Tuesday, July 29, 2008

Craze for Specialist Consultation

Recently, I had an interesting experience. A-25-year old guy working in a Software Company in Banglore came to me with complaints of lack of appetite, giddiness, nausea and headache of a week duration. He had seen a doctor there in Banglore but the medicines prescribed did not help him.
Just looking at his eyes made me realise he was jaundiced. I examined him fully and came to a conclusion that he was having jaundice probably due to acute viral hepatitis. Before ordering a panel of tests to find out the exact cause of jaundice, I asked him to show me the Banglore doctor's prescription. He gave it to me little reluctantly. To my utter surprise, the doctor he had seen is a senior consultant in Neurosurgery at a posh hospital. The doctor had not spotted jaundice, may be because at that time [6 days ago] it was not as evident as it is now. He had given him anti vertigo and anti vomiting tablets.
I was curious.Why you went to a neurosurgeon? He said his friends told him it was better to see a top most consultant of Neuroscience as they all felt the problem was in Brain. Still why a surgeon? You could have gone to the neuro-physician? The reply shocked me.Only the neurosurgeon in that hospital had an American degree.
This craze for specialist consultation [after self diagnosis] is growing among the upper and middle income groups in India. Most often this leads to delayed diagnosis and delayed treatment. Many doctors also encourage this for selfish motives. The patient with headache go to a neurologist first and the one with chest pain will always go to the cardiologist first. The concerned specialist first rules out all the illnesses that he can treat by a panel of investigations. If all are negative, then only the patient is referred elsewhere.

With tons of medical information available on the Internet, many patients believe that they can diagnose themselves. They also believe that they can chose the specialist they want to consult. Many decides which medicines they will take and which they would not. Is this trend of patient emancipation beneficial to the society? Many believe so but I am not so sure.


1 comment:

CALpumper said...

I always see my Physician first! Always!!! The only specialist I see is my Endo and that is ONLY for my diabetes, oh and let's me know too.

Get the word out somehow, an American degree (or anything American for that matter) is Not always a good thing or the answer.

The internet is scary in the sense of self diagnosis. Most "good" sites remind you to consult your Physician. It is SO important. Only the patient knows their symptoms, their body but they have to tell the Physician and a decision will be made after discussion. I feel that is the safest and smartest way to go, Every time.

Thanks for the post Doc. Glad you were able to help this guy.