The Anarchy of Medicine

I have had a thing against medicine and the people involved in it for a few years now. I read about people like Eva Vertes and am impressed by their passion and presence of mind, but most of the time I am simply saddened that these people possibly believe in their exclusivity enough to behave inexplicably.

They aren’t bound by rules. Except in House M.D., nowhere have I seen a doctor explaining his or her decision or reasons for prescribing certain medicines. Wrong diagnosis? Sorry, let us try again. Medicine has also corporatized, but neither does competition bring down prices nor does recession spell doom. At the same time, players in this industry have a keen business sense.

One of medicine’s greatest areas of progress is around reproduction, enabling couples highly “incapable” to produce their own babies. In a world with millions of orphans, one would think that people would automatically choose adoption as the better alternative and move on. But from a business point of view, two points suggest why medicine makes progress in this area. One, sex sells. Two, more people born would mean a lot more customers for medicine.

If you keep aside the sentiments about how invaluable life is, medically speaking, there is a need for price tags. At the very least, how much does a headache cost? An allergy? A seizure? A heart? The answer is, “depends”. On a lot of parameters. Normally in any other industry one would start standardizing, collecting and calibrating these parameters. But it just won’t happen here.

Go to an orthopedist and he or she will first ask you to get an X-ray before even examining you. Fine. You would expect an X-ray taken for one particular area of your body in one particular angle to cost Y1 bucks using one technology and Y2 bucks using another technology. In reality, you will find the exactly same X-ray costing Rs.120/-, Rs.180/-, Rs.250/-, and Rs.450/- in four different places. Why? Different technologies? Different levels of personnel training? Different bedside manner? Different levels of the nudity of nurses and boys? Place value?

Now get an angiogram because the doctor asked you to. It costs you A1 if you get it as an out-patient, A2 if you get it as a patient sharing a room with other patients, A3 if you get it as a patient in a single room, A4 if you get it as a patient in a single room with A/c, A5 if you get it as a patient in a single room with A/c and Cable. The exact same angiogram. Why? The room rent is accounted for separately, mind you. Then why, oh, why? Because you are expected to afford it?

Why not?

Surgeries can be worse.  I have known cases where teams of doctors dilly-dally about what to do in situations far from life-threatening, discussing among themselves while leaving the patient in ignorance. Why is the surgery being postponed? Why was that part removed too? You won’t understand. Why worry when it is not life-threatening anyway? You are under good care.

Duh! the poor patient is in pain due to the not-life-threatening issue, starving due to the pre-op fasts, depressed due to the drugs, senseless due to the anti-septic, bored with the talkative nurses, frustrated with the incommunicative doctors and those are not your parts!

There are so many great business minds at work, but what about minds trying to cure diseases?

What can anybody do about it?

I simply try to avoid doctors and medicines, tell myself that they do no good, delude myself that what I see or feel is my mind playing games with me and that if I play along it might just disappear.