MIND YOUR MEDICINE PART 4: Why does your medical bill pile up?

 

Part 4: Why does your medical bill pile up?

Diagnosis, Management, Prescription, the tripod towards wellness.

 Though the terms Diagnosis, management, and prescription are best left to the discretion of the Doctor, it is imperative that a common man be aware of it. The simple reason being, the final bill that we get during the discharge from the hospital, is linked to them. Whether the patient is cured of his illness or not, the bill invariably makes us struggle for breath. In anxiety to get well, we invariably nod our head in affirmative to whatever the doctor suggests. The three legs of the tripod represent the above terms, upon which the doctor infers his approach. Each term, depending upon the magnitude and nature of the illness, contributes towards the bill.

Diagnosis

This constitutes the first leg of the tripod.

Diagnosis in simple term is an investigation to catch the real culprit. In medical terminology, “The art or act of identifying a disease from its signs and symptoms under the guidance of a Health specialist”. Diagnosis, based on history, physical examination and medical tests of the person concerned, augment the specialist to draw a line of approach towards treatment.

There are varieties of diagnosis done based on the condition of the patient. For example,

Clinical, Laboratory, Radiology, Biopsy, counselling and so on. Sometimes, the doctor recommends types of diagnosis to rule out certain anticipated diseases based on symptoms, as more than one disease can have similar symptoms. The mode of approach depends upon the style of the doctor. A few get the diagnosis done step by step, whereas, others expect all the diagnosis done at once. Again, this depends upon the condition of the patient. We should be aware of the fact, that the nature of the illness, sometimes may not be known, in spite of the diagnosis. Naturally, the expenses go up and we start unnecessarily blaming the doctor. Remember, there are hidden health problems too. The doctor may refer you to a super-specialist.

 Management

This forms the second leg of the tripod.

Management of the clinical condition is the main aim of a physician. Based on the conclusions drawn via diagnostic procedures, the doctor decides on the line of action to improve the condition of the patient. He starts the medical care of the patient for the illness or injury. This is called treatment. Treatment may completely eliminate the problem or minimise the symptom/sign.

Management can be done by suggesting lifestyle modifications or by prescribing medications. If any disease is diagnosed in the early stage, it can be managed simply by lifestyle changes e.g. exercises, yoga, change in dietary habits etc.   

When the medical care completely relieves the disease along with the symptoms/signs, then it is called a cure.

A treatment/cure could be through medication, surgical operation, therapy, counselling. Many times, the way the learned doctor speaks/interacts, treats/cures the patient.

In extraordinary conditions, if the doctor feels that the disease is incurable, may still continue the treatment. This, however, will not relieve one from the disease but provide strength/energy to withstand the ill effect for a reasonable length of time.

Again, based on the type of treatment/cure and duration of time, the bill escalates. Don’t forget the type of ward you choose, if the treatment requires hospitalization.

If you are lucky to be diagnosed with an illness that requires no hospitalization, the doctor will advise for medication at home and reevaluation after an interval of time. He will just prescribe the medicines.

 Prescription

 

The third leg of the tripod is prescription.

After the processes of diagnosis and decision towards treatment, the doctor invariably writes the plan of action. On his/hospital official pad, he will write a minimum of three things. These scribblings are authorization for the pharmacist to supply the contents as per norms. It is like a license. It also contains the following instructions:

1.      Name of the medicines with conditions.

2.      The quantity of each medicine/ Duration

3.      The frequency or the number of times to be taken in a day.

4.      The mode of taking.

5.      The future date of checkup if needed.

 

In addition, other instructions like B.P. and weight monitoring may also be written.

The symbol

 in the beginning stands for medical prescription, it means ‘Please take’.

1-1-1 means three times a day. Morning, afternoon and night. Similarly, 1-0-0, 0-0-1, 0-1-0, 1-0-1 have respective meanings.

This indication depends upon the longevity of the effect of each medicine. If medicine X can act for 24 hours, it is denoted as 0-0-1 etc. Many medicines prescribed to be consumed in the night, is to safeguard the patient from any mishap while fast asleep.

Other instructions about side effects, diet, exercises and other precautions to be taken are usually given orally.

Even here, the price of the medicines prescribed by each doctor varies based on the brand/the company which manufactures.

 

Is there any correlation between the cost of the medicine and its efficacy in the subsequent episodes?