The answer is easy. You cannot.
I have been practicing ENT surgery in Delhi since 2008. It has now been 9 years since I have been doing this. Am I happy? A resounding NO is the clear answer. Why do I say this? Truth is I do alright, make good money, treat many patents but I am so unhappy about the state of affairs of this system. This Blog of mine will try and explain why..
Corporate hospitals provide good infra structure. This works well. Nursing staff are fine too. They are not the best but they are reasonably trained and well meaning. This works too.
What does not work is the culture and business processes in place. Let me explain this. The Management – always Finance people – evaluate the REVENUE and MARGINS and so on. Doctors who generate big revenues are rewarded. Those who do not, are penalized – either directly or indirectly by diverting traffic to the “better performing” Doctor.
How does the Doctor improve his REVENUE ?
By doing surgical procedures & by Hospital admissions.
The ambitious Doctor tries his best to CONVERT Outpatient consultations into either of the above. Net result is that patient who could well be managed conservatively as you would prefer, is offered surgery. Overall thus, the hospital encourages this practice.
What does this mean for the patient? – Your chances of being offered surgery are far higher than if you visit a place that does not work like this.
What does this mean for a Doctor? – If you want to do well and look to be doing well in the eyes of these Financial guys, look hard and weave stories to confuse patients and ultimately offer them surgeries / procedures / admissions / ICU stays etc.
Sounds terrible but thats the way it is. You can scream sour grapes but you are not right. The truth is hospitals tell you in your face that you must do nothing unethical and then go on to rewarding those who are practicing to CONVERT all the time. In my opinion, this system is no good. It smells rotten and will soon rot. You can just not trust an opinion you get in one of these places unless you have a friend who understands and can make that decision for you. But whom do you trust? The Specialist or your friend? very difficult.
So what is the answer then? There is a good one – believe it or not. Go and see a reliable trust worthy knowledgeable Internal Medicine person. Let him make the call first as to if you need to see a specialist at all. If you go to an ENT surgeon with headaches, 4/5 will diagnose you with sinusitis and offer you surgery. If you go to a Gastroenterologist, 4/5 will endoscope you. If you go to a Physician, he is likely to treat you with anti allergics or antibiotics and you are done. If he refers you for an opinion, then go see a Specialist. Its not that difficult. And when you think about it, you will realize that I am right. Because I am. 🙂
So to convince you further, do you know that in UK a Specialist is not allowed to see a patient without a referral note from a GP? Even in the private set up? Why do you think it has been stitched this way? USA also needs you to see your Doctor first. In India, because Specialists are available at a low cost all the time, people go directly to them. And when they offer you surgeries….. we know what happens.
Ask me questions. Prove me wrong…. go on..