Dr Shaurya, 65 years old is a registered medical practitioner and senior physician, running his own private clinic in Austintown, a lower income neighbourhood in Bangalore. He has been practicing medicine for 38 years and has had the clinic since the beginning. Over the years he has built a strong relationship with his patients. Though he does not have a medical degree, he did 5 years of Ayurvedic and 2 years of modern medicine studies.
He works by himself for 12 hours every day apart from Sundays. It’s a walk-in clinic where patients get a ticket number and wait in the waiting room for their turn. In a busy day Dr Shaurya sees more than 150 patients, and he spends on average 3-5 minutes per patient. Amongst other illnesses he treats and prescribes medicine for diabetes, typhoid, viral fever, infective hepatitis and infections.
We spent a couple of hours with Dr Shaurya, where we got to observe him with his patients and ask him questions about his practice. During our observation we noted that Dr Shaurya would prescribe some medicine, including antibiotics, most of the time. Here are some highlights:
With the reality that patients cannot afford multiple consultations or proper lab tests he believes he is doing the best he can.
What patients want is quick relief. They need to go to work the next day
We give a provisional diagnosis, mainly because of the financial condition of the patients and the pressure on time. We give them antibiotics for 3-4 days and if there in not much relief we ask them to come back on the fourth day and we carry out further investigations
It may not be correct in general, other doctors would examine and test first and then prescribe, but we do it the other way around. For our setup it is correct.
Compliance is a huge issue in India. Some people are literate and have low awareness levels which results in them not completing the antibiotic course. I tell them about the effects of resistance but they don’t understand