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How should we be treated? Physician’s duties that every patient is to know

19/ 06/ 2017

Andrey Gardashnikov, Oncologist, chemotherapist, Oncological clinic “Ukrainian Center of Tomotherapy

When people go to the health care facilities, they basically want to get help in solving their problems or to be convinced that such problems don’t exist. Not many of them expect that the quality of medical services will be high especially if it is an ordinary polyclinic. Sometimes physicians allow themselves a disrespectful attitude while covering with the fact that it’s only the result that matters. There is also a belief that one shouldn’t expect anything decent from the state medical care, but if so how is it possible to enhance the quality of the health care? A physician of any health care facility in any city or village is primary a specialist, who must carry out the duties imposed on him by law.

It’s not a secret that the quality of medical treatment in our country depends not only on the qualification of the physician, but also on the equipment and capacities of the health care facility. All over the world for the diagnostics and treatment of different diseases physicians use special protocols with the clear “action plans”.

The protocols of the diagnostics and treatment are systematically developed and scientifically reasoned recommendations aimed at practical use. They are action guidelines. The main purpose of these protocols is to reflect the current state of the scientific research and its implementation into practice. They guide physicians in their decisions and actions. However, in our country the compliance with such protocols is extremely problematic, as the possibilities and technologies available in other countries are only appearing in Ukraine. Because of this, physicians are often driven by the available means and capabilities. They prescribe treatment that is familiar to them and is available at their health care facility, or which they provide by themselves. In addition, the treatment may be prescribed based on the solvency of the patient and his relatives that is not always rational. Under such schemes, the patient is deprived of his legal right to be informed about all possible ways of treatment and to choose one of them being fully acknowledged of all possible consequences.

According to the physician’s ethics code:

Article 20. The physician must provide the patient with the exhaustive information needed for timely and quality medical treatment.

  1. The physician must inform the patient about the necessities, risks, immediate and possible long-term health effects of the planned medical treatment, the alternative treatment modes, their comparative effectiveness, patients’ rights and their possible protection.

The perfect example witnessed by almost everyone is fluorography, a diagnostic aid that is still obligatory in our country (by the way without any legitimate grounds) but for many years forbidden abroad due to its low informative value and high radiation dose. Only few physicians say that it is much safer and informative to make digital radiography as at their polyclinics there is only a fluorography, which they continue to prescribe.

I had many patients in my practice that came to me after the ineffective or unsuccessful treatment provided by physicians that offered treatment strategy without informing the patients about the alternative cancer treatment. They simply prescribed the treatment that was available at their health care facilities regardless of its efficiency in the particular case.

The Verkhovna Rada of Ukraine; Law of 19.11.1992 № 2801-XII

Article 39. The obligation to provide medical information

Medical worker must provide the patient with the intelligible information about his health, the purpose of the proposed diagnostics and treatment modes and the prognosis of the possible disease development including life and health risks.

I would like to explain it using the example of my professional activity at the modern oncological clinic “Ukrainian Center of TomoTherapy”: it is important for patient to know about his problem and all the possible solutions to treat it in order to effectively combat the disease. At the state health care facilities, physicians do not pay attention to this issue at all. In order to achieve best possible results and preserve the quality of a person’s life the modern approach to cancer treatment involves a combination of several treatment modes and three obligatory stages of diagnostics. Unfortunately, today cancer is diagnosed even with the help of ultrasound, and surgery remains the most popular method to fight cancer, which in most cases leads to relapses and irreversible consequences such as disability.

Do not implicitly trust the physicians and do not shift responsibility for your health. Even if the person has minor problem, he should be confident that he is provided with the full information, the diagnostics is carried out according to the protocols, and the treatment chosen for him is the most effective one. If there is any uncertainty about the qualifications of the physician, do not be afraid to change him. If there are any doubts about the established diagnosis, it is always possible to check it asking the opinion of another specialist (a reference) or simply go to another health care facility. The cause of communication between the physician and the patient is health that is the most precious and indispensable thing in life. That is why if the physician does not have time and desire to tell you everything about the diagnostics and treatment modes or does not want to answer all your questions and to prove that the proposed treatment is the most effective one, this specialist is not entitled to provide treatment at all. Pay attention to your health and entrust it only to professionals!

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