What should medical profession offer to the suffering? Worst case scenario or a ray of hope?

Since my experiences of last week, with medical practices prevalent in Singapore, I have been pondering about about one particular aspect of this modern way in which interaction between the medical profession and the patients or their near ones is carried out. I have briefly mentioned about one particular conversation in my earlier article, but would rather repeat it here for the sake of continuance of my thoughts.

After admitting a person in the emergency ward of an hospital because of acute abdominal and chest pain due to a fall on ground from vertical standing position, we were patiently and anxiously waiting for more than 2 hours in the Hospital veranda. Meanwhile the patient did undergo X-ray scan, ultrasound scan and even CT scan. As we found out later, results of all these tests showed no abnormality of any kind. Even then, our first interaction with a staff member of the hospital, managed to intensify our anxiety instead of being smoothing it out. We were then told that the fall could have damaged the bladder or kidneys because there were traces of blood in the urine. Kidneys could have been damaged permanently and she might need dialysis is future. Because ultrasound tests showed presence of some fluid in the abdomen, we were told that there is a possibility that bladder might have ruptured or because of rupturing of some veins, there might have been some internal bleeding, which might need operating upon etc. etc.

I am aware that all these medical possibilities certainly were possible. But the point which I am trying to raise is whether it was really necessary to point out to all the negative possibilities at that point of time? Wouldn't it have been better to say that all tests are negative but because of blood traces in urine and presence of fluid in abdomen, further investigations or keeping her for observation is needed. I am told that this trend of narrating worst case scenarios has its origin in USA, because of the possibility of lawsuits by the patients for not providing accurate information to them by the hospitals. Slowly, it has spread all over western world and some other countries like Singapore and Malaysia.

I fondly remember our old family doctor in India, who treated all of us in the family, from ages of 4 or 5 to 84 or 85. Whenever we approached him with a complaint, his first reaction used to be absolutely casual as if falling sick is something very routine. He would just brush off any deeper or sinister possibilities. My father had a stroke, when he was about 70 years old. Those were the days when Doctors would make a home visit if illness was serious. A specialist Physician was contacted and he made a visit to our home. After examining my father, his entire body language and words were so encouraging and supportive, that my father, who till that moment, was not even able to lift his finger, was able to pick up a rubber ball and grab and press it slightly. Such is the magic power of a physician's words and body language.

I am not at all for keeping the patient and his/her near ones in ignorance, as was the practice earlier. They must be informed about the ailment fully and the treatment that is given. But shouldn’t the physician, through his body language and speech offer a ray of hope to the suffering. Why should he/she or near ones be told about the worst case scenario possible even before treatment has began. Medical science has progressed by leaps and bounds. The diagnosis these days, is made on basis of many tests. But what is lacking, is the Doctor's moral boosting support, which according to me is most critical for any quick recovery. Specialist Doctors these days have become Robots dishing out pessimism instead of optimism.

I somehow feel that the old system of family Doctors and home visits, was much better for the patients and their recovery. Modern medical practice has become just another business avenue to earn money for the investors. A visit to a Doctor no longer remains something that would console and boost moral of a patient but a mere business transaction.

14 June 2013