Silence of  REEL Heroes: #Aamir-Khan, when REAL Heroes  #doctor/nurses are thrashed #NRS-Hospital


                    When  examples of stray incidents were portrayed as general phenomenon on television and a great mistrust was created, the existing gap further  widened between  doctor – patient, the REEL hero #Aamir-khan got a great applause. Society believed  and trusted  the stars, who entertained , enacted stories and danced to make them happy, keeping them entertained. Masses believed easily, what  Reel hero, while entertaining  told them and not trusted the doctor, who was awake at nights to save their  lives. REEL heroes earned name,  fame and money  by unilateral poor projection of doctors in filmy stories, right or wrong or just stray incidents. Larger good work and hard work of doctors was of no consideration. Sad  era for medical profession, where reel heroes, who merely act are trusted more than real doers. Now when doctors are being nearly killed, just because  for being on the bedside of patients, the silence of REEL Heroes,  proves the  hollow applause, they have generated for themselves.

 NRS hospital 

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

The old adage  “All that glitters is not Gold” is particularly relevant  in current era of media domination where media  projection shapes the perception and may defy  the  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.

Society, in general, needs to be wise  enough  to realize the importance   of  getting  rid of  these blinders in  real life . One such factor that causes an illusional mist in the  thoughts of masses is projection in films. They create a mirage of illusional glitter wherein  there is blurring of real life from the reel life of heroes. The larger-than-life unreal persona of the celebrities on screen looks too charming and sometimes becomes undeniable and dominates mind of masses. The super-human characters played out in films appear to be real. The problem arises when the imaginary characters of the reel life stories are emulated in real life. Individuals as projected character fill in  peoples’ imagination and are perceived as real and   becomes ingrained in mind. 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 act of   inspiration  in real life  as  the actual purpose accomplished in the end of a movie  is entertainment of society and business for themselves. A recent  candid  admission  by the actor # Mr-Irrfan-Khan  that film stars should  not be role models  was impressive (Hindustan times) .

   At the best, a particular projected character  (and  not individual acting star) may be a  role model. An actor or super star, 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 rationale 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.

   A  soldier contributes to our society much more in real terms. Even a junior doctor saves many lives in a  day in emergencies as compared to work of a superstar in films.  A teacher, nurse or scientist have 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 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.

 

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 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.

 

Even good films  may raise some social problem, which everyone knows already and offer no practical solution in reality. Therefore what good it brings to the public, beyond entertainment, is any body’s guess. The persona, actors usually  project on screen, may actually be far from his or her real personality. In most of cases, what he does in movies and reel life, is actually away from  possibility of real life . But strangely in present era, people lose sight of what is mere perception. It is clearly a story, tale, a drama, a myth and is not the real identity of the people, we see on-screen.

 

 

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  ke   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.

 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 reel heroes.

 

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

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”.

Blatant cruelty & #oppression-of-doctors: Re-entering Hammurabi Era (1750BC)


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 scant  unity  amid this chaotic problem. The community has been broken  and pushed to behave as single suffering   individuals. whatever way  they choose to react ,  the slightest reaction may  invite the ire of many unknown people, may be mighty and revengeful.  

          By showing cruelty and being revengeful towards doctors , our society is in a way re-entering the realm of an ancient medical regulatory  system, Hammurabi Era (1750BC). Certain aggrieved health care consumers may welcome a move toward harsh penalties in the name of justice and simply for revenge but we need to keep in mind the  poor outcomes in complex diseases, limitation of science and of course the idiosyncrasies of the human body.  Fear factors and  Impact  of present legal complexities,  on doctors  is  already on a par with that of  Hammurabi  era.

Then why  doctors  be  made a punching bag for venting out emotions of the bereaved relatives. Nothing and really nothing can justify this barbaric act. Emotions should not be allowed to take such a demonic form.

This is simply jungle raj, goonism and  expression of a most  uncivilized kind of society, which simply cannot be excused by any sort of reasoning. The incident is being  protested by the professional bodies as is the routine and after few day things normalized for everybody else except that terrorized doctor .  

If the courts, the commission for women’s rights, and the human rights commission are maintaining silence, is it because the rights of doctors were never clearly defined and outlined.  The duties of a doctor have always been enumerated but the rights have never been discussed.

           Human rights of doctor and medical community have been grossly violated by physical assaults. It is painful to see that the authorities that are supposed to take action have maintained a silence all these years about this issue.

What is role of human rights commission, if rights of a hard working community like doctors are violated and what is it supposed to do? I really fail to understand what else will it take to shake them out of their stupor ?

NRS Hospital Violence

Hammurabi era

female doctor assault

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


There is increasing discontentment among doctors because of  present complex and punishing system. They are bound by so many factors that they finally end up at the receiving end all the time. They are under Hippocratic oath and therefore expected to work with very high morality, goodwill and kindness for the sufferings of mankind and dying patients.  They are also supposed to maintain meticulous documentation and also supposed to work under norms of  medical industry. They are supposed to see large number of patients with fewer staff and nursing support while still giving excellent care in these circumstances. And if these were not enough, the fear of courts and medico-legal cases, verbal threats, abuses, and physical assaults and show of distrust by patient and relatives further makes working difficult. Additionally there may be bullying by certain administrative systems at places, who use pressure tactics to get their own way.

Enslavement of doctors

NRS Hospital doctor assault

Young doctors  complete  training and find themselves working in a hostile environment, at the receiving end of public wrath, law, media for reasons they can’t fathom. They  face continuous negative publicity, poor infrastructure and preoccupied negative beliefs of society.

       They face physical assault , routine instances of verbal abuse and threat 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 as well.  Even female doctors have not been spared by mobs. Silence of prominent social people, celebrities, human right commission  and society icons on this issue is a pointer towards increasingly uncivilized mind set of society. 

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  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 serve an uncivilized society?”

 

Deadly doctor assault at #NRS-Hospital-Kolkata: doctors- save yourself


The condition of the intern, who was admitted to a hospital, was stated to be critical . After Death of Patient, Relatives Clash With Junior Doctors in  #NRS-Hospital-Kolkata-west-bengal Hospital Over ‘Negligence’

An intern was injured in the clash and regular services at Nil Ratan Sircar Medical College and Hospital were disrupted as clashes broke out over the death of a 75-year-old patient.

        Unwillingness or failure of government to prevent such attacks on doctors will have deep ramifications on future of medical profession. Silence of authorities, human right commission is really appalling.  Role of doctor associations, parent institutes have been spineless and not encouraging.  Media, celebrities, film stars in spreading the hatred against the medical profession and creating an environment of mistrust is unpardonable, where stray incidents were portrayed as normal routine just to earn money and fame. Ultimately doctors have been left to fend for themselves individually or with friend groups. 

Kolkata: A clash erupted between junior doctors and relatives of a patient at a state-run hospital here late Monday night after the 75-year-old died due to alleged negligence, police said Tuesday. An intern was injured in the clash and regular services at Nil Ratan Sircar Medical College and Hospital were disrupted as the junior doctors began a sit-in, demanding better security, they said.  Family members of Mohammed Shahid, a resident of Tangra, allegedly assaulted some junior doctors at around 11 pm last night after he died. As a result, a clash broke out, virtually turning the hospital premises into a battleground, the police said. Shahid’s family members were also angry over a delay in handing over his body, they added.

A large team of police personnel from Entally police station intervened and restored to lathicharge to bring the situation under control, a senior Kolkata Police officer said. More than 50 doctors shut the gates of the medical institution and began a sit-in on Monday night, demanding “protection”, the police said. The condition of the intern, who was admitted to a hospital, was stated to be critical, they said. Services at the hospital, including the emergency services, were affected on Tuesday as the junior doctors’ continued their protest.
West Bengal Medical Education Department director, Dr Pradip Kumar Mitra, visited the hospital and tried to persuade the doctors to withdraw their protest, but in vain.


    Empathy, sympathy, compassion and trust  of the doctor towards the patient, will definitely get a hit after these incidents. Everyday  the news of assaults on doctors, court cases against doctors, negative projection of the medical profession   in the media are viewed  by doctor’s community anxiously. Recent senseless attack  on doctor  at NRS Hospital Kolkata again a warning to children, who wish to be doctors.

      Merely taking some token  action and showing  protest will not solve the problem. It does not compensate for the  damage done to medical profession. Sympathy, compassion and trust of the doctors towards patients will definitely reduce. Who will be  the ultimate sufferer, does not need a Einstein brain to predict.

                    This insecurity or fear of the uncertainty tends to affect the thinking process of doctors and the way they practice medicine or deal with the patients. Many will like to be defensive in practice, or try not to treat very sick patients.  Why would someone try complex surgeries with risk involved? Few will limit themselves to follow protocols. Going extra mile with risk, which not everyone will like to take. Many will become health managers or  do something else than do active clinical work. Who should risk his life while doing routine work?

     Patients might get their revenge for the  naturally occurring disease, but they will lose compassion and trust of doctors in the long run. If that is the way to impart justice in this era, doctors will have to find some way to save themselves.

 

#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?”

Working night shifts (#doctor&Nurses) may cause DNA damage, risk of cancer & Heart diseases


        Medical profession getting stressful is nothing new.  There are multiple dimensions to  the multi-pronged stress in present  era.  A new dimension has been discovered. Night shift are integral part of a hospital, doctors and nurses life. But it has shown to be having far reaching consequences. Night shifts have been linked to DNA damage and more serious illnesses.   If these kind of effects prove to be correct in future, it  needs a serious thinking over the issue.

    Researchers found that on-call doctors who were required to work overnight on-site had lower DNA repair gene expression and more DNA breaks than those who did not work overnight.

Working night shifts can damage a person’s DNA, increasing the risk of cancer as well as cardiovascular, metabolic, and neuro-degenerative diseases, a study has found. For the study published in the journal Anaesthesia, researchers analysed blood samples of 49 healthy full-time doctors taken at different times.

“Although this work is very preliminary, it is clear from the results that even a single night of sleep deprivation can trigger events that may contribute to the development of chronic disease,” said Siu-Wai Choi, of the University of Hong Kong.

Researchers found that on-call doctors who were required to work overnight on-site had lower DNA repair gene expression and more DNA breaks than those who did not work overnight. In these overnight on-site call doctors, DNA repair gene expression decreased and DNA breaks increased after sleep deprivation.

Damaged DNA increased after only one night of sleep deprivation. This DNA damage may help explain the increased risk for cancer and cardiovascular, metabolic, and neurodegenerative diseases associated with sleep deprivation, researchers said.

Medical Consumer Protection Act: Root of “Us and Them Syndrome”. Effect on medical profession


In present scenario, when patient is no more “patient” and  defined as consumer, doctors is not more than a service provider. With  Medical Consumer Protection Act acquired roots,  the whole system of medical delivery  and healthcare has changed. Most striking is this  entire fiasco is the “Us and Them” syndrome that seems to afflicted  every one. Doctors are pitted against every one, for example,  Doctors vs administrators, doctors vs patients, doctor vs managers. From regulation, insurance and legal system, every change has affected doctors adversely. They have been reduced to just only one component  of the industry, who deliver care and remain at receiving end. Other important stake holder are patients. How this change has been beneficial for patients? Suppressed professionals  can be used to work more, get less paid and can be dragged to court. So fear of all kinds will make them more  careful. It should be a win-win situation for all, except doctors. Therefore everyone makes merry, while doctors sulk, except those who can mingle with the present scenario and act smart in  changed business and legal milieu.

reblogged

Negatives effect on medical profession: cons or disadvantages of  medical consumer Protection Act

  1. Promotes Defensive medicine: Every patient with any illness has potential to complications. Progression of any disease state can cause death.  If doctors start looking at every patient as a potential litigant, especially those who are dealing with very sick ones,  practice of defensive practice is a natural consequence. This may manifest as excessive investigations, more use of drugs and antibiotics  and even  sometimes even refusal to treat very sick patients. Worst scenario of excessive fear will be  refusal of very sick patients in emergency situations or non availability of doctors.
  2. Erosion of doctor-patient relationship: stray and occasional Incidents about negligence and the cases in courts or  their outcome are given wide publicity in media. People are unable to understand the correct  application of such stray incidents to themselves. But they always try to imagine themselves in the scenario applied. Because of prejudiced notions, a sense of mistrust gradually creeps in,  which then extends to and involves their own treating doctor .This sense of mistrust multiplies manifold whenever there is  some adverse or even small unpleasant  Ultimately doctor and patients move forward together with a strained relationship and the treatment goes on with a surmounting sense of mistrust.
  3.  Increased cost of care:   With the creeping in of practice of defensive medicine, there is a need to document everything and to offer everything possible in the world, leading to inflated  medical costs.  Insurance  companies and lawyers have positioned themselves in between. They charge everyone heavily for allaying the fears , both  patients(medical insurance, lawyer fee) and doctors(indemnity insurance, lawyer’s fee) alike. The vicious cycle of rising costs , need for insurance, medicolegal suits, high lawyer fee (for patients and doctors) goes on unabated. All these contribute significantly to overall increased cost of health care.
  4. Enhanced insecurity in medical profession : Needless to say,  consumer protection act has increased the anxiety  and insecurity in  the medical profession. One keeps wondering which patient will prove to be his bane and finish his total career or will result in professional hanging or a media trial, with these having real probability in today’s day to day practice.
  5. Unnecessary litigation: Legal cases can be put on doctors for various trivial reasons e.g  for sense of revenge or to extract money or simply for not having to pay for services.  In an era where family members , brothers and sisters fight for money, it will be naïve to think that idea of making money from doctor does not exist. These are further stoked by the incidents of previous high compensations granted  by courts .
  6. Increased paper work: excessive documentation and time consumption: crucial and large chunk of time of doctors and nurses, goes in completing documentation. Needless to say, this time previously was dedicated solely to patient service. Management is now-a days more worried about completing paper work as well. Initially it was a symbolic documentation , but now there is requirement of mammoth paper work. It leads to consumption of time  that was meant for real discussions for the benefit of patients.
  7. Doctors used as scapegoats for revenge : Any unsatisfied patient can vent his anger by putting complaint or case  against the doctor .  This is done to some extent for revenge or  trying to find some   human factor which can be punished. Not uncommonly doctors are used as  scapegoat to have  a concession on the patient treatment by health organizations. Everything can be easily put on doctors as they are universal final link to a patient’s treatment and adverse effects.
  8. Distraction of doctors from the primary point of intention:  Nothing else ever has  distracted doctors  more than these medico-legal cases and punishments. In many cases, saving themselves becomes more important than saving a patient. Uncertainty of prognosis, grave emergencies and split second life saving and risky  decisions which may later be proved wrong by retrospective analysis, complex  medico-legal situations are endless distractions that have creep in and are enough to distract doctors from primary point of intention.
  9. Early retirement or burn out:  Becoming a doctor and practicing has become a tough job. After people have reached a point of financial security or when near point of burn out, doctors tend to leave practice. No wise man will like to face medico-legal complexities in older age. Taken to court for a genuine decision by self  is enough to spoil and tarnish  health, wealth and fame earned by  grilling the whole life.
  10. Reluctance to do emergency, risky work: If the decision to decide or act or help someone in an emergency situation, puts ones own life and career to risk, why should one put oneself in that deciding position?  Therefore increasingly, financially secure doctors are staying away from the riskier jobs.
  11. Only Doctors are sufferers of the act: Patient can have poor outcome because of any reason. It can be severe disease, poor prognosis, rare or genuine complications or even unintentional mistake or human errors, system errors or deficiency. But retrospectively doctors can easily be blamed because of wisdom of hindsight.  All patients with unrealistic or unexpected outcome can go to courts. Whatever court decides, harassment of doctors is full and permanent. There is no compensation possible for the sufferings and agony spanned over years, even if court decides in favour of doctor.
  12. Spoils teamwork among doctors; Whenever there is adverse outcome in any patient, all the doctors involved may start looking  for whom to blame  among themselves. All of them will try to pinpoint other’s mistake.  Such situation produces a bitter and worst kind of disagreements among various teams or specialties. Mutual understandings take a back seat and the teamwork is spoiled permanently. Administrators in a bid to be safe, encourage putting doctor’s concerns against each other, creating a strange sense of enmity. Ultimately  a mutual understanding and team work takes a hit.
  13. Hugely benefited are medical industry, law industry and administrators; Rampant misuse of consumer protection act has instilled a sense of deep fear in mind of medical professionals. The act has been used as a whip for doctors by all these three stakeholders. Fear of medico-legal cases has reduced doctors to cheap labour. Industry has used the protective systems to gain out of doctors hard work.  Benefits to law industry are obvious and don’t need to be elaborated. Besides this, even insurance industry has collected money both from doctors and patients by creating the fear.
  14. Right decisions or wisdom of hindsight?; A certain element of doubt always remains in minds of doctor whether he will get justice in the long run, or will end up being victim of sympathy towards patient or clever lawyering.  What was medically right and judicious decision at that real time situation may look wrong later  retrospectively, especially when retrospective analysis  is done over years with fault finding approach.
  15. Delayed treatment in emergency situations: Due to prejudiced minds, it is not uncommon for patient’s relatives to keep seeking second opinion, thereby delaying consent for procedures, surgeries and treatment. Though doctors know this problem but they obviously cannot proceed without necessary documentation. With increasing mistrust, even emergency treatments are delayed only to repent later.  
  16. Instigation by law industry; Windfall profits for lawyers and law industry at the cost of doctors is a disadvantage for medical profession: One can see zero fee and fixed commission advertisements on television by lawyers in health systems even in  developed countries. They lure and instigate 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 is a major disadvantage for medical profession.

 

  1. Hostile environment for young impressionable doctors: The young and bright doctors complete their long arduous  training and then suddenly find themselves working in a hostile environment, at the receiving end of public wrath, law and  media for reasons they can’t fathom. They face continuous negative publicity, poor infrastructure and preoccupied negative beliefs of society.
  2. Subject of continuous blackmail: Even with routine complications amongst very sick patients, a threat looms over doctor’s head. People do not accept even the genuine complication, what to talk of unintentional mistakes.  Mistakes are always easy to  pinpoint with retrospective analysis and with lawyers pondering over it for years. In such situations , doctors are sitting ducks for  any kind of

 

 

 Positives, Pros or advantages of medical consumer protection act:

Although there are doubts, whether it will have any positive effect in long term, except monitory benefit to patient’s relatives and lawyers.

  1.     Quick  redressal of grievances:  patient will get satisfaction, if there is a genuine negligence case
  2.  Better quality of care will increase;  medical systems will improve as they will need to lessens the errors and  court cases. Better systems from abroad are also copied to improve the efficiency.
  3. Better introspection by medical profession: although doctors from the beginning are sensitive about their work and always look at how better results can be achieved. But act will make this process more formal and official.
  4. Training of medical professionals: it will be difficult  to put  errors under carpet.  Doctor will like to get trained better as no one want to be in soup.
  5. Future  learning from court cases:  each and every court decisions  is viewed carefully by medical fraternity. Improvement in protocol and policy making is a natural consequence.
  6. 6. Eye openers for medical profession: court cases and decisions have acted as eye opener for medical profession. It gives an idea, how law looks at medical treatment. It has made clear that medical science and medical law are a bit different. In real time, things are easier to be said than done.
  7. 7. Better documentation and communication: Doctors to save themselves, documentation is the key. Previously doctors were doing everything, but not documenting. But now there is lot of stress on documentation.

   Stress itself is not a bad thing. It can often help us perform at our best, expand beyond our limits and  achieve  better results.   The real problem lies in the fact that In this age of  anxiety prevailing more for care givers,  do not get enough relief  from stress.

        But sad thing about this kind of learning is that it is at the cost of few, unfortunate doctors, who were in difficult situation, actually suffered, did not know the legal implications  of  their acts or  situation. Most of the time, it is a system failure, but blame can be pinpointed to doctor.

May be The Act has good intention, but its practical application in its present form may cause more harm than good.    If the core of the health care  (medical hands) are harmed, no one can benefit in the long run.

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

Advantages & disadvantages: pros & cons of medical consumer Protection Act


With patient defined as consumer  and  Medical Consumer Protection Act takes roots,  the whole system of medicine and healthcare has changed. From regulation, insurance and legal system, every change has affected doctors adversely. They have been reduced to just only one component  of the industry, who deliver care and remain at receiving end. Other important stake holder are patients. How this change has been beneficial for patients? Suppressed professionals  can be used to work more, get less paid and can be dragged to court. So fear of all kinds will make them more  careful. It should be a win-win situation for all, except doctors. Therefore everyone makes merry, while doctors sulk, except those who can mingle with the present scenario and act smart in  changed business and legal milieu.

Negatives, cons or disadvantages of medical consumer Protection Act

  1. Promotes Defensive medicine: Every patient with any illness has potential to complications. Progression of any disease state can cause death.  If doctors start looking at every patient as a potential litigant, especially those who are dealing with very sick ones,  practice of defensive practice is a natural consequence. This may manifest as excessive investigations, more use of drugs and antibiotics  and even  sometimes even refusal to treat very sick patients. Worst scenario of excessive fear will be  refusal of very sick patients in emergency situations or non availability of doctors.
  2. Erosion of doctor-patient relationship: stray and occasional Incidents about negligence and the cases in courts or  their outcome are given wide publicity in media. People are unable to understand the correct  application of such stray incidents to themselves. But they always try to imagine themselves in the scenario applied. Because of prejudiced notions, a sense of mistrust gradually creeps in,  which then extends to and involves their own treating doctor .This sense of mistrust multiplies manifold whenever there is  some adverse or even small unpleasant  Ultimately doctor and patients move forward together with a strained relationship and the treatment goes on with a surmounting sense of mistrust.
  3.  Increased cost of care:   With the creeping in of practice of defensive medicine, there is a need to document everything and to offer everything possible in the world, leading to inflated  medical costs.  Insurance  companies and lawyers have positioned themselves in between. They charge everyone heavily for allaying the fears , both  patients(medical insurance, lawyer fee) and doctors(indemnity insurance, lawyer’s fee) alike. The vicious cycle of rising costs , need for insurance, medicolegal suits, high lawyer fee (for patients and doctors) goes on unabated. All these contribute significantly to overall increased cost of health care.
  4. Enhanced insecurity in medical profession : Needless to say,  consumer protection act has increased the anxiety  and insecurity in  the medical profession. One keeps wondering which patient will prove to be his bane and finish his total career or will result in professional hanging or a media trial, with these having real probability in today’s day to day practice.
  5. Unnecessary litigation: Legal cases can be put on doctors for various trivial reasons e.g  for sense of revenge or to extract money or simply for not having to pay for services.  In an era where family members , brothers and sisters fight for money, it will be naïve to think that idea of making money from doctor does not exist. These are further stoked by the incidents of previous high compensations granted  by courts .
  6. Increased paper work: excessive documentation and time consumption: crucial and large chunk of time of doctors and nurses, goes in completing documentation. Needless to say, this time previously was dedicated solely to patient service. Management is now-a days more worried about completing paper work as well. Initially it was a symbolic documentation , but now there is requirement of mammoth paper work. It leads to consumption of time  that was meant for real discussions for the benefit of patients.
  7. Doctors used as scape-goats for revenge : Any unsatisfied patient can vent his anger by putting complaint or case  against the doctor .  This is done to some extent for revenge or after finding  human factor which can be punished. Not uncommonly doctors are used as  scape- goat to have  a concession on the patient treatment by health organizations. Everything can be easily put on doctors as they are universal final link to a patient’s treatment and adverse effects.
  8. Distraction of doctors from the primary point of intention:  Nothing else ever has  distracted doctors  more than these medico-legal cases and punishments. In many cases, saving themselves becomes more important than saving a patient. Uncertainty of prognosis, grave emergencies and split second life saving and risky  decisions which may later be proved wrong by retrospective analysis, complex  medico-legal situations are endless distractions that have creeped in and are enough to distract doctors from primary point of intention.
  9. Early retirement or burn out:  Becoming a doctor and practising has become a tough job. After people have reached a point of financial security or when near point of burn out, doctors tend to leave practice. No wise man will like to face medicolegal complexities in older age. Taken to court for a genuine decision by self  is enough to spoil and tarnish  health, wealth and fame earned by  grilling the whole life.
  10. Reluctance to do emergency, risky work: If the decision to decide or act or help someone in an emergency situation, puts ones own life and career to risk, why should one put oneself in that deciding position?  Therefore increasingly, financially secure doctors are staying away from the riskier jobs.
  11. Only Doctors are sufferers of the act: Patient can have poor outcome because of any reason. It can be severe disease, poor prognosis, rare or genuine complications or even unintentional mistake or human errors, system errors or deficiency. But retrospectively doctors can easily be blamed because of wisdom of hindsight.  All patients with unrealistic or unexpected outcome can go to courts. Whatever court decides, harassment of doctors is full and permanent. There is no compensation possible for the sufferings and agony spanned over years, even if court decides in favour of doctor.
  12. Spoils teamwork among doctors; Whenever there is adverse outcome in any patient, all the doctors involved may start looking  for whom to blame  among themselves. All of them will try to pinpoint other’s mistake.  Such situation produces a bitter and worst kind of disagreements among various teams or specialties. Mutual understandings take a back seat and the teamwork is spoiled permanently. Administrators in a bid to be safe, encourage putting doctor’s concerns against each other, creating a strange sense of enmity. Ultimately  a mutual understanding and team work takes a hit.
  13. Hugely benefitted are medical industry, law industry and administrators; Rampant misuse of consumer protection act has instilled a sense of deep fear in mind of medical professionals. The act has been used as a whip for doctors by all these three stakeholders. Fear of medicolegal cases has reduced doctors to cheap labour. Industry has used the protective systems to gain out of doctors hard work.  Benefits to law industry are obvious and don’t need to be elaborated. Besides this, even insurance industry has collected money both from doctors and patients by creating the fear.
  14. Right decisions or wisdom of hindsight?; A certain element of doubt always remains in minds of doctor whether he will get justice in the long run, or will end up being victim of sympathy towards patient or clever lawyering.  What was medically right and judicious decision at that real time situation may look wrong later  retrospectively, especially when retrospective analysis  is done over years with fault finding approach.
  15. Delayed treatment in emergency situations: Due to prejudiced minds, it is not uncommon for patient’s relatives to keep seeking second opinion, thereby delaying consent for procedures, surgeries and treatment. Though doctors know this problem but they obviously cannot proceed without necessary documentation. With increasing mistrust, even emergency treatments are delayed only to repent later.  
  16. Instigation by law industry; Windfall profits for lawyers and law industry at the cost of doctors is a disadvantage for medical profession: One can see zero fee and fixed commission advertisements on television by lawyers in health systems even in  developed countries. They lure and instigate 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 instigations of lawsuit against doctors is a major disadvantage for medical profession.

 

  1. Hostile environment for young impressionable doctors: The young and bright doctors complete their long arduous  training and then suddenly find themselves working in a hostile environment, at the receiving end of public wrath, law and  media for reasons they can’t fathom. They face continuous negative publicity, poor infrastructure and preoccupied negative beliefs of society.
  2. Subject of continuous blackmail: Even with routine complications amongst very sick patients, a threat looms over doctor’s head. People do not accept even the genuine complication, what to talk of unintentional mistakes.  Mistakes are always easy to  pinpoint with retrospective analysis and with lawyers pondering over it for years. In such situations , doctors are sitting ducks for  any kind of

 

 

 

 

 

  1. Positives, Pros or advantages of medical consumer protection act:

Although there are doubts, whether it will have any positive effect in long term, except monitory benefit to patient’s relatives and lawyers.

  1.     Quick  redressal of grievances:  patient will get satisfaction, if there is a genuine negligence case
  2.  Better quality of care ;  medical systems will improve as they will need to lessens the errors and  court cases. Better systems from abroad are also copied to improve the efficiency.
  3. Better introspection by medical profession: although doctors from the beginning are sensitive about their work and always look at how better results can be achieved. But act will make this process more formal and official.
  4. Training of medical professionals: it will be difficult  to put  errors under carpet.  Doctor will like to get trained better as no one want to be in soup.
  5. Future  learning from court cases:  each and every court decisions  is viewed carefully by medical fraternity. Improvement in protocol and policy making is a natural consequence.
  6. . Eye openers for medical profession: court cases and decisions have acted as eye opener for medical profession. It gives an idea, how law looks at medical treatment. It has made clear that medical science and medical law are a bit different. In real time, things are easier to be said than done.
  7.  Better documentation and communication: for  Doctors to save themselves, documentation is the key. Previously doctors were doing everything, but not documenting. But now there is lot of stress on documentation.

   Stress itself is not a bad thing. It can often help us perform at our best, expand beyond our limits and  achieve  better results.   The real problem lies in the fact that In this age of  anxiety prevailing more for care givers,  do not get enough relief  from stress.  If the core of the health care  (medical hands) are harmed, no one can benefit in the long run.

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