Cost of heath care and Bangladesh

by Gopal Sengupta
December 22, 2011

http://www.weeklyblitz.net/2007/cost-of-heath-care-and-bangladesh

The increased cost of health care and the urban-centric nature of our health delivery system make it unaffordable and inaccessible to the majority of our citizens. The health-hospital, pharmaceutical and medical education industries, which profit from disease and illness, also complicate the situation. These factors have resulted in dissatisfaction with quality of health care for the vast majority of the population and a crisis in health care in Bangladesh.

What we see back in Bangladesh that health care is often less than satisfactory and treatment less effective when only disease is treated rather than when both disease and illness are managed together. Poor compliance, poor clinical care and medico-legal problems are often due to discrepancies between patients' and doctors' views of clinical reality. Many problems presenting to doctors are now viewed from a specialist perspective. The progressive medicalisation of distress has lowered thresholds for the tolerance of mild symptoms and for seeking medical attention for such complaints. Patients visit general practitioners and physicians when they are disturbed or distressed, when they are in pain or are worried about the implication of their symptoms. However, the provision of support currently mandates the need for medical models, labels and treatments to justify medical input. The divergent frameworks employed to view the clinical reality of disease or illness artificially forces the divide. There is a need to view disease-illness issues through alternating medical and patient lenses in order to see the full picture.

It is true that modern medicine is turning out to be a unidirectional pursuit of finding a copybook cure for most diseases, neglecting the holistic way of alleviating an illness which has a psychological component to it. Every cure or treatment should be followed by counselling to relieve the patients of fear and negative perceptions which accompany a disease. Effective treatment should go much beyond the mundane routine of prescription and surgery. It should have a human face.

I have read some articles in our media which have expressed concern over the widening divide between cure and healing. Illness and disease are two sides of the same coin, having a cause-effect relationship. A judicious balance between different systems of medicine can help a patient recover faster. Even though modern medical treatment is based on science, people should be adequately educated so that they do not become victims of modern technology. The physician's prime aim is to treat the patient in an integrated manner keeping in mind the idea of holistic health and healing. The emphasis should be on wellness rather than illness. The failure to address issues related to the disease-illness dichotomy and the cure-healing divide and to bridge the gap between these part-perceptions is a major cause of patient dissatisfaction. Only a few good doctors know the difference between disease, illness, healing and cure. They also know how to manage them.

While my only son wanted to study Health Science at Marianopolis College as a mandatory course to study in the faculty of Medicine, he has been asked to write an essay in only one page explaining why he has wanted to study Health Science. I've read his essay where he has written in his concluding remark that the familiarity with a respected physician and my appreciation of his/her work, or the tragedy I experienced with the long and tormented agony of my grandmothers might have influenced me in wanting to study medicine. I want to be Health Ambassador of Canada to the poor countries.

I personally assume that it was not the case. One must not forget that recovery is brought about not by the physician, but by the sick man himself. S/He heals him/herself, by his/her own power, exactly as s/he walks by means of his/her own power, or eats, or thinks, breathes or sleeps. The physician's highest calling, his/her only calling, is to make sick people healthy - to heal, as it is termed. As said by Oscar Wilde, "The young physician starts life with 20 drugs for each disease, and the old physician ends life with one drug for 20 diseases". In true sense and the ground reality in our motherland, one of the first duties of the physician is to educate the masses not to take medicine. Their role is to develop techniques that allow us to provide emergency life-saving procedures to injured patients in an extreme, remote environment without the presence of a physician. My dear Physicians, in order to succeed, your desire for success should be greater than your fear of failure. In this world it is not what you take up, but what you give up, that makes you rich. A little sincerity is a dangerous thing, and a great deal of it is absolutely fatal.

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