The Poverty mindset

This happened just yesterday in the clinic. I was longing to write about this subject, though, for the longest time. It is a nightmare that doctors experience repeatedly, almost every day. I would be hard put to find a doctor to whom it hasn’t happened.

A close relative (she-who-shall-not-be-named) called me saying that her friend wanted to see me for her diabetes. This was an elderly lady who lives alone. I asked the lady to come as the first patient of the day so she would not have to wait, and I could give her enough time. She didn’t turn up at the agreed time, but several hours later.

I received a call from the front desk at the hospital, asking whether she should be charged or not. I said yes, you can charge her.

Now, I know what you are thinking if you are not a doctor. Oh, my god! Doctors are such looters. Poor elderly lady, a friend of a close relative, and she wants to charge her! There is no humanity left. This is all a business.

Well, let me give you a little clearer picture. This elderly lady has a son living in the US who is extremely wealthy. Her two daughters, who live close by, are very well settled. The receptionist said that the daughters who had accompanied the lady told him; they were asked to come directly and not to make any registration paper or any payment. In the middle of a very busy clinic, I did not have the time to think about it.

Anyhow, to move along, I finally saw her. We spoke, we laughed, and the consultation was over. They also took a consultation from my nutritionist. And as they moved out to the corridor, they asked me with wide, innocent eyes,“Doctor, your payment?”

And I thought to myself if you really intended to pay, why didn’t you just pay when you were asked to? This is a very common tactic that people use. They won’t pay when asked but later will pretend like it had just slipped their mind and how they fully intended to pay the whole time.

And I will confess–that I chickened out! All I needed to say and have said over and over to myself in the privacy of my home later is, “Yes, please pay my consultation fees as you leave. Thank you!”. But I fell prey to that familiar devil–“looking good”, “not looking greedy or mean”–none of which I am, but these are the games our mind plays on us.

Many of you may think, “What is one consultation? What is the big deal? Was I going to become poorer if I didn’t get paid one miserable consultation fee?

Well, it isn’t the money. It is the sense of being used. Anger that people who can pay-don’t. That our time is of no value. Repeatedly, we receive phone calls from random people who are friends of friends, friends of relatives, friends of other patients — for free advice — on the phone, by email, or in person, on your morning walk, at the grocery store. At weddings, birthdays, and funerals, In restrooms. In the lift, while walking to the car. In the beauty parlor, at the gym. These are all places someone has accosted me for free medical advice.

Let me tell you why I am peeved explicitly about people who can pay.

I remember the time a young, poor girl consulted me many years ago. She was barely fifteen and had never had a period. Her mother, who had accompanied her, was anxious. Her father was a rickshaw driver, so could not attend the consultations as missing work one day meant no money. I undertook some investigations, arrived at a diagnosis, and started the treatment. This entire process involved several visits. I was very mindful of their financial status and I did the consultations for free.

At one consultation where I was starting the treatment, what she said to me brought tears to my eyes. She told me, “Didi, when I grow up and start earning money, I will come and consult you and pay your full fees.”

And she did! After so many years, she still sees me. She pays my fees; she insists on paying and I accept it with great pride and satisfaction. I will not become richer by one person’s fees, but so much richer by the courage and grit of this young girl. In an eerie coincidence, as I went home late one night from the hospital, the rickshaw driver told me, “My daughter comes to this hospital for her treatment.” I asked him his daughter’s name. It was the same girl. He refused to charge me for the ride.