Thursday, October 20, 2011

Reading the fine lines....

During my lifetime , I have seen technology advance from punched-card data processing, to wi-fi on laptops, black and white photos to biometric data capture including your eyes, cars that were pushed, to cars that spoke,  and tomatoes that were eaten, to those that were used to hit political opponents, and even used as projectiles in Tomatino festivals.

In the big urge to sit up there with the "advanced countries", we ran rough shod across many things, without understanding them. It was a climb with an abnormally steep slope,  and it involved jumping on to several bandwagons, aided greatly by an opened up economy, becoming an outsourcing capital, the onslaughts of IT hardware, cell phones, and miniaturized wonders from China.

Suddenly, the concept of what you thought "expensive" underwent a huge change. It was OK if clothes/makeup now cost half as much as a small flat, so long as they were authored by a European fashion house/designer.  Watches no longer remained something you got for graduating, but became  one of the several you wore and threw away. We appropriated Tomatino festivals because someone in Spain did it, and never mind that middle class housewives were in distress over the rising cost of tomatoes in a double digit inflation world.  We started the showing of commercials on TV, like abroad, without worrying about something advanced countries have : a "truth in advertising"  Act, and we showed  "cassettes and CD's"  and "soda"  being substituted as words for alcohol ads of well known hard liquor companies and no one in control, bothered.  We started showing dangerous things on TV,  with a a warning running below in an ant size font, spoken in an unintelligible manner by some guy in a huge hurry, because that was the way to protect yourself.  This applied to businesses too.  In the big hurry  to become world class, we simply skipped some things. The emphasis has been on external show, and unfortunately, what got ignored was the thinking inside, or as one might say, the anatomy inside.

One recently had the opportunity to function as a caretaker for someone who had some cardiac emergency procedures done in what is touted as a world class, XXXX credited hospital. Everything was very well organized, spic and span, constantly being monitored and cleaned, moved like clockwork, the technology worked seamlessly, the medical expertise and communication was excellent. Of course, the proclivity of us Indians to arrive in droves, full family in tow, to see patients, had the security folks at their  wits end, one felt they needed some PR lessons in communication,  but one let them be.   This hospital has rules displayed all over the place, and they simply pointed out the rules.

Before we were discharged and left to go home, we had to fill in several feedback forms. One of the questions pertained to we being shown the "patients' charter of rights" . Well, we were not shown any such thing, so I was about to tick "No", when they hurried to present one sheet to me. I read through it, didn't think there was anything to crib about in that, and ticked "yes". Didn't want someone up there to chew out some dedicated nurse who was doing an excellent job of her nursing.

This morning, I returned to the hospital to ask for some detailed report ,  indicated by our office  as a  "reimbursement" requirement. Mind you the data  was all there in their system. The menu to generate that report  existed, and the front office fellow who could do that was yet to arrive . Fair enough.

The guy at the counter looks at me.

" We cannot give you a copy. We will email it to your section office." He fiddles with the mouse.

" Maybe you can email a copy to me ? " Me. Thinking it to be a routine thing.  

" No Ma'am. We cannot email it to you . We always send it directly to the office in question."  He gets a call and stops to answer it.

" Can I speak to your PRO, or even your Director ?  I insist. This is data pertaining to medical procedures we underwent, what we paid for,  our name is there, I have an ID in your system, and how can you refuse us this ? "   Things are happening in a familiar way. I foresee a battle.

"Ma'am, they wont be here till an hour from now. But our superior should be here in 15 minutes, if you care to wait. "   I park myself firmly at the counter.  In a lifetime of standing in queues, and battling queue-jumpers, leaving a place at the top of the yet unformed queue, seems a bad idea.

There are a whole bunch of framed notices on the counter. One pertains to the aforementioned "patients' charter of rights".  I read through the whole sheet, as I alternate between leaning from one foot to another.  They urge me to sit.

But I have seen  the charter of rights, item no 16, and I have seen the light.  I stop leaning from one foot to another.

The adrenaline  flows. There are wheels within wheels churning.

The guy finally arrives, a decent smiling chap. He has a look at my request. I repeat it.  I need to mention the patients charter of rights. Item no 16, says, I have a right to my own clinical data.  I straighten up, a few notches taller.....

"You see , you guys are refusing me something that is guaranteed to me by the patients charter of rights.  My clinical data. By emailing it to someone else ( even if it is the concerned  office )  without my permission, you are actually trespassing on the patient data confidentiality aspect ." ( I wasn't sure of this but said it anyway. Most of the time the other side doesn't understand anyway).

The fellow looks up. "Ma'am , let me see. "

"No.  I insist on a hard copy first. You may email it later to the office with my express permission, with a copy to me , so i can check the version.  Else , I am writing to your board, about violation of my rights as a patient. Whats more, I am approaching the consumers court about this, and will not hesitate to file a query under RTI. "   (I wasn't sure what I was going to ask under RTI, but said it anyway. I could think about that later. In this day and age, RTI was the magic word....)

The fellow went in with the paper. Another guy comes out and asks me to wait for 5-10 minutes. The stuff is being processed.

I get my report in the next 5 minutes !

What a complete waste of time and words.  The hospital has not trained its fellows at the front office in the patients' charter of rights; what is an acceptable request and what is not.  Displaying stuff in pretty fonts all over the place in transparent frames, is considered enough.  It impresses.   That is what all world class hospitals do.  It simply isn't enough to train people on the various systems.  They must be cognizant with whatever information is displayed on the counter. 

And I wondered what would have happened if it was someone not familiar with reading these framed notices.  He/she would have got overawed with all the presumed sophistication,    would have never known who the clinical data was being sent to, what was sent , despite the fact that one paid through one's nose for the entire hospital stuff.

Sometimes, folks just keep quiet, thinking that  whatever the counter types are saying is the gospel truth.  Some may think it is better to just shut up and let them do whatever they say, because they don't want to be seen having an argument, regardless of the fact that they are being wronged.    They would have made several trips between the hospital and the reimbursing authority, and been , maybe, but hopefully not, taken for a ride.

Is it too much to ask, that there be no doubt when I ask for access to data pertaining to myself /us ?  When it is an individual filing in an office for reimbursement of the hospital expenses as per rules, ,  doesn't it make sense to have all the hospital papers routed through the applying person ?  On what basis did the guys refuse at first ? 

I admit I threw in the RTI bit just to see the effect.  It did no harm. Like they say these days when they present some new thing, no trees were killed in the process, no pollution was caused, no flora and fauna was destroyed,  etc etc  

I foresee several guys rushing inside or suddenly occupying themselves otherwise when they sight me approaching the counter next.

Never mind.

I just hope I don't have to go to any hospital soon, anytime in the near future.......



  1. I am glad you got your info in the end. Too bad about the hassle.

  2. Hmmmmm sounds familiar to me -- seems I've been through some similar experiences and they were even worse when my kids were little, their Dad in the military and I had to deal with doctors in a military hospital. I came to believe that all military doctors and their assistants were the ones who graduated at the bottom of their class. Two of my children AND me are here today not because of the military doctors/help, but in spite of them!

    Rant on, my lady! I'm with you!


  3. Wow. You are braver than I am. I am one of those people who hates confrontation with strangers. I hate it with anyone, but strangers in particular, because it always makes me cry.
    I have never had this problem with Canadian hospitals because we have health care programs, but that could change as soon as the present federal government manages to disable every province's health care system. Thank you for the warning. I might need this kind of information sooner than I think.

    Kay, Alberta, Canada
    An Unfittie’s Guide to Adventurous Travel

  4. Really proud to know someone like you. And you did the right thing. I have had my own experiences at many private hospitals and they have been real bad. This one time, I had gone for a post-op emergency and was made to wait for endless time for the doctor to arrive from the OPD. I was in severe pain, but the staff ignored it and I had to sit on those metal chairs in the waiting area. Whenever my sister approached the front office guy to inquire when the doctor would arrive, he would just tell her to wait without even making a call to the doctor. Finally, I went up to them and raised a storm! It was only then that the guy called up the doctor who rushed to see me immediately. And to think of it, I had undergone a surgery in that very hospital the previous week! Private hospitals are now 5-star hotels... exorbitant prices and automated services with no empathy or human touch!

  5. gigihawaii Thank you.

    Sylvia, Kay, Neha Thank you. Actually, I have no complaints about the medical treatment or expertise etc. That was fine. Its this thoughtless unnecessary hassle with paperwork, post discharge, after the place pretends to take the high ground.

  6. you definitely are brave...I would have just come back and told RD to go and get it!

    but honestly..I wasnt even aware of such a thing..thank you for the enlightenment..and yes I hope you NEVER have to go back there EVER!

  7. Wow!
    You remind me of Rajni!
    Remember Rajni?
    That was an old popular TV serial on Doordarshan which my wife would watch eagerly and draw inspiration from.
    It had Priya Tendulkar in the lead role as Rajni.

    Great to hear this.
    You are absolutely right.
    Info for which you have paid is rightfully yours and they had no business withholding it from you.

    My experience in the two hospital experiences I had in the past year were pleasant. Even without my asking, all my records were packed neatly in a sealed envelope and given to me at the time of my discharge. They even prepared a CD of the scans, endoscopy and the angioplasty and included it.


  8. R's Mom There was no one else who could have gone to get this :-( any case I did learn a lot from the experience....

    G. Vishwanath Methinks you and I are the same generation. And yes I remember Rajani from the Doordarshan Days very well.

    The hospital did give me a nice file and stuff with all kinds info on investigations done, CD's of the angioplasty, dopplers etc, various ECG's and stuff. But the reimbursing authority asked for complete details under Drugs and Investigations, which they hadnt given. What I thought was a routine request turned into a battle. Hence the post . :-))

  9. Good for you for standing up for your rights!

    And thank you for your lovely poem.