Low doctor to patient ratio
Given NIMHANS’s reputation as an institution of eminence and that treatments are sometimes offered at greatly subsidized costs, the doctors receive a staggering number of patients every day.
A government-run institute, NIMHANS is visited by patients diverse both in their linguistic and socio-economic backgrounds as well as in their level of medical understanding.
A majority of the patients have not received a formal education and thus may not grasp complicated information about their condition and treatment. The situation is often further aggravated by the doctor using technical jargon and overwhelming the patient with more information than they may be able to retain.
Patients travel from across the country to seek aid at NIMHANS but, given India’s linguistic diversity, are often confronted by a situation where they do not speak the same language as the doctor. Although a third party at the hospital is usually brought in to translate, this makeshift translation loop invariably results in miscommunication.
Various factors working in conjunction thus lead to information being repeated multiple times to different stakeholders in the situation so as to ensure the patient receives essential information. However this results in doctors spending more time counselling when they could employ their time otherwise.
For diagnostic and interventional procedures to be carried out at NIMHANS, the patient has to sign a consent form. Ideally this would happen after they have understood the details of the treatment, its risks and costs, and can provide informed consent. The process of the doctor explaining all the details of the condition and treatment to the patient, at both the pre-diagnostic and pre-intervention stages, and advising them on their options is referred to as counselling.
However, many previously mentioned factors act as impediments to the process of them understanding. In addition to this, as the consent forms are currently only available in English, many patients face difficulties in making informed decisions.