Docs' exorbitant fees making common man practice self-medication

HIMALAYAN NEWS SERVICE

n The first thing that hit my mind as I went through this topic was the most heard dialogue from all doctors when we visit them, “So, what is your problem?” It’s quite obvious for us, that doctors should be visited only when we actually have answers to their question! So we don’t prefer visiting them with minor disturbances in our health, rather, we try to solve it ourselves with the intake of some well known medicines easily available in the market, that too without any prescription. This shows we are still not aware about its effects on our health. For example, intake of one Cetamol to cure a headache gradually multiplies from one to two and more tablets and we rarely notice it. The increasing dose without any reference from a doctor may cause very serious health problems. That is why I avoid taking medicines as much as I can and only when it’s unbearable, do I visit a doctor and follow their prescriptions. I also suggest everyone to only use medicines when you actually need them which you can be sure of, by visiting the doctor as soon as you feel unwell.

— Shreeja Shrestha,

Bhaktapur

n When we ask for medicine at the chemist’s, we only say that where we have pain not the cause of that pain because we don’t know the cause. I think it is compulsory to visit the doctor to know the cause of pain to cure it completely.

— Sunil Baniya

n We are in a situation where most of the experts (doctors) stay in comfortable places rather than the rural parts. The consultation fee of the experts is very high so most of us can’t afford it and normal people are afraid of different kind of tests to be performed by the doctors even in normal condition. We all know well that the rate is too high and some tests are unnecessarily done. Mostly the doctors don’t stay in hospital and spend full time on the clinic. The living standard of people in the remote places is very poor and people die untimely because of diseases like cholera and diarrhoea. The government has not launched any kind of health insurance scheme. Though people are conscious about their health condition, sufficient medicine is not available in health centre and they have to spend time and money to reach the health centre. It’s true that in some of the cases we simply take the suggestion from health worker and take the medicine without doctor’s prescription without taking the case seriously.

— Asit Baral, Masbar, Pokhara-7

n I visit doctors when it is a serious case related to my health otherwise, I deal with minor cases on my own. People really do not like to visit doctors these days because they think that they can deal with the illness, wounds and pains by themselves. They really think that they are smart enough in this regard. The other reason must be due to modernisation by which people think that they should take care of their health on their own. Besides, I don’t think that minor health issues really need doctors. It just needs right kind of treatment. It is really the major health issue that really requires treatment by the doctor.

— Pratik Shrestha,

Buddhanagar, Baneshwor

n Doctors are considered as God in the 21st century. Doctors save people from death. The main reason that people don’t consult the doctor is just to save money. It is clearly written on the cover of the medicine that medicine should be taken only under the prescription of the doctor but due to lack of knowledge they don’t follow instructions. Every year more than 12 lakh people die just because of taking wrong dose of medicine and consuming drugs. Out of which about four to 6000 citizens are of our country who die every year just because of taking wrong dose of medicine. I visit doctor twice a year and sometimes I hesitate to visit the doctor in case of minor illness because I also prefer saving money.

— Rajan Kumar Shah

n Yes, most often we take medicine without doctor’s prescription. We don’t visit doctor or any hospital just because the fees of the doctors are high and if we go to the private hospitals then the charges are unbearable. For a check-up they charge at least Rs 400 depending upon the qualification of the doctors. Can a common patient bear to pay such amount?I am a student and I also work to earn my living. The expenses are so high that there wouldn’t be any money left for saving. I do not visit doctor until my health gets worse. Sometimes I recover by resting for two or three days. I am not telling others to follow what I do. I want to say, if the doctor charges less fee or provides free medical check up then the patient will visit a doctor and use the medicine which they prescribe. And these should be practiced immediately. Developed countries practice this policy so their citizens are healthy and are safe from any health ailments.

— Moin Uddin, Ghattekulo, Kathmandu

n It is very true that we should only use medicine on the prescription from a doctor. But, it is a bitter reality that most of the Nepalis use medicine based on hunch and what they hear. I too fall under the same category. I think lack of awareness is the main reason. Also, most of the people don’t have easy access to the hospitals. They have to travel many days to use this facility. Similarly, many people have a misconception that it costs high to visit a hospital or taking appointments from doctors. On the other hand, the service of doctors is not affordable to most of the Nepalis and it consumes lot of their working time. The most common aspect is people are gradually losing their faith in doctors as the cases of carelessness of doctors frequently come in the media without consulting a doctor.

— Sulochana Panta, Kavrepalanchowk, Birtadeurali

n Frequently visiting a doctor obviously is not harmful for anyone. People rarely bother to consult a doctor or medical practitioner for healing their physical or mental illness, be it a minor or major in nature. Besides, money also matters a lot. The minimum rate of a doctor costs approximately Rs 300 per consultation, which is a huge some for a common man. In addition, s/he needs to go for various lab test procedures. Moreover, pharmacists’ practice of being so called doctor breeds wrong tradition. They are free to sell various kinds of drugs without prescription of the doctor. Lack of controlling mechanism to mitigate such problem is also playing pivotal role for enhancing the trend. As a result, laymen are compelled to take medicine, sometimes outdated too, without being aware about the significance of health and the risk of its possible side effects. For me, as representative of average Nepali citizen, consulting a doctor for ‘not -so -seriously’ ill is an exceptional case.

— Moti Ram Dahal,

Kaleshwor-1, Lalitpur

n ‘Health is wealth’. So, be it a minor illness or a major one, one should always consult a doctor or medical practitioner whenever something goes wrong with us. We are in a period more advanced than the previous one, with sufficient health facilities and health assistants. So, hesitating to visit doctor in a “not-so-serious” matter might develop into a major illness which becomes difficult to treat. Thus, considering the saying “prevention is better than cure” we must consult a doctor at least once a month. But in our country due to illiteracy many people still believe in dhamis (witch doctor) and due to lack of proper health facilities in the rural areas, many people take medicines without the doctors’ prescription, which is not good because it may adversely affect our health. Visiting a doctor at least once a month makes us aware about our health condition which helps to maintain our health.

— Garima Poudel, Masbar, Pokhara-7

n There are different types of people in our society. They have their own choices. Those who are conscious, careful and aware like to visit doctors, if it’s serious or not. There is another group who don’t take their health seriously and do not bother to consult a doctor or medical practitioner when they become ‘not-so-seriously’ ill. But I think it is a wrong practice. In my opinion, ‘Health is wealth’. Without good health one cannot do anything in his/her life. One has to remain as non-living thing. Even if we are okay then we need to visit doctors time to time and should do full check up once a year. ‘Prevention is better than cure’ so we should try for healthy living by eating fresh food, balanced diet, doing exercises et cetera. If anything goes wrong in the body then we should not hesitate to visit doctors. Without consulting them we cannot go to the depth. We should know that minor diseases can be the symptoms of major ones. So be aware, visit your doctor regularly.

— Agrim Poudel, Masbar, Pokhara-7

n I think being seriously ill and then going to hospital to take advice from the doctor is a very bad practice. It is very harmful for our health and this way you have to spend more money so I think people have to go for regular check-up for their health. Mostly people who live in the city have to go for regular health check up because of their lifestyle.

— Sunil, Kathmandu

n Yes, it’s very true that one should consult a doctor whether it is minor or major disease. It’s not good to follow prescription of medical shop owner, it’s not right practice. But let me tell you this, I thought of this question a week ago, when I got a small ring on my back. When I saw it I was tensed. So I told my parents to get me checked by doctor, when I went to doctor it was torturous than the problem. There was a long queue and my number was last. I was told to get an appointment at 5:00 pm, but instead got an appointment at 9:30 pm. And was told that it was a simple rash and I was given a medicine worth Rs 2,680 for a simple rash. A question arose in my mind why should I visit a doctor for a simple disease? If you get cough, I think 95 per cent of the people will take cough syrup than going for an expensive check up.

— Anonymous

n Falling sick once in a while is natural and nothing out of ordinary but we cannot run to a doctor every time we sneeze. For our simple problems there are simple remedies prescribed by our grandmothers. But if we have to take medicine then it is not only stupid but suicidal to do it without doctor’s prescription. One can get a list of medicines from the doctor that can be bought over the counter and safely taken like paracetamol or aspirin. But these drugs are to provide immediate relief rather than cure. Maybe what prevents us from seeing a doctor is the long wait or fear of hospital/doctor or distaste for medicine or expensive treatment. But whether we like it or not doctors are indispensable in our lives. Only a sick person can tell us how much he or she needs God and doctor.

— Vandana Tiwari,

Kathmandu

n No, it’s not the right practice at all. We may have a little knowledge about which medicine to take for which illness but we might be unaware of the dose of medicine and the time interval between two intakes. Also, some painkillers seem effective instantly but are harmful in the long term if taken recklessly. Moreover, a simple doctor’s advice may help to shorten the recovery time as his/her prescriptions work not only physiologically but also psychologically. We believe doctors are life-savers. Therefore, their words/prescriptions automatically create a recovering spell on our mentality that ‘I’ll soon be fine because I’m under a learned professional’s care’.I visit a doctor at least once in two months though I don’t get sick and believe me, it’s fruitful. But we all know it’s impossible for everyone in Nepal. Firstly, the mass-misconception that, doctors are to be visited only for serious illness/injuries prevents us from getting regular check-ups. Secondly, it’s the economic factor and lastly, uprising sceptics that doctors prescribe medicines even for minor cases, which can be naturally cured, just to earn more money. However, we must not forget that good doctors are life-savers.

— Ila Shrestha

n Generally we take medicine when we fall ill. Taking medicine has benefits but it also has several adverse effects especially with allopathic medicines. Therefore, one should be very cautious while taking a medicine for any problem. Nepalis have been taking medicine from medical stores without doctor’s prescription. Obviously, it is not good practice. In my case, I am very sensitive in regard to taking medicine. I am a health practitioner, have knowledge about medicine, but I do visit a doctor when I fall ill. Taking medicine without doctor’s prescription is not good practice in Nepal. But unfortunately it is happening because of not easy availability of doctors and health practitioners and health institutions, unaffordable doctor’s fees, not easily accessible health centres in remote parts of the country and many more.

— Keshab Singh Air,

Siddheswor 9, Khodape, Baitadi

n Self- medication is a wrong practice as it invites serious consequences. But in our context, it is commonly seen that people experiment different types of medicines without consulting medical experts and doctors. There are various reasons behind people not approaching the doctors. In my understanding, financial constraint is one of the main reasons that keeps people away from doctors. They find it easy and cheap to go to a pharmacist and buy medicines rather than wasting time and money for the appointment and other lengthy procedures that one needs to undergo for various tests after seeing a doctor.

There are many others who shun away from doctors as they fear they would not be able to cope with the situation if in case something is wrong with them. Thus apart from financial condition, psychological and procedural factors are also equally responsible for preventing people to approach a doctor and seek their advice. It is really unfortunate to see literate people adopting such short cut means. Though National Drug Policy bars selling medicines without the prescription of medical practitioners, pharmacists seem to have involved in such illegal practices openly. To check this unlawful act and wrong

practice the government should come forward with a strict

policy and implement it thoroughly so that the sale and

haphazard use of medicine could be checked. At the same time it becomes the responsibility of the pharmacists to observe medical ethics and think twice before selling medicines without the prescription.

— Ambika Pandey