In My Brother’s Opinion

The last post that I made described my brother's near disaster health crisis that caused the family a certain amount of panic. After that experience, my brother decided to cut short his vacation here in America because aside from his concerns on his health, he was not totally impressed with the quality of health care he received from the hospital where he was confined for some five days.

According to my brother, who is by the way a physician back in the Philippines, technology and equipments used in the American healthcare system is way advanced as compared to a developing country like the Philippines but it came short with the basic doctor-patient relationship. The patient is always part of the treatment process and having the patient included in the loop in terms of communication and planning is essential. In the case of my brother, he was on a daily contact with his resident primary physician and the nurses, but the nephrologist assigned to him had visited him only once. A nephrologist is a physician who has been trained in the diagnosis and management of kidney disease. He was the one who ordered a series of dialysis treatments for my brother. Normally, whenever a procedure or dialysis in my brother's case is performed, blood tests will follow and the results should be discussed with the patient including the next plan of action to be performed. My brother never had this kind of meeting with his nephrologist in-between dialysis treatments. He would ask his primary resident physician but the doctor will still have to refer to the nephrologist for the results. My brother would take some initiative to pressure his nurses to have the results read to him so that he would know his status. He would just be surprised that a dialysis technician would come to his room and perform the treatments without him knowing in advance. Eventually, my brother told his primary physician and the nurses about his predicament. He told them that he was not questioning his nephrologist's capability and ability to handle his case but all he asked for was only transparency. His nephrologist should be transparent enough to him about all the results and what to do next or the plan of action after a procedure. My brother told them that this is not the way he and his fellow doctors manage their patients back in the Philippines. He also noted that with all the buttons to push in all the hi-tech equipments, he was wondering if they will be able to diagnose and come up with a treatment plan when any of these are not available and just use the very basic techniques in managing the disease.

My brother is doing fine right now and we even went to San Diego over the weekend. My mother wanted him to undergo another dialysis treatment before he travels back to the Philippines but he declined. He would rather see his nephrologist back home and perform his follow up treatments there. At least in there, he knew his doctors well and he will feel at ease with them. His vacation here will be cut short by 3 weeks.