On wrong diagnosis, wrong medication and unnecessary surgery
(for a facebook group)
These things do occur. But I think the issue is complex and there is the danger of oversimplifying the problem.
1. First, we do not know the magnitude of the problem. Except for
personal experience and stories from other people, there’s no evidence
of how big the problem is in Nagaland. A statement like, ‘Naga doctors
often give wrong medicines’ do not hold water. A person who has had two
bad experiences at the doctor’s chamber may be enough for him to make
such a sweeping statement. But for each complaint, we do not know if
there are a thousand cases rightly diagnosed and rightly treated. To
make allegations without solid evidence won’t be right. 2. Are all
such complaints truly/proven cases of medical negligence or are there
gaps in communication and understanding? There will be cases where
patients lodge no complaint. But how many doctors are charged of
negligence, proven guilty and debarred from practice in Nagaland? 3.
Lack of facilities for investigation (laboratory, radiology)
constrains doctors in diagnosing diseases and their management. 4.
Medical Science is not like mathematics where 1+1=2. Doctors make cost
benefit analysis, bargain, and negotiate with human beings who have
choices and emotions. For every headache, one cannot order a CT scan.
Sometimes, the diagnosis may be more costly than the treatment. Right
medicine for the rightly diagnosed disease may not work either due to
poor patient compliance or body resistance to the medicine, or for other
reasons. 5. Doctors are human beings and there may be different
ways/styles of approaching a sickness without going off track. Some may
want to boast saying, ‘your previous doctor should have done this/that’.
I worked in Delhi and yes, Indians sure can show that they know better.
When you visit a second doctor, the course of disease might have been
changed. Also patients influence the practice of medicine. There are
people who think that doctors who give more medicines are good doctors.
Having said that, doctors also need to constantly update their skills;
their clinical skills but also communication skills. And we need to have
respect for fellow human beings as persons and not simply as machines
to be fixed. The power relation between a doctor and patient can be as
unequal as a slave-master relation. In a clinical setting, the doctor
can be manipulative, Mr.-know-it-all, and cold as ice. It may not be
difficult for a surgeon to open an abdomen and justify later, the only
intention being to thicken one’s wallet/purse. Personal link to a
pharmaceutical company, diagnostic lab, or a private nursing home can
turn people in white coats into vultures, making money out of others’
On the whole, there is a need for change at multiple
levels. Strengthen legislation and measures to check malpractice.
Provide better diagnostic facilities. Carry out research. Follow
standard treatment protocol and codes of conduct. Hold CMEs to update
knowledge, and trainings to upgrade skills. Go for second/third opinion.