Fish Bile ‘Treatment’ Lands Woman in Hospital- Folly of Fringe Theories in medicine


    It has become a common practice to advertise health products or therapies that claim to be panacea for all ailments enhance immunity, to increase power and health by creating an impression on minds on various platforms. Instead of producing scientific evidence, such products and therapies are sold under disguise of natural therapies or alternate medicines. Needless to say, the objective evidence or global neutral trial for the claimed efficacy or about real side effects is always missing.

    Companies have created huge fortunes based on circulation of such pedagogic narratives and social knowledge. But in real sense, these are actually chemical and have biological actions and reactions. Chemical derived from natural sources can have side effects and contain impurities.  Global neutral trials to validate effects and side effects remain an urgent need of the hour for all health products.

   Suffering for the common public is immense. Doctors’  sincere warning had no effect rather they were called as medicine mafia.   Unfortunately  false beliefs  like local religious figures can cure cancer and kidney diseases  cause they could communicate with invisible spirits  and gain knowledge. Unsurprisingly the cranks  have been  wrong and innocent patients suffer.   Doctors objecting to  elevation of  crank theories were painted as  western medicine agents,  or nattering nabobs of negativity.

 Here is an example of the folly of following fringe  theories.

Fish bile ‘treatment’ lands woman in hospital

Fish bile ‘treatment’ lands woman in hospital

 A 52-year-old homemaker from Dum Dum had to undergo a few rounds of dialysis and was put under intense critical care for a renal failure, triggered by ‘fish bile poisoning’. The patient had ingested raw fish bile for four consecutive days as a treatment to cure her diabetes prior to being rushed to Manipal Hospitals Kolkata with acute abdominal pain. Doctors at the Salt Lake hospital found the patient had low blood pressure and was in a state of shock. Initial reports showed a significant derangement of liver and kidney functions. It led doctors to treat common causes of liver and kidney injuries or drug induced organ damage. When further tests didn’t match with these diagnoses, the team started looking for a possible cause. The patient then revealed she had ingested bile of Rohu fish for four days to control her diabetes. “Consuming fish bile causes acute kidney and liver injury with the need to go for long term dialysis. This patient had to be put under dialysis within 72 hours of admission,” said internal medicine and critical care consultant. She was discharged from hospital after a month.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

Doctors in Israel Protest Violence against Medics


          Violence against doctors has become a serious issue in India. But problem is a global one to some extent. The underlying basic  reason for the omnipresent malaise is the altered doctor-patient equation globally and growing mistrust in the saviours. The mistrust is propagated by opportunist medical industry, media and law industry for their selfish motives as doctors are shown as front men for the failures.  Poor outcomes are projected because of medical errors and mistakes. Every death is thought to be because of negligence rather than a natural complication of the disease.  Because of the instigation and poor law enforcement in favour of doctors, the response of  lay public to these unfortunate incidents has become extremely erratic and out of proportion. As Governments remain more or less indifferent, and doctors have become punching bags for inept health systems.  Law industry has been enormously benefited financially due to medico-legal cases against doctors. Media has sold their news items not by good ground work, but by sensationalizing and mischaracterizing the real basic issues, airing one single incident as generalizations.  An atmosphere of mistrust has been generated against medical profession. Administrators and Industry have put themselves on higher pedestrian by selectively projecting the genuine failures and mistakes of doctors.  Local goons have blackmailed doctors over genuine complications and the natural deaths occurring in hospitals.    There is a little token action by police after routine incident of violence against doctors.

  Consequently violence (legal, verbal or physical) against doctor has acquired an epidemic proportion, omnipresent world-wide. As a result, medical business has thrived whereas medical profession is suffocated and art of medicine has been dying a slow gradual death.

   But in Israel, doctors seem to be united against this menace and their associations are actively pursuing the issue.

          Doctors in Israel to Protest Violence against Medics 

The strike was called after family members of a patient who died at a Jerusalem hospital on Monday attacked medical staff and caused significant damage to the intensive care unit after they were informed of his death.

The union said the hospitals and clinics would operate on a weekend schedule for 24 hours on Thursday, offering reduced services.

 

 

Union calls for attacks on medical staff to be treated as severely as attacks on police; action comes after patient’s relatives ran amok in Jerusalem hospital

Staff at public hospitals and clinics will strike on Thursday to protest violence against medics, the doctor’s union announced Tuesday.

The Israel Medical Association, announcing the strike, called for a police presence in every emergency room, and said hospitals and community clinics needed improved security systems. The association also urged a change in legislation so that an attack on medical staff would be viewed with the same severity as an attack on a uniformed police officer. The chairman of the Israel Medical Association, Prof. Zion Hagay, said that Thursday’s strike would be just the start of action taken by the medical establishment if changes were not made to protect workers.

“We have long announced that we will not accept any more incidents of violence in the health system, and it has unfortunately become a real epidemic,” Hagay said at the start of the association’s meeting on Tuesday evening. “The lives of doctors must not be abandoned, and this initial strike is only a warning.”

“As long as the Israeli government does not immediately take the necessary steps to increase the personal security of medical staff, we will not hesitate to increase  it.There has been no announcement from the nurses’ union on whether they will be joining the strike.

The strike comes in the wake of violence at the Hadassah Medical Center in Jerusalem after a patient died there on Monday.

An initial investigation found the patient died after taking an overdose, police said, without giving further details.

Relatives of the man arrived at the hospital and were notified of the patient’s death.

After they were given the news, a number of the patient’s relatives broke doors and windows in the unit, damaged the nurse’s station, computers, and equipment, and attacked staff. Two members of staff were lightly injured, requiring medical treatment.

Police said they arrested an East Jerusalem resident in his twenties on suspicion of being involved in the violent clash at the medical center.

Recent months have seen an increased wave of attacks against medical teams and facilities across the country.

In November, nurses at Haifa’s Rambam Medical Center held a strike for several hours in protest of a violent incident in which staff members were beaten and threatened by the family of a dying cancer patient.

Earlier the same month Rambam said it had to forcibly remove dozens of people who gathered outside the facility after a victim of violence was brought there for treatment. According to hospital officials, riot police were called to the scene to prevent the crowd from entering the hospital.

And in Beersheba, four people were hurt and 19 were arrested in a massive brawl outside Soroka Medical Center that included gunfire.

In 2017, in one of the most severe cases in recent years, a man burned 55-year-old nurse Tova Kararo to death at the Holon clinic at which she worked.

Nurses already held multiple strikes this year and last year over severe staff shortages during Covid, which resulted in additional state funding. 

A doctor and three nurses at Rambam Medical Center in Haifa were assaulted last month by relatives of a cancer patient. Staff were beaten and threatened by the family of the patient, who eventually died, The Times of Israel reported.

Chairwoman of the National Association of Nurses, Ilana Cohen, said at the time that if the government did not take action to fight such violence, “we’ll hold a strike throughout the entire health care system.”

“War has broken out here,” Benny Keller, the head of Rambam’s security, told the Kan public broadcaster Wednesday, according to The Times of Israel

“Two or three times a week, the hospital turns into a battlefield between warring clans.”

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

CJI Ramana’s Concern about Violence against Doctors: too Mild a Remedy, Need Concrete Action


            

            While violence against doctors should be a concern to everyone, more so for the public, but sadly everyone in society has preferred to take advantage and reap benefit of the situation at the cost of doctors. Government has remained more or less indifferent, whereas people don’t have minimum basic health amenities and doctors have become punching bags for inept health system.  Law industry has been enormously benefited financially due to medico-legal cases against doctors. Media and celebrities have sold their shows and news items not by good ground work, but by sensationalizing and mischaracterizing the real basic issues, airing one single incident as generalizations.  An atmosphere of mistrust has been generated against medical profession. Administrators and Industry have put themselves on higher pedestrian by selectively projecting the genuine failures and mistakes of doctors.  Local goons have blackmailed doctors over genuine complications and the natural deaths occurring in hospitals.  There is a little token action by police after routine incident of violence against doctors. Consequently medical business has thrived whereas medical profession is suffocated and art of medicine has been dying a slow gradual death.  Actually public needs to be concerned as the society itself is going to suffer in the long run,  not realizing  that people themselves are responsible for their health problems and not the doctors. 

     At this stage, Chief Justice of India N V Ramana on Saturday expressed serious concern over rising violence against upright and hardworking doctors and lodging of false cases against them.  The show of concern is nice gesture, as problem is clearly evident to all, but merely  expressing a concern at this stage is too mild a remedy.  When cancer is in late stages and  needs a radical surgery,  applying an ointment will not work.

Rising violence against doctors saddening, they deserve better: CJI Ramana            

Rising violence against doctors saddening, they deserve better: CJI Ramana

Chief Justice of India N V Ramana on Saturday expressed serious concern over rising violence against upright and hardworking doctors and lodging of false cases against them. The CJI said that he would also like to pay his tribute to the unending spirit of doctors, who work tirelessly round the clock for their patients. Doctors are mentors, guides, friends and counsellors. They should always remain active members of society, and solve problems faced by the people,” he said. The CJI said, “I am extremely saddened to witness rising violence against doctors. Several false cases are being lodged against upright and hardworking doctors. They need a better, and more secure, working environment.  This is where professional medical associations assume great significance. They have to be proactive in highlighting the demands of doctors.”  The CJI also expressed concern about the healthcare system in India and said that more than 70 per cent of the population resides in rural areas where people don’t have minimum basic amenities, forget about the comfort of corporate hospitals.

“Even Primary Health Centres (PHC) are also not properly equipped, if there is a PHC there are no doctors and if there is a doctor, there is no PHC. If both are there, there is no infrastructure. This is the situation in this country and in this scenario this type of affordable technique of detecting cancer through ultrasound at the preliminary stage is very helpful,” the CJI said.

Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

A comparison of imparting Justice Vs Health: Grave injustice to medical professionals


        Justice is needed for satisfaction of soul and peaceful mind, is of same importance what is to the health of body. Justice delayed gives a sense of hurt and pain to soul. Pendency in courts simply reflects the grave injustice people are living with.

 Pendency in courts casts a ‘pall of gloom’, presents a hopeless situation: AG

          Justice and Health- Both are crucial for happiness of the living beings as well as society as a whole.  Hospitals are full of patients and so are courts with litigants. None of the people go to hospital and courts happily and everyone invariably wants early relief.

   Compare the situation in courts with a hospital.  Once a patient visits hospital, he will be treated almost instantaneously; irrespective how many patients’ doctors might have to examine in a day or night. There is almost nil pendency in hospitals, be it day or night, emergency or routine cases.

     Now can we expect similar treatment at courts? Do the people visiting courts are imparted justice in real sense.  Doctors get few minutes to decide. Most of the time, for the investigations and the treatment few visits are required. But there is no pendency. In Government hospitals, even appointments are not given. A doctor sitting in outdoor will see hundreds of patients. On emergencies night duties, doctor will not be able to count how many he/she has stabilized or numbers treated.

      Even in such chaotic systems, doctor can be punished, dragged to courts or assaulted for unintentional mistakes, that are  almost always secondary to load of patients or inept infrastructure.

     The work at hospital continues day and night, 24 hours and 365 days, despite almost always lesser number of doctors and required manpower. Systems in hospitals  are designed and maintained meticulously   to have no pendency what-so-ever situation is.   Larger number of patients go back home treated well and very few unfortunate patients are unable to recover, but still whatever is required- is done invariably.

Pendency in courts casts a ‘pall of gloom’ , presents a hopeless situation: AG

NEW DELHI: India’s top law officer K K Venugopal on Friday said litigants’ fundamental right to speedy justice lay in tatters and implored country’s top judges to take drastic measures to arrest their waning confidence in justice delivery system caused by monstrous pendency of 4.8 crores cases, many for decades. When we look at the pendency, a pall of gloom settles. We find that we are in a hopeless situation,” Venugopal said, “How has the justice delivery system deteriorated to this extent? If you look at the pendency over the years, we realise that over a lakh of cases are pending for more than 30 years at trial court level and 10-15 years in HCs. How do you believe that so far as litigants are concerned they would have confidence in the justice delivery system?” “But against whom the poor litigant can complain, or an under trial who is incarcerated for a number of years which he would have undergone had he been convicted and punished? Do they file a case for enforcement of their fundamental right? But against whom?

44 million pending court cases: How did we get here?

       There are about 73,000 cases pending before the Supreme Court and about 44 million in all the courts of India, up 19% since last year.

According to a 2018 Niti Aayog strategy paper, at the then-prevailing rate of disposal of cases in our courts, it would take more than 324 years to clear the backlog.

Grave injustice for medical professions:

  1.  A doctor making wrong diagnosis (gets few minutes to decide) can be prosecuted, but courts giving wrong verdicts (get years to decide) are immune?

     2. Compare the remuneration of lawyers to doctors. Doctors gets few hundreds to save a life (often with abuses) and lawyers can get paid in millions (happily).

      3. Doctors treat the body and larger is still not fully known about mechanisms. Still doctors can be blamed for unanticipated events. Whereas  law is a completely known and written subject.

   4. If health is citizen’s right so should be a timely justice.

         Despite doing so much for patients, still people’s behaviour to doctors and hospitals is not respectful. Doctors are punished for slight delays and people and courts remain intolerant to unintentional mistakes. But people can’t behave in the same manner to courts and legal system and keep on tolerating the blatant injustice for years. 

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

   

The Book-‘At the Horizon of Life & Death’:Blackmail of Doctors by opportunist goons, legal industry, Vulture Journalism


      While doctors are usually blamed for any mishap, be it natural poor prognosis or genuine complications, rarely people get to know their side of the story — how a dying patient affects their psyche, how they deal with these patients and their kith and kin, what are the kinds of abuse and threats made when they are not able to save a life despite their best efforts.  Book describes stories the blackmail doctors face from opportunist goons, legal industry and vulture kind of journalism. Every day blackmail by legal industry, journalist and local goons, similar to what Dr Archana Sharma went through and others doctors are  facing have been described.

         Dr Pankaj Kumar, Director Critical Care at a Delhi Hospital, India has come out with an insightful account of these very aspects of a doctor’s life.

    The 300-page book (English) contains 20 stories divided into three parts viz – Larva & Pupa Syndrome, Hope & Fear & Medical Lawsuits. The book is available worldwide on Kindle Amazon, Apple, Barnes & Noble, Tolino, Kobo, Scibd, BorrowBox, Baker & Taylor , Vivilo, Overdrive  etc.

         His book ‘At the Horizon of Life & Death’ is a Reality Fiction that reflects the sensitivity involved in dealing with patients facing death.

     Through the eyes of its protagonist Dr Anand, the book captures significant moments in the treatment trajectory of critical patients. The book tries to create awareness regarding pertinent issues faced by the medical professionals like demoralisation, expensive medical education, the extreme pressure and suicidal ideation, the plight of the nurses and support staff, assaults and violence and the medico-legal intricacies involved in day-to-day practice among others. The author has also taken care to guide aspiring doctors to make well-informed career decisions.

     Part One (Larva & Pupa Syndrome)-  talks about the expensive medical education, and the issues students face in medical college.

    Part Two (Hope & Fears) talks about the beginning of doctors’ professional journey, the disease demons they face while dealing with critical patients, dilemmas of doctors and patients near death situations.

    Part Three (Medical Lawsuits) is about how doctors are always working under the threat of medico-legal lawsuits.

        While stories are fictional, the scenarios and the problems in them are very real — things that he faced or saw his colleagues facing.

     Medical profession has become victim of mistrust generation and blame culture. Everyone keeps harping about the few black sheep in the community, while larger good work of doctors is not highlighted enough.

    The stories span from Dr Anand’s initial days in the emergency room and capture his struggles in complex medico-legal scenarios over the next four decades. This book is an effort to bring back focus on the treatment of the patient as opposed to the mistrust, legal frameworks and policies surrounding the healthcare practice.

Suicide by Dr Archana Sharma has exposed the blackmail; medical professionals are going through in current era. Doctors have become sitting ducks for punishments complaints, blackmail, and legal complexities besides every day harassment. Negligent police, indifference of Government and venomous media has made it impossible for health care workers to work in a peaceful environment.  It may not be a good idea to opt for a medical career any more.

More naïve would be to pay millions to be a doctor.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

Unjustified Profiteering in Medical Education Pushing Indian Students to Ukraine


       The ongoing Russia- Ukraine conflict has generated a discussion about a sub-plot, which links to India’s medical education.  There have been reports that there are 18000 Indian medical students in Ukraine. People are wondering why Medical Students from India need to go to Ukraine for studying medicine. Answer is quite simple and does not need an Einstein Brain.  It is the steep fee that private medical colleges charge from students which is unjustified and beyond any logic. It just needs a sincere ‘Government Will’ to implement the justified fee for MBBS seats in private medical colleges in India. Medical colleges in Ukraine, Georgia, Kyrgyzstan, Bangladesh, Philippines and China have been benefitted because of the severe exploitation of medical students in India.

      It needs a sincere and honest assessment of the fee and expenditure of medical college and education rather than a permission for heavy profiteering. If honest calculations are carried out, the fee should not be more than one fifth of present rates, taking into account the hospital services expenditure.

What draws med students to Ukraine? Affordability

What draws med students to Ukraine? Affordability – Times of India

Why do Indian students go to Ukraine to pursue courses, especially MBBS? Because of affordability, says Manjula Naidu, proprietor of a firm that helps send students to Ukraine’s Bukovinian State Medical University. Usha Rani, an Anekal resident whose son is in first-year MBBS at Zaporizhzhia State Medical University, said she wouldn’t have sent him to Ukraine had she been able to pay nearly Rs 80 lakh for an MBBS course in Karnataka. Though Karnataka has more than 9,000 MBBS seats, government quota seats account for not even 40%, forcing many aspirants to opt for countries like Ukraine, Georgia and Kyrgyzstan. What students and their parents find attractive is the Rs 25-30 lakh package for the entire course. Besides there are consulting agencies to help them with loans and the medium of instruction is English.  On the other hand, the first fee slab for an MBBS seat in a government college is Rs 59,000 per year, followed by the second slab of government quota seats in private colleges (Rs 1.4 lakh per annum). The next fee slab is of private seats (management quota) in private colleges that varies from Rs 10 lakh to Rs 25 lakh a year. Even more expensive are the NRI quota seats and those in deemed universities.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

     REEL Heroes Vs Real Heroes

     21 occupational risks to doctors and nurses

     Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

Medical Consumer Protection Act: A Loss making deal for patients too?


       With the evolving medical science and health care getting intertwined with business, braided changes in medical regulation and law are not an unexpected development. New models of medical regulation, business and law in health care have emerged and progressed in last few decades.  Despite a wish to govern and regulate medical profession strictly, the laws and regulations still have to go a long way to provide real justice to everyone.   No one really knows how to regulate this difficult area,  which encompasses life and death, deals with extremes of poverty and riches, mortality and morbidity, pain and  relief , sadness and happiness, smiles and sorrow and other uncountable emotions, all intertwined with financial aspects.But the wish of administrators to govern medical profession strictly with punishments is not new.  Hammurabi (5000 years back) at the start of civilization believed that doctors needed to be punished in case there was a poor outcome. Strangely it was at a time, when no one understood the complexity of human body and the limitations of medical science; even basic anatomy and physiology of body was not discovered.  

      Considering the limitations of medical science along with uncertainties and complexities of human body, regulation of medical profession and system of punishments still remains somewhat unfair to doctors, even after 5000 years.  It is still based on principles of revenge and retributions rather than developing a robust system by learning from mistakes. By application of an average wisdom, doctors can be easily blamed for poor outcomes, as they are always and universal a common visible link between treatment and poor outcome. 

           One of the examples of easy punishments for doctors is Medical consumer protection act that was implemented in 1995 for medical services. Patients were defined as consumers and hence doctors were converted to service providers in lieu of some money.  Consequently the changed definitions altered the doctor-patient relationship in an irreversible way.   

    The reality is that neither doctors, nor patients are ready for such a legal relationship. More-over   the system is not robust enough for such a change.   To work with weak infrastructure, non-uniform medical education, poor numbers of support staff, inept health system along with legal complexities has pushed doctors into a shell and predisposed them to harassment. 

          Rather than   developing a system to promote   good doctor-patient relationship, Medical Consumer Protection Act has created a situation of ‘us versus them syndrome’. It caused erosion of doctor-patient relationship and escalated cost of care.   Propagation of stray and occasional incidents about negligence case in court or their outcomes are given disproportionate wide publicity in media. The patients are unable to understand the correct application of such stray incidents to themselves. Such cases may be frivolous,  just one in million or a rarity, but people always try to imagine themselves being in the hospital chaos due to the   scenario projected.  It gives a negative projection about medical services and enhances patients’ fear to seek treatment at right time.

    There is a growing mutual mistrust; doctors too have started looking at every patient as a potential litigant. Especially while dealing with very sick ones, practice of defensive medicine is a natural consequence. This may manifest as excessive investigations, more use of drugs, antibiotics and even reluctance or refusal to treat very sick patients. 

    With the mandate to practise evidence based medicine, doctors need to document everything and to offer everything possible, leading to skyrocketing medical costs.  To save themselves, doctors have to do mammoth paper work, leading to consumption of time that was meant for real deliberations for the benefit of patients.

           Consequently insurance companies, medical industry and lawyers have become indispensable and have positioned themselves in between doctor and patients. Besides creating a rift between doctor and patient, they charge heavily from both sides; from patients (medical insurance, lawyer fee) and doctors (indemnity insurance, lawyer’s fee) alike. The vicious cycle of rising costs, need for insurance, medicolegal suits, and high lawyer fee (for patients and doctors) goes on unabated. All these contribute significantly to overall inflated cost of health care.

       Not uncommonly doctors are used as scape goats to have a concession on the patient’s treatment from administrators.  

       Medical consumer protection act has increased the anxiety and insecurity among   medical professionals.   Doctors can be dragged to courts for trivial reasons, for example the sense of revenge, simply for non-satisfaction, to extract money or simply for avoiding paying 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 doctors does not exist. These money-making ideas are further stoked by the much publicized incidents of high compensations granted by courts.

     Medical lawsuits and complaints (right or wrong) are breaking medical professionals from within, not to mention the toll it takes on their confidence and belief, which takes a lifetime to build.

     Whenever there is adverse outcome in any patient, all the doctors involved start looking for whom to blame among themselves. Due to legal pressure they try to pinpoint each other’s mistakes.  Mutual understanding takes 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 among medical professionals.

    The ease with which doctors can be harassed has led to rampant misuse of medical consumer protection act and it has instilled a sense of deep fear and insecurity in the mind of medical professionals. The act has been used as a whip against the  doctors by all, including  medical industry, law industry and administrators.  Only doctors are visible as those who deliver care, so they remain at receiving end for poor outcomes and all these industries remain invisible.    The industry has used the protective systems against medicolegal cases to gain  maximum benefits  out of doctors’ hard work.   

      In court cases, a certain element of doubt always remains in mind of a doctor whether he will get justice in the long run, or will end up being  a victim of sympathy towards patient or clever lawyering.  So taking medical decisions in critical situations is becoming more difficult  in view of the future uncertainty of disease.

             Windfall profits for lawyers is a strong  incentive   for  law industry to promote   instigation  of patients by against doctors .  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 on ‘sharing and commission basis’. There is no dearth of such relatives and lawyers who are ready to try their luck sometimes in vengeance and sometimes for the lure of money received in compensations. 

       Consequently doctors are now an easily punishable human link for poor outcomes.  Medical professionals work with continuous negative publicity, poor infrastructure, and preoccupied negative beliefs of society and burden of mistrust.

  Strangely  Medical Consumer Protection Act applies  only to doctors, that too selectively. All  other professions and services  are   out of it, not even other constituents of health services. Selective application is what is  demoralizing the doctors.  Considering the uncertainty and kind of work done by  medical professionals, actually it should be other way around.Mistakes are always easy to be picked with retrospective analysis and with lawyers pondering over it for years. In such situations, doctors are sitting ducks for any kind of blackmail.

            Nothing else has ever distracted doctors more than medico-legal cases and punishments. In certain circumstances, saving themselves becomes more important than saving a patient. Decision making also becomes difficult  by uncertainty of prognosis,  grave emergencies, split second lifesaving and risky decisions that may later be proved wrong by retrospective analysis with wisdom of hindsight with luxury of time and fault-finding approach.  The possibility of complex medico-legal situations in doctor’s  mind are enough to distract doctors from their primary point of intentions ‘the treatment’.

          Therefore increasingly, financially secure doctors are staying away from the riskier jobs. No wise person will like to face medicolegal complexities in older age. Taken to court for a genuine decision is enough to spoil and tarnish health, wealth and fame that was earned by  slogging  the  entire  life.     

     Patients can have poor outcomes for many reasons. It can be severe disease, poor prognosis, rare or genuine complications or even unintentional mistake or human errors, system errors or deficiency. Whatever court decides,  while consuming years, the harassment of doctor is full and permanent. Even if court decides in favour of the doctor, there is no compensation possible for the sufferings and agony spanning over years.  Therefore, a single mistake can undo all the good work of past, and the illustrious future work that could have been accomplished.

        If the decision to decide or act or help someone in an emergency situation, puts one’s own life and career at risk, why would anyone put himself in that difficult  position?  

         Medical Consumer Protection Act  has become a tool to harass doctors and money making tool for lawyers, medical industry or administrators. But  it would be naïve to assume that by whipping doctors and regulating them in such a harsh manner will be helpful to patients in long run.  The consequent insecurity among doctors, practise of defensive medicine, enhanced costs, excessive documentation and the distraction from the primary point of intention (treatment)  are few of the  side effects, which will  definitely be passed on to the patients inadvertently.  After all doctors have to save themselves as well. As a result,  now the battle of life and death will be fought with less zeal, with subdued and demoralized soldiers.

          Patients are unable to realize their loss for punishing their saviours. For doctors, no rewards if you win, but sword hanging if one loses.  Fear factors on doctors and impact of present legal complexities is already at par with that of Hammurabi’s era. Consequently being consumer may be overall a loss making deal for the patients.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

     REEL Heroes Vs Real Heroes

     21 occupational risks to doctors and nurses

     Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

How to Deal with Online Internet Addiction?


NEW DELHI: Has the Covid-19 pandemic worsened addiction to the internet among children? The footfall at psychiatric out-patient departments in hospitals, especially those offering help to kids hooked to the net, be it for online gaming, chatting with friends or sharing videos, offers a glimpse of the problem. At AIIMS, the number of parents seeking help for their children, among them the most being those addicted to online gaming, has increased significantly after the pandemic. The special clinic was inundated with requests from parents seeking help, nearly 80% of them are related to online gaming, 15% about excessive use of social media and the remaining 5% related to problems like pornography”.

Times of India carries an article about the problem of  increased online addiction  during the pandemic.

The parents of a Class XI student — name withheld on request — approached AIIMS because their son was gaming online for hours, and wasn’t willing to give up the habit. The son even hit his father when the latter tried to take away the laptop. In another case, a Class IX student hooked to online gambling spent Rs 75,000 in a single week on his parent’s credit card.  Children have developed mental and emotional issues due to addiction to online streaming services. The girl would stay awake all night to finish the TV series and sleep during the day. It continued for six to seven months. She developed insomnia and began hallucinating, which is when the parents panicked and brought her to hospital. We had to put her on psychiatric medications and counselling. During the pandemic, however, the problem increased multiple times. The schools were closed and classes were being held online. This increased the children’s access to digital technologies. Secondly, social interactions shifted online due to restricted physical movement forced by Covid.  They Spend more time online led to the addiction. As for online gaming, doctors said these activities were designed to attract young people and were addictive in nature. Online gaming causes the same kind of craving and withdrawal that you see with any other addiction such as substance abuse.

        What is the solution to this?  Internet use is one of the important pillars of learning and growth in today’s time and, therefore, it may not be advisable to prevent school children from using it.  It may be prudent to promote safe usage of the internet. Very importantly, parents should be aware of the warning signs in their children, for example behavioural changes, reduced interaction with family members, children spending most of their time in their rooms, irregular sleeping or eating habits and mood changes that may signal troublesome usage of the technologies. If the habit persists and worsens, it may be advisable to seek expert help. The problem of internet addiction isn’t limited to children belonging to particular social strata, the doctors said. “We need to have more cyber addiction clinics in government hospitals so even those who cannot afford private treatment can seek timely help,” said one senior medico. “It can help prevent serious mental health issues in children and even save lives.” The doctor added that most children suffering from internet addiction improved with behavioural therapy and counselling. It was only in rare cases that medical management became necessary, he added.

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Mother blames & sues social media addiction (Instagram and Snapchat) for   daughter’s suicide


Social media has helped people communicate more and instantly. The use of social media among children has increased tremendously. But without doubt, it has great addictive potential and one such case as mentioned is reflecting just the tip of the iceberg.  The side effects can be manifold, like psychiatric illness, loss of education, disconnection from the reality and loss of time are only a few, which are evident.  

Connecticut mother sues Meta and Snap, alleging they contributed to suicide of 11-year-old daughter who had ‘extreme addiction’ to social media

  • A woman in Connecticut is suing Meta and Snap, alleging their platforms played a role in her 11-year-old’s suicide.
  • Tammy Rodriguez claims her daughter killed herself in July after “struggling with the harmful effects of social media.”

A Connecticut mother is suing Meta, the company formerly known as Facebook, and Snap, alleging their “dangerous and defective social media products” played a role in her 11-year-old daughter’s suicide.

The complaint, filed by Tammy Rodriguez in San Francisco federal court earlier this week, claims Selena Rodriguez suffered from depression, sleep deprivation, eating disorders, and self-harm tied to her use of Instagram and Snapchat.

According to the filing, Selena began using social media roughly two years before her death by suicide in July 2021, during which time she developed “an extreme addiction to Instagram and Snapchat.” The filing also claims the 11-year-old missed school multiple times because of her social media use and that she was asked to send sexually explicit content by male users on both platforms.

Rodriguez wrote in the filing that she attempted to get her daughter mental health treatment several times, with one outpatient therapist saying she had “never seen a patient as addicted to social media as Selena.” At one point, Selena was hospitalized for emergency psychiatric care, according to the complaint.

In a statement, Snap said it couldn’t comment on the specifics of an active case but told Insider “nothing is more important to us than the wellbeing of our community.”

“We are devastated to hear of Selena’s passing and our hearts go out to her family,” a Snap spokesperson told Insider. “Snapchat helps people communicate with their real friends, without some of the public pressure and social comparison features of traditional social media platforms, and intentionally makes it hard for strangers to contact young people.”

The spokesperson continued: “We work closely with many mental health organizations to provide in-app tools and resources for Snapchatters as part of our ongoing work to keep our community safe.”

Meta and lawyers for Rodriguez did not respond to requests for comment.

Internal Facebook documents leaked to The Wall Street Journal last year revealed the company is aware Instagram can be harmful to the mental health of teenagers, with one document stating that “32% of teen girls said that when they felt bad about their bodies, Instagram made them feel worse.”

Karina Newton, Instagram’s head of public policy, wrote in a September blog post that the Journal’s story “focuses on a limited set of findings and casts them in a negative light.”

In other documents retrieved by Facebook whistleblower Frances Haugen, the company found 13.5% of teen girls said Instagram makes thoughts of suicide worse, while 17% of teen girls said Instagram exacerbates eating disorders.

After Haugen gave an interview with “60 Minutes” about the findings, Facebook previously issued this response: “It is not accurate that leaked internal research demonstrates Instagram is ‘toxic’ for teen girls. The research actually demonstrated that many teens we heard from feel that using Instagram helps them when they are struggling with the kinds of hard moments and issues teenagers have always faced. This research, like external research on these issues, found teens report having both positive and negative experiences with social media.”

Earlier this month, Angela Underwood Jacobs, the sister of a federal officer killed last year, sued Meta, alleging the company “knowingly promoting extremist content” that contributed to her brother’s death.

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NEET-PG-Counselling: A larger public emergency issue due to Pandemic


        NEET PG Post-Graduation after MBBS is an entrance qualification exam, one of toughest and important exam not only for medical students but for medical colleges and hospitals. As this exam will decide and form the back bone of the health care system in the whole country. Ultimately this exam will be the check gate to supply specialist doctors to medical colleges, hospitals and private health institutions in all the states.  Post graduate trainees form the bulk load of doctors performing the duties.  Needless to say these doctors form the back bone of the total health system across the country. For last two years, these junior doctors were at the forefront of the fighting the pandemic. 

       Since NEET PG was to be conducted in Jan 2021, but due to pandemic got postponed to Sept 2021 and result were declared few months back.

      NEET PG counselling is not only issue for doctors but an actually a larger public health issue and kind of emergency due to pandemic, which will decide the availability of doctors to public.

         Actually it is in patient’s interest to have early counselling.

         It is a sad situation, when the world is preparing to tackle the wave of pandemic due to Omicron Variant, other countries are ramping up their health care infrastructure and manpower, and Indian doctors are being dragged on roads by police instead of employing them in hospitals.

       Its importance assumes an emergency situation in face of looming pandemic. If the administrators had perceived it as merely a trivial doctors’ issue and remained complacent, it had been a grave mistake.

     What was the emergency to change and frame new rules when a pandemic of such a large proportion was going on?

    A delay in academic counselling means a wasted year for the NEET PG aspirants. It also means that 50000 doctors are missing from the medical system and  the health care force because of bureaucratic delays, at a time when health care staff is overworked and in desperate need of more hands.

      Point to ponder here is that is it the doctors who desperately need help? More precisely and in reality it is the patients and public who need doctors desperately. An early counselling is in public interest actually, the point administrators have failed to understand.

       But sadly, it is up to the wisdom of administrators that decides “what is emergency and what is not” rather than medical wisdom, a case of misplaced priorities.

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