Doctors in India normally don't talk to their patients, especially the outpatients.

A normal doctor -patient interaction in India begins with the patient entering the doctor's chamber, greeting the doc with folded hand gesture, taking the stool besides the doctor's table, handing over to the doctor his/her outpatient slip, and start telling the doc the purpose of the visit. The doctor, most often keeps looking at the slip, not bothered to look at the patient, scribbles some medications in an in-legible handwriting on the patient's slip, hands the slip to the patient, the patient gets up, says thank you and leaves.

In such a scenario, No Wonder Asthma management is unsatisfactory in India.

According to a latest study conducted by Indian Council of Medical Research, around 15 million people in India are suffering from asthma but management of the disease continues to remain unsatisfactory.

The study found that practitioners (doctors) believed informing a patient that he/she has asthma is not important. It also found there was huge under utilisation of inhalers, the mainstay of asthma therapy.

Other findings of the study:

1) None of the patients were provided any educational material about the disease.

2) 66 per cent of the patients were not told of any preventive measure to lessen the symptoms.

3) 94 per cent were not given information regarding early signs of worsening of asthma care.

4) Only 44 per cent of the patients were prescribed inhaled therapy and majority of them learnt the use of inhalers from the package insert, other patients or hospital staff rather than their doctor.

5) Majority of the asthma patients were not aware of their doctor's qualification and most of them had consulted more than two doctors at primary and secondary healthcare before visiting the referral (tertiary) chest hospital.

6) High prevalence and poor control of asthma make its management a major public health issue worldwide, especially in developing countries.

The Study concluded that the optimum review of asthma management in the community is essential to improve asthma control. In addition, teh latest study concludes the same, which many previous studies conducted in many states had come up with. Stressing on teh need to implement suitable interventions, the study stressed on the need to improve the improve asthma management in the country.

The research was conducted among 50 patients in a public tertiary care chest hospital. They were interviewed on quality of asthma management before visiting referral hospital, asthma knowledge and asthma quality of life.

Reasons for India's poor showing on Asthama Management:

Lack of lietracy, and more importantly , the lack of health awareness among the people, is the main cause. This ignorance makes the patients visit wrong doctors. It'll look surprising to some, but in India, even educated people don't know the difference between a physician and a Specialist doctor.

Another impritant reasosn for "NOT on talking terms" relation between a patient and a doctor, is the society according too much respect to doctors. A mindset too tilted in doctors' favour that a patient doesn't gather courage to ask even simplest of questions.

The Right Thing to Do:

It's absolutely NO NEED to treat doctors as some imposing figure -- Someone who should be seen with respect. Instead, one should treat a doctor like any other service provider. And here as well, the more questions you ask and the more freely you talk to your doctor, the better service (treatment) you'll get.

Hence, the next you visit a doctor, let your behaviour be guided by general norms of social conduct; a conduct which you practice for fellow members in the society; And talk freely and Ask Questions. No need to KowTow.

A Good Doctor will always appreciate that.
----