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Sunday, October 23, 2011

Specialisation in medicine: a double edged sword? !

The human body has its own engineering technique and they are inter connected to work in tandem with other organs. As we have the various functions within the body the different school of treatment thro' the different branches of medicine like--  ayurveda, homeopathy, allopathy, siddha, unani etc have their own composition and some  try to treat the patient rather than the ailment.

Cure for Cancer, Alzheimer's,Parkinson ,are an on going process and still researches are done to find a better cure with minimum side effects to the patients. A patient's mental , physical and neurological disorders pose a challenge to a physician. Hence a general physician finds it difficult to manage and cope with a patient, and here comes the specialization. A three decade ago, specialists were not so many and a general physician could do away without the specialists. I am reminded of my earlier school days, we had only one teacher as Class Teacher to teach all subjects  and this was a routine till class five, and above six, subject teachers were appointed to take classes.

 As the degree of severity increased with the level of stress and living style of people, the number of ailments catching up youngsters also rose alarmingly. Result a general physician opting for specialised study in the branches of his interest. 

New vistas and institutes opened up with many getting qualified to treat in different fields of medicine.  The specialisation helped patients in a large scale , with their focused knowledge and exposure, specialists were able to come out with the right diagnosis , thro' various specific investigative procedures.

Chances of ruling out the level of treatment could also be made with the test techniques. To cap this , medical researches helped in drug discovery for proper prescription. Specialists could see the light at the end of the tunnel, with their specialisation and updating their knowledge by keeping  track of these developments which are relevant to his branch.

On the contrary,  a general physicians diagnosis could not come at par with the specialists , as after the general physicians' recommendation, patients seek an expert's guidance. At times no two doctors agreed , so a third opinion was sought .Working in collaboration with an integrated approach is missing in the field of specialisation, the specialist focuses on his theory fails to see the main cause or side effects. 

Visiting a clinic has become a commercial event, you fix an appointment, explain in brief, and the doctor with his / her specialization spends a five minute to each patient on an average!That too after the investigatory report, will a specialist be able to diagnose a patient's case in such a short time duration? The result- the next visit soon taking place. Without prior appointment a specialist cannot be consulted.

How to overcome this, one could be to make all general practitioners to undergo some training to understand and detect specific symptoms and advise the patient suitably.
All special branches come under one roof rather than shifting the patients from one place to another in a critical condition during golden hour. A subsidiary in a hospital with all branches of medicine for a patient throughout his treatment. 

All multi speciality hospitals to get some concessions  from the government so that they don't end up taxing patients exorbitantly. 

From my experience..........

A few years back my grand daughter fell sick when she was just a week's old was admitted in a super special hospital in Bangalore.The first question we were asked was whether we are corporates and have any policy back up.   Since we did not have any  we just got her admitted as an ordinary 'cash' case.  She was kept in NICU for three days from Sunday to Tuesday , later shifted to a twin sharing room as single room was not available. She was there for two days from Tuesday to Thursday,and at the time of  discharge when  we went to pay , we were shocked to see the bifurcation in the bill. 
This hospital has the best NICU care in Asia.The  NICU room charges were high and the rest were as per the room we had opted out. To be precise, the X ray , doctors visits, consultation, nurses care, the lab tests etc differed from room to room tariffs : that is all these are based on the type of rooms taken. An X ray which may cost Rs. 250 for an ordinary ward  will be  changed to Rs.300/ 500 / 800/ as per the tariff of the deluxe, super deluxe rooms. I questioned the clerk whether they are going to give the X ray and the reports  in colors to charge so high . There was no response, and the charges for an ordinary caesarian runs in lakhs.  I do not think it's a right procedure to tax a patient who has to pay heavily for medication as well his hospitalization.  Who will verify and do justice to common people? 

Second one was at the time of my daughter -in-law's delivery time , the nurse gave her IV drips thro her left hand and something went wrong which had its repercussion on her left wrist.   It is the duty of the nurses to enquire whether the patient is a left handed one the right handed one and the Iv is given viseversa.. Unfortunately the nurse did not ask and it was given to my DIL on her left hand and she is a left hander, Who is suffering now?

It's better to remain healthy and avoid going to these money minting hospitals who do not have any heart.
Health is Wealth and disease is a curse!!!!!!!!!!

1 comment:

  1. Well spoken!

    I remember my childhood days when the family physician was Dr Ramamurthy- a doctor with no fancy degrees after his name-a man of few words but a patient listener-just a visit to him was enough to cure us of any ailment, major or minor.

    Today's scenario is a sharp contrast, certainly. Doctors barely listen to you, let alone examine you-the moment you tell them what your complaint is, they start writing down a battery of tests - not to diagnose, but to eliminate the cause.Time is money-in the hospital near my house, the doctor has two cabins-while he's attending to the first patient, the second patient waits in the second cabin and an intern makes the preliminary enquiries, checks BP and notes down the details in the case sheets-the doctor walks in, looks at the case sheet before even looking at the patient and quizzes the intern on his grasp of the case,explains to the patient what his line of treatment will be even as he dictates the prescription to the intern, signs and is off to the first cabin where the third patient is waiting with the first intern! This is OPD which goes on from 7.30 pm to 11.30pm five days a week!

    I must explain the two cabin riddle here- if the doctor waits for patients to walk into his cabin one after the other lots of time is lost-they shuffle in slowly and also get out slowly owing to their weak condition and are in no hurry to leave as they want to clear so many doubts, which results in precious time being lost-who wants to lose time and money in the bargain? A minute saved, is money earned!