It seems the diagnosis and prescriptions of Dr. Google are becoming increasingly popular in Bangladesh. Many are following it and as days go by, more are becoming interested. It began during the corona era and is now expanding.
Increased access and capacity of internet communication and the rather dismal record of Bangladeshi doctors and hospitals encountered by Bangladeshis have created this virtual doctor's popularity.
They are not only misdiagnosed but have to pay hefty bills for the same. Impoverishment due to the medical expenditure of the final days of a patient, particularly the elderly, has become a common phenomenon.
Many speak about the moral values and social responsibilities not to mention personal integrity of the medical establishment etc. However, it's all talk because no establishment institution is any different from the rest.
It was during the corona epidemic when people particularly the older ones like me began to have health issues and it was part panic, part fear of getting infected that drove many to the internet. I myself began to experience various symptoms including having difficulties passing urine, passed blood and was in pain. I finally ended up with a top-notch doctor.
He sent me six seven tests by phone message which I needed to take at his referred diagnostic centre. Two days later, I got the results and went to see him.
He had just returned from the operating theater and looked at all the tests including the ultra- sonogram - a bit perfunctorily and said, I had probably developed a very large tumor which was causing all the problems and it could also be cancerous. So he recommended that I get a corona free certificate and return for an exploratory surgery the next week to detect the tumor and then we could move on to the next stage of treatment.
I wasn't satisfied with the way I had been dealt with and so turned to Dr. Google. The net informed me that the symptoms were similar to urine infection (UTI) and I needed a urine culture test done, something the doctor had never asked for.
The best thing about Dhaka's diagnostic labs is that they rarely ask for any reference if the tests bring money. Two days later I got the results, detected the urine infection and found the generic name of the drugs on the next. Even then I went for confirmation to a simple MBBS doctor and told him everything. He agreed with the test's diagnosis and prescription.
I improved dramatically in just 2 days, returned to health in a week and stayed fine until the next two episodes which hit me over a period of a year of corona. However, the UTIs no longer haunt me and have been fine since then. Dr. Google helped me more than any doctor I could find.
The current medical crisis is a matter of demand and supply. The difference between Bangladesh and most other countries is that there are no agencies to regulate the market. Those who are generally held to be the market guardians are themselves part of the market and the line between the regulator and the supplier is thin if at all. And since the GOB is also a provider of care and diagnosis though its outlets, market regulations simply don't exist.
Isolating the medical profession from other branches of services is not only unfair but illogical. No regulatory sector works in Bangladesh including say the financial services sector. So the medical profession is part of the wider problem of systemic efficiency. It's not about good people but inefficient market management. This will continue. Chances of improvement of the situation are dim if not non-existent.
Bangladesh on its own doesn't have the capacity to provide acceptable medical care either at the private or public level. The cure sector simply doesn't have the capacity to perform adequately and may even lack the skills to do so. Yet Bangladesh has produced some of the best performances in the public health sector, locally and regionally.
What worked here was public participation and that is key in Bangladesh but also the ability to provide quality health care. While many of the medical cases are complicated, many are not and there is opportunity to offer services at the micro level without accessing metropolitan health systems. In other words community based investment for community level diagnosis and health care.
Our refusal to admit our lack of capacity has negatively affected the services. Once we can do an audit of what can be done and what we can't do, we can focus. Google services are already in operation in Bangladesh and the coming days will see more of this. So perhaps, low-end hospitals with junior expatriate medical professionals will produce not just better facilities but necessary competition for the medical market.
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