Heading straight to a specialist may not always help patients: Doctor explains

"Doctor... I'm not convinced. Shouldn't we do a few more tests before confirming that's what I have? Is this really the right treatment? And doesn't the medicine you've prescribed have side effects?" If doctors are to sum up how patients have changed over the years, they will probably do so with questions like these. Drawing on more than four decades of experience in medicine, Dr Sunny P Orathel, Medical Superintendent of Rajagiri Hospital, Kochi, reflects on this changing patient mindset.

Google can't replace a doctor
At a time when information on virtually every subject is available at the tap of a screen, Google has become the first stop for many patients whenever they experience a health problem. They search for information about their symptoms, the diagnosis, the medicines prescribed by their doctor and even the possible side effects of those medicines. With so much information instantly accessible, many begin to place greater trust in search results than in their physician's clinical judgment.

The problem, however, is that internet searches often throw up the most severe or worst-case scenarios. A simple search for a headache, for instance, can produce results ranging from migraine to a brain tumour, leaving patients anxious and confused. By the time they walk into a doctor's consultation room, many have already arrived armed with information gathered online.

Most people tend to overlook the fact that every patient and every medical condition is unique. Information available on the internet may relate to advanced or severe stages of an illness and may not necessarily apply to an individual's condition. Instead of providing reassurance, it can create unnecessary anxiety not only for patients but also for their families. In many cases, it also strains the doctor-patient relationship.

While being informed about one's illness can be beneficial, even the educated often forget that Google can never replace a doctor with years of experience diagnosing and treating patients.

Time to bring back the family doctor
Another noticeable shift is the growing tendency among patients to head straight to specialists and super speciality hospitals even for minor ailments. In such cases, doctors often feel compelled to order the latest diagnostic tests. The reason is straightforward. Any missed or delayed diagnosis ultimately leaves the doctor and the hospital liable.

But it was not always this way. Before speciality and super speciality hospitals became commonplace, people would first turn to the trusted doctor in their neighbourhood, their `family doctor'. For every minor illness, they approached this doctor first.

Ideally, patients should consult a doctor who knows them well at the earliest stage of an illness. In many cases, a condition that can be treated with a simple course of medication may end up consuming more time and money when a patient approaches a super speciality hospital directly. If the illness requires specialised care, the family doctor can always refer the patient to the appropriate specialist.

Reviving the family doctor system would also strengthen the doctor-patient relationship. Today, most patients arrive with diagnostic reports already in hand. In some cases, such investigations may not even be necessary. Yet, doctors often feel compelled to prescribe them to reassure patients and earn their confidence.

Each patient tells a lesson
Winning the trust of not just patients but also their families is one of the twin challenges before a doctor. If a doctor responds to a patient by carefully listening and reflecting what is being said, treatment becomes far more effective. In healthcare, success depends not only on being a good listener but also on having strong communication skills.

An introverted doctor may not always be able to draw out every detail from a patient. For an accurate diagnosis, it is important to gather as much information as possible. Understanding a patient’s condition calls for an open and receptive approach. When a doctor listens patiently, it naturally builds trust among patients and their families.

Discussing the details of an illness, treatment methods, prescribed medicines, the steps patients need to follow, and the challenges they may face further strengthens the doctor-patient relationship. Viewing each patient as a textbook can also contribute positively to a doctor’s career growth.

Why preparation matters
Although medicine is a profession without retirement in spirit, anyone aspiring to become a doctor must be prepared for it from the outset. From the first day of medical education to the end of their careers, doctors are required to remain closely connected with society. In a changing world, every doctor must evolve with time.

Doctors also have the responsibility of educating society about healthcare, disease prevention, and the rational use of medicines. Given that patient care is always the priority, personal interests often have to be set aside. The experiences of healthcare workers during the COVID-19 pandemic clearly reflect this selfless commitment. No matter how advanced technology becomes, human intervention by doctors remains essential at every stage of care.