There is a joke going around that says if you are sick, go see a shaman because it’s cheaper than seeing a doctor.
Good doctors are money-making machines in Mauritius. They charge an arm and a leg. A visit to a specialist will set you back about Rs 1,500, if you are lucky Rs 1200, add a few hundreds more if they have to use some equipment to run a test.
We all know that people will borrow money to pay for healthcare if it means getting their health back. We all would, no exceptions unless we want to die, and irrespective of your income level, you would pay the fees. Someone who earns Rs 6,000 a month will have to pay about 25% of their monthly salary for one visit.
True, not all specialists are busy all of the time but there is a handful who are. A good number of cardiologists, gynecologists, and obstetricians, pediatricians charge around Rs 1,500 per visit, on average twenty minutes. Plus they are consultants in private clinics where a bedside visit costs about Rs 4,500, and these ones are no more than ten minutes. Why a bedside visit at the clinic costs four times more than a visit in their medical office is hard to comprehend.
I once asked a cardiologist plying his trade at Darné why it’s so. That’s just the way it is, he told me. They don’t need to explain anything to anyone. And that’s exactly where the crux of the matter lies. They are unaccountable to no one, even if they don’t provide the care you’ve paid them for, even if they misdiagnose your illness or send you to the operation room when it’s not necessary. Many people had surgeries which, in the end, were not medically necessary. Naturally, they took place in a private clinic performed by a fee-for-service surgeon.
Many women were told they needed a hysterectomy only to be told it wasn’t necessary on a second opinion. I find it very strange that gynecologists in the private are more in favour of hysterectomies than their colleagues elsewhere. A leading gynecologist on the island, one everybody lines up to go see, was once ready to perform a radical hysterectomy on a patient without even resorting to a second test to eliminate false positives. The patient’s husband insisted on a second test. It turned out that tissue samples were mislabeled. That patient was lucky; others weren’t so lucky in womanhood, agony and money. If such an occurrence had taken place in the country where she trained, it would have been dealt with by the medical board, but why is it allowed to happen here inconsequentially?
In Europe and North America, it is a common occurrence to see doctors go through a disciplinary process, some are even suspended or have their license to practice revoked. When was the last time you heard a doctor being sued for malpractice? In addition to being well protected by their brotherhood clan, there is no mechanism to regulate their profession. They don’t have to upgrade their skills, they are not required to attend medical conferences to renew their practicing licenses. Often, they may not even be aware of new research findings that invalidated a previous therapy.
There is more. Upon becoming a medical practitioner, they must take the Hippocratic oath, which is to uphold strict ethical standards, the primary one is to put the health of their patients above their ability to pay them. At Darné, in the hallway, this oath is displayed prominently. Yet before you even get to see the doctor, you are asked how you’ll pay for the visit. Pay first then you see the doctor. So much for the oath and doctors have no qualms at all about it.
I took my late father to see a leading physician at Darné. While examining him, his mobile rang at least six times and he answered them every time, often talking to other doctors, pharmacists or even taking appointments to see other patients. Not once did he apologize for his ethical lapses. Was he able to focus on the patient who toiled hard to pay him his exorbitant fees? A French woman who ran a corporate hospital once observed that doctors in Mauritius are des machines à fric. She knows a thing or two about doctors.
Unfortunately, in this country, much like we have seen with lawyers recently, ethics goes out the window when money comes knocking at the door.
Of course, not all doctors are money-hungry, a number of them are truly good human beings putting the health interest of their patients above all. Alas, they are now the exceptions.
That said, what have successive governments done to bring this run-away profession to account for its shortcomings? What have they done to protect the people against these practitioners gouging their clients – for they are treated more like clients than patients – for every penny they can? Diddly squat.
Perhaps one day we will truly have a government with the best interests of all of its citizens at heart.