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Questioning your doctor

The number of Nairobians walking into hospitals and doctors’ offices every day is massive. Take a walk into Nairobi hospitals any day of the week if you need some proof or into some doctors’ waiting rooms. Chances are you’ll encounter unending queues. A quick glance will pick out some individuals who look too well, what would they be up to?

There is ongoing realization in medical circles that well patients form a huge bunch of individuals seeking healthcare daily. The reason for this is twofold. There is an ever increasing awareness of personal health and the push to be proactive. Doctors are to blame too, they continue to recommend routine visits, tests and interventions with hardly any justifiable scientific basis or benefits to patients. Unselective medical interventions are costly, unnecessary and liable to causing harm.

No doctor’s visit should be ‘routine’. And no medical test, intervention or treatment should ever be regarded as routine. A visit to the doctor must be for a specific reason, ordered tests must aid in decision making, and any proposed treatment must confer tangible benefits. So called routine general health checks are not equivalent to the recommended and scientifically proven screening tests for various diseases. Scientific studies show time and again that healthy adults, without any symptoms, do not benefit from general non-specific health checks. Their odds for a longer disease-free life are not increased, but the potential for harm is real.

Doctors have a duty to keep up to date, and only recommend interventions that have proven benefits. Most routine clinic reviews are hardly justifiable, it is not unusual for patients to have unending reviews every so many weeks that amount to nothing. Doctors can take a step back and refrain from requesting tests that add no value to issues at hand. Equally, outdated recommendations and many prescriptions can be avoided by individualized care based on best practice guidelines.

A US organization is taking the lead in advocating for the right care at the right time for everyone. Doctors are reminded to only recommend care that is truly necessary, supported by scientific evidence and free from harm. This is the only way of effective use of healthcare resources. Patients must feel free to engage with their carers and get as much information as possible to inform on decision making. It is only in this way that the most appropriate care can be provided, based on individual circumstances.

Nairobians must be ready to question their doctors. You must be crystal clear about your ailment, and the options available for treatment, including doing nothing. Asking questions helps clarify what is necessary, and what can be shelved. If your carer doesn’t like to be questioned, go elsewhere. In many cases, you can avoid unnecessary doctors’ visits, keep away from interventions that are a waste of your time, and save cost. And crucially still remain healthy!

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