Saturday Sep 16, 2017
When you enter an ‘international’ hospital in Islamabad, two types of visual displays attract your immediate attention. The first are verses from scriptures adorning the walls on each floor. For believers, it is an accepted truth that all diseases and cures come from divinity. Reminding the patients and their attendants of this may be construed as an attempt to absolve the hospital of any misdiagnosis, wrong treatment, and outright negligence that may result in the further deterioration of a patient’s condition.
Another type of display is a poster or a notice that strictly warns patients and attendants that any misbehaviour with the doctors or medical staff may result in serious consequences for both. Fair enough.
Keeping in mind our society, this seems to be a well-deserved warning. But wait, what do you do when you are handed down a bill that is exorbitantly high for just a night’s stay and nobody seems to be able to explain why? You feel like shouting but you can’t. Perhaps, the only option you have is to bang your head against the wall. This writer is not a medical writer. If I had been one, the episode that I recount here might never have happened.
During the Eid holidays, some guests from Karachi came over to stay with us in Islamabad. We were delighted to have company for Eid. All went well until our guest’s daughter developed indigestion – a usual occurrence on Eid. Frequent bowel movements made her lose water so we had to take her for medical treatment.
Since general physicians are not available during the Eid holidays, we had to take her to the nearest hospital, which is run by a ‘trust’. At the registration counter Rs5,000 was demanded and duly deposited by the host – since you don’t ask your guests to make payments in such situations. We found that the emergency treatment was good.
The lady doctor at hand was caring, courteous and polite. During the next couple of hours, multiple samples of blood were taken for lab tests. Then, a mobile X-ray machine appeared with technical staff to carry out chest and abdominal X-rays. Immediately, a regular saline drip was administered with some medicine and the patient’s condition improved within hours. After around six hours, another doctor, with an even more considerate demeanour, appeared. She claimed to be a consultant. The doctor examined the girl and informed us that the patient needed monitoring for at least 12 hours before she could be discharged.
Though we were sure that the girl was all right and could be discharged from the hospital with some medicines, the charming ‘consultant’ was adamant that anything could happen suddenly. Of course, we could not put a life in danger, so we agreed and the girl was taken to the MICU – which is referred to as a slight step-down from the ICU. The mother of the girl stayed with her daughter for the night and the men returned home. The next morning, we reached the hospital to have her discharged. But the doctor who had been assigned to her was not there.
The MICU was a big hall with around 10 beds and a couple of nurses and ward boys were on duty. The mother of the patient informed us that during the night, two more samples of blood and urine were taken for tests. When they came for the third time in the morning, she refused to allow more blood tests because the girl’s condition had improved. We kept waiting for the release but no doctor was in sight. After every passing hour, we asked the hospital to discharge my guest’s daughter. But the answer was the same: only the assigned doctor could allow it.
For another five hours, we were just reading the verses on the wall or the notice of warning not to misbehave. Finally, we politely told them that we would take the girl home even if she wasn’t discharged. At this, they made a couple of calls. Suddenly, a doctor appeared and informed us that the girl was still not well and it was customary to move the patient to a private room.
After our subdued protests, he agreed to discharge the patient after we signed a paper taking full responsibility for anything that went wrong after she was allowed to go home. Then comes the worst part: we were sent down to the cash counter, where we were given a bill amounting to Rs55,000.
The breakup you ask? The admission fee for Rs4,000 and the MICU charges amounted to Rs8,000. We were charged Rs2,000 each for the visits of various doctors, Rs6,000 for a medical officer on duty, Rs5,000 for nursing care, Rs19,000 – yes, 19k – for lab tests, Rs2,000 for radiology, Rs1,800 for pharmacy charges, Rs3,600 for the emergency clinic, Rs900 for general medical procedures, Rs610 for hospital amenities and Rs350 as a registration fee.
Is this not a travesty of medical ethics? Nobody even informed us that we should be ready with that much money. When we demanded to see the lab test reports, we saw all the reports absolutely clear. Why on earth did they need to take so many tests without even asking us? At the cash counter, there was no doctor to explain anything to you. Back with the patient, the paramedical staff was not ready to explain. The new faces in the emergency don’t know who made the bill. The only answer we got was that it was all standard procedure that they carry out and we should have known it.
In such situations, you feel like becoming one of those ‘uncouth’ and ‘uncultured’ lot who misbehave at hospitals. But then you realise that it is of no use. You read the verses and the warnings again, pay the bill and blame yourself for not asking in advance what the bill would look like. Lesson? Never allow a private hospital – even if it claims to be run by a trust – to hospitalise the patient for a minor problem. If you do, ask for the estimated bill – to which I am sure they will give you a roundabout answer. Caveat emptor.
The writer holds a PhD from the University of Birmingham, UK and works in Islamabad.
Originally published in The News