Are Doctor & Nurses Dispensable Disposables?


 

It is surprising that  doctors and nurses, who can save many lives, have to put their own lives at risk for the want of proper PPE’s. The cost of PPE’s is not more than few hundred rupees.  Even such a cheap facility is not available to the saviors for their own protection. Such episodes are not only  painful to the medical fraternity but also expose the hypocritical  attitude of the administrators as well as  the insensitive approach of society towards health care workers, although everyone expects doctors and nurses to be sensitive towards every one. Such incidents demoralizes and causes deep discouragement to the front line doctor and nurses, but sadly remains a routine business for administrators. The pain of being  treated like a dispensable disposables remains as  a deep hurt within.

10 govt docs, 70 private nurses have quit in Telangana over safety, hospital infra.   (Times of India)

 

At least 10 senior resident doctors deputed on Covid-19 duty at government hospitals and 70 nurses in private facilities have quit their jobs, with most citing poor protective gear to combat the virus as a reason.

While the senior residents said they were dejected with the poor state-of affairs at hospitals and the looming threat of contracting the infection, some individual doctors and nurses took a break from the profession, until the pandemic, gets over. These doctors are from the Osmania Medical College (OMC) and Mahatma Gandhi Memorial (MGM) hospital Warangal among other government hospitals. So far, 300 doctors and other medical personnel in the government sector alone have contracted the virus, with worries of sub-standard protective gear and long working hours, forcing doctors to even go on strike. Some senior resident doctors deputed from the OMC to the Chest Hospital never reported for duty, while others served for one or two months before putting in their papers. “The problem is not just that there was a threat of infection and we didn’t get proper personal protection equipment (PPE) kits, it seemed like a waste of effort. Even if a patient was dying in front of me, I could do nothing at all,” said one of the senior resident doctor who had resigned from the OMC .

“We didn’t have staff, we didn’t have the infrastructure, we didn’t have proper PPE kits or any other provision required. It seemed like a futile effort,” he said. Despite the guilt of having resigned in the middle of an ongoing pandemic, the doctors said that their presence or absence hardly made any difference to the situation. Authorities ignored repeated complaints It was like there is everything wrong, but no one was there to take responsibility. I felt bad about resigning but after over a month of working and making repeated requests for additional doctors and nurses, there was no difference. It was just a blame game,” another doctor told TOI. From the medicine department at Osmania General Hospital (OGH), six senior residents have resigned, while few others have resigned at the MGM hospital, said Dr Mahesh Kumar, president, Healthcare Reforms Doctors Association (HRDA). “At the beginning of the pandemic, there was a lot of issues with PPE kits and infrastructure and despite repeated representations they were not sorted out. Most of the residents resigned in the first two months of the pandemic, discouraged by the situation and fearing for their personal safety,” he added. Apart from doctors, 70 nurses who are at the frontline have gone missing from work too. “A least 30 of these nurses went missing from a single corporate hospital. Currently, there is a huge shortage of nurses as most are reluctant to do Covid-19 duties,” said Laxman Rudavath, president, Nursing Officers Association of Telangana.

 

25 factors, why health care is expansive

21 occupational risk factors for doctor and nurses

Altruistic professions are not cherished

Administrators refrain risk to doctor and nurses

REEL Heroes Vs REAL Heroes

Noble doctor-Ignoble death #Chennai doctor death #Covid-19


 

Chennai Locals Pelt Stones at Ambulance Carrying Body of Popular Doctor Who Died Due to Covid-19.

Hercules, who ran the New Hope private hospital in Chetpet, battled against the disease for 15 days at the Apollo Hospital in Chennai before succumbing to it.

 

Chennai: Locals at an upmarket locality in Chennai pelted stones at an ambulance ferrying the body of popular doctor and medical entrepreneur Simon Hercules who died due to coronavirus after a 15-day struggle with the disease.

Hercules, who ran the New Hope private hospital in Chetpet, battled against the disease for 15 days at the Apollo Hospital in Chennai before succumbing to it.

The ambulance driver and a sanitation worker were wounded in the attack that happened late on Sunday night. Police sources confirm that 20 people have been arrested.

According to a relative of Hercules, locals opposed their attempt to bury the body despite the fact that permission was granted. “They refused to allow the cremation of the body. I make this teary-eyed post to all you that a sincere doctor who died treating Covid-19 patients does not have the space for a decent burial,” said Dr Bakiaraj.

This is the second incident of a doctor being disallowed a decent burial in Chennai. Recently, in Ambattur, a doctor from Apollo Vanagaram was not allowed space for burial by locals.

 

The incident at Chennai is not only disheartening for doctors but dissuades others to carry out the noble work and discourages many to take responsibilities of medical care. This brings forth the narrow-minded nature of public, without realizing their own loss.  Doctors are not  God and are simply human beings. They may become victims of the diseases, while they try to save the patients while putting their own life at risk. This incident not only unmasks their vulnerability to catch diseases, the adverse circumstances they have to work, but sadly victims of underserving public wrath.

If such is the behavior of the public towards doctors, why children should become doctors at all? Why doctors should put themselves at risk while in pursuit to save lives?

21 occupational risk to doctor and nurses

Altruistic professions not respected in the present era

Global clap for Doctors-Nurses; ‘God in only Corona-times’==Looks opportunistic & temporary


 

In times of Corona- war, what doctor and nurses really wish and need is uniform applause all times, genuine legal regulations,  freedom from industrial enslavement and sensible or true projection from media. Much needed are PPE’s,  good protective gear and an environment, where the voice of “every worker with patients” is heard.

An applause or clap for a specific and short time under the shadow of Corona looks opportunistic and temporary. The continued attacks on doctors, even on the doctors looking after Corona patients, just indicate, how deeply disrespect and hatred for saviours have been encrypted in the minds of people, especially by insensible statements from media and celebrities. The hatred and instigation had come from the people, who have not treated a single patient in their lifetime.

Before Corona episode exploded, doctors and nurses continued to work with the burden of mistrust, legal complexities and hurt. They were working and saving lives before as well. Despite doing good they were on receiving end of imposed consumerism, battling legalities, subject of public violence without much support from any quarter. The insult and assault on doctors were considered business as usual. The ridiculous attitude and beating of doctors were thought of as natural reactions of emotional mobs.

Most of Media and Celebrities earned applause, fame, money,  for themselves by spewing venom and citing stray incidents as generalization against the medical community.   Hence instigating and turning the opinion of masses against health workers.

Although it was good to see an overnight change in the attitude of people and media, as Corona-war was declared. But at the same time, continued episodes of violence against doctors gave an indication that it may be a temporary satisfaction for doctors and claps or applause may live only till Corona fear.

If it was a true applause, why it was not done before Corona exploded. After all,  doctors were doing their work before as well.   Sudden applause comes now in view of the risk to their life as a professional obligation, without proper PPE’s and deficiencies in protective gear.

Doctors and nurses just need PPE’s, good protective gears and a  safe environment.  Children of today, who inspire to be doctors, are watching with anxiety, the treatment given to saviors. An opportunistic or temporary applause without any concrete support will  not inspire good doctors or nurses in the future.

 

 

Reel Hero vs Real Hero

Blaming  doctors for the death of coronavirus patient family members attacked them Hyderabad 

#Nurse/doctor/soldier vs Filmy superstar: Reel Heroes or Real Heroes. what does the society Need/deserve?


 

     In the current era of media domination where media projection shapes the perception and may defy reality.  Media has dominated our lives and can sway the opinion formation of masses.  Written media, television, social media can collectively influence the mass opinion.

   A reel hero who acts like a soldier is famous and richer and than the actual soldier, who dies unnamed and in penury.   Children of today’s times will strive to become, who is worshiped and paid respect by society and therefore will prefer to become the ‘Reel heroes’.

Even a junior doctor saves many lives in a  day in emergencies as compared to the work of a superstar in films.  A teacher, nurse or scientist have a contribution which is more fruitful to our generation. Also, the scientists, who contribute immensely and bring about the real change in our lives. Their contribution is huge to our society and much more than doing just acting on screen. The reel actor merely imitates the real-life lived and actual work done by real heroes like a soldier, doctor or teacher. Someone who only acts and  behaves like one, is respected and paid thousand times or more than the real one. In reality, people need  more than mere entertainment and reel role models and actors in their real lives.

       A  society truly needs the real people, who work and act for them, more than just entertainment. It will need a total change in the attitude of people to deconstruct their perceptions, which are based on mere projections and are away from reality.

21 occupational risk to doctor and nurses

The naivety of masses to perceive the projected character as real one  goes beyond a reasonable thought process and imagination.

These roles played in films are  not  really acts of   inspiration  in real life as the actual purpose accomplished at the end of a movie  is entertainment of society and business for themselves.

   At the best, a particular projected character  (and not individual acting star) may be a  role model. An actor or superstar, is simply doing his work of “acting” in  the end. This work of acting may bring an entertainment of few hours at the most.

One  cannot stray away from the wisdom to  choose between what we consume merely for our entertainment and  what we believe or face in real life. One needs to differentiate between rational truth behind the celebrity gimmicks in the media and exaggerated sensationalism. Sensation created merely for a commercial successful venture should not be allowed to overpower the judgments of real life.

 

But the problem starts, when these false perceptions created merely   by a projected  glimmer    takes the shimmer  away from the real worthy. The real  professionals and people who are worthy of glory become invisible behind  the glittery mist, a haze, which is unreal and unhelpful in real life.

  Compare the trivial  amount of  remuneration, fame  and respect the real worker  gets  as compared to the film stars, who merely imitate their actions. Reel projection for the purpose  of entertainment is more easier to enact and more profitable  than actual performance  in real life.  It is easier to become a reel hero, as it requires little hard work or just connections to get an opportunity.  Some one can be a reel hero just  by  dynastic factor  easily. Hard work is definitely required but that may or may not be prerequisite.

In present era, real contributions by people, who are saviours of human life and  the real heroes, remain unappreciated. People are so besotted by  fame and money that they fail to appreciate the sacrifices made by real heroes. Filmy super hero  just imitates  a doctor, soldier,  dacoit or a street hooligan and just pretends to be one on the screen.

     But there are  real life heroes that exist around us. Doctors awake at night saving lives every minute or soldier in freezing cold are worthy  of more respect and are real heroes.  And it is up to the society  to look beyond the superficial and reel story, and focus on the real life actors. There has to be an true effort to make, respect and appreciate  real heroes.

Point to  ponder  is that whether society needs people  just  acting like   doctors,  soldiers  and not the  actual and real ones, who saves lives. Does Society need  only  entertainment, because respect  which is paid to someone who is  just  an   actor, is  not extended to real doctors, soldiers or other altruistic professions.

         It is time to recreate and worship real heroes, who have become invisible behind the glittery mist.

Society needs to envisage the bigger real picture, and should not be mistaken for another projected story.                          

The perception of the projection will decide, what does the   society actually  need- or desire-or deserve , “Reel Heroes or Real Heroes”.

#Doctor-wife-killed-by patient #Warning to Doctor/medical profession- becoming a victim of easy revenge


Any patient who visits hospital carries a static or progressive risk of death, howsoever little his illness looks to be . A genuinely poor prognosis or progression of disease or routine complication can cause or result in death. But by application of average wisdom of the people who do not have an idea about complexity of medical field, can easily blame doctors. So doctor even when doing his best is at risk of revenge or harm from public as well as authorities. A fundamental question about such situations will come to doctor’s mind naturally. What happens when doing some good work by our self causes harm to ourselves? Here you are trying to save some one. It is a happy situation for him if you are successful. But due to some reason patient dies or there is poor outcome. He has all the rights to harm you in more than one way. What if he happens to be a powerful person, a VIP, criminal or a goon. What if he becomes revengeful towards you. Doctor will turn into an object of revenge. Money a doctor receives in “what so ever risky situations” or even for saving a life is peanut. But if patient decides to sue him, court may ask to pay something , doctor may not earn in his life time. Or in extreme cases physical violence and even killing the doctors is also some thing which is not unheard off and is on the rise. And this process can happen any minute, any day and continues for years till he continues to work the whole life. Even single mistake in entire career, that too unintentional is enough to cost name, fame or even life. Even it may not be a mistake, or just be a naturally poor prognostic disease, which can be interpreted as an error easily. For people who do not treat patients, how so ever learned they may be, are unable to recognize the difference between the negligence or genuinely poor prognosis. Thanks to media and our celebrities, who have created a doctor- patient mistrust for their own populist gains. An impression is being created, as the poor outcome is because of doctor’s mistake by selective projection in a certain manner.

not-satisfied-with-treatment-man-kills-doctor-s-wife Irritated that a doctor, who wasn’t able to cure his itch for six months, was away in Delhi, an Indore man stabbed to death the doctor’s wife and injured her son. According to the police, the incident happened at the clinic of Dr Ramakrishna Verma in the Malwa Mills area of Indore, on Thursday morning. The doctor ran his practice from home. Tukoganj city superintendent of police (CSP), BPS Parihar said, “The accused Rafiq Rasheed (45) was suffering from an itchy skin disease for which he was getting treatment from Dr Ramkrishna . Verma for the past six months, but without any results. When he went to the clinic at about 11 a.m, Verma’s wife Lata informed him that her husband was in Delhi. This apparently angered Rafiq who got into an altercation with Lata (50) and stabbed her repeatedly with a knife he was carrying. As Lata screamed for help, her son Abhishekh (19) came out and Rafiq stabbed him too and ran away. However, some people who came hearing the screams managed to nab Rafiq and handed him over to the police.” The locals took both mother and son to a nearby private hospital where Lata was declared brought dead. Abhishekh’s condition is said to be critical, police said.

Being revengeful against doctor is very easy. They have become sitting ducks for revenge. Verbal abuse, physical harm, legal remedies, disciplinary actions, punishments, social mudslinging, court cases and legal harassment are common remedies easily available. In absence of support, lack of law and order enforcement, physical assaults and even murder is also not a distant possibility. Here it was just a treatment failure or may be a poor response to treatment, which resulted in killing of doctor’s family. If trying to treat some one can result in harm to one self, why should the doctors will choose to treat. More over why should one become a doctor at all. Such incidents of extreme violence are not merely disaster for a family, but they are warning signs to whole of profession.

Many in such unfortunate situations must have a thought in mind “ why should one become a doctor and treat patients?”

Women doctor and nurses more prone to work–life imbalance


 

Being a health provider  is a tough and stressful job. In any hospital, work goes on during  day and night. Rather many times nights are more heavy and challenging. The systems at odd hours are run by doctors and nurses. Continuous requirement to do odd time shifts, hard training and work demands tend to affect the overall work-life balance of doctors and nurses.

For women, it is particularly more stressful. As at some stage of life, both professional and personal roles become too demanding.  Expectation at both fronts is guided by the idea of perfection. Perception of deviation from the ideal or little imperfection   can lead to sense of aversion, linked to  average performance for them.  If they try to match the ambitions, want more in career, from the partner, children, or themselves, face the real risk of burn out. The cognizance  that perfection cannot be matched or arduous to achieve, in their circumstances, is hard to be realized  at both places.   The quest and  passion of  the women doctors or nurses, to seek perfection at both places, makes them  more prone for  burnout. This  is  a consequence to  a grave exhaustion, in their bid  to balance everything.  Woman doctors and nurses, are specially  more susceptible to stress of a kind,  as most of them face the same ordeal.

Family priority:

Perception of role identity at home  is little different on  being a woman doctor/nurse.  Male doctors are in a better position to  prioritize their work duties over their family duties  in order to  provide financial support for their families. For female doctors , there is a natural tendency to  prioritize their family life.

  Inflexibility or shift working a routine:    

         The  issues will always remain, like spending long hours at work due to inflexibility, or requirement to do shift  duties , need to stay more with patient and training requirements. For females it is very common and  frequently  lead to an imbalance between work and family duties.   More  time spent at work has an direct impact    on family requirements. Sometimes  there are financial requirements of the family, for which they are forced to  negate the effect on family duties.  In such situations they are unable to successfully complete these family duties.

High career ambitions:

Higher  education leads  to ambitions for higher social recognition and better career orientation. These goals are another  reason for taking this dual stress.  In order to correct this  imbalance, many  women doctors  expose themselves to unsolicited job stress. This reflect  in lives as chronic lack of time and  leads to pressure and stress.  The mentioned stresses and strains could lead in the long term to irreversible, physical signs of wear and tear, as well as to negative effects on the human cardiovascular and immune systems.

   Prolonged and odd working hours:

In medical profession,  simply working hard is not enough anymore. To get ahead, a rigorous training, prolonged working hours are  new standards. There is very  little time left to be divided   among relationships, kids, and sleep.

 

Conflict by Perception:

The conflict of work and family is further exacerbated  by perceived deviation from being a  good worker  at  work place and  ideal mother at  home. At work  place, they are looked as less dedicated and similarly at home as well.  Lack of organizational support  for doctors/nurses is main reason for these kind of imbalance.  They are squeezed in between  pressures at work and demands at home.

Extending families:

These day, pressures are so high that  many young women doctors,  want to just stay at home and do housework without having careers. May  give up careers to have children. It strikes to young doctors as a surprise, simply how difficult it is to build a family. The learning curve of taking care of family along with professional  responsibilities is too steep. In such situations, when everything is compounded, with  workload, it becomes utterly exhaustive.

Motherhood:

Breaks taken for family requirements may be taken as red flags, by employers. Delivery and feeding child become  difficult tasks specially in clinical branches, where long duties are routine.

Motherhood needs to be squeezed in between the requirement of profession. Changes in schedule or adjustments made are perceived as “being different”.

While women are increasingly represented in the medical field, they still face challenges balancing work and home life. The frustrations manifest in  burnout and dissatisfaction within a field they once enjoyed.

also read: work-life imbalance for doctors/nurse & consequences

 

Work-life imbalance for doctors/nurses & consequences


 

For doctor and nurses, time of work and action is determined by need of the patient. Whereas in most of other professions, time of  work  can be carried out at any convenient time. As a routine, most of the  human being  work  during day time, by  convention that is 9 AM to 5 PM . whereas, It is not uncommon for medical and nursing professionals to have more heavier  and challenging night shifts.  Most of clinical branches, doctor and nurses  remain busy through out night.

Across the globe, in the  medical systems, specially  not so well organized, it is  a common routine  for the  doctor to get night calls  everyday and  lots of them  rarely gets undisturbed normal sleep.

Needless to say that doctors and nurses do a herculean task to stream line their family and professional life. Kudos to those, who can nurture their hobbies, along with difficult clinical branches. Maintaining a work-life balance remains a distant dream for most of successful clinicians. This balance can be defined as a satisfaction gained by spending time on activities according to one’s wishes, which are besides their clinical work.

Areas of life other than work–life may  include  personal interests, family, social or leisure activities or hobbies.

Work–life  imbalance is the lack of  proper alignment  between work and other important life roles. It is a kind of balanced  state of time, achieved by spending time  on  demands of personal life, professional life and family life, that  is satisfying.  Work-life balance  is not limited to flexible work arrangements  to carry out other life programs and practices.  Work-life balance is a term commonly used to describe the balance that a working individual needs between time allocated for work and other aspects of satisfying life.

The thing that strikes as a  surprise  to most of doctors  of  starting a family  is simply how difficult it is. The learning curve of taking care of family  along with professional responsibilities is  so steep,   While working as doctor  in learning or training  phase, parenting requires  an abundance of energy, time, and grit

And when the responsibilities of being a parent are compounded with the realities of being a trainee doctor, it starts to be too much. It never feels like enough time for anything and  it really becomes utterly exhausting. There is always a struggle constantly with the balance of spending quality time with  family,  trying to study and perform well.  There is little time for hobbies or doing things  to  maintain  sanity of mind.

The environment of work today for doctors has become  more intense with legal issues,  burdening much more   than it was few  decades ago. Burdens beyond clinical work and associated stress  have   created  the need for a better  balance between work and life. Doctors have started thinking to devise or alter  the working in an effort to have a better balance. Experience of  being over-worked, long working hours and an extreme work environment has proven to affect the overall physical and psychological health of  doctors  and deteriorate family-life.

Although there are no structured studies on the issue, but doctors have started feeling difficulty balancing work and family. But the effects are already evident like alcohol and drug abuse, increased rates of divorce and suicides. Increased feeling of stress and  early burnout is an  natural outcome. Doctors,  who have attained  stage of financial security tend to have an early retirement, or reduce working hours.

Consequences of work–life imbalance

Problems caused by imbalance and consequent stress  has become a source of major concern for doctors and nurses.  Symptoms of stress can  result in  both physiologically and psychologically changes. Profession suffers as the workplace becomes the  greatest source of stress.

Persistent stress can result in cardiovascular disease, sexual health problems, a weaker immune system and frequent headaches. It can also result in poor coping skills, irritability, jumpiness, insecurity, exhaustion, and difficulty concentrating. Stress may also perpetuate or lead to binge eating, smoking, and alcohol consumption.

In medical profession,  simply working hard is not enough anymore. To get ahead, a rigorous trainings, prolonged working hours are  new standards. There is very  little time left to be divided   among relationships, kids, and sleep.

This ordeal is prolonged over years  results in  less time spent with family, friends, and community as well as pursuing activities that one enjoys and taking the time to grow personally. Even close friends and  relatives slowly start  becoming distant.

Extending family and becoming new parents  causes  extreme stress  in doctor’s life.  It can have  negative effects.  Between trying to balance a new schedule, managing additional responsibilities, and lacking flexibility and support, they can only increase stress.

Consequently, the evolving system of  health care have made doctors more prone to burnouts. Their  quest to be the  ideal, hard-working, perfectionist ultimately  turns them loner, the grim and stressed individuals.

related article: women doctors  and nurses prone to work- life imbalance

“EDG scale of doctor’s comfort: guide for medical students” – How to choose medical specialty


Choosing a medical specialty is possibly one of the most important variable factor in doctor’s life. This one factor will decide the rest of the  life of the doctor. General rough guide to the factors involved, which persist forever and throughout the life, after a doctor chooses a specialty is given below. There can be individual variation depending upon the individual attitudes, compromises and way to do practice. Therefore there will be some variation in all the fields for individuals, places, systems and countries.

Re-blog

There can be extremes and variations  on either side of spectrum, but are exceptions. Following article does not include satisfaction and earning gained from   other businesses done by doctors, running nursing home or hospitals, commercial gains  from pharmaceuticals etc. this is on basis of income purely from professional work of treating patients.  These  factors and units can be used as a scale for guidance of medical students and hence named as EDG scale of doctor’s comfort (Extinct doctor good)

Factors

  1.      Earning
  2.      Prolonged tough training
  3.      Satisfaction of treating patients
  4.      Satisfaction of making diagnosis
  5.      Emergency & odd hour duty
  6.       Stress of life and death
  7.       Legal complexity and stress

The Unit—-Single * or (I) is  one unit. With experience and years of work , this unit  (for same doctor) will also multiply with age.

UNIT

India ( * or 1) is  1  million  rupees/annum

Advanced countries- (* or 1)== one lac or 100,000 dollars/ annum

 

General practice

 

 
       1.  Earning **to ***      2-3
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

**
Internal medicine

 

 
       1.  Earning **to****        2-4
       2..   Prolonged tough training

 

**to***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***

 

cardiology

 

 
       1.  Earning **to*******  2-7
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****

 

gastroenterology

 

 
       1.  Earning **to******   2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

**

 

Neurology

 

 
       1.  Earning **to******  2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***                  3

 

Nephrology

 

 
       1.  Earning **to******   2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

***           3

 

Pulmonary medicine

 

 
       1.  Earning **to*****     2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

***                    3

 

 

Emergency  Medicine

 

 
       1.  Earning **to****     2-4
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****                4

 

Anaesthesia

 

 
       1.    Earning **to*****     2-5
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

**
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****                 4
Endocrinology

 

 
       1.  Earning **to*****       2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

**                2
Psychiatry

 

 
       1.  Earning **to*****       2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**                  2

 

 

 

 

paediatrics

 

 
       1.  Earning **to*****       2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

****                  4

 

Critical care

 

 
       1.  Earning **to*****   2-5
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****           4

 

Paediatric critical care

 

 
       1.  Earning **to*****     2-5
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****               4

 

General Surgery

 

 
       1.  Earning **to*****      2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****               4

 

Minimal access surgery

 

 
1.          Earning **to******    2-6
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

***                3

 

 

Cardiac surgery- CTVS

 

 
       1.  Earning **to******    2-6
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****               4

 

Urology

 

 
       1.  Earning **to******    2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***                 3

 

Gastro-surgery

 

 
       1.  Earning **to******    2-6
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****            4

 

Neurosurgery

 

 
       1.  Earning   **to******   2-6
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****            4

 

Head and Neck surgery

 

 
       1.  Earning **to******   2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***               3

 

Orthopaedics

 

 
       1.  Earning **to******                2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***                             3

 

Ophthalmology

 

 
       1.  Earning **to*****             2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**                           2

 

Radiology

 

 
       1.  Earning **to******   2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

*
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**                  2
ENT

 

 
       1.  Earning **to*****    2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**                 2

 

Dermatology

 

 
       1.  Earning **to*****   2-5
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

*
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

*                1

 

Gynaecology/obstetrics

 

 
       1.  Earning **to*****   2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****

 

Plastic Surgery

 

 
       1.  Earning **to******    2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

*
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**              2

 

 

Oncology

 

 
       1.  Earning **to*****   2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

**               2

 

Onco-surgery

 

 
       1.  Earning **to******     2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

**                    2

 

Anatomy

 

 
       1.  Earning **to***     2-3
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

Nil
       4.  Satisfaction of making diagnosis

 

Nil
       5. Emergency & odd hour duty

 

Nil
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

Nil

 

Physiology

 

 
       1.  Earning **to***
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

Nil
       4.  Satisfaction of making diagnosis

 

Nil
       5. Emergency & odd hour duty

 

Nil
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

Nil

 

Biochemistry

 

 
       1.  Earning **to***    2-3
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

Nil
       4.  Satisfaction of making diagnosis

 

Nil
       5. Emergency & odd hour duty

 

Nil
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

Nil

 

Microbiology

 

 
       1.  Earning **to****    2-4
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

0 to*
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

*
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

*

 

 

Pathology

 

 
       1.  Earning **to ****    2-4
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

NIl
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

*
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

*

 

Medical administrator/Manager

 

 
       1.  Earning **to********  2-8

sometimes multiple

       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

Nil
       4.  Satisfaction of making diagnosis

 

Nil
       5. Emergency & odd hour duty

 

*
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

*

. There can be extremes and variations  on either side of spectrum, but are exceptions.

If the reader have some different view, or want to add something, they are welcome to  write in comments. This table just  highlights a trend of factors and may not be perfect. But it gives the factors which need to be taken into account,  before choosing specialty.

How to choose medical specialty? Variation of doctor salary, earning & important factors


Choosing a medical specialty is possibly one of the most important variable factor in doctor’s life. This one factor will decide the rest of the  life of the doctor. General rough guide to the factors involved, which persist forever and throughout the life, after a doctor chooses a specialty is given below. There can be individual variation depending upon the individual attitudes, compromises and way to do practice. Therefore there will be some variation in all the fields for individuals, places, systems and countries.

There can be extremes and variations  on either side of spectrum, but are exceptions. Following article does not include satisfaction and earning gained from   other businesses done by doctors, running nursing home or hospitals, commercial gains  from pharmaceuticals etc. this is on basis of income purely from professional work of treating patients.

Factors

  1.      Earning
  2.      Prolonged tough training
  3.      Satisfaction of treating patients
  4.      Satisfaction of making diagnosis
  5.      Emergency & odd hour duty
  6.      Stress of life and death
  7.      Legal complexity and stress

The Unit—-Single * or (I) is  one unit. With experience and years of work , this unit  (for same doctor) will also multiply with age.

UNIT

India ( * or 1) is  1  million  rupees/annum

Advanced countries- (* or 1)== one lac or 100,000 dollars/ annum

 

General practice

 

 
       1.  Earning **to ***      2-3
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

**
Internal medicine

 

 
       1.  Earning **to****        2-4
       2..   Prolonged tough training

 

**to***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***

 

cardiology

 

 
       1.  Earning **to*******  2-7
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****

 

gastroenterology

 

 
       1.  Earning **to******   2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

**

 

Neurology

 

 
       1.  Earning **to******  2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***                  3

 

Nephrology

 

 
       1.  Earning **to******   2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

***           3

 

Pulmonary medicine

 

 
       1.  Earning **to*****     2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

***                    3

 

 

Emergency  Medicine

 

 
       1.  Earning **to****     2-4
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****                4

 

Anaesthesia

 

 
       1.    Earning **to*****     2-5
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

**
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****                 4
Endocrinology

 

 
       1.  Earning **to*****       2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

**                2
Psychiatry

 

 
       1.  Earning **to*****       2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**                  2

 

paediatrics

 

 
       1.  Earning **to*****       2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

****                  4

 

Critical care

 

 
       1.  Earning **to*****   2-5
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****           4

 

Paediatric critical care

 

 
       1.  Earning **to*****     2-5
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****               4

 

General Surgery

 

 
       1.  Earning **to*****      2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****               4

 

Minimal access surgery

 

 
1.          Earning **to******    2-6
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

***                3

 

 

Cardiac surgery- CTVS

 

 
       1.  Earning **to******    2-6
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****               4

 

Urology

 

 
       1.  Earning **to******    2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***                 3

 

Gastro-surgery

 

 
       1.  Earning **to******    2-6
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****            4

 

Neurosurgery

 

 
       1.  Earning   **to******   2-6
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****            4

 

Head and Neck surgery

 

 
       1.  Earning **to******   2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***               3

 

Orthopaedics

 

 
       1.  Earning **to******                2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***                             3

 

Ophthalmology

 

 
       1.  Earning **to*****             2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**                           2

 

Radiology

 

 
       1.  Earning **to******   2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

*
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**                  2
ENT

 

 
       1.  Earning **to*****    2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**                 2

 

Dermatology

 

 
       1.  Earning **to*****   2-5
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

*
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

*                1

 

Gynaecology/obstetrics

 

 
       1.  Earning **to*****   2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****

 

Plastic Surgery

 

 
       1.  Earning **to******    2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

*
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**              2

 

 

Oncology

 

 
       1.  Earning **to*****   2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

**               2

 

Onco-surgery

 

 
       1.  Earning **to******     2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

**                    2

 

Anatomy

 

 
       1.  Earning **to***     2-3
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

Nil
       4.  Satisfaction of making diagnosis

 

Nil
       5. Emergency & odd hour duty

 

Nil
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

Nil

 

Physiology

 

 
       1.  Earning **to***
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

Nil
       4.  Satisfaction of making diagnosis

 

Nil
       5. Emergency & odd hour duty

 

Nil
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

Nil

 

Biochemistry

 

 
       1.  Earning **to***    2-3
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

Nil
       4.  Satisfaction of making diagnosis

 

Nil
       5. Emergency & odd hour duty

 

Nil
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

Nil

 

Microbiology

 

 
       1.  Earning **to****    2-4
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

0 to*
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

*
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

*

 

 

Pathology

 

 
       1.  Earning **to ****    2-4
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

NIl
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

*
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

*

 

Medical administrator/Manager

 

 
       1.  Earning **to********  2-8

sometimes multiple

       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

Nil
       4.  Satisfaction of making diagnosis

 

Nil
       5. Emergency & odd hour duty

 

*
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

*

 

. There can be extremes and variations  on either side of spectrum, but are exceptions.

If the reader have some different view, or want to add something, they are welcome to  write in comments. This table just  highlights a trend of factors and may not be perfect. But it gives the factors which need to be taken into account,  before choosing specialty.

Administrative and infrastructure deficiencies in health care: fail and blame for doctors


Adverse outcome in patients  can be  because of  many factors. Most of the time it is  serious illness, natural poor prognosis of disease, genuine complications or infections. Sometimes, It can be deficiency of equipment, malfunction, lack of infrastructure or facilities. There can be poor training or lack of  proper human resource and many others. There may be unintentional or human errors  by doctors or staff.  Root cause for most of the problems  can be traced to  administrative and system deficiencies rather than mistake of doctor. But since doctor is universal final link, when a patient dies, who  is visible on the bedside. So by application of an average wisdom, it is the doctor who will be held responsible for any problem or adverse outcome. Administration and people who are responsible for building infrastructure, procurement of  equipment and allocating finances or manpower  are not visible in forefront. It is very common for the doctors  to find themselves in a helpless situation, specially  in presence of  deluge of patients, difficult circumstances, scarce resources  and other  administrative issues.  In cases of adverse outcomes,  administration can   pretend to hide behind the common escape route by punishing doctors and hold them  guilty for the adverse events, as no other cause or person   is visible. By retrospective analysis  and  wisdom of hindsight along with luxury of time , it is a cake walk to give  verdict of one’s choice later, by fault finding analysis.

Non availability of ventilators or  malfunctioning  is not an issue, for which doctors are responsible. Procurement and allocation of funds is an  administrator’s domain.  But it is common that  doctors can be accused for not saving a life. They can be punished, dragged to court and even assaulted physically by crowds.  Dismal percentage of availability  of ventilators in Delhi Hospitals is a tip of the iceberg. This can be even  worse in other parts of the country. Ironically crowds visiting the hospitals only see and blame  the doctor, who is present on bedside and trying to save the patient. Patients hold them responsible for  malaise of the system  and fail to see the presence of  large  administration and industry,   that is behind  the scene. An unfortunate era,  when  the  doctors are blamed on  individual basis for system failure. In present circumstances, Lack of medical wisdom among masses is a cause of  huge discouragement for doctors.

With  High court being proactive in asking about the number of ventilators, the administration can not pretend to hide behind any more, but masses need to know the real truth.

Only 3.4% beds on Delhi Govt Hospitals have ventilator facility against the minimum requirement of 10% in every state run medical center. For  over 10,000 beds,  only 348 ventilators are there. That is an extremely low number.

52 of 400 ventilators in Delhi hospitals non-functional, state tells HC.

After 3-year-old Farhan died in the national Capital for an alleged want of proper ventilator care earlier this month, the state government of Delhi has told the High Court that a substantial number of ventilators in its government hospitals are not working. The state also told the HC on Tuesday that they were aiming to have a web portal up and running within two months, which would provide an online daily update on ventilator and bed availability across Delhi’s government hospitals.

After directions were issued by the HC, the state asked all its hospitals to provide a status update on ventilators and according to the information received from the government hospitals, up to 52 ventilators (13 per cent) of the total of 400 ventilator beds (including 300 ICU and 100 non-ICU) available in the hospitals are non-functional. “Fifty-two ventilators are non-functional and efforts are being made to get them repaired. The procurement of 18 ventilators is under process,” said the reply filed by the state government in the High Court on February 12.

The state government also stated in its reply that as far as maintaining real-time information on the availability of vacant beds in Delhi government hospitals goes, it may not be feasible to implement real-time availability information in the initial phase and the Delhi State Health Mission should be advised to start uploading information on bed availability in all the hospitals once a day in the morning.

The state government also said the State Programme Officer (MIS) of the Delhi State Health Mission has been requested, in

a letter dated January 31, to prepare a web portal for online bed/ ventilator availability and that such a Web portal should be made functional within two months.

The state government through an email sent on February 7 has also requested all the hospitals to complete repair, condemnation and procurement of ventilators at the earliest, according to Nutan Mundeja, Director General of Health Services.

After the matter of alleged unavailability of healthcare to Farhan came to light, the High Court moved a motion against the Union of India and sought a reply.

The number of ventilators as compared to bed strength in government hospitals is meager. “In private hospitals, there is one ventilator bed for every four normal beds. In government set-ups though, even as we have over 10,000 beds, we have only 348 ventilators. That is an extremely low number. Also, these ventilators may not be evenly distributed across the city,” pointed out  stated U Jhamb, Director, Professor and Head, Department of Paediatrics at the hospital.

 

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