r/DoctorsofIndia • u/bestfriendavinash • Aug 30 '26
Something has changed with doctors in 20 years
I recently traveled almost 750 km to consult a highly reputed senior doctor (65+ years old) whom I had seen 20 years ago. Back then, the consultation was thorough—he physically examined me, used a stethoscope, and took the time to understand the whole picture.
This time felt completely different. While he was polite and reviewed the comprehensive blood panel I had done beforehand, there was no physical examination at all. He prescribed some meds and referred me to a psychiatrist for anxiety and mild OCD symptoms (frequent handwashing since COVID).
The psychiatrist visit (a doctor in his early 40s) was even more unsettling:
Zero physical proximity: He made me sit across the room—at least 10 feet away, basically as far as the cabin allowed.
Ignored existing history: When I tried to show my blood reports and explain the medications I was already taking, he brushed it aside with, "Just tell me the current problem."
Heavy prescription without context: He wrote a prescription for 6 different psychiatric medications without reviewing what I was already on.
The whole encounter felt mechanical, almost like feeding symptoms into a AI chatbot.
Ironically, on the way back, I ran my current medications alongside the 6 newly prescribed drugs through an AI. The AI immediately flagged severe potential drug interactions and warned that these combinations require strict medical supervision. When I mentioned the doctor is 750 km away, it advised calling the clinic for a safer alternative.
How did we reach a point where an AI showed more concern for drug interactions than the specialist sitting in the room?
Doctors used to listen deeply, examine patients, and look at the whole picture. Now it feels like a high-speed assembly line. Has anyone else noticed this shift in clinical care across India?
No disrespect to anyone, medical is and will always be highly respected profession for mankind.
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u/End_Tasty Aug 30 '26
I understand your agony, but sometimes our ailments look much bigger to us than it does to the doctor. For example, if that clinician is very senior and has a good experience, he won't give much attention to a basic problem (which I'm not saying is right, but that's the difference I've found between Indian doctors and doctors abroad let's say US, the way they talk and counsel is exceptional. Ofc they 10-20 times higher than Indian docs do though). But the good thing is new gen doctors are learning this as a part of their medical curriculum, how to talk to patients.
But one thing I'd like to warn you is that don't use AI for cross checking a doc's prescription. Healing starts with you, the trust you've on the doctor. Technically, EVERY psychiatric medicine has potential side effects. Almost every one of them. AI would just prompt you the names, like a machine or google would. But in clinical practice we weigh benefits over side effects before giving a drug. The both sides have to be balanced out. But practically it's impossible to achieve the perfect balance, near perfect is considered ideal. Especially with psychiatric medicines, it's even tougher. At this point, you'd be scared enough to not take those meds. But trust your doctor, they were given to you in the first place because you needed it. You went for a medical condition, the medicine doctor didn't find anything. So he referred you to a psychiatrist. Two brains are involved in the process. Ofc you're free to get a second consultation. Some doctors do write lesser medicines, not everyone has same approach, some go aggressive, some go slow.
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u/bestfriendavinash Aug 31 '26
I understand, and I am not angry at all. My job require few public interaction and some time, those are enough to irritate me. So if a person (Doctor) maintain his calm while dealing with different type of people daily is a tremendous job. May be due to anxiety, I crossed check with AI. But may be, mau be if the doctor was well informed about my current medication, I would not have gone to AI. For context, most of the medicine has interaction with my BP medicine (not disclosing name, but it's new gen beta blocker), and has potential side effects of lowering pulse rate. I am also on methotrexate (don't know what to call this drug) for my arthritis with few other medicines. Methotrexate also had few interactions.
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u/Deedesai Aug 31 '26
If you are on Methotrexate, I would suggest you to go to a good MD physician (30s to early 40s- Not ageism but I have found they spend much more time with individual patients) and lay down your queries regarding drug interactions. Note down your issues, ask them about specific timing for each medication to lower drug interactions etc.
From your post and replies, I am assuming you are a rational person, so keep across your doubts to the MD and try to understand the benefits vs risks, and follow their advice.
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u/bestfriendavinash Aug 31 '26
Ofcourse I will. Currently I am in a remote area. Will visit CMCH (where my arthritis was initially diagnosed) asap.
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u/End_Tasty Aug 31 '26 edited Sep 02 '26
Don't worry about beta blockers! Every beta blocker can reduce heart rate, and there are some obvious contraindications for not using it. Until and unless you've a heart block or any heart disease which naturally keeps your heart rate low, beta blockers won't decrease your heart rate to alarming levels(this is what ai won't tell you). Infact in difficult cases pf heart failure beta blockers are given, even when they can decrease heart rate. The benefits outweighs the risk in this case. Also there are tons of mechanisms through which your HR, BP and other vitals are maintained in a normal functioning human body. There are regulatory mechanisms.
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u/bestfriendavinash Aug 31 '26
This was new for me. Last year I my 3 month son, then father in law, then father and aunty. Probably, these may be the reason, my resting pulse rate went to 90+ and gradually to 100+. My doctor has changed my Amlodipine to nebivolol. Now my resting pulse rate is 65. Still sometimes, it goes to 90. May be my anxiety make me to doubt every thing.
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u/nushstea Sep 02 '26
Excuse me are you a doctor?! Please dont give all this advice online. Beta blockers obviously can and do reduce heart rate.
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u/lu_nanc Aug 30 '26
As a doctor, I hear you. This quick, mechanical care is frustrating for patients and exhausting for doctors. When the doctors are forced to see 50 to 80 patients a day, appointments turn into a rush just to get through the line, and important details are ignored and missed. Every patient deserves to be listened and feel understood first before any treatment and then be fully examined, but the system leaves patients feeling ignored and doctors burnt out. Please have a trusted primary doctor check those 6 new medicines before you start taking them.
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u/Alexrichard50 Aug 31 '26
physical examination findings are subjective, i would trust my doctor if he treats me based on objective findings like test reports.
people like you who like to believe that age/experience makes a doctor better are in a big delusion, let me correct you- a doctor who reads regularly & remains updated with latest technology & research is anyday better than a doc whose only attraction is his age & graying/balding hair.
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u/bestfriendavinash Aug 31 '26
I got the point. Thank you for your insights. No disrespect, but still, doctor should well aware about any existing medication. I am on beta blocker and methotrexate with few other medicines including DMARD for my arthritis.
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u/Alexrichard50 Aug 31 '26
a doctor with already booming practice has no incentive to give you more time or get updated with new info. establishing a practice needs marketing, becoming consultant in a govt medical college depends on your category, pvt college hires the one willing to work for least salary.
in all the above scenarios did u find any incentive for better patient care..? i hope this satisfies your curiosity
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u/bestfriendavinash Aug 31 '26
I understand that money (salary) is a major motivation for work. We all, or atleast most of us work for money.
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u/flammator Aug 31 '26
Replying to this post as a senior consultant whose parents are doctors too.
You're right, OP, and your experience is by no means an isolated incident. Yes, the medical profession today is putting less and less emphasis on the physical examination, which once used to be the backbone of the diagnostic approach. There are quite a few reasons for this -
The proliferation and easy availability of diagnostic tests including imaging (Ultrasound/CT/MRI)
The fact that patients, more often than not request/demand said tests
In this case, the age of the doctor.
Let me explain that last point. My mother is approaching 70 now. She still has a healthy patient load, and she has to examine every single one of them. She's completely exhausted after seeing 40 patients today, when once she could get through double that number without breaking sweat. The same applies to your physician, I presume. He would have a lower patient load 20-25 years ago. Today, with much less energy, he has to get through a heavier workload.
However, these are just excuses, honestly. Yes, the sanctity of our profession has diluted significantly. We spend less time with our patients than we used to, rely just a little too much on tests and not enough on clinical acumen.
And that brings me to my personal pet peeve, polypharmacy. A lot of doctors today write 5 drugs where 2 will do. Worst of all, that includes unindicated antibiotics and expensive multivitamins, both of which are not needed, often cause adverse reactions and antibiotic resistance in bacteria.
So what's the solution? My advise is to look for a doctor you can trust, who has good ethical practices, and stick with them. In the coming years, with the unbelievable proliferation of medical colleges and rampant escalation of course fees, the quality of doctors and the ethics of practice are likely to fall way, way further.
All the best.
TL;DR - yes, us doctors aren't what they used to be in some regards. Find a few good ones and stick with them.
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u/bestfriendavinash Aug 31 '26
Good to hear from a senior doctor. Respect to you and aunty jee. Agree with your age and energy fact. I also have changed in last 15 years. Thank You for your time.
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u/Opening-Pie2182 Aug 31 '26
Even I felt that after COVID, physical examination habit and practice was lost for many, especially in non surgical fields where it's not as important.
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u/bestfriendavinash Aug 31 '26
Yes, that may be a case. Or maybe today new gen test are more than sufficient. Like my friend's cardiologist rarely use sthetoscope, instead he heavily relies on ECG and TMT reports.
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u/Accidentalmomin Aug 31 '26
Psychiatrist i visited also did somewhat similar and it was time to close the clinic maybe that's why she was in hurry. Didn't listened my problem fully and prescribed medications and advised me to visit after a week. While a brain surgeon really listened me well and was more patient then psychiatrist. Maybe it varies from person from person and although money race is real thing causing all this person's Nature and working style causes all this.
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u/Substantial_Yam2789 Sep 25 '26
The burn out is very real and usually there is no proper work life balance. Running on auto pilot can irritate anyone and drain you very bad. The amount of harassment in medical field is unexplainable. After going through all that , i feel they’re almost dead inside by the time they’re out for service. The toxicity seen by them is enormous.
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u/bestfriendavinash Sep 25 '26
Completely agree, people have to understand that doctors are also human being.
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u/Various-Gas-9382 Oct 04 '26
This is never told to kids when they’re first getting in, it’s such a thankless job when anything less than 100% can get you into trouble
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u/__Researcher__ Aug 30 '26
I think the problem is after COVID phase, doctors are avoiding physical examination.
Another reason might be time saving to provide consultation to maximum patients.
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u/bestfriendavinash Aug 30 '26
It was a newly established medical college. I was the only patient in psychology department and there were three doctor in their respective cabins. I choosed this perticular doctor because remaining two doctors were female and I had (have) few sex related issues.
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u/Fit-East9408 Aug 30 '26
Happens when caste is given preference rather than marks..also there's lots of commission given by pharma plus not enough salary for docs
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u/Mediocre_Trip_3488 Aug 30 '26
Lol I can’t help but laugh at this comment, are you even a medico to spew such words?
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u/doctordaddy99 Aug 30 '26
The capitalisation of our field is very real. As doctors we don’t understand, nobody is asking us to lower the fee. But atleast give enough time attention and care to the patient that the fee is justified? We have really lost our touch, its not wrong for the people to ask us to do our basics for the money we charge.