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.

  • AR

    @MNA:
    Umm, AKUH isn’t exactly a ‘charity hospital,’ if you go by the purchasing ability of a randomly picked Pakistani. Of course they’re into philanthropy, but that doesn’t mean that every second person you encounter there is getting subsidized healthcare. Recommend

  • excalibur

    In all fairness to the readers, both the author and teh AKUH rep who appeared in this forum some time back should provide us an update if they wouldRecommend

  • Doctor-to-be

    I’m a medical student in a govt. hospital in punjab. I started my clinical rotations earlier this year and before we were taught the clinical procedures, we were taught medical ethics. In fact, that makes a major chunk of my clinical rotations this year. The importance of informed consent, reassurance, informational care, respect for the patient and most importantly empathy were grilled into us. Out of a month-long rotation we would spend at least 2 weeks going over the norms of a doctor-patient relationship, every month. We were explained, and whats more, made to practice even how to approach and address the patient.
    But whats disturbing is that a lot of the freshly graduated house-officers and post-graduate doctors in practice seemed to have forgotten everything they had been taught. Most of them would have a condescending approach towards the patient, quite similar to the one described in this blog.
    Ironically, the senior doctors seemed to have a greater sense of respect for patients than the junior ones. Recommend

  • Unkown

    In USA, when we meet the doctors, we really feel great but when the bill comes, we prefer that we should visit Pakistan and get treatment from Pakistan. With much less money, we can meet the relatives and get treatment both. Just few kind words and good environment in the hospitals of USA cost too too muchRecommend

  • A Med-Student

    As a medical student I can tell you that our institutions (Punjab mainly) really don’t teach us bedside manners. Sure, we’re incorporating Behavioral Sciences in our studies but that hardly covers this issue because although the subject has been introduced, there is no actual stress upon it. And I agree, umm there are many doctors here (Lahore) who are so filled with pride that they fail to answer the patient’s or their well-wisher’s concerns. I think it also has something to do with how these medical colleges throughout Pakistan select their students, on what basis they give admissions. Sure getting good grades and MCAT scores should be the priority but that should not be the only criteria in my opinion. I think the students should go through a thorough Psychoanalysis, or maybe at least a proper interview to determine whether or not they have the right mind set for this career or not; And if not, can their mind set be changed? Because I tell you one thing, good MCAT scores can get you admission, but they can’t teach you manners etc I see students in my own college, who are without a doubt brilliant students, have great MCAT scores but they lack the true essence required by a medical student. They show disrespect to teachers, blatant disrespect. They are top of the list on vandalism of the hostel property. They act like they are the ‘Dons’ of the college harassing the juniors, meddling with the girls, picking fights with seniors etcRecommend

  • http://UAE excalibur

    More than a month now and no update either from AKUH or the author herself

    was all this pure fiction ?Recommend