Check That Receipt

(8 Apr ’07)

            A patient’s relative came in very angrily to the counter. He claimed that he’d been charged for a test that hadn’t been done. This is what had happened. He didn’t come in with a prescription. He told the girl at the counter what tests had to be done and accordingly she made the voucher and took the cash. Next, she guided him to the laboratory where he was to hand over the samples. The next day, he came in to collect the reports. The girl at the counter said that one test hadn’t been reported. This relative then went home and showed the other reports to the family doctor who claimed that he’d never asked for that particular test at all. Back came the relative to quarrel with us. “You charged me for a test I didn’t ask for.”

            Now, although we always ask for a prescription, for common and routine tests we don’t insist upon it. The relative accused the hospital of cheating and so forth. My point to him was: yes, the girl could have made a mistake, she could have heard wrongly, it was possible. But equally, he could have said the wrong thing, too. Verbal orders are prone to errors. Second, should the person who owns the receipt not check what’s written in it? When you buy a railway ticket, don’t you check the destination, time, seat numbers? When you buy kothimbeer from a pavement vendor, don’t you turn every leaf this way and that? Then why take no responsibility for the care of your own flesh? The counter staff isn’t always wrong.

            When it comes to dealing with doctors/hospitals, people (including reporters from the Press) frequently confuse mistakes with negligence. Human errors can be reduced by following systems, but not eliminated. Surgeons, physicians, nurses, are human. A strong protocol does help in reducing mistakes drastically. If something is overlooked (the dose of a drug, for example) an alert relative certainly can point it out. Unfortunately, though, relatives can also interfere with routine work.

            I often suggest the following to relatives of admitted patients who come me with grievances: 1. Have only one relative dealing with the hospital. Just one. And he or she must be the decision maker. 2. List all questions in a diary, whether a colleague has asked it or the patient him/herself, no matter how minor or ridiculous the query. 3. Divide the questions into medical and administrative. The medical questions should be asked of only the admitting consultant, not a junior doctor, not the nurse or the neighbouring patients’ relatives. The administrative questions should be addressed to the staff at the counters. In smaller, privately owned hospitals, the doctors would be able to answer the admin questions, too. 4. Be careful not to be taken in by greed (I’m going to do another piece on that) but have faith that many doctors/hospitals are transparent and willing to stay away from dishonesty.

            A last word: whenever you pay for something, whether a doctor’s fees or a lab test or a nursing service or a physiotherapist or audiologist service, get a receipt, check it out and ask all questions before you leave the place/person. Go away satisfied. Subsequent quarrels may lead to bitterness, but they won’t solve anything.

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