I don’t trust doctors. I respect their superior knowledge, but I know from experience that they are fallible. I qualified as an RGN so my views are backed by plenty of experience. I’ve worked as a nurse in various medical and surgical specialties, and I’ve been employed in hospitals in Ireland, England, and the Middle East. I’ve seen plenty of medical errors and near misses. Medical professionals are just people and as liable to mistakes as anyone else. The reason why most of these mistakes don’t lead to tragedy is that the system makes allowances for human fallibility.
Medical Errors Happen
Some of the most dangerous medical errors occur because of drug prescriptions. Doctors have a lot on their mind and they will sometimes prescribe the wrong drug for the wrong patient. They can also mess up the dosage – occasionally prescribing lethal amounts. In hospitals I’ve worked these errors are usually picked up before the patient is given the wrong medication. Nurses are accountable for any drugs they hand out. This means that even if the doctor has made the mistake it is up to the nurse to spot it. Patients may wonder why nurses take so long to hand out a few tablets; it is usually because they are double checking the prescription. It is also the nurse’s responsibility to check for any reasons why the patient should not be taking the drug. Nurses make mistakes with drugs too, but a lot of errors are discovered because they don’t just hand out medications blindly.
Western nurses tend to be very assertive – they have to be. Their role is to act as an advocate for patients and you can do this if you are timid. This job of standing up for their patients will often bring them into conflict with doctors. It can become heated. Nurses do not see doctors as their bosses but instead as fellow members in the multidisciplinary team. They have different agendas and so this can mean disagreements. Such conflict is actually good because it helps ensure that patients get the best possible care. If a nurse sees the doctor making an error they will have no fear about challenging this.
Nowadays patients in western countries tend to be well informed. There once was a time when doctors were held in awe, but those days have gone. The web makes it easy to find out about the different medical conditions. I’ve met many patients who were far better informed about their diagnosis than the expert. People are no longer happy to just trust the doctor. They want to know what is going on and they want to be part of the decision making process – this is only fair as it is their health on the line.
In Thailand They Treat Doctors like Gods
I’ve never worked in a Thai hospital, but I’ve spent a fair bit of time in them over the years – especially since my son was born. Before moving to Thailand I had the arrogant assumption that the hospitals here must be a bit primitive. In fact there are some that would rival the best in Europe and the States. It is a mixed bag though; the hospitals in rural areas can be very basic. There is (almost) free health care for the poor, but in many ways you get what you pay for.
My biggest concern with health care in Thailand is that doctors are treated like gods. They are viewed as infallible beings, and they seem to expect such adoration. I’ve politely asked questions in the past about their treatment plans for my son, but they act as if such queries are an insult. I’m just expected to be the obedient recipient of their wisdom. My last experience with a doctor here was to check out my sore ribs. This sleepy physician wouldn’t answer any of my questions. All he was prepared to do was prescribe medications that I was already taking anyway. This was a private hospital, and it wasn’t cheap.
From what I’ve seen of the nurses in Thailand they are caring and competent. I’ve also witnessed how they act as handmaidens to the godly doctors. There are clinics which are run predominately by nurses, but once the doctor is there it is clear who the boss is. I would imagine that it is rare that a nurse will stand up for a patient against the doctors. It is also unlikely that they will question the doctor’s actions – maybe it is better to let a patient die then to cause a god to lose face.
Apparently this unwillingness to treat superiors as fallible is widespread in Asian culture. There was the horrible case of the Korean airliner that crashed because the crew were unwilling to question the captain. These underlings knew that the boss had made a terrible error, but they were too afraid of making him lose face to warn him. I could imagine a similar situation happening with doctors here in Thailand.
What do you think?