Doctors need to get right bedside manner

Indonesians spend a whopping US$300 million on overseas medical services each year, an official of the Ministry of Health announced earlier this week.

I dare say I understand some of the reasons.

Several months ago in Melbourne, an Australian friend of mine was hospitalized for minor surgery. When I casually asked her during a visit how she found the service, she replied that it was remiss in many aspects and, being an experienced qualified nurse, she knew what she was talking about.

The last time I was in hospital was some 20 years ago, so I could only remember the whole experience vaguely, and was unable to say whether the condition had been any worse or better than in my friend's hospital. Nonetheless, I recalled thinking that the hospital service had been generally good, and the medical team courteous.

The doctors and the nurses, before doing anything to me, had walked me through it first, then had made sure I had no more questions.

I only nodded as my friend explained the shortcomings in the service, which in all honesty I would have easily overlooked.

The next time I visited her, she was filling out a questionnaire from the hospital management. To my astonishment, she did not pull her punches in expressing her dissatisfaction.

"But you're still here. Aren't you afraid they'll now ignore you, punishing you for criticizing them?" I asked.

"Why should they?" she said, surprised at my question. "As a private hospital, they should be grateful for my constructive criticism, pointing them in the right direction to improvement."

I was not convinced. My concern for her welfare brought me back the following afternoon. To my even greater astonishment, I found her talking to the doctor she had complained about. The doctor was explaining himself and apologizing for causing her grief.

And during the rest of her stay, all her other complaints were attended to.

All this came back to me when I visited my brother, then very ill, in one of Jakarta's supposedly best private hospitals.

I was amazed to see how off-hand the medical consultants were, not only to their patients, but also to the patients' families.

Yet, except for my sister-in-law, who knew the reasons behind my consternation, the family members of most patients I talked to did not find it strange that if they wanted to have some of their queries answered, they had to conduct a "doorstop interview" with a medical consultant, after stalking the said consultant for some time.

They found it normal that the consultants, being so much in demand, should only grant them brief audiences.

Then when I was fortunate enough to talk to my brother's medical consultants, I had the impression that I was holding them up from doing something very important, and that they were extending a great favor by deigning to speak to me.

I assumed that the high costs of hospitalization in Australia made the medical practitioners in its hospitals able to afford more personal and better service to their patients compared to Jakarta. I was therefore flabbergasted when told of the costs of the medical and hospital treatment of my late brother. They were not much less than those in Australian hospitals.

There seems to be no correlation between the costs and the quality of medical service here. The discrepancy, I suspect, lies in social attitudes and expectations. The perception of doctors as those who have the power to save people's lives, as well as the capacity to amass great wealth, brings a certain degree of disproportionate adulation and awe from the public, which many doctors take for granted.

Unfortunately, few of them show awareness that the patients and their families are entitled to their respect as well. The Hippocratic oath, as I understand it, does not automatically extend prestige and higher social standing, but extracts a solemn promise from doctors to do their utmost to save lives.

Unless medical practitioners in this country take time to ponder this fact and review their practices, it's little wonder that increasing numbers of people who can afford private medical and hospitalization go overseas for that purpose. After all, the costs are not much higher than those at home -- and they get the service they know they deserve.

-- Dewi Anggraeni