Patient-doctor relationship: Changing perspectives and medical litigation

Abstract

The patient doctor relational dimer has become complex with the hierarchical or fiduciary manner changing to an equal or un equal relationship. Trust and control are interchangeable, leading to increased patient requirements for disclosure and expectations of a cafeteria approach in diagnoses and management of his/her bodily condition. From any mismatch, there is a potential for medical litigation. In this context, the rise of global consumerism, the explosion of information available on the internet, and the changed manner of the medical profession from being shrouded in mystic / ceremony to trifurcation of medical services to doctoral diagnoses and management, ancillary pharmacy industry, and paramedical services like nursing, counselling and the new age quackery have contributed to this dimer.

Ethical Issues in Modern Day Dental Practice

“…If these did not achieve the desired change in treatment, they turned to "countering tactics" of arguing that the treatment is too weak, too powerful, or insufficient. To augment their authority, the doctors used tactics of wielding overwhelming knowledge, medical threats about the consequences of ignoring advice, disclosures that the treatment may take longer to work for the patient or a personal appeal to the patient as an acquaintance (Ganesh, 2009).…”

“…For instance, a risk of feces leaking into the vagina, which is unpleasant but not life threatening, must be mentioned. A doctor cannot discharge the duty to inform simply by providing pamphlets about a proposed procedure, such as a pamphlet mentioning capsulation, infection or asymmetry (K. Ganesh, 2009 …”

Telemedicine in India: current state, challenges and opportunities

“…Further, as telemedicine may result in a patient being treated by multiple doctors across geographies, it can lead to several contentious issues related to ownership and accountability regarding the treatment of the patient, leaving the doctors and health workers unsure about their legal obligations and responsibilities. As the medical services in India are covered under the Consumer Protection Act (1986) and there have been an increase in the legal suits on the doctors (Ganesh, 2009), policy makers need to address these issues to enable diffusion of telemedicine in the broader healthcare delivery system.…”

Medication concordance in modern medicine – A critical appraisal from an Indian perspective

“…Such an inclusive approach is expected to increase the degree of compliance or adherence. The abstraction of patient concordance in this patient–doctor–drug trifecta can be reflected through an off-track “cafeteria approach.”[293031] The treatment options are supposed to be presented to the patient as a “menu” with description of the “food items” (medicines) the patient may “wish to relish,” complete with “price tags,” and “recipe.” This may be a radical oversimplification, but this approach may give the best results for medication intake behavior, because the patient will take a voluntary informed decision and will be highly motivated to pursue well-understood treatment objectives. In a cross-sectional study on concordance, trust, and patient enablement, conducted in Pune, it was concluded that better concordance was associated with significantly improved trust in the doctor, and with significantly enhanced patient enablement.…”