Doctor v/s doctor: always a lose-lose game

Doctors are only human. On occasion, ethics takes the backseat, sometimes unintentionally, sometimes ‘intentionally’.

In life everyone wants to prove his or her one-upmanship. And in this process we spoil medical relations.

Our role as doctors is not only to protect our patients – we must also protect the ‘other doctor’. In short, it’s important how we talk before our patients.

Let’s analyse how we inadvertently start playing the game of doctor v/s doctor.

When a patient who has been seen by a junior doctor comes to our clinic, we comment indirectly about his lack of experience by saying, “He is a budding doctor.” Or we show total ignorance of his skills, sometimes even his competence, and say, “He was my houseman. When did he start private practice?” We may even go to the extent of doubting his qualifications, saying, “He is from a ‘deemed university’,” or “I know how he got admission to medical college. How did you land up in his hands?”

You are in your consulting chamber and a patient tells you that he had been to another doctor earlier. You refuse to even glance at the case papers and tell the patient to forget all about the previous doctor. Or you spend a full 45 minutes in studying the case papers, implying that a complication had occurred, and then say, “I don’t understand anything.”

Sometimes you even digitally scan the papers, prepare slides and present them in ‘scientific’ conferences.

If a patient says the other doctor is attached to a big hospital and you have a small set-up, you downgrade his skills by saying, “He has to show a certain number of cases, that’s why he must have admitted you.” If the patient says the other doctor has his own small hospital and you are attached to a big hospital, then you may say, “He was thrown out of this hospital,” or “He didn’t get an attachment in this hospital,” or: “In small private nursing homes they do anything,” or: “Last week we admitted two of his cases.”

This process does not stop in the consulting room. After admission, while taking rounds, you ask the staff (softly but loud enough for the patient to hear you), “Where is the patient admitted for complications from such and such doctor?” Or you ask the RMO, “Do you remember the other two similar patients? Now there is another gift for you…”

Sometimes our script goes to such an extent that when the patient has finished telling you everything, you say, “This is a textbook complication,” or: “Thank God you came here alive,” or “You are very tolerant. Anyone else would have gone to the consumer court,” or: “Now, forget everything that he has done.”

Such communication is bound to reflect poorly on the medical profession. If you want a better relationship between medical professionals, you should say:

“See, complications happen. That’s why they are mentioned in our books.”

“This could have happened even with me. Such complications are very common.”

“Nobody wants to harm patients. He has not done anything with an intention to harm you.”

“I will phone him personally and discuss your case so that I know exactly what was done and we can manage your case successfully.”

“You should not think of going to court. You must concentrate on getting better fast.”

“Thinking about courts will not help you in your recovery.”

“Everyone responds differently.”

“On occasion patients need many procedures for a single problem.”

“If you like, you can take a second or third opinion.”

“Everyone has good and bad experiences with any particular line of management.”

Never let down another doctor, directly or indirectly, at public functions or in conferences.

Medical ethics is easy to follow only if you know how. Remember, the boomerang that you throw is bound to come back and hit you harder.