Our Final Days

This week we are back in Dehradun. It’s nice to be in a familiar environment and have the chance to explore more of the city. Our goal is to see a Bollywood movie before we leave!

We are also able to continue doing yoga here with a guru named Dr Deeraj. He explained that Deeraj translates to patience in Hindi. He certainly has a lot of patience in accommodating my lack of flexibility. He holds the sessions in a yoga gym above his home. Although it is at 6am we always walk out happy we went!

Our rotations consist of cardiology in the mornings and pediatrics in the evenings. Both are private clinic settings. One thing I learned about healthcare here is that health information is not private. Many people wait in line within the same room to see the cardiologist. I later confirmed with Myank that it is not private here like it is in the US. 

There is a large public hospital in Delhi that is funded by the government and is entirely free. One of our preceptors shared that patients do not want to go because there are no appointments and you will likely be waiting all day causing them to miss work, etc. In addition, there is a high risk of being seen by inexperienced physicians. Since the pay is much less than the private sector, new docs may begin working there part time as they build up an outpatient practice.

Insurance, or lack thereof, here is another interesting thing I learned about. Very few people in India have insurance and when they do it is only used in rare circumstances. Medicine is very cheap so patients pay out of pocket. For example, an office visit at the pediatricians clinic this week was 300 rupee (69 rupee is $1 USD). Because of how inexpensive the care is, medical tourism, where people come to India to seek medical treatment, is increasing.

A final interesting thing I learned is about rising antibiotic resistance here. There are three important contributing factors. First is doctor shopping, Because office visits are cheap, patients will see multiple physicians until they are written a script for antibiotics. Second, our preceptor said there is “back stabbing”. For example, if a patient were to go for a second opinion which differed from the first opinion, the physician may say “that doctor wasn’t good”. The third reason for antibiotic resistance is that there is no law enforcement on drugs. If patients are educated enough to know some drug names, they can go without a prescription to any chemist (equivalent to a pharmacy in the US) and ask for it. If patients are less educated they may see a “quack” who will prescribe a much higher dose than what is necessary for treatment of their illness. Finally, if a chemist works near a certain physicians office they may begin to learn treatments for various illnesses. They then will give medicines to patients without seeing a doctor.

I continue to learn so much about both culture and healthcare every day I am here. I wish I had more time!



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