A patient booked an appointment to see a doctor in the clinic for 8 am. She showed up at 10 am. She wanted to be seen immediately as she had an 11 am meeting. She wondered why the delay as she would miss her appointment. Especially as she booked to see the doctor! Yes, but at 8 am.
Money, money, money
Our patient refused to pay consultation since he was referred by another doctor. He assumed that since he was referred by his own doctor, he did not have to pay consultation. To another hospital, completely! Some people also invoke the fact that they are civil servants as a badge of honour. As if it connotes access to cheap or free service! The civil service?
The medical report
A patient came to the clinic for consultation. After the consultation, he demands a letter, a medical report for his employers. Oh, he wants it now as he does not want to have to come back at another date. However, writing a medical report takes time and requires due care and attention. This is also very important if it is a medico-legal report. Doctors need to be careful about legal documents.
The bill estimate
A lady came to the clinic and after the consultation requests for her surgical bill estimate. She needs the bill estimate to use in raising funds from her employers and well-wishers. The next time she was seen was on Facebook, recovering from the operation in India!
Another medical report
A patient we have not seen for many years returned to the clinic expecting to be seen for free. Oh, she is an old patient! Moreover, she actually came because she wants a medical report to use in getting a visa.
One patient came to ask for a bill estimate to use in collecting money from his employers. He wanted the bill inflated so he will have money to send his children to school. Yes, we know the economic situation in the country is bad.
The India returnee
The patient returned from India and called to come over with the medical reports and drugs to show us in the clinic. This, following an operation she refused to have done in Nigeria. Ostensibly so we can continue the follow up care here in Nigeria. It is too expensive to go back to India!
The practice of medicine in Nigeria is actually very interesting and full of surprises. Each day is full of adventure and learning opportunities abound: if you care to look. It is also quite fun in many parts though it can be frustrating. Frustrating for both medical practitioners and the patients and relatives!
Meeting patients’ expectations and demands can be challenging and a clear explanation of the principles, protocols and ethics may be warranted. Asking for medical reports to reflect a certain view point for a specified aim is wrong. Asking for an inflated bill estimate so as to obtain money from employers, friends and well-wishers is also objectionable.
Patients also need to realise that medical practice though infused with humanity is a business. Someone has to pay for the services rendered or there will be no service.
We need to move towards scheduled appointments for patients. This may help in diffusing many problems. If instituted, even the Nigerian patient will get used to it. Booking will certainly stop the massive queues in many of our hospitals as there are only those many hours in a day for booking. Patients should also know to call the clinic or doctor if they are unable to meet their appointment time or will be late. The appointment can then be rescheduled.
The new doctor’s pledge maintains utmost respect for human life and doctors are enjoined to shun ethnicity, political affiliation, gender or social status in delivering their duty. So we will not treat people different based on their bank balance.
Similarly, we do not want patient’s to feel that they are all powerful and above it as it impairs our care and due attention. Do not come to the clinic feeling all important as it may lead to mistakes at the detriment of your health. Don’t be rude to hospital staff and under no circumstances attempt to compromise the integrity of your doctor. If you ask your doctor to lie for you, how can you trust him in the future? Yet, trust is an important ingredient in doctor-patient relationship. Therefore, we must keep reminding our patients of the sanctity of the doctor patient relationship.
Mutual respect is important.