Telemedicine, Indian patient-doctor relationship:-
A person contacted me over phone referred by a very close acquaintance regarding his father's cancer treatment. He wanted the treatment to be undertaken in a posh corporate hospital only, nevertheless he wanted my opinion(free of cost of course) as he was on a doctor shopping spree. When I saw the documents he had already consulted at least half a dozen doctors in various hospitals. He hadn't brought his father, the patient himself, so I had to be contend with examining only the different examination reports & prescription of doctors. It turned out to be a widespread metastatic cancer with the patient's age being 76 years. I explained him the protocol. He thanked me and mentioned that he'd get the old man treated at a very posh corporate hospital. In the very first interaction of ours the concerned person told me nonchalantly on my face that he has done so much googling for his father's cancer and consulted so many doctors that he himself has become an "oncologist", even his gym-mate is an oncologist, he impressed upon me.
Now that his surgery has been done and chemotherapy started I'm inundated with his phone calls & WhatsApp messages/images to verify how correct the treatment is going on and when to take which drug(especially chemo & post-chemo injectables). I was asked to administer the drugs prescribed by the other doctor nowhere in my radar, bandwidth or spectrum. The concerned son implored me to do so since he wanted to get it done at his home or nearby clinics but all of the physicians refused to do so since they were not the prescribing doctor (and because the drug was a post-chemo haematopoietic modifier which came in a prefilled single use syringe which no one dared to touch).
First of all I would've put the old man on a different protocol as per my knowledge & experience, secondly I'm in no position to dictate or even suggest what drug to give,when & how as the patient is not under my care and the respective drugs have their own safety(or to say adverse effects) profile. Complying with social etiquettes and medical ethics as well as the laws of the land I cannot explain each and every nuance to the patient's son(he anyways has kept his queries limited to telephonic/electronic conversation) Only. Finally I succeeded(probably so) in convincing fellow to consult those Doctor(s) only under whom he's actually & physically getting his father treated.
Footnote: The patient could die of his old age itself or from his metastatic cancer or because of some adverse effect of chemotherapy or any reaction to the post-chemo drug. Who'll shoulder the blame in such a case that too not being the primary or referral physician? Or even a possible criminal charge? When the son happens to be a man in Khaki....
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