Refusing a Poor Patient – Do Doctors feel bad about it?
Very bad, Helpless, if ever we have to!
Time and again, we come across patients who donot have enough money to pay for the treatment, or pay up more than they can actually afford. It is unfortunate, that we have to earn off on someone else’s misery.
Question is who wouldn’t feel that way? Would you not, if you were in our shoes?
We would certainly treat them for free, if we can still make a decent living for ourselves. The real question is what do you do about it or can you do anything about it?
Several times, doctors waive off their fee, many times treating totally for free. Other times, they refer them to smaller nursing homes or write a referral letter and send them to the Govt hospital. Many times they even pay money out of their pocket for medicines and consumables but then there is a limit, Even NGOs who raise money from public refuse after a limit.
No doctor leaves a patient to die in a critical condition even if he/she have no resources but expecting a full treatment without expenses will be unjust.
No matter how much good intentions you have, you need money to run your system. Everything come for a cost, the sweepers, the lights, the equipments, nursing staff, medicines, you as a doctor will have to pay for them and no one can afford to pay them out of pocket.
“Even a temple needs resources to keep itself clean, else it will get dirty” .
Almost every doctor feels equally bad but then they just move on. With time they stop reacting to such things. Several reasons. The most important is that it’s emotionally draining. Every other patient is like that and if you start attaching with everyone you will go in depression. Some waive off fees and feel better. But that doesn’t really help. It’s like dropping coins into the beggar’s bowl. Who’s going to foot the NEXT BILL? A treatment never ends at one treatment. Feeling bad is not an effective way of dealing with the situation. So most doctors deal with it by being unemotional. They accept that there are limits to what they can do and they have to move on. Some are practical, and refer them to smaller nursing homes where they can afford treatment or to their colleagues who work in these places.
But every day a new day arrives, bringing new patients with different problems, and you learn to live with that. The fact is that every patient has a problem and no one feels rich enough to pay for unexpected and unwanted disease.
Government hospitals are there which treat for free but still patients will prefer private ones because of quality and this quality needs resources to build in. The problem is not an individual one, it’s a systemic malaise and expecting the doctor to respond to a systemic problem is unfortunate. How much can you?
Then why people feel emotional and blame them as money minders when some incident of this sort is highlighted?
Because the public sees only that one case in isolation and they feel doctor did not treat because the patient didn’t have money. They fail to see the whole picture of a hospital/clinic where lots of patients are treated for free or with a highly discounted treatment. So when some patient is refused, that is highlighted in media and that gives a wrong perception. On 1st of every month, every staff will ask for the salary, no matter if you treat your patients for free or not.
And like that you have to learn to deal with it. If you care, you go all the way to help them out. If you don’t, that’s alright. You do what best you can. That doesn’t make you more or less ethical. Ethics just mean doing your best without any wrong intention, ethics doesn’t mean free or cheap.
Either way, it doesn’t make you better or lesser.
Doing the job is the real work. Judging whether it is right or wrong is not for us to do. If it’s wrong, it’s everyone’s responsibility to find a solution for it. And it’s everyone’s responsibility to present a picture as a whole and not the isolated incidents because trust between a doctor and patient takes years to build.