Empathy missing from healthcare

Tens of thousands of Bangladeshis fly abroad every year not for leisure or business, but for treatment. From India to Thailand or Singapore or even the United States, hospitals have become familiar destinations for Bangladeshi patients seeking quality healthcare. For the affluent, a check-up or surgery in Thailand or Singapore is routine while for the middle class, India is the 'go-to' option. According to official data, patients from Bangladesh spend around $400-500 million annually on medical treatment abroad. Unofficial estimates suggest the actual amount may be double the official figure. This unusual outflow of patients occurs despite remarkable progress in Bangladesh's medical education and healthcare. Over the past three decades, the country has seen a boom in medical education. The number of medical and dental colleges is around 150, with the majority of them privately run. These institutions produce a large number of doctors every year and attract thousands of foreign students, particularly from Nepal and India. Alongside these, Bangladesh boasts quite a number of doctors famed globally for their skills as well as some modern health facilities, mostly in the private sector. Despite these, a large number of patients continue to mistrust domestic healthcare. The reasons are not equipment, facilities or treatment success rates. At the heart of this mistrust lies doctors' behaviour with the patients. Complaints are common that doctors spend very short time - in some cases a few seconds - during consultations, barely listening to concerns in detail. According to studies, doctors spend 48 seconds per patient on an average in Bangladesh against 10-20 minutes in Singapore. Many patients also complain about doctors ignoring their issues, scolding them or dismissing them without proper explanation. By doing this, doctors deny the fact that the patient is the most important part of the treatment process. This behaviour leaves patients feeling unheard and dissatisfied even when the prescription is medically correct.

On the contrary, a patient visiting a doctor in Thailand, India's Chennai or Singapore often returns with a completely different experience - full of satisfaction. Doctors there spend adequate time with patients, listening to them, discussing the symptoms thoroughly and explaining test results clearly. Our doctors ignore the fact that small gestures like a smile or a bit of patience have great therapeutic value. It is no exaggeration to say that a patient gets half cured by a doctor's kind behaviour.

The trust issue in Bangladesh healthcare system begins much earlier - in the classrooms of medical colleges. The medical education system here lacks a focus on communication with patients. Medical curricula are full of clinical and theoretical contents but they keep little room for modules on doctor-patient communication and empathy. What medical students find in their curricula about patient communication is just a brief mention in forensic or community medicine. They spend several years mastering anatomy and pharmacology but receive almost no guidance on how to communicate with patients, how to deliver bad news, or handle emotional patients. Inefficiency and indifference in communication emotionally disconnects doctors with their patients. Thus mistrust grows.

Bangladesh requires reform on multiple fronts - education, regulation and professional culture - to get over this problem. The medical education regulator, Bangladesh Medical and Dental Council and the statutory professional membership body, Bangladesh College of Physicians and Surgeons should introduce mandatory courses on communication, empathy and ethics across all stages of medical training. Hospitals should establish systems to monitor patient experience and provide feedback no matter whether they are public or private. Doctors who demonstrate good communication should be recognised and rewarded. They should be friendly and still command respect. Awareness campaigns should be launched for developing understanding between them. Above all, everyone concerned needs to keep in mind medicine is not only a science, it is an act of humanity too.

rahmansrdk@gmail.com