Saturday, May 05, 2012

An experience with doctors


I have a problem called folliculitis over the past year and a half which results in random and unexpected skin infections. Although the problem is not per se very serious, it can get pretty painful, socially awkward and cause disruption to productivity. The infections occur randomly with no specific cause. Trying to get this problem properly treated has been an interesting and not fun experience. I saw a bunch of doctors over time with no resolution to the problem. Finally I had the luck to bump into a great doctor who solved the problem for me with minimal trouble (more on that below). But what was disturbing about the experience with the other doctors was how different their prescriptions were, from what actually worked finally.
I overall saw 7 doctors about this problem. The range of options suggested included:
- undergoing (expensive) antibiotic courses
- doing (expensive) blood tests to find out what was the exact nature of the infection
- using an antibiotic soap and a nose ointment
- yoga and meditation. This from a Manipal Hospital doctor who looked ill at ease and out of depth and suggested that there was nothing much that could be done.
- getting hair replacement therapy. Really. One joker of a guy was disappointed to see that I had come to him with a skin infection instead of a baldness problem. After cursorily looking at the boil and prescribing antibiotics and a blood test, he tried to sell me a hair replacement treatment course. This guy was also morbidly obese and badly dressed, hardly the kind of personality to inspire confidence.

With no progress (and taking the Manipal docs advice seriously) I let the problem lie for a while. Then, I again tried to address it during my sabbatical when I had some time. Having no way to identify a good doc, I decided to pick a few doctors and try a consultation with all of them. I got really lucky with the first doctor (Dr. Divya Appachan) but decided to go ahead and see one more, just to follow through on the original plan. Doing that provided a nice comparison, since I visited them both on the same day with exactly the same symptoms.
The two doctors were a study in contrasts:
1.) Dr. Divya Appachan spent a considerable amount of time, looking closely at each boil and asking me questions about the nature and frequency of the infections. The other doc, (call him Doctor A) took a look at one sets of boils from a safe distance and that was it. Both diagnosed it as folliculitis.
2.) Dr. Appachan explained a set of measures that I could take to manage the infections. An ointment (T-Bact) should be applied immediately as soon as a new boil shows up. The boil is likely to go away right away if that is done. In case it doesn't, it would tend to grow and a small amount of pus would form. She showed me how to poke it painlessly with a sterile needle to discharge the pus. Following that, using the same ointment should do the trick. If these measures didn't work, she said we would go to the next step of an antibiotic course. But it would be better to avoid the antibiotics. I had a bunch of questions that she listened to and patiently explained the answers to. She also suggested that the (expensive) antibiotic soap that I had been using based on earlier doc recommendations should not be needed. She did not ask me to visit again, unless I had a problem.
The treatment has worked very well so far and I'm feeling very good about it. I haven't had to visit her again.

After the quick examination above, Dr A, on the other hand, prescribed two sets of powerful antibiotic treatments simultaneously. We'll hit it from both sides he said with the enthusiasm of a child setting up a toy battle. Never mind that the battlefield in this case was my body, and the ammunition, my wallet. He asked me to come back afer a week of the treatment.

3.)Both charged the same

I guess I don't need to add further comments on the above. Its a sorry state of affairs. I think the approach of seeing several doctors before picking one is not a bad one.

1 comment:

Unknown said...

My father went to the a doctor in my town Chitradurga. He was diagnosed for cataract and was asked to come back when the vision goes down fully. It did in a year and my father went back only to realize that there is no cataract. He then went to Bangalore, was diagnosed for Glaucoma.

My father waited one full year on himself to lose 75% of his vision!

Three years back he was operated in Apollo Hospitals for a lung infection. The doctor forgot to prescribe the necessary antibiotics! And the infection relapsed!

I hate the negligent doctors of my country.