Whistle-blower Doctor who informed about Corona-sacked in Kerala


 

The ease with which doctors can be punished for doing even the right has finished the independence of the medical profession. The harassment of Chinese whistleblower doctor and now  sacking of the doctor who informed authorities about the coronavirus patient in Kerala are just an example of day to day troubles doctors are facing in every day working. These incidents are just the tip of the ice-berg. The evolving systems in the present era have made it difficult to deliver health care in the right way, as a consequence to routine harassment of doctors. Who will be the ultimate sufferer does not need an Einstein brain to predict.

 

 Kerala: Doctor who informed authorities about patient with coronavirus symptoms sacked by clinic.. Adoctor in Kerala on Tuesday alleged that she was sacked by the management ofthe private clinic she was working with for informing authorities about an NRI patient who reportedly declined to undergo the mandatory check for coronavirus. Dr Shinu Syamalan said the patient had come to the clinic recently with suspected symptoms of the virus. “When he was asked whether he had visited any foreign countries, he said he was coming from Qatar. But he had not reported to the health department about his foreign trip,” she said. When he was directed to inform about his foreign travel to the state health department, which has been monitoring people coming from abroad for the virus, he refused and said he was going back to Qatar, she told reporters. Concerned over the health of the person who had a high fever, Syamalan informed health and police authorities. “Officials who let the patient go abroad do not have any problem, but I have become jobless,” she posted on social media. 3/10/2020 Kerala: Doctor who informed authorities about patients with coronavirus symptoms sacked by the clinic – Times of India https://timesofindia.indiatimes.com/city/kochi/kerala-doctor-who-tipped-authorities-about-patient-with-coronavirus-symptoms-sacked-by-clinic/articleshowprint/74564864.cms 2/2 She alleged she was sacked by the management of the clinic for reporting the matter to police and informing the public about the incident through social media and through television. “The argument of the management is that no one would turn up for treatment in the clinic if they come to know that it was visited by patients with suspected symptoms of Coronavirus,” she said. There was no immediate reaction from the management of the private health clinic. Official sources said the district medical officer (DMO) at Thrissur has complained to the collector against Shinu Syamalan accusing her of defaming health officials. Sources said the DMO informed the collector that health officials had tried to prevent the patient from traveling abroad immediately after getting information from Syamalan.

corona virus unmasks risk to doctor and nurses

21 occupational risk to doctor and nurses

Reverberations of the slap #CMRI-hospital-Kolkata;whether to choose medical profession?


The consequence and reverberations of the slap landed on the doctor, subsequent to the death of patient in CMRI hospital  Kolkata,    are  more than  routine.  Media and celebrities usually   have proudly  projected on screen and television that doctors can be beaten and assaulted, in case there are unexpected results or in case of dissatisfaction. But the news is viewed by medical community anxiously and is definitely a poor advertisement for younger generation to take medicine as profession. As incidents are widely publicized and masses following their “Reel Heroes” depicting violence against the doctor is seen as a routine and looked as an   easily do-able  adventure  due to  non-willingness of  authorities to take stringent action.

doctor assault is like corona virus

In such cases, everybody seems to get falsely satisfaction  by the fact that the doctor must have been the culprit, who was   unable to save the patient. Medical community becomes anxious as the fear of more brazen attacks as the incidents can trigger   many more. As patients will continue to get treatment in hospitals and few cannot be saved, so every death declaration may be a harbinger to such attacks in future.

Doctors will be scared and avoid risky patients   or difficult surgeries may be avoided.

There can be complications or genuine poor prognosis. Even mistakes and errors are part of treatment.  The problem is that soft skills, deep knowledge and polite behavior is now been taken as weakness of doctors and not helping them   anymore. A notion  that   assaulting a doctor under emotional  outburst is taken as normal and should not be punished.

Brutality against doctors reveals a deep prejudice and lawlessness, merely on the basis of perceived negligence. Government is either unwilling to act and establish a strong culture of deterrence, so justice been elusive for medical professionals.

Even murderous assaults on doctors are not enough to shake administrators, courts  and doctors’ body out of slumber.  Definitely such violence, if unabated will be   poor advertisement for   next generation to take medical profession as a first choice.

female doctor assault 

#Choosing-to-be-doctor in lawless society: A self inflicted disaster #uncivilized-society #Govt-apathy serving an uncivilized society

21 occupational  risk to doctor and nurses

Corona Virus unmasks danger to nurses and doctors, which administrators prefer to refrain or oppress


 

Working of a doctor and nurses has never free from risk to themselves. The risk is generally underestimated, although it often involves major  risk  to their  life. Problem is that  majority of people, society, governing bodies  and even doctors themselves do not perceive or acknowledge  many times  the risks seriously.  Deadly Corona virus has unmasked and unveiled the danger to nurses and doctors,  the topic often suppressed, shunned by administrators and those who govern.

    An extreme example is the Chinese doctor, who was reprimanded, humiliated and made to apologize for doing right.  But this one example  is tip of the iceberg, for the Global phenomenon, where risk to front line workers is ignored routinely. They are just taken as  the routine workers, who have consented to be sacrificed. Chinese doctor Li Wenliang, one of the eight whistle-blowers who warned other medics of the coronavirus outbreak but were reprimanded by the police, died of the epidemic on Thursday,

 

  As per reports, 40 staff members of Wuhan hospital are  infected with Virus.

    Administrators and regulators refrain to study data that would establish and quantify the occupational hazards of being a doctor and nurses. Some of these hazards may be known, but there is no comprehensive analysis of workplace risk for physicians and nurses, like those that have been done for other professions. As physicians, we have a sense of the risk, and yet we remain engaged, continuing to care for our patients as we know  “these things” happen. Perhaps society prefers to remain blissfully ignorant of the sacrifice and risk their doctors  and nurses take on, comforted by the fantasy of the serene  hospital. Perhaps we  all despise to let reality and data shatter the illusion.

   But since  these risks are increasing exponentially every day, because of unknown and mutated germs (bacteria and viruses),  awareness is needed.  There are lesser set procedures, lack of awareness, not protective equipment or supportive society, governance and  laws, at most of  the places globally.  doctors  and nurses continue to work  in danger zones. These risks can be of varied types and contracting the diseases is just one of them.

Patients carrying specially unknown germs are  handled by doctor and nurses, who have no clue, what they are dealing with.   Time gap in such  patients coming to the  hospital  and  the exact diagnosis of finding a dreaded disease, may be  quite dangerous to doctors and nurses. To add to the problem, In  large number of patients, exact viruses cannot be diagnosed or even suspected. In many cases of ARDS, the causative organism cannot be  isolated or identified.  It is important for  doctors and nurses  to take universal precautions at every level. There can be many more viruses or germs which are yet to be discovered or mutated ones that  are unknown.

H1N1, Zika,  Ebola,  SARS  are few examples,  just to imagine that they existed and handled by health workers as unknown germs, till they were discovered.

Worst part is that our systems are not defined to prevent, treat or compensate or even acknowledge for these big disasters, if it happens to healers. These problems are not known to students, when they decide to take medicine, nor they are taught in medical school. Most of the time they have to fend for themselves, if problems occur.

Everyday globally, the doctors and the nurses  greet the new day and return to their work of taking care of their patients, knowing well the risk  involved.

Maybe it is time that we are little more aware  and acknowledge that even doing everything in best manner and honestly, they are in a  conflict zone and  are all in harm’s way. Just be careful and be mindful that  doctors, nurses, and healthcare workers,  may get  sickened, injured, disabled even  as they care for their patients in best manner.

21 occupational hazards to nurses and doctors

Corona outbreak Whistle-blower Chinese doctor was harassed; dies of infection


Chinese doctor Li Wenliang, one of the eight whistle-blowers who warned other medicsof the coronavirus outbreak but were reprimanded by the police, died of the epidemic on Thursday, official media reported. Li, a 34-year-old doctor who tried to warn other medics of the epidemic, died of coronavirus on Thursday in Wuhan, the state-run Global Times reported. He was the first to report about the virus way back in December last year when it first emerged in Wuhan, the provincial capital of China’s central Hubei province. He dropped a bombshell in his medical school alumni group on the popular Chinese messaging app WeChat that seven patients from a local seafood market had been diagnosed with a SARS-like illness and quarantined in his hospital. Li explained that, according to a test he had seen, the illness was a coronavirus — a large family of viruses that includes severe acute respiratory syndrome (SARS) which led to 800 death in China and the world in 2003. Li told his friends to warn their loved ones privately. But within hours screenshots of his messages had gone viral – without his name being blurred. 2/6/2020 Chinese doctor who first warned about coronavirus outbreak dies . When I saw them circulating online, I realised that it was out of my control and I would probably be punished,” Li was quoted as saying CNN recently. Soon after he posted the message, Li was accused of rumour-mongering by the Wuhan police. He was one of several medics targeted by the police for trying to blow the whistle on the deadly virus in the early weeks of the outbreak. Overall 564 people have died in China due to the virus and 28,018 confirmed cases have been reported from 31 provincial level regions, the National Health Commission reported on Thursday.

corona virus

doctor nurses at risk from mutated virus

21 occupational risk to doctor and nurses

Human-to-human transmission of China Corona virus # symptoms # doctor, nurses


Symptoms: including fever, coughs, breathing difficulties and pneumonia.

Coronaviruses are transmitted between animals and people, and the outbreak in Wuhan has been linked to a now-closed seafood market where live animals were reportedly sold. Preventive measures were also being taken to protect doctors and health care workers.

Patients carrying specially unknown germs are handled by doctor and nurses, who have no clue, what they are dealing with. Time gap in such patients coming to the hospital and the exact diagnosis of finding a dreaded disease, may be quite dangerous to doctors and nurses.To add to the problem, In large number of patients, exact viruses cannot be diagnosed or even suspected. In many cases of ARDS, the causative organism cannot be isolated or identified. It is important for doctors and nurses to take universal precautions at every level. There can be many more viruses or germs which are yet to be discovered or mutated ones that are unknown.

H1N1, Zika, Ebola, SARS are few examples, just to imagine that they existed and handled by health workers as unknown germs, till they were discovered.

China’s National Health Commission has confirmed human-to-human transmissionof a mysterious Sars-like virus that has spread across the country and fueled anxiety about the prospect of a major outbreak as millions begin travelling for lunar new year celebrations.

Zhong Nanshan, a respiratory expert and head of the health commission team investigating the outbreak, confirmed that two cases of infection in China’s Guangdong province had been caused by human-to-human transmission and medical staff had been infected, China’s official Xinhua news agency said on Monday.

Authorities earlier reported 139 new cases of the new strain of coronavirus over the weekend, bringing the total number of infected patients to 217 since the virus was first detected last month in the central city of Wuhan.

Cases were confirmed in Beijing, Shanghai, and Guangdong province in the south, heightening fears ahead of the lunar new year holiday, when more than 400 million people are expected to travel domestically and internationally.

State broadcaster CCTV said on Monday evening there were seven suspected cases in other parts of the country, including Shandong in the east, and the south-western provinces of Sichuan, Guangxi and Yunnan. Five people who travelled from Wuhan were also being treated for fevers in Zhejiang province.

“People’s lives and health should be given top priority and the spread of the outbreak should be resolutely curbed,” said China’s president, Xi Jinping, weighing in on the matter for the first time.

The strain has caused alarm because of its connection to severe acute respiratory syndrome (Sars), which killed nearly 650 people across mainland China and Hong Kong in 2002-03. Three people have so far died in the current outbreak, which has spread to Thailand, Japan and South Korea.

The World Health Organization has said an animal source was “the most likely primary source” of the outbreak, with “some limited human-to-human transmission occurring between close contacts”. Researchers worry the number of infections has been severely underestimated.

21 occupational risk to health workers

Risk to health workers working in remote areas (specially-Women; Doctors & Nurses)


 

Often  an issue is raised that doctors and nurses  are hesitant to go to  remote places.  Brutal rape and murder of Hyderabad vet doctor  is an evidence of the  dangers lurking because of  preying eyes   and lack of security, specially to women health workers (doctors and nurses).

 A  ghastly  incident that highlights the dangers associated with entering unfamiliar places, unsecured environment  and a dark world with  no one to listen to   heart wrenching cries of the unassuming victim. With no serious policing activities, it may turn out to be unthinkable nightmare.

       But  the lady doctor  went  to a place where transport was difficult and paid the price. A  women  is being  posted to an area where transport and security  were not provided and thereby  assigned  an unsafe posting.

         Doctor   should consider these factors before joining at unsafe places.

          Problem is that the system does not take into account the risk to health workers, their convenience  and  family obligations. Their difficulty in transport,  the security issues, providing basic amenities are  not considered important by  administrators.

  The system  that failed to  provide proper transport and security is the  real culprit.

 Till  some one  puts a question to  the  system and makes them accountable, there will be  more cases of this kind.

  Had  the  deceased  not been  a doctor, or from  some  other profession,  there was no compulsion  for her to go to remote areas.

        Lack of medical facilities  and infrastructure add to the  risk, as the health workers are held responsible for  all the short comings. Not infrequently they become the punching bags for the  inept system and infra structure deficiencies.     Females doctors and nurses are at greater  risk for obvious reasons and strangely there are no special provisions made for their security. Usually they are allotted a place where  they have to fend for themselves.  If one thinks it seriously, risk is even  greater than anticipated.

   Women -Doctors & Nurses- need to take precautions and save themselves in view of system insensitivity.

 

21  occupational-risk factors – for doctor and nurses

Real story of female doctor assault- serving uncivilized society

Work life balance problem for female doctor and nurses

Disadvantage of being a doctor

Who killed Hyderabad  Vet Doctor? Answer : “OUR SYSTEM”


 

      A vet doctor  was subjected to   brutal rape and death in Hyderabad.  An incident that filled  our hearts with  grief  and  pain.

Who are culprits? The four men, caught and will be given punishment. But are they alone the culprits?

       No; there are culprits who will not be even named. Our system is the biggest culprit.             

 Often  an issue is raised that doctors do not go to  remote places.

 But  the lady doctor  went  to a place where transport was difficult and paid the price. A female is posted to an area where transport and security  were not provided. She was given an unsafe posting with no security  and no transport.   The person who gave her  such posting is also the  culprit

         The system  that failed to  provide proper transport and security is the  real culprit. Till  some one  puts a question to  the  system and makes them accountable, there will be  more cases of this kind.

        May  the departed soul rest in peace. 

       Doctor   should consider these factors before joining at unsafe places.

 

 female  doctor  assault ; serving uncivilized society

Young veterinarian murdered, set on fire near Hyderabad after her vehicle broke down

The victim, who had left her house in Shadnagar for Kolluru village to attend her duties at a veterinary hospital, called her sister on Wednesday night to inform that her two-wheeler had broken down while returning home.

A young veterinarian has been murdered by unknown persons, while her burnt body was found on Thursday in Shadnagar town close to the Telangana state capital, police said.The charred body of the victim was found at Chatanpally bridge near Shadnagar town in the Ranga Reddy district.The victim, who had left her house in Shadnagar for Kolluru village to attend her duties at a veterinary hospital, called her sister on Wednesday night to inform that her two-wheeler had broken down while returning home.She told her sister that she was feeling scared and that somebody had offered to help her and taken her vehicle for repair. When her family members tried to contact her later, her mobile phone was found to be switched off.Police said the charred body of a female, aged between 20-25 years, was found near the bridge. Sridhar Reddy identified victim’s body as being that of his daughter.Senior police officers rushed to the scene for launching their investigations and were scanning CCTV footage from a nearby toll gate for clues.It may be recalled that in another gruesome incident earlier this month in the same district a man burnt alive a woman revenue official inside her office near here, but in the process also suffered critical burn injuries himself. The shocking incident occurred in the Abdullapurmet Tahsil Office in Ranga Reddy district on the outskirts of Hyderabad.

 

 

 

Black coat vs white coat: medical profession vs law industry


Every medical  case that goes to court involves lawyers and their expensive fees. Most of the time even though the doctors may be right, he has to defend himself with the help of  lawyers.  Law industry has been  benefited enormously because of consumer protection act at the cost of doctors. Increasing mistrust and unhappiness in patient’s mind definitely does not  help patients and doctors, but ends up benefiting law industry.

Strangely  doctor’s fee are quite low but lawyers charges them astronomical amounts, which are beyond any logic.

      In a country where people  fight with their parents, brothers and  sisters for money and property, it will be naive to think that idea of making money from doctor  does not exist. With court compensations going into crores, doctors  can sense many times that some patient relatives  try to use the opportunity. They have nothing at stake so they try to make some noise on social media and harass the doctor in court or on social platforms. Even for patients, who had poor prognosis at the very onset of treatment, relatives can create problems, many times due to financial reasons. Doctors have no protection from these nuisance. All these factors further enhance insecurity in doctor’s mind.

It is  because of career building of few professions, that medico-legal cases are being fueled. Medical errors and complications are integral part of the treatment . Even simplest of diseases carry some amount of risk.  These  will still remain, even if doctors are hanged to death. Natural complications, poor prognosis can be attributed to errors by clever lawyering and because of benefit derived by other professions.

Many careers  are  shining in name of preventable deaths  and medical errors at the cost of medical profession.  The managers, right activists, media   and lawyers  have made their career and wealth out of it. Ask any doctor really, are these issues really preventable beyond  a point.  The  line separating errors or natural complications is really blurred and arbitrary. People who work in life and death situation know it well that  even natural poor prognosis can be labelled and proved as error by retrospective analysis and wisdom of hindsight and more certainly with luxury of time at disposal for lawyers and courts.

It becomes a unbalanced match specially when the amount of money which was paid to doctor to save a life was peanuts as compared to now being paid to punish him.

 Zero fee advertisements and fixed commission ads on television by lawyers in health systems in certain developed countries is an example of instigation against medical profession. They lure patients to file law suits and promise them hefty reimbursements. There is no dearth of such   relatives, lawyers who are ready to try their luck, sometimes in vengeance and sometimes for lure of money received in compensations.  This encouragement and instigation of lawsuit against doctors has become a major disadvantage for medical profession.

Sense of impending  injustice  is fueling among doctors, giving   a  feeling  of   sitting ducks  for harassment.

what if money is taken out of medico-legal cases

Reshaping medical industry & medical profession/Doctor: #Doctor assault


 

    Routine instances of verbal abuse,  threat  and physical assaults are common incidents. Usually media justifies assaults on doctors, administration and courts are of little help. Doctors suffer for  no fault of theirs. Many become punching bags for the inept medical system and invisible medical industry. The threat of physical assault is quite real these days.  Recently, even female doctors have not been spared by mobs. Silence of prominent social people, celebrities and society icons on this issue is a pointer towards increasingly uncivilized mindset of society. But these are not without having long term effects. There will be definite effects on how medical profession and industry reshapes  in coming times.

    1.  Poor advertisement for  Private medical college seat- Doctor assault is definitely a poor advertisement  for the medical students, who want to buy a private medical college seat by paying millions. Medical colleges are owned by rich and powerful.  There is possibility of loss of business. Why should one pay millions and bear  risk of being beaten or killed, while doing such a  stressful duty. People will be fearful to be doctors on a free seat, leave alone on the paid seatIt will be a naïve idea to pay millions and be a doctor.

       So  “loss in business” is something which can force administrators and  government to make laws against doctor assault and lawlessness against doctors.  That is the only silver lining  of doctor assaults. If private medical colleges are to survive and attract rich candidates  and earn money, a law to protect doctors is a must.

 

  1. Closure-Bundling out single practitioner and doctor run small practices: small nursing homes and single or doctor couple practices depend on a good doctor patient relationship. In  an era of deep mistrust  generated by media, it is difficult for individual doctor to have community practices, which were cheap and helpful locally. Doctors can not work with fear and in an unprotected environment. Automatically these smaller units will cease to exist and practically   It is a natural consequence of such incidents. There will be scanty friendly neighborhood doctors or their quality will  suffer.

 

  1. Lesser   doctors for emergency work: as working in life and death situations is attracting heavy risk to doctor’s life, there will be less enthusiasm to work in emergency situations. If the  situations continue, it will be more of a forced decision rather than  elective to work in emergencies.
  1. Corporate health care will be a way of life: when doctors owned small practices becoming extinct and  remain rudimentary or  cease to exist, the investor run big set ups  will be the only option. The big systems will be run on business model and doctors will be better protected workers in  the industry. That will become way of life as far as health care is concerned.
  2. Doctor & nurses turning into cheap labor: biggest threat of the oppressive system is the minimizing  independence of doctors as professionals.  Dependence on investor driven big health systems will increase. So abundance of skilled manpower will be available to investor led healthcare, and doctors and nurses  end up  being converted    into cheap labor for industry.
  3. Good for administrators and health managers: the dream of health industry to have cheap skilled manpower, is not that distant now. Security risk will close independent practices and they will be available for safer zones,  which for administrators and investor is a dream coming true. Less expensive abundant skilled manpower is an administrator’s delight.
  4. Demoralization of doctors and nurses: needless to say, it is one of darkest era for medical professionals. They are ebbed from all sides. Medical profession reeks of desperation and desolation, with not any one from power corridors to protect them, no courts, no human right commission for them to save the saviors from its decrepit state. Real medical profession has been devastated with little hope of regeneration.
  5. Survival of  commercially fittest doctors: doctors who survive in changing environment will be commercially fittest, able to entrench themselves in changing business environment, able to wriggle through legalities, well connected, glib talking, able to connect to industry. Doctors, who  do not possess above qualities, will not survive the health markets.
  6. Medical Community broken to single  suffering individuals: Every doctor knows that some thing is really wrong happening against the profession.  Not only every day minor irritants but there  are recurring episodes of blatant cruelty against doctors. The whole profession is being criticized openly in the garb of stray incidences or in cases of genuine poor prognosis. Each and every doctors  wants  to react.  But no one knows  really “ how to do it”. There is no unity  amid this chaotic problem. The community has been broken  and pushed to behave as single suffering   whatever way  they choose to react ,  the slightest reaction may  invite the ire of many unknown people, may be mighty and revengeful. More over, it is the individuals, not a community, that remains  non-united,  whose  career   and life is at stake.
  7. Effect on patients: at present,  leave it to wisdom of readers.

An example-How word twisting by media blames doctors for administrative failure, makes them scapegoats


Just look at the heading “ Doctor ambulances rushed to fight disease only when the spotlight’s on it”

This is just an example how real issues of administrative failure are made to look as doctor’s fault by clever word twisting by media. A Heading in “Times of India” gives an impression that doctors did not respond to encephalitis cases early and did so after spot light of media. Whereas content of news item correctly putforth the administrative issues. An application of average wisdom will always misinterpret it as doctor’s fault. No doctor will be able to leave his place of work without an administrative order.

Now issue comes whether such word twisting is deliberate or just a mild error, or just an ignorance about working of medical system. It is hard to believe that national daily like Times of India is ignorant about the working of medical system. It is a simple fact that no doctor by himself can leave his work place or patients, to visit Bihar. It will always a administrative decision to send them, if some crisis is there.

Such language errors are also not expected from such highly esteemed newspaper.

Are these word twisting a deliberate attempt to sway public opinion, so as to camouflage administrative failure. By an average wisdom, using such language, buck stops on the doctor. No one even thinks about the large and powerful administration and health industry, which has decisive powers but remains invisible. Media by making such carefully worded headlines keeps that veil intact for the powerful administration.

Similar or even more word twisting has become common blaming doctors. But sadly in the process doctors are made scape- goats and always bear the brunt of public ire.

This is just an example, how innocuous looking word twisting can shift blame to doctors, whereas in reality these are administrative failures.

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