamzaRecommend

  • Doc’s advocate

    It is so easy to criticize and so hard to put yourself in any one else’s shoes. For a comment above that says docs in Aga Khan are ridiculously well paid…well none of it it comparable to the average salary of the docs abroad. They have specialists and super specialists and we over here have to cover all of that on our own sometimes. Most hospitals are underemployed and the doctors are overworked. And do you know the kind of patients we get here? There are patients ready to kill over anything, those that come blazing with guns and threaten to shoot doctors.I have personally experienced it while I was studying, about 3 years ago.
    There are inadequate ratios of doctors to patients and many go untreated. You want value for money? This is the typical Pakistani psyche’. It doesn’t matter what a horrendous job a person does as long as you do it with love. If I am a patient I would prefer a rude doctor who knows what he’s doing to a doctor who talks sweet and doesn’t. I would give the docs some leverage too.
    Your country is killing volunteers who are trying to wipe out polio here and you’re complaining about bedside manners. Boo hoo. Everything is a disgrace and a mess in Pakistan right now. Give some credit to the doctors who are treating patients on jobs that stretch for many, many hours at a time with few breaks and with so many threats to their lives, they are still not acting cowardly and escaping. Recommend

  • ss

    doctors at AKH treats every patient as Zakat wala patient and nurses treatment is even worse than Doctors :-/Recommend

  • mokh

    “DrFarhad-the blogger already stated she was on her own-she didnt have a whole retinue with her.
    A lot has been said of case load of doctors here-this was the doctors first patient of the day-pity help her last one.
    Doctors are paid less in Pakistan and conditions are tough but cost of living is also an awful lot lower here.Recommend

  • Mohammad Hamza

    would the author please write to Patient feedback at AKUH and relate her experience in this forum to bring a sensible proportion to this debate.
    Also confirm if other hospitals have a similar patient feedback system.and their effectiveness

    Constructive criticism should be the objectiveRecommend

  • Aisha Rehman

    I am a doctor myself but I truly understand what you are trying to say. I have been on the receiving end of this treatment myself and it has become common practice among Pakistani doctors. Our biggest excuse is that we are paid enough, we have many more patients to deal with etc etc. Truth of the matter is there is no excuse for bad bedside manners. Recommend

  • Khalid

    @Doc’s advocate:
    With due respect to my sister Miss Zahra, I am surprised that Doctor of AKU behaved like a Dr serving at DHQ Hospital. Agha Khan hospital has a good repute. The management must take it seriously so that it is not repeated in future. However, I would like to mention we should not compare Pakistani living standards with Canadian or Americans. We are a poor country always obtaining loans from IMF, World Bank and from other countries. How can be we like them…it is not possible.In Pakistan,
    Constable of Punjab Police is getting better salary as compared to MBBS Doctor.
    Rs 22000/- are paid to doctors doing House Job.
    Mostly House Officer on doing House Jobs are Un-Paid
    House job duty is performed continue for 36 hours without rest.
    Passing Part-I has no criteria set by PMDC. A Doctor passing Part-I with 80% marked as considered FAIL because PMDC does not have career planning.
    Part-I result is based on “Available Vacancies” in various disciplines
    PMDC claims Rs.15000/- for Part-I exam and repeatation exams.
    Now Part-II
    *Most time Part-II is done UN-PAID. Some lucky doctors are being paid Rs 42000/-pm
    Duty is performed for 36 hours (Paid or Un-Paid)
    No facility of any food, tea etc at working place.*
    many more problems
    As a community we all should understand and work for the better Pakistan. Recommend

  • unmet47

    Its part of Medical education in Pakistan to teach doctors how to behave. What the doctors did to you, if they do that in an exam they are actually FAILED.

    During the exam doctors have to perform physical examination of the patients, and marks are divided for introduction (of the doctor), explanation of the procedure (including whether they would feel pain or not), proper screening (covering) of the patient and then the other technical things. Then there are marks for adjusting the patients’ clothes afterwards (if necessary).

    There are different kinds of doctors just as there are different kinds of patients. There is a lot of rude attitude in many doctors in the govt sector but then there are many others who are well-behaved.

    I don’t agree with you when you say “they are just doing what they are paid for.” You wouldn’t say the same thing about the army would you?
    This is not Canada or America where doctors are well paid and here they are doing much more than they are paid. And then talking about the government sector, half of them are working un-paid (talking about the HOs, Trainees).Recommend

  • Abdul Qadir

    I do not think all this has anything to do with superiority complex ,money, or overworking etc etc It is just our mentality. We need to change our mentality. Its not only in the medical fraternity this attitude problem is there in every facet of life. We are getting sick in the head.Recommend

  • Insaan

    @MNA:
    A large chunk of us have western passports in our back pockets but we sweat it out on the streets of Karachi ourselves to come to work and offer our services at the hospital.

    It takes the same amount of time to respond rudely or nicely with a smile, but it makes whole lot of difference to a patient. A good doctor should treat a rich foreign returned patient the same way as a patient who has no money.

    Please leave your passports and ego at home. As a medical professional your first responsibility is to do your best and that includes answering concerns of your patient, that may take few seconds.Recommend

  • Muhammad Zafar

    Author. Stop behaving like a spoilt complaining child. I have been through many bad experiences with doctors. In fact the whole of Pakistan is like this. There are millions of poor Pakistanis whose lives are a million times worse. This Pakistan. It is a poor over-populated country. Accept the situation and stop whining like a baby.Recommend

  • Mehdi

    @to all and author

    Patient care is reflective of society and people in general. Pakistan if you take as a whole comes with way too many baggages unlike many normal functioning countries in the world. To author, I empathize with your experience but keep in mind you are living in Pakistan. Budget allocated to treat and sickly and poor, and rest of the society is meager compare to your military budget because you need to have a country for your mighty army to feed. So please don’t be alarmed by the current state of medical care. When Pakistan govt. can honestly spend 50% of their federal budget on education and health care only, society in general in Pakistan would uplift itself from a horrible state they are in now to an average functioning society. I look forward to people badgering me in this blog. Hope this good message is published. thank you all for reading. I just provided a prognosis. Also now please don’t start a 5th India vs Pakistan people war :) Disclaimer – I am neither an indian nor a pakistani. Recommend

  • Mehdi

    @Muhammad Zafar:

    she is highlighting a problem. If you consider yourself a good paki Muslim, they you should speak up against injustice or wrong doing. Author felt violated while under going medical check up. Please stop being uber pakistani patriot.Recommend

  • Mehdi

    @author

    you can ask your friend who designed the animated picture to be patented humor board :)Recommend

  • Motley fool

    [email protected]:
    So being over husy is the best excuse you can come up with,for bad bed side manners , Doctor.?Recommend

  • https://twitter.com/DrSalmanAKhan Dr Khan

    Bonjour! Greetings from Canada.Recommend

  • Aaqib

    I agree with the statement that there are good doctors and there are bad doctors. My worry is for the Institute of excellence in Pakistan. You ask any body which one is the best Hospital in Pakistan and AKUH will be in top three if not the number one in every body’s list. Now my question is should we not make Institutes responsible to maintain certain standards?
    We can have different excuses for Goverment Hosptals but the private Hospitals should improve there standards.
    Author: Thanks for the story. You practically highlighted sentiments of many patients visiting these private hospitals, which can force you to begging if you belong from a middle class but visit these hospitals in a hope to get good medical treatment with care.
    . . Recommend

  • http://www.karachicc.com Saif Ahmed

    Doctors at Agha Khan treat you like an object! I and my family had been a witness of their rude behaviour just last November. There are doctors and then there are “Badey Doctors”. Unfortunately, I never had a chance to meet one of these great men/women. I do not blame any hospitals or doctors for my father’s demise as I firmly believe that your time if fixed. Having said that I must say that these so called Masihas could have made us feel better. We had such a horrible experience that never in my life, I am taking my loved ones to this so called best hospital in Pakistan.
    I was really disappointed to see those doctors misbehave in such a manner with their patient’s. I could go into details but it is too painful to even think of.Recommend

  • Insaan

    @Doc’s advocate says ” If I am a patient I would prefer a rude doctor who knows what he’s doing to a doctor who talks sweet and doesn’t. I would give the docs some leverage too.”

    No one wants a doctor who does not know what he is doing. I guess if you have a choice between between a rude and a polite doctor who are equally good, you will choose a rude one.
    Being nice and being rude takes about the same time, but makes a whole lot of difference to the patients. Author mentioned few incidences which she will remember for years to come. If doctors had been nice she would recommend them to her friends.

    Only those people whose first priority is to serve humanity irrespective of money they make should go into field of medicine. Money can’t buy the satisfaction and gratefulness of patients a doctor gets by curing a patient.Recommend

  • TAN

    @Ali S
    Docs @ akuh are “rediculously LOW PAID” (all….from senior to junior level). The full-time seniors, along with all the juniors, on top of that, are not permitted to establish a private pratice!!!!!Recommend

  • Zaffar

    That is why we wanted IK to arrive and lead us into being a new nation. He represents the change which we so desperately needed in all respects. This was rejected by some factions of the society. Shame. Recommend

  • doctor

    I am a post graduate trainee doing unpaid training at one hosp. So to run my home I have to work at another hospital in evening shift. Some time I have to be 24 hrs. On call. And I graduated from a top ranked medical college of this country purely on merit. I get only 2 days per month off. And this routine is continuous since last two years. So please can someone tell me how can I keep smiling and have a charming personality for all day long. And please don’t ask me about my pay and the number of patients I have to see all day in this over populated country. Strange to see people still make complaints and doctors are the one who mostly have to apologise. As far as this article is concerned since she seems to be a private patient attending a private hospital, can definitely lodge a complaint via pt. Feedback system. But for government hospitals we doctors also need an understanding attitude from this society. Recommend

  • Anony Mouse

    So what Pakistani hospital or clinic are you going to go to next time?

    BTW – I don’t know of any Canadian hospital where you can have an appointment for 9:30am and expect to get to work on time for 10:00am.Recommend

  • DS N

    Sounds like just another typical day in a just another gynae/obs clinic.. not surprising at all. for some odd reason , female gynaecologists seem to have an attitude problem (and that’s putting it mildly at the least). this is a well known fact amongst the medical professionals. the author was most likely treated badly a gynae resident and not the consultant. over the years, the consultants acquire some tact and patience when handling patients , but these overworked residents are mostly on edge and don’t bother to waste much time with pleasantries. my personal experience has taught me that bed-side manner is not something that can be instilled in a doctor in med school, it’s the compassion and the basic etiquettes taught to one long before they are enrolled in a medical institution. sorry to say, most of the time , patients are left at the mercy of these “doctors” from interior sindh and small towns. these fresh off the boat doctors look down upon everyone and everything and like to think they’re God’s gift to mankind,because they’re worshipped back home for holding an MBBS degree, when in reality they lack even the most basic manners when dealing with another human being. their arrogance is amusing at times. no doubt , with time they prove to be competent at their job but they’re far from decent human beings. it’s just sad really. like they say … “parhay likhay jaahil” .. Recommend

  • aftab afridi

    so sorry for such a terrible experience. in pakistan, doctors are given good training as far as the science of medicine is concerned, but there is no training (or minimal training) as far as the ethics of medicine are concerned. this issue needs to be highlighted Recommend

  • Asad

    @ the author
    You schedule an appointment at 9 30 am for a GYN appointment and expect to be AT WORK by 10 am?
    wow… who was your doctor? Dr. Super Woman?
    No wonder you are upset. I’m sure you were late at work that day and your employer ended up writing a blog just like you did.
    had a good/bad day – come home – blog about it – latest trend Recommend

  • Nandita.

    Good blog, Zahra ! Very well written :-)Recommend

  • Zunaira Butt

    @357:
    fazool answer…… totallyRecommend

  • farah.S

    Article is a bit too subjective. Naming the hospital reflects grudge and vendetta.
    Better the writer should try some other local hospital next time she needs a doctor.

    Riding on a high horse doesn’t help.Recommend

  • https://twitter.com/Pugnate Noman Ansari

    @Muhammad Zafar:

    And that’s why the situation is so bad. Because people like you expect people to take it up the wrong ramp, and accept everything.Recommend

  • mgkhattak

    There should be – there must be AND there is no excuse to the patient’s rights. Your concerns must b taken to the higher authority and the Doctor involved must be scrunitised and WARNED.
    This is not a common practice believe me! it depends on personal behaviour as well. Which reflects in there professional attitude . But when it comes to Gynea/OBS i trust your ‘concern’. I am myself a Doctor.Recommend

  • Ejaz saeed

    This is a true reflection of apathy all the people face in such hospitals. I would like to narrate 3 experiences I and my wife underwent at this most prestigious hospital.

    i. In 2007, I was taken to Agha Khan for some cardiac issue. It was around mid day when we reported at the emergency. After certain tests and examinations, I was diagnosed to require immediate procedure. I was kept waiting till mid night on the pretext their was no bed available. so they proposed to shift me to another hospital. Later on I was told by a doctor friend working at the Hospital that it was not the bed issue, infact the ECG machine was not working. The treatment at the other hospital was at its worst and the charges were even higher than AKUs charges. Later on I was told this hospital is run in Covinance with AKU doctors. In patient facilities were almost non-existing and the whole system was run by Ward boys. By afternoon, my family arranged for my shifting to Taba Hospital, where I received top of line treatment.

    ii. My wife required minor surgery for some gynae problem. When she was shifted to the private room, she aws given drip. I was attending her. I was shocked to see the colour of the liquid turning from white to pink. I rushed to call the nurse and when we reached the room it was all red. The nurse was also horrified and explained it was some type of gravity problem, blood was flowing into the bag instead of saline wate going other way around.

    ii. My wife delievered a still born baby and after delievery wsa shifted to the private room. She is ahytertensive patient and with every reading taken she was having higher reading than the previous reading. she kept informing the Doctor about it but no help came. I kept writting my remarks in the register. The complaints was also passed on to the head nurse, who was kind to make a visit to enquire about the whole matter. she called some people and went awy. Considering the condition of my wife deterioting with every passing minute, I took it upon myself to administer her medicine we normally use. Ultimately, the doctor arrived around 10 PM. Compaining that he has to travel all the way back from his clifton residence to attand the patient. Finding the patient’s condition normal after administration of the medicine, he was surprised to know that this was done by me at my own risk. he charged me heavily for the special visit. Next the doctor incharge paid a visit. without discussing anything about the patient history, she standing at the door exchanged greetings and went awy, adding another hefty amount to the charges.Recommend

  • Shahid aslam

    I had a similar problem visiting this prestigeous hospital. I made an appointment with the ENT specialist. I ensured to report at the appointed time. I confirmed with the clerk my arrival and I noticed my name was at No. 2 position for the patients registered for the day. I kept waiting and the patients registered later were being called in, ignoring my turn. I protested. By chance a nurse known from a previous visit to the hospital happen to come to the consulting Clininc. Knowing my situation, she managed to send me in. The doctor straightaway rudely asked me what is the problem. I told him about my problem and without waiting for a minute and even making any further inspection of the ear or asking any questions, wrote LIDOSPRIN on the paper and handing over the prescription almost asking me to get lost. I paid the full consultation fee in return for rs 50 or less medication, which I was already using. God have mercy and save us from ever visiting these so called healers. they spray salt on your wounds.Recommend

  • excalibur

    thank you for protecting your blogger’s malafide post by eliminating any voice of dissent.PatheticRecommend

  • mokh

    @Mohammad Zafar
    I dont think the writers whining-the point is that if there are so many problems in a country-change must come from the top-so the best hospital which does set a high example in treatment,cleanliness and services-needs also to expect its faculty and staff to set an example in patient/doctor relationships.
    unfortunately a lot of the staff is not faculty trained but partimers who appear to be renting the facilities at the |Clifton campus especially-they should all have to go through a basic refresher course when they are offering services in the name of the hospitalRecommend

  • http://www.aku.edu Rasool Sarang

    I am a representative of the Aga Khan University Hospital. Many thanks to Ms Zahra Peer Mohammed for bringing this issue into our knowledge and readers for their valuable feedback. We are in contact with the writer since yesterday.Recommend

  • MNA

    just a random google search will open your eyes to what a massive scamming con industry they have over there. Go and reap the benefit the fruits of capitalism …..humanity died once governments/society stopped making schools and hospitals and replaced them with malls and plazas.Recommend

  • Mehdi

    @Rasool Sarang:

    Sir, you should consider yourself and the hospital lucky. If this was the case in US or any civilized OECD countries, you would have been sued for millions of dollar, most likely your hospital could have been closed due to the debt you would have incurred. I think you guys owe an apology to the general pakistani populace for patient negligence.Recommend

  • Insaan

    @doctor:
    So please can someone tell me how can I keep smiling and have a charming personality for all day long. …… But for government hospitals we doctors also need an understanding attitude from this society.

    I agree doctors on Internship should be paid reasonable salaries. Smiling and charming does not require an extra effort. Patients will respect you for being a caring doctor. It will also keep you in good mood and relaxed. 24 Hr on call may be to train you for real life emergency situations.Recommend

  • excalibur

    @ sarang

    please let the forum know the facts of the case and the remedial action taken.
    Recommend

  • Sam Saj

    By the way how much did she pay in Canada for the curteous service. Consider the doctor to patient ratio in Pakistan and in Canada and than compare.Recommend

  • Liz

    AKU is one of the worst places to get treatment.
    I was going through a miscarriage and had to wait for almost an hour in the ER!
    Two friends passed away due to the doctor’s carelessness.
    I would prefer any small hospital any day! Atleast i would get my money’s worth.Recommend

  • Clarus

    girls become doctors to get a good rishta and guys become doctors to make money abroad and eventually end up with a new passport. what they are doing here is just a preparation for a career abroad while studying at government funded med schools at a subsidized fees and doing house jobs/initial years of practice for the sake of it. Remember how some doctors went on a strike in punjab knowingly that end result would be death of poor patients, could there be anything inhumane? Recommend

  • Citizen

    @Insaan:

    You make it sound like Pakistani doctors can never reach that standard. This horribly pessimistic and unknowledgeable attitude is bringing our nation down.Recommend

  • MNA

    @Mehdi:
    But this is not Canada or USA. Consider yourself lucky this is only Pakistan, because you would be paying through the noses for the privilege of being taken care of. I don’t know what you which you would have preferred…..a simple, no frills, cheap health care or over the top, boutique but extortionately expensive western medicine!!!!!!!

    The last I heard, un insured americans were flying to Cuba and Jamaica to get their hearts operated upon.Recommend

  • Mehdi

    @MNA:

    you have no idea what you are talking. Did I hit a raw nerve ?Indeed I am extremely lucky to have to access to world’s best medical care. What’s your point ? Are you trying to defend those doctors who provided negligent patient care. Seriously Pakistanis are really delusional when it comes to patriotism.Recommend

  • Saad Munir

    @Khalid:
    This is not good justification! Since you have already decided not to rectify the fault that you yourself pointed out, so what can be further said?Recommend

  • Dr. Amyn Malik

    How dare you question the manners of us doctors? Don’t you know we are all knowing and know what’s best for you? We don’t need to explain ourselves to some worthless patient. You should be thankful that we take out time to even consider listening to your problems

    Now I hope Zahra knows me well enough to take these comments in the sense they are meant to be taken in. Not sure about the rest of the people here :P

    FYI – these consultants are just as rude to their trainees. Actually, most of them are downright degrading. Just ask any medical student in Pak.

    PS: For all those who think this attitude of docs is worth defending because they are underpaid, unlike what people in this country think, a human being’s worth is not measured in money.Recommend

  • Maria

    My mother is a Pakistani doctor working in North America; A lot of foreign doctors here have bad bedside manners but also bad manners in general. It’s not just Pakistani doctors but all IMGs ( International Medical Graduates) from developing countries who rush patients in and out to make money here in the West too. I note that my mother’s medical colleagues always complain about money here too, no matter how much they get paid. They lack the professionalism and manners you see in native Western trained doctors. It’s not about money but culture since a lot of Pakistani doctors have been living and earning here for decades but you can’t change their thinking or behaviour. Even if you paid them more, they would behave just as arrogantly. Sadly , the simple immigrants who do labour jobs give doctors unnecessary lift even though they are just doing a job! Even though my mother is an international medical grad herself, she is the first to admit that you can’t compare the professionalism and culture of people from poorer countries even if they pass the exams and do training here. The problem also is that a lot of immigrants from the developing world living in North America are very uniformed and bad behaving patients too. My mother always complains that they abuse the system here, never come on time or come late, are very demanding, try to cheat with drug cards and always think that only they matter and other patients can wait. They don’t give a proper history, complain about many things at once, tell you that they are related to so and so which means they need VIP treatment or they want the doctor to help them do some kind of disability fraud and fill out forms fraudulently. So the problems are not just due to the immigrant doctors here but also the mentality of the immigrant patients living in the West. I have seen that when bad behaving immigrants here go to their home countries, they behave even worse there because they think they are doubly special! Rather than understand, they pretend to be more Western than a Westerner who at least has some sympathy or understanding not to belittle the developing country’s services. It’s a problem with many dimensions. As for the guy Khalid who complained a house officer makes less than a constable in Pakistan, does he not know that a house officer (resident ) in Canada or US makes less than a policeman, fireman, teacher, nurse and almost every job here? They make the same as a general labourer or “mazdoor” when they do residency (house job). Look up the minimum wage here! It’s only a qualified doctor that makes more.Recommend

  • MNA

    @Maria:
    Can you ask you rmother to come back to Pakistan and work with us in hospitals here…..please.Recommend

  • excalibur

    I think the blogger has achieved her objective of creating an unncessary discussion by targeting a private hospital when she could have filed a complaint and if the outcome were unsatisfactory she could have shouted. ( she went there not once but twice )

    All IMGs and local med grads in the States are required to pass the Step 3 CS/CK which includes bedside manners as well.

    As in every profession there are good and bad apples in medicine as well. Best to chill out and vote with your feet by going to the better outfits.

    Still waiting for AKUH to update their side of the storyRecommend

  • Sane

    Mostly Doctors are snobbish, specially those who are ‘Consultants’ and charge high fee. Apart from medical ethics as how a patients should be talked they do not have manners to talk with even ordinary person in daily life. Yes, if person is influential or filthy rich their behavior and attitude becomes otherwise.Recommend

  • Sane

    @Khalid:

    we should not compare Pakistani living standards with Canadian or Americans. We are a poor country always obtaining loans from IMF, World Bank and from other countries. How can be we like them…it is not possible.In Pakistan,

    We are a poor country living on loans…… so, we should not correct ourselves in terms of attitude or manners. What an absurd logic you give. If policemen are getting better salary and they are well-off, join the lot do not think to become a medical professional. Apart from police there are many other professions; even a fruit vendor at a lucratively placed roadside THELA earns more than an executive, policeman or doctor. Meat sellers earn unbelievably hefty per month amount (profit) at least in five figures. Choose the option.Recommend

  • Insaan

    @Mehdi:
    If this was the case in US or any civilized OECD countries, you would have been sued for millions of dollar, most likely your hospital could have been closed due to the debt you would have incurred. I think you guys owe an apology to the general pakistani populace for patient negligence.

    Sued for what? Author just went for a gynecology exam. Doctor examined her. It appears some swab test or biopsy was done the next day. Why should hospital apologize to the general Pakistani populace?Recommend

  • ptr

    This sad for the best Hospital in Pakistan’ but there are very kind doctors too’ stars always doesn’t matter’ Recommend

  • Insaan

    @excalibur:
    I think the blogger has achieved her objective of creating an unncessary discussion ….
    Still waiting for AKUH to update their side of the story

    This discussion is unnecessary but you still want an update from AKUH for some reason. Recommend

  • Insaan

    So many people complaining about Pakistani doctors. It is beginning to look like a mental health issue. A psychological study is needed to see what is going on. Just think for a moment when you are irritated you are not on your best behavior.Recommend

  • Insaan

    @ptr:
    We should not assume all patients get treated bad in this hospital because a Canadian returned author felt she was treated bad. Author did not give details of her TOTAL interaction, just mentioned responses to 2 or three questions she asked.

    To solve the problems, each and every person who visits for treatment or for medical check up SHOULD be asked about their experience at the hospital, including questions about attending physician, nurses and other staff etc. This short Interview can be done at the time of discharge or when patient is finished with consultation. Patients can also be asked what can hospital do to improve the service. This should take 2-3 minutes. Interviewer should have something like IPAD to record ratings and complaints. Information can be recorded in a database form

    To make things easy questions can be designed which can be rated 0 to 9, where best is 9.
    For example how would you rate your doctor over all, how likely you will recommend this hospital to your friends etc

    Educated patients can be given option to access to share experience online or thru email

    This information can used to see how each doctor is doing. Good doctors can be given a Certificate like “Best doctor of the month” or in some other way.

    This information can be used to teach hospital workers and doctors to improve services and patient/doctor interaction.

    Counseling should be provided if needed. Doctors can have problems too.

    In this case I don’t think hospital needs to give any more information to the readersRecommend

  • excalibur

    @ Insaan

    Insaaniyat demands that we should hear from the accused party as well for the right of defense instead of encouraging the tamasha of Nawaz / Chaudhry doing a Musharraf.Recommend

  • ptr

    Everyone in Pakistan is underpaid’ so stop crying about your pay’ it is still good enough’Recommend

  • NY foreigner

    I think the problem is that your best and brightest doctors are all going oversees. I go the the NYU dental center for dental care and 80%+ of the interns and residents are from India and Pakistan (that says nothing of doctors educated in Pakistan who go abroad after they graduate).
    I have nothing but good things to say about the many medical practitioners from your country who have given me excellent care over the years.
    Your problem is one of brain drain.Recommend

  • excalibur

    @ NY foreigner

    Your comments are spot on. Brain Drain , indeed, is the root cause of the problem.It leaves the mediocre precipitate and it can only rise to its own level of competence.

    This phenomenon occurs across almost all sections of society. As for politics , no genuine and sincere person can either afford or withstand the hegemony of feudal/dynastic goons who rule the roost since Indepenedence.Recommend

  • Mehdi

    @Insaan:

    I did say the premise for taking legal action is due to negligent in patient care. If you live in the west then you will know what the law is Recommend

  • Mehdi

    @Insaan:

    She is protesting against the wrong thing she observed. It is her right as a human being. It’s pakistani like you who is the problem. You won’t raise your voice against anything because you think it is in patriotic to say anything against Pakistan.Recommend

  • excalibur

    @ mehdi

    Sorry but you are going over the top now. You are not the only one living abroad. If you go public against anyone and are sued for libel you cannot even pay for it as your future generations will be required to do so.It is her word against the doctor’s. Can she substantiate anything in a court of law ? Does she have any witnesses ?

    Based upon one sided narrative, no direct complaint to the hospital,repeatedly returning to the same hospital despite the bad experience, misusing a public platform,not allowing the hospital to respond and remedy the grievance

    The hospital can claim that it is a deliberate attempt to malign them based upon some agenda.
    Let us be balanced and sensible.Recommend

  • Sterry

    @excalibur: What brain drain? Every city in Pakistan has multiple medical schools and there are no jobs for the graduates; That’s why so many Pakistani doctors in the West just sit around and do labour jobs when they can’t pass the easy exams for foreign graduates. Those that pass like to go home and show off, “look at my house in US” like parhay likhey jaahil. In a country of 200 million losing a few thousand trained doctors makes no difference when there are thousands of unemployed doctors in Pakistan. The so called brain drain would make sense if the foreign trained professionals were the first choice of Westerners!Recommend

  • Insaan

    @Mehdi: She is protesting against the wrong thing she observed. It is her right as a human being. It’s Pakistani like you who is the problem. You won’t raise your voice against anything because you think it is in patriotic to say anything against Pakistan.

    Go back and read all of my comments for this blog.
    I am not a Muslim or a Pakistani.
    After you read my comments for this blog, you decide for yourself if your comment makes any sense.Recommend