Trusting Your Doctor: A Message to Our Nepali Community in Christchurch
In our Nepali community, we carry forward many strengths including resilience, family values, hard work, and deep respect for education and experience. These values have helped us settle and succeed in places far from home, including here in Christchurch. However, when it comes to health, some of our habits and expectations from Nepal don’t always align with how medicine is practiced in countries like New Zealand or Australia.
This article is written with respect and care, especially for our older generation and those who grew up in Nepal, to help bridge that gap.
The “Mechanic” Analogy: Understanding the Doctor’s Role
Think about your car. If something feels wrong with it, you take it to a mechanic. You don’t usually tell the mechanic exactly what parts to replace or insist on unnecessary checks. Instead, you explain the issue, and you trust their expertise to assess, diagnose, and fix the problem.
Doctors work in a very similar way. We are trained for many years to listen carefully to your symptoms, examine you clinically, use our knowledge to determine what is most likely going on and decide whether tests or medications are actually needed. Just like a good mechanic doesn’t replace every part of a car “just in case,” a good doctor does not order every test or prescribe medications unless they are necessary.
Why “More Tests” Is Not Always Better
In Nepal, it is common to feel reassured when many blood tests, scans, or medications are given. It can feel like “more is better” or that a doctor is taking things more seriously. However, modern medicine has taught us something important: Unnecessary tests can often cause more harm than good.
Tests may show something abnormal that is not actually a problem (i.e. false positives), leading to stress and more invasive testing. Finding conditions that would never have caused harm in your lifetime and over diagnosing conditions may make you spend more time and resources and not to mention add unnecessary stress to your life. Furthermore, in publicly funded systems, unnecessary testing can delay care for others who truly need it, including for your future self! Some scans also expose you to radiation that should be avoided unless clearly needed as well. All of these are potential ways that over investigating can do more damage if not indicated.
A doctor choosing not to order a test is often a sign of good clinical judgment, not neglect.
Why Doctors Don’t Always Prescribe Medication
Another common expectation is that a consultation should end with a prescription (especially antibiotics) or multiple medications. Many illnesses, such as viral infections, do not improve with antibiotics but instead with time, rest and monitoring. Sometimes all we need to do is be aware. Additionally, taking unnecessary medications can cause side effects. When unwarranted these can cause you more harm than good.
Overuse of antibiotics will also lead to antibiotic resistance, which is a serious global problem. The consequence of this is that when you really need antibiotics they won’t work and infections take longer to cure and become more severe. In countries like New Zealand and Australia, doctors are trained to prescribe medications only when the benefit clearly outweighs the risk.
Sometimes, the best treatment is simply rest, fluids, time and monitoring. This may feel unfamiliar, but it is often the safest and most effective approach.
The Value of Clinical Assessment
In Nepal, access to healthcare can sometimes depend on availability rather than structured systems. As a result, people may rely more heavily on tests to confirm diagnoses. Here, doctors place a strong emphasis on clinical skill such as taking a detailed history, performing a thorough examination and using evidence-based guidelines.
In many cases, an experienced doctor can make a safe and accurate management plan without needing extensive testing. This is not because resources are limited but because medicine has evolved to understand when tests are useful and when they are not.
Cultural Differences in Healthcare Expectations
It’s important to acknowledge that this difference in approach is not about right or wrong but about different systems and training.
In Nepal, patients often expect immediate treatment and medications. Doctors may feel pressure to meet these expectations. Managing these expectations tend to push doctors to provide subpar treatment plans and use options that prioritise maintaining a positive doctor-patient relationship. Due to misguided practice and financial difficulties in Nepal, many people may develop a mistrust of doctors thinking that they are trying to take their money for no reason. It is these intricacies that push doctors to change management plans with different patients even if they have the same problem. Trying to balance good patient care with a potential mistrust of health professionals alongside some patches of poor clinical judgement creates challenges in how they practice.
Access to follow-up may also be limited. In Nepal with the population rising, healthcare professionals burnout and are overworked as well as underpaid. All this combined with less resources and inadequate resource allocation make the idea to monitor symptoms and escalate if needed as a less reliable and impractical care plan. In Nepal we may need more information to be sure that we aren’t missing anything.
Different diseases exist in Nepal compared to NZ. Many tropical diseases and waterborne illnesses in Nepal are not found here and so do not need to be on the radar as much. Similarly, we have different common problems here so the diagnoses doctors try to rule in and out vary based on the demographic and geographical climate of their environment. In New Zealand and Australia there is more emphasis on long-term safety and evidence-based care. Follow-up is usually available if symptoms change and doctors tend to avoid unnecessary interventions when possible. Understanding these differences can help build trust and avoid frustration on both sides.
Trust Is a Two-Way Relationship
For healthcare to work well, there needs to be trust. From the doctor’s side they commit to listening to us, taking our concerns seriously, using their training to guide safe decisions and giving us the best possible advice for our health. Patients should be aware that not every illness needs a test or pill and they should be open to advice, even if it differs from past experiences.
Ask questions if unsure as communication is always encouraged. Ensure that when you leave the health setting, whether that is a GP or the hospital that you are happy with the plan and if not please ask the doctors to explain why and what they are doing. In a busy world they try to balance their time amongst many patients but without knowing what issues we have they will not know how to help.
Advice for Our Nepali Community
- Please share your full story. Don’t hold back symptoms or concerns as this helps the doctor make better decisions.
- Ask questions respectfully. It is completely okay to ask, “Why don’t I need a test?” or “Why is medication not necessary?”
- Avoid comparing directly with Nepal. Healthcare systems differ, and what was common practice there may not be best practice here.
- Follow up if needed. If symptoms persist or worsen, return for review as this is an important part of care.
- Focus on prevention. Regular exercise, healthy diet, sleep, and stress management are just as important as treatment.
A Final Thought
As a community, we have come a long way; from the hills, villages and cities of Nepal to building lives in developed places like Christchurch. Along this journey, we have learned to adapt to new systems, including healthcare, and this is part of our growth.
Trusting your doctor does not mean giving up your voice. It means working together and combining your life experience with the doctor’s medical expertise to achieve the best outcome for your health and wellbeing.
Just as you trust a skilled mechanic with your car, trusting a trained doctor with your health can help you avoid unnecessary interventions and focus on what truly matters which is safe, effective, and meaningful care.
With respect and care for our community,
Dr Rishav Dhakal
