NMC Bill and bridge course, a suggestion: How to create doctors for area of need, if required?


Crosspathy is dangerous to human race and potential global catastrophe because of antibiotic resistence.  All  allopathic medicines are hazardous chemicals in inexperienced hands. Incorrect and massive use of antibiotics will  cause antibiotic resistance, which has global ramifications. From this angle, it is a retrograde step. When all over the world, need is being felt that there has to be better control of antibiotic prescription.  We are entering an era, where antibiotics are getting useless and more so because of rampant misuse of antibiotics.  Rather than exercising a better control, it will be a catastrophic to human race world over by causing antibiotic resistance.

Will  thousands of alternate medicine graduate will dispense all antibiotics,  anticancer , anti diabetic , cardiac medications? It is hard to think about hundreds of potentially dangerous medicines being given without structured training and  proper exams in this system of crosspathy.

Following steps should be taken before implementation:

 

Main Aim; to create doctors  for area of need. (AON doctor)

  1. To identify areas of need; most basic step is to identify the areas of need, where doctors are not available. Government should identify area of need and implement the scheme in selected areas, and with  selected simple drugs. Such areas should be such that which do not have medical facilities or lack doctors. Areas which already have doctors will not accept the diluted  or suboptimal care, for example urban population.
  2. Limited seats-To identify the number required; let us say start with pilot project of  selecting 500 to1000 such doctors. All the lakhs of alternate doctors  can not be allowed to prescribe allopathic medicines. It will put the community at risk.

 

  1. To identify the skills required for the area; for example emergency, for paediatrics or obstretics and gynaecology, trauma.
  2. Willingness to work in area of need- to identify the doctors: have a written competition from all candidates who apply for bridge course. To identify doctors who have given willingness to work in these areas of need. People who perform well should be taken for bridge course  only on limited seats. Bridge course should not ne free for all.
  3. To develop a structured bridge course, which should be around one year after comparing the course of MBBS and the course done by the candidate.
  4. Admission and exit in the bridge course should be through exam and limited seats.
  5. Bridge course and allopathic medicines should not be made free for all, that any body can dispense it. We can get benefit only if is specific to needs of people. If everyone is allowed to practice allopathy in all locality, it will be a global hazard besides our community as well.
  6. These trained doctors will have an undertaking to serve in area of need only. For a period at least 10 to 20 years.
  7. Number should be limited but training should be good.
  8. A special course needs to be designed separately for one year, so that people in area of need do not get substandard care

Without proper planning and implementation and identification of area of need, this bridge course will not benefit anyone, rather it can be disastrous.

 

 

MEDICAL LAWSUITS FOR COMPENSATION: ARE DOCTORS SOFT TARGETS ?


Doctors save the patient, but save yourself also.

In an era, when family members, brothers and sisters fight for money among themselves, it will be naive to think that idea of extracting money from the doctor does not exist. With courts giving millions in compensation, lawyers are ready to fight cases on zero fee and divide the booty later. There may be many relatives, lawyers who are ready to try their luck, sometimes in vengeance and sometimes for the  money received in compensations. This encouragement and instigation of lawsuit against doctors is becoming a major disadvantage to doctors. Here is a news from a paper showing the problem.

Dentist accused of botching up an implant, produces video of complainant feasting at gurudwara langar: Senior citizen claims Rs 35 lakh from her dentist saying her implant was botched up and she was unable to eat; the doctor produces a video of her feasting at a gurudwara langar; cops close case.

In this case the doctors was really smart and lucky. The doctor was able to generate some evidence .  but  most of the time, things lie in grey zone and it becomes very difficult for the doctor to defend. Unfortunately  sympathy of the court and public sentiments runs against doctors . Thanks to media and celebrities for the  negative and  campaign against medical profession.

Many a times problems are just part of genuine poor prognosis or just bad course of disease or simply complications of the treatment.  Public has failed to realize that during treatment of  human body, complications  are inevitable and will always happen.  Retrospective analysis and wisdom of hindsight, always throws better light. But during treatment all this luxury is not available to doctor. Genuine complications can be easily labeled as mistakes of the  treating doctor. Unfortunately, if there is a lawsuit against a doctor, he will be wasting all his time with lawyers and courts, which will takes years to sort out.

Problem is that, there is no deterrent for patients to put cases on a doctor. Even when  case is  just with a intention to harm, revenge or extortion. Harassment of the doctor is full and permanent, even if he is not at fault. Lawyers and patient’s  relatives can always have a field day, at the cost of doctors. Society may be slow to anticipate their long term loss at present.  Till that time, doctors will have to  find ways to save themselves, as this doctor did!

 

 

Reversal of medical advancement, reversion of the enemy : ANTIBIOTIC RESISTANCE


Substances with antibiotic properties had been used for various purposes since ancient times.

Before the early 20th century, treatments for infections were based primarily on medicinal folklore. Mixtures with antimicrobial properties that were used in treatments of infections were described over 2000 years ago. Many ancient cultures, including the ancient Egyptians and ancient Greeks, used specially selected mold and plant materials and extracts to treat infections.

For their successful development of penicillin, which Fleming had accidentally discovered but could not develop himself, as a therapeutic drug, Chain and Florey shared the 1945 Nobel Prize in Medicine with Fleming.

Germ theory and discovery of antibiotics has contributed a lot to development of modern medicine. Treatment of advanced multi system diseases, complex surgeries, advanced procedures have become easier to handle because of  advent of antibiotics.  

Over the last several decades, antibacterial drug use has become widespread with their misuse being an ever‑ increasing phenomenon. Consequently, antibacterial drugs have become less effective or even ineffective, resulting in a global health security emergency. These infections will be associated with a high consumption of healthcare resources manifested by a prolonged hospital stay and high mortality. The World Health Organization  has identified antimicrobial resistance as one of the most important problems for human health with significant adverse impacts on clinical outcomes and higher costs due to consumption of healthcare resources.

Antibiotic resistance is a serious problem in all parts of the world including Asia–Pacific, Latin America, Middle East, Europe and North America regions. A particular concern is the misuse or overuse of antibiotics, which has led to the development of resistant or super-resistant bacterial strains.

Reasons for widespread antibiotic resistance:

  1. High burden of infectious diseases
  2. Poor control of infectious diseases and lack of prevention.
  3. Easy availability of antibioics.
  4. Liberal prescription and crosspathy. Common and unrestricted use  by alternative medical system doctors, non doctors and quacks.
  5. Over the counter sale of antibiotics by pharmacists.
  6. Self administration of antibiotics by patients.
  7. Shorter courses and irregular intake of antibiotics by patients.
  8. Inappropriate doses of antibiotics, specially if given by non trained person.
  9. Pressure by patients for early recovery, resulting in over prescription.
  10. Presence of large number of generics of molecules and their quality not ensured.
  11. Poor environmental sanitation, widespread  water contamination, animal waste.
  12. Lack of proper regulation and control of quality of antibiotics
  13. Unregulated  use of antibiotics in animal industry, agriculture, and aquaculture.

 

It is not uncommon to see patients not responding well to treatment. Such scenario increase difficulty for doctors, besides they may be blamed for not doing enough. Reasons may be any of the  above.  Bacteria have been the occupants around us in environment  and also in our body, have acquired deadly weapons  quickly.  Discovery of antibiotics have not lasted even 100 years. Over enthusiasm and euphoria  created by  mass production and use of antibiotics may prove lethal for human race. Antibiotic resistance has potential to undo all the advancement and is a threat of return to pre- antibiotic era .

 

 

Misdiagnosis of health care, wrong and misdirected treatment of real problem


       Yesterday, there was a painful news in paper about the death of a child due to rabies.  It is really painful  loss of life due to a preventable disease. Every one sympathizes with child and parents. But equally strange was the suggestion  that action will be taken  against the  doctor.  Newspaper also  fails to raise a point that,  why at all a preventable disease should happen?  Similar trend we always see in media, when some death occurs due to diseases like dengue and malaria, it is a doctor, who treated the patient or trying to fight with the advanced complications is punished or made a scapegoat and projected as a villain in the story by media.

  No one including administration,  government, courts or media raises a point, that why at all the diseases which  are  completely preventable,  should happen and  keep on happening.  In my previous article, I mentioned the misplaced priorities of media about the same.  At least public, who is suffering should understand that dog bite and mosquito bite is preventable. Therefore more emphasis should be on preventing these bites. That should be made a priority. If  that bite is not prevented and no action is taken to prevent that, these diseases will keep on happening in  a large proportions.  Beds  and doctors are limited in number and will be unable to treat it, specially in advanced stage. So we need really good people to make a proper diagnosis  of our health care. Every time such cases happen and these are preventable disasters, doctors are sacrificed as scapegoats.  Some one sensible need to do a root cause analysis of preventable deaths.  Media people will  have to  find the correct remedy  and demand for it. Otherwise it is not going to help and treat sufferings of common people.

Medical lawsuit:bad lottery for doctor, Will ever there be justice for doctors?


Court’ s decisions, delivered with retrospective analysis and wisdom of hindsight puts the doctors  in  disadvantageous position, who have to decide  in the circumstances of  future uncertainties of diseases. Patients  will   always be unhappy due to disease and tend to blame the doctor. Doctors can bear  with the level of understanding of patients, ignorance of patients towards medical science, but it is  hard to digest the court’s  judgments of these types. Every drug, howsoever innocuous it may be, has different reaction in different humans. It is impossible to predict which patient will  have allergic or idiosyncratic reactions.

Here a neurologist has been punished because of rare side effect of the drug, which can happen to any one and with any drug.  If content of the newspaper are correct and this is the judgement, it is really unfortunate for the doctor and medical community as a whole.

So if doctors are being punished for uncertainity of medical science and there is  ignorance of courts towards the same, it will become impossible  for doctors to work.  It seems that in future it will be difficult to treat even a single patient because patients, courts and everyone either  do not accept genuine and routine complications of the disease or the outcome and  blame  the doctors  knowingly.

These kind of  judgments  are setting up   precedent for cases of negligence against medical professionals, for no fault of theirs. Thereby instilling a sense of fear in the minds of doctors, besides decreasing the faith in judiciary as well. Doctors are helping everyone, but getting zero justice themselves from all quarters including courts, have made medical professionals  sitting ducks  for harassment  by all possible means.

Now the neurologist will spend more money on lawyers in defending himself. He will waste his time in courts rather than treating patients. Above all, damage to his professional soul and morale of medical professionals as a community will get a jolt. Even if wisdom prevails and higher court does the justice later, the irreparable damage is already  done to medical profession.

The atmosphere of falsely created vigilantism is pervading everywhere against doctors, with the result that wisdom, judgment, intellectual debate, and basic common sense is being abandoned for the sake of populist judgments. The perception thus created against doctors by media and celebrities has done immense damage to profession, resulting in bringing the doctors  to their knees. Whether there is any substance to the allegations, unfortunately, does not seem to matter.

If doctors are going to be penalized despite  doing their job correctly, then God save the people and medics. If this is the  justice imparted to doctors, good doctors will choose for safer options. As society is unable or unwilling to do justice to doctors, should it expect good doctors to treat their patients? Or actually does the society deserves to have good doctors?

 

NMC bill, Medical crosspathy and antibiotic resistance : recipe for potential global catastrophe


   Genesis of a system, where every body will suffer and no one is beneficiary.  There has been lot of debates going on  about the Government willingness to allow crosspathy. There has been indications in newspapers about possibility of government  allowing Ayurvedic,  homeopathic and Unani medicine graduates and others  to practice modern allopathic medicines.  Most importantly which medications will be allowed to be practiced? Will  thousands of alternate medicine graduate will dispense all antibiotics,  anticancer , anti diabetic , cardiac medications. It is hard to think about hundreds of potentially dangerous medicines being given without structured training and  proper exams in this system of crosspathy. No one is bothered about the fact that every allopathic medicine is a potential hazardous chemical, if not used properly.

              It will be done through some bridge course. The structure and effectiveness of the said course is yet to be knowm. Whether it will be of 3 days or 3 months?  Who will be able to do it ? whether some level of efficiency  will be expected or every body will be allowed to just dispense allopathic medicine. What ever some one may argue, bridge courses can not be substitute to proper training for these complex diseases and drugs. Following may be side effects of dilution  of medical education and crosspathy:

  1. Alternative or ayurvedic medicine systems themselves: detrimental to these systems themselves because of many reasons. If  the  ayurvedic doctors   start allopathic practice, how we expect ayurvedic stream to florish and respected. It will be diluted to no end. After few years no one will be left will ayurvedic practice.  In my opinion it is a death sentence to ayurvedic system.

       Secondly,  the decision is not respectful to ayurvedic stream itself. Stream of                Ayurveda will suffer.

  1.  Public and patients: crosspathy clearly means a diluted and suboptimal medical services. Government may create few area of need and implement the scheme in selected areas, and selected simple drugs.
  2. Allopathy will be clearly a sufferer. If every body can practice allopathic medicine, why one should go for rigorous training. It will discourage the people who have opted and got admission to allopathic courses. They are paying and slogging hard for their training.
  3.  Dangerous to human race and potential global catastrophe:  All  allopathic medicines are hazardous chemicals in inexperienced hands. But  incorrect and massive use of antibiotics will  cause antibiotic resistance, which has global ramifications. From this angle, it is a retrograde step. When  all over the world,  need is being  felt that there has to be better control of antibiotic prescription.  We are entering an era, where antibiotics are getting useless and more so because of rampant misuse of antibiotics.  Rather than exercising a better control, it can be a catastrophic to human race world over by causing antibiotic resistance.
  4. have our public and people given consent for such diluted medical  excellence and services? It is  public  ultimately who  accepts  a decision for suboptimal medical service. Government may create few area of need and implement the scheme in selected areas, and selected simple drugs. But that also has not been planned.

 

25 factors -Medical treatment costs becoming expensive: are doctors responsible?


Although doctors are blamed for expensive medical treatment, but the real cause  is the aberrant evolution of medicine and medical education to almost an industrial model. There has been tremendous rise in health care  expenses in last few decades and it is usually borne by the government, taxpayer, insurance or patient himself. Discontent is all the more if patients  are unable to bear these expenses and if the results are not as per  expectations ( realistic or unrealistic).

Following features have led to increasing dependence on investors in medical field which then has to run along the lines of an industry to ensure its financial viability-

1.Newer technology and  rapid advances in newer innovations in medical fields  for improvement in diagnostic and newer treatment modalities. If a hospital or doctor does not upgrade, it will be regarded as  having obsolete technology.  Most of these medical technologies  are extremely expensive and owned and marketed  by big multinational companies who  sell them.

Since cost involved is very high, there can be various types of deals involved between  middlemen  involved in selling and buying these equipments and technologies. Doctors  are the  end users of these technologies, but  not part of business process. They are actually the consumers and users  for  these technologies.

2.Expensive real estate:  A self made doctor at the start  or even during his life time, does not have the kind of finances  to build  a hospital which needs a large parcel of land with commercial location. Therefore there  is a need for big investment or investor to pitch in and invest funds.  And if they invest, obviously they would look for some returns.

3.Equipping the Hospital: Building of hospital with the  infrastructure  and equipping it well needs lot of money and investment which only an investor can provide. Same is true for maintenance of equipment, bills,  insurances, AMC  etc.

4.Staffing of Hospital: A hospital needs lot of skilled human resources, health care being a highly labour intensive industry.  Doctors , nurses,  technicians, para medical, administrative and clerical staff is required.  Employment of non medical  in hospital industry too has been increasing because of various regulatory requirements and complex processes other than just treating patients.

5.High regulatory requirements:  globally the requirements of regulatory authorities have been sky rocketing and it requires  a lot of manpower to maintain such data. Getting accreditation etc are  processes which requires manpower, time, and a legal team. All these legal  requirements are expensive.

6.Consumer protection act:  This single important factor can increase the cost of  healthcare for the patient. As doctors are increasingly scared of being dragged to court, they are always on backfoot and are forced  to do defensive practice. Investigations are required for documentation. Patient and courts will ask for proof and goes by documentation.  Medical problems are very complex and  sometimes it is difficult to judge  the future course of disease or decisions for surgery, or how patient will behave before or after surgery. A doctor, thus, will always try to play safe legally  in present scenarios. Because everything he does will be scrutinized later, with retrospective wisdom,  by courts. And   since doctors manage  so many patients everyday, they never know which one will harass and deceive them  later.  Mistrust has increased to such an  extent that patient relatives do not understand even if things are told in good faith and in patient’s interest.  Summarily doctors have to safeguard themselves from treatment as well as legal and  documentation hassles.

7.Expensive legal services:  Every 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  benefitted 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. Strangely  doctor’s fee are quite low but lawyers charges them astronomical amounts, which are beyond any logic.

8.Increased expectation of patients : People want exceptional care, best in the world with best technology,  that also at a price less than  even a meal in restaurant, and then they want a quick relief!!  This is an expectation almost impossible to fulfil. Even government hospitals, which are funded by taxayer’s money find it difficult to provide free treatment with quality.

9.Large claims given by courts:  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. Doctors have no protection from these nuisanse. All these factors further enhance insecurity in doctor’s mind.

  1. Expensive and time consuming Medical education, on sale: Although an open secret , as reported routinely in news, medical seats are big business. Each private medical college seat sells for huge money. Such doctors, who have purchased seats have already  behaved as investors. Once these  doctors are in practice, they will try to  recover the investment. This can obviously push up the health care costs not to mention vitiation of the medical fraternity.

11.Requirement for maintaining huge data and audits:  to maintain standards, to have accreditions, for medicolegal issues , large data storage, audits and surveillance is required. These systems also need  new systems and manpower.

12.Employment of large numbers of  non-medical personnel:  earlier management work was handled by doctors. All senior doctors were given small and differnet  departments of  administrative work at very little  or no extra cost. But now for all these works separate administrators  are appointed. Now a days ratio of doctors to nondoctors is higher as compared to previous years. Increased regulatory and  and insurance system needs more non- medical staff.

But  productivity of hospital still remains by  doctor-patient interaction.  This change in arrangement in Hospitals has caused  increase in costs and hence pushed the health care  expenses. Advantages and disadvangages of these changes  in arrangement will be known  with time in future.

13.Non regulation of  businesses  associated with large health care industry: for example pharma industry,  suppliers , biomedical, equipments, consumables. Such individuals,  although play important part in medicine, cost, sale and purchase, but are largely  unregulated. Unlike doctors, who are regulated by multiple governing bodies. But doctors are  often perceived  as culprits for these costs escalation.

 

14.Increasing extinction of Single doctor and  small setups: for them it will be difficult to keep pace with newer technology and buying expansive equipments. It will be difficult  for them to manage requirements of new medical system, legal problems . At the most they will continue to provide cheap medical services,  but for only common and simple ailments. It will be difficult to manage serious patients and sick and complex patients in view of high public expectations . These set ups are under severe security threat and pressure because of non – acceptance of even genuinine complications of treatment.  As legal requirements increase,  these systems will become unviable and option of common public for cheaper, friendly services may become extinct. So it will decrease  the  easy and  sometimes last option of  doctors to settle with a small set up. Chances of them to work for investors  and insurance companies will increase, and they will be cheap labour for industry.

15.Medical and health Insurance becoming indispensible:  Insurance companies are every where.  They sell policies to patients , as well as doctors.  In fact, they are  positioned between doctor and patients. They make money from both sides. Obviously more expensive the treatment, more dependence on insurance. Therefore a cycle has been set up.  Increase in  insurance cost  will push health care  more expensive and a vicious cycle is set up. One should not be surprised, if in future treatment to a large extent will be dictated by insurance companies.

 

16.Conversion to a industry:

Because of above reasons Medical and health care has become an industry and needs investors. So as it is business proposition. Funded by investors and run on commercial principles, the  doctors are being slowly reduced to  skilled labour, alienated from the core.

  1. Aging, multiple diseases : as life expectancy is increasing, it is leading to multiple diseases and more complex diseases  and new expensive treatments.  In this changed scenario and  all people  want to prolong life as much as possible. Cost of prolonging life with multiple problems is quite high. It consumes more medication and resouces and hence consequently pushes up the cost of medical treatment.

18.Evolution of complex infections:

    Advent of antibiotics   and germ theory was thought to be game changer in medical history. But because bacteria proved to be smarter than humans and acquired resistant. New and expensive antibiotics have been gradually being rendered useless. Need for more antibiotics is causing treatment to be costlier.

 

19.Evolution  of  advanced treatment:  Invention  of Expensive and new diagnostic techniques along with highly technical treatments by industry is not without added cost.  Although it may be useful in certain patients, but how much it will help overall in masses, for general treatment, as it increases the  cost of overall treatment.

20.Increasing  need for heightened security:  It is not uncommon to have mobs causing physical harms to medical workers  and  damaging hospital properties. These incidents have caused increased need for security for the premises and adding to the cost.

 21.Complex interplay of various industries eg pharma industry and consumable industry:  large  number of consumables pharmaceuticals, sutures,  surgical instruments, IT industry, drugs, implants, medical supplies are required.  These industries supply their items on a price commanded by them and there is complex interplay  of various industries.

  1. Non uniform and variable care and cost:  each city has multiple hospitals. Care and cost varies in  every set up. Even all government set ups are  not uniform in facilities and cost. Private setups  vary in cost and care, to the extent of  maximum possible variations. All this non-uniformity has created confusion in the mind of patients and variation in financial issues.
  2. Poor public health care facilities: due to less expenditure on health care, government health care facilities have been under developed.  Less  investment by government has given way to private health care to flourish.

24: Conversion to a industry model  and entry of Investor: all the above investments are very expensive. Doctors usually do not have that much money to invest. Therefore   Investors and financers  have become indispensible part of health.   once investor invests money, it will be driven on business principles.

 

  1. Future course: I do not see in future that this arrangement is going to change , rather it will be strengthened more and more and quality care will become more costly. Doctors will  be totally  alienated  from financial  and business aspect, because industry will  not be sustainable without an investor.

 

As we look at reasons above, Doctors are no where in the financial picture and  to be blamed for increase in overall health cost.  But since only doctors are visible part of industry, who treat and interact with patients, often they are blamed for  the cost. They have actually being alienated from financial aspect, barring small percentage of doctors, who are financially literate. Consequently, the doctors who will be unable to entrench themselves in the business milieu will be unfit  in future and hence extinct.

Hammurabi’s medical regulation code (1750 BC): Noble profession has always been regulated cruelly ?


Children are always taught in school that medical profession is a noble one. But they are never told, about the cruelty this profession has faced since ancient times. the ancient rulers always blamed the physician for the poor patient outcome and also made regulations to regulate medical profession, and this was when the medical science was not even developed enough to deal with most diseases.

A great military commander, Hammurabi consolidated small states in the vicinity after ascending to the throne on the death of his father. Sometime around 1780-50 B.C., the Babylonian king Hammurabi promulgated the now famous  Code of Hammurabi, covering both civil and criminal law.

Hammurabi’s Code of Laws was considered the first documented Code ever used by human civilization in Mesopotamia, the cradle of civilization, the land of Assyro-Babylonian culture. This era first saw the interface between medicine and law in the dawn of civilization.

Among the 282 laws in Hammurabi’s Code, nine (215-223) pertain to medical practice:

 

HAMMURABI’S CODE OF LAWS :

  1. If a physician performs eye surgery and saves the eye, he shall receive ten shekels in money.
  2. If the patient be a freed man, he receives five shekels.
  3. If he be the slave of some one, his owner shall give the physician two shekels.
  4. If a physician performs an operation and kills someone or cuts out his eye, the doctor’s hands shall be cut off.
  5. If a physician performs an operation on the slave of a freed man and kills him, the doctor shall replace the slave with another slave.
  6. If he had opened a tumor with the operating knife, and put out his eye, he shall pay half his value.
  7. If a physician heal the broken bone or diseased soft part of a man, the patient shall pay the physician five shekels in money.
  8. If he were a freed man he shall pay three shekels.
  9. If he were a slave his owner shall pay the physician two shekels.

 

As we can see, it did  not take into account  the earlier works or contribution of doctors to society. It also did not take into account the  uncertainty of medical science and uncertainties of the outcome.  The regulatory system was based on  principle of revenge and punishments.

Deselection of providers: Hammurabi’s Codex specified the harshest form of deselection possible. If the physician erred through omission or commission, his fingers or hands were cut off, immediately stopping his practice. This severe punishment for negligence supposedly weeded out physicians incapable of delivering adequate care. In addition, it prevented these physicians from practicing in a different locality. Obviously, such a penalty discouraged a physician surplus.

Since ancient civilization, medical regulation has been always cruel to doctors.   Hammurabi at the start of civilization believed that doctors needed to be punished in case there was poor prognosis. He failed to understand the complexity of human body and the limitations of medical profession.

Today our system  is becoming somewhat  similar, to those ancient regulations in  terms of punishment and revenge. Differential payment system for health care also resembles the Code of Hammurabi in some respects.And this is despite the fact that now we are very well conversant with the workings of the human body and despite cognizance of the poor prognosis in certain disease states.

In an effort to institute managed healthcare, our society is in a way re-entering the realm of an ancient medical care system. 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.

 

 

https://en.wikipedia.org/wiki/Code_of_Hammurabi

Code of Hammurabi. (2017, December 18). In Wikipedia, The Free Encyclopedia. Retrieved 16:58, December 23, 2017, from https://en.wikipedia.org/w/index.php?title=Code_of_Hammurabi&oldid=816023447

 

 

Doctor’s predicament: How to treat prejudiced minds of patients?


            “Medical negligence” is the word in the air. Routine complications of treatment, poor prognosis of severe diseases and death of sick patients are blown out of proportion and projected as negligence of doctors. All these insinuations are creating fear in the minds of gullible masses, who do not have any idea about the complexity of medical profession and treatment of diseases.

       Thing have become so difficult that it will become difficult to treat even simple diseases in future. Non acceptance of natural progression of disease or genuine complications of surgeries by a patients has created fear among doctors. This is due to vicious campaign by media and has done irreversible damage to   doctor patient relationship.

 

   Instead of trying to improve the health care system as a whole, focus has settled on blaming the doctor only. Less number of doctors, poor health care system and insufficient resources are nowhere in focus.

   Being a doctor is a tough journey. Nature of work that provides relief to human beings, while sacrificing his own personal life should be respected by civilized society. But sadly, doctors are projected in a bad light  due to vicious campaign by media and celebrities.  The due respect and appreciation is sadly lacking. This kind of malicious allegation against a profession community has created a sense of mistrust against the doctors in the mind of patients. Situation has become so bad that a patient, while interacting with his doctor, is not trusting the correct advice and decisions taken by a doctor in good faith.  Patient will question the advice and most of the time delay his own treatment. Not uncommonly the treatment is delayed and crucial time is wasted for unnecessary reasons.   

    Hostile environment, risk to doctor himself, unrealistic expectations of society, retrospective analysis, physical and verbal assaults, medical industry and medico–legal issues have created a complex environment for doctors.   

           Although doctors have learnt to live with this pain of mistrust thrust upon them and they are suffering. But it does not require an Einstein brain to anticipate that who will be suffering ultimately due to this kind of  mistrust.  Society seems to be going to self  destructive mode. At present, doctors and patients both are sufferers. May be media and celebrities will earn some money and fame by creating and propagating this mistrust.

 

 

 

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