I just finished reading ‘Better‘ by Atul Gawande. A couple of chapters – ‘On fighting’ and ‘The bell curve‘ – made me think of a year old experience with a doctor, a very well known gynecologist to be precise and one who was almost a ‘celebrity’ himself. He delivers babies of film stars and has had an impeccable record of delivering babies.
In, ‘On fighting’, Gawande writes, “The seemingly easiest and most sensible rule for a doctor to follow is: Always Fight. Always look for what more you could do.”
In ‘The bell curve‘, he writes, “If the bell curve is a fact, then so is the reality that most doctors are going to be average.” Somewhere in the middle he talks about “positive deviants”, doctors and hospitals who keep ahead of the average in the bell curve. He hints at a few reasons that can cause erroneous positive deviants, “…death among the elderly or disabled mostly has to do with how old or sick they are to begin with” or “some allege that the differences are explained simply by the differences in the specific gene patients inherit or by the social class of their families.”
I’ll add one from my end to that list, not accepting or allowing cases that are high risk! And, that takes me to this ‘celebrity’ doctor. he knew about our history of miscarriages (and thereby, how much we were trying for a baby) but states upfront, “we do not believe in giving medicines” if the pregnancy has to be helped along. That’s morally wrong for a doctor, isn’t it? By adopting such an approach, he’s not even thinking about “what more could I do” to help. Worst part still, he’s gaming ‘the bell curve’! The reason why he’s appears good at his profession is because he doesn’t allow / take risky cases.
In our case, we happened to need these medicines and all we needed were dydrogesterone popularly known as duphaston and low dose asprin.
We calmly switched doctors.
