Doctor-patient communication in developing countries
BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7412.450-a (Published 21 August 2003) Cite this as: BMJ 2003;327:450All rapid responses
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JP Unger and colleagues letter on Doctor Patient communication in
developing countries is appreciable1. We agree with them that in
developing countries, biomedicine is the dominant paradigm, and poor
communication is the rule in public services1, 2. We also appreciate their
concern on individually tailored patient care.
We would like to discuss a few additional problems and possible solutions to
this topic. In our view illiteracy and ignorance are the main problems in
India and perhaps in other developing countries. Educating a patient on
individual disease is a real difficult task unless he has some primary
knowledge about health. Despite explaining the clinical problem and the
treatment options to the patient in his own vernacular language, prompted
by illiteracy, the patient will throw back the options to the explaining
physician himself. This is partly attributable to poverty and financial
constraints. However this is the common scenario which physician confronts
everyday while communicating with patient.
The problem of illiteracy has to be solved at the primary education level.
By solving this patient understands the importance of communication. Then
patient himself will initiate discussion on his clinical problem.
Education at grass roots level will also prevent from patients belief in
miraculous or supernatural cures for a treatable clinical disorders and
prompt him to obtain evidence based medicine.
1. Unger JP, Ghilbert P, Fisher JP. Doctor-patient communication in
developing countries. BMJ 2003; 327:450
2. Unger JP, Van Dormael M, Criel B, Van der Vennet J, De Munck P. A plea
for an initiative to strengthen family medicine in public health care
services of developing countries. Int J Health Serv 2002;32: 799-815
Competing interests:
None declared
Competing interests: No competing interests
Re: Doctor Patient communication in India
The doctor patient communication is very important and a commonly
ignored topic in India. With the changing times there is increase in
awareness of the right to information. Moreover, there is rising level of
education and The Consumer Protection Act (CPA). These things have
brought the importantce of doctor patient communication into the light.
Still, the communication is not the best as there is high load of
patients on doctors and lack of basic education in rural population.
However, less the communication is, but the Faith is still there. The
doctor is believed to be next to God. Moreover, the actual in India
situation does not permit 100% communication, as most of the
patients themselves do not want to know more about the disease or do not
have the courage to listen about the bad prognosis of some diseases. The
strong sense of faith in the doctor does not let the Indian people feel the
lack of communication between them and their doctor.
Competing interests:
None declared
Competing interests: No competing interests