Keeping a healthy trust between doctor and patient

By Carol Ann Campbell

http://www.nj.com

The new president of the Medical Society of New Jersey grew up in a 5,000-year-old Indian city, Mathura, where his father ran a jewelry shop and the family’s roots stretch to the 14th century.

Today Rajendra Prasad Gupta, a gastroenterologist, makes his home in Princeton and has a practice in Ewing Township. He is on staff at Capital Health System and is the second Asian Indian to lead the state’s largest physician organization. He returns to India frequently to volunteer at an endoscopy unit his family funded. 

As president of the medical society, what are your priorities?

The physician has gone to medical school, through long and expensive training, and the patient has the full trust of the physician. They both want the best done. But the physician is constantly second-guessed, by the insurance companies, the malpractice attorneys, the government — you name it. That trust in the relationship is being eroded. I want to bring control back to the doctor-patient relationship.Don’t we need ways to reduce the cost of medicine?I ask this question: How much of that health care dollar goes to the physician? Less than 15 to 18 percent. Should health executives and health insurance companies make enormous profits by denying care for the sick and needy?

What role do malpractice lawsuits play?

You go through all this training, and you come out of medical school, and you want to help people. If you make a single bad judgment or have a bad outcome you are vilified. You are made to feel you are the worst human being on the planet. One doctor who was sued told me he felt like committing suicide.

How has the death of two of your children affected your work as a physician?

We had two children born with a very rare genetic disorder, Hallervorden-Spatz syndrome. It took a long time to diagnose. I was not in a remote village in India. Here I was a doctor, and I was in America, and I couldn’t do anything. The second diagnosis, my child was on my lap and I saw the results of the electro-retina gram (an eye scan that found a missing part of retina) and diagnosed him myself. It was the worst day of my life.

Both children died before the age of 11. I think it increased my compassion. I can feel the pain of my patients and their relatives. I learned that the physician-patient relationship is paramount. (Gupta and his wife also have a daughter and later the couple adopted two sons, both now in college.)Nearly half, or 44 percent, of the doctors in New Jersey are graduates of foreign medical schools, the highest percentage in the nation.

How do cultural differences affect the doctor-patient relationship?

America’s greatest strength is the diversity of its people. At first I spoke with a British accent, which could be a hindrance. Doctors are highly educated and intelligent. If I can pass boards and get my license I can learn the American accent. In society there are cultural differences, but I think it is important to live in America as an American.

Does your Indian background help you?

I learned yoga as a child and I still meditate. I think holistic medicine is helpful to keep people well. But when illness strikes we need science.Does discrimination exist against foreign trained doctors?If an American tried to practice in India he would face discrimination. It’s a nationality issue. But having said that, how do you deal with discrimination? It’s easy to sit outside and complain. I believe in fighting from the inside.

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