Doctor & nurses at risk from unknown or mutated germs@ Mystery virus in China


 

First pneumonia death from mystery virus in China, world on high alert

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

21 occupational risk to doctor and nurses

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

The death of a 61-year-old man  due to pneumonia from a mystery virus in the central Chinese city of Wuhan on Saturday has put the world on high alert against another new life-threatening illness. Seven of the 43 others diagnosed with the disease are in a critical condition, but no new cases have been reported since January 3.

To protect the world still smarting from the lightning spread of devastating viral diseases such as H1N1, Zika and Ebola, the World Health Organisation (WHO) issued this year’s first  international travel and trade alert on  on January 10 that advised all international travellers to report symptoms of fever with breathlessness and difficulty breathing, especially if they have travelled from China.

On January 9, China announced that the cluster of pneumonia cases reported in December in Wuhan in the Hubei Province of China was caused by a new coronavirus.

Only six viruses from the coronavirus family infect humans, which would make the new one the seventh to cause human disease. The coronavirus viruses cause diseases ranging from the common cold to very severe and life-threatening illness from Middle-East Respiratory Syndrome that caused 851 deaths since it was identified in 2012, and the Severe Acute Respiratory Syndrome (SARS), which killed 774 of the 8,098 people infected in an outbreak that started in China in 2002.

“Though currently there is no evidence of human-to-human transmission, we need to remain vigilant. WHO has shared with all Member States technical guidelines on surveillance, testing as well as infection prevention and control practices for suspected cases. WHO is in close contact with national authorities in the region and will extend all possible support to ensure core capacities are geared up for addressing potential cases that may come to countries,” said Dr Poonam Khetrapal Singh, WHO regional director, South East Asia Region.

Unknown threat

Some countries in the region, including Indonesia, Myanmar and Thailand, have started screening passengers travelling from China for pneumonia symptoms at airports. The health ministry reviewed the situation with WHO experts on Wednesday and plans to start providing travellers with risk-reduction information at airports and other ports of entry, travel agencies and conveyance operators.

“We are waiting and watching as entry screening at ports of entry like airports, seaports, train stations and border check-posts are not cost-effective. It is resource-intensive but offer little benefit,” said a health ministry official, who did not want to be named.

Though no pneumonia have been reported outside Wuhan, which has a population of 11 million, WHO said there is need for caution as the city is a major domestic and international transport hub with heavy population movement. Travel in the region is expected to significantly increase during the Chinese New Year in the last week of January, which increases the potential of infected travellers carrying to other parts of China and the world.

New viruses are formed when mutate to jump species and cause infection in humans. SARS jumped from the civet cat into humans, MERS from dromedary camel, H1N1 from pigs, and Ebola from bats, just to name a few.

The Wuhan City cases have been linked to the South China Seafood Wholesale Market, where some of the patients worked as dealers or vendors. The Huanan Seafood Wholesale Market deals with fish and other seafood, including sea mammals, along with chicken, bats, rabbits and snakes.

Signs of trouble; The clinical signs of the new lung infection are mainly fever, with a few persons reporting difficulty in breathing. Clinical signs include chest x-rays showing bilateral lung infiltrates (markings) associated with pneumonia and tuberculosis.

With no infection among health care workers treating the patients, preliminary information suggests there is no significant human-to-human transmission, but till the mode of transmission is clearly established, it’s best to take precautions to stay safe.

The WHO advises people travelling in or from affected areas (currently Wuhan) to avoid close contact with people with acute respiratory infections; wash hands frequently, especially after direct contact with ill people or their environment; and avoid close contact with live or dead animals. In case of respiratory symptoms before, during or after travel, travellers must seek medical attention and share their travel history with the doctor.

“The WHO advises against travel or trade restrictions on China based on the information currently available on this event,” said Dr Singh.

 

 

Healthcare system a sinking ship: Says Niti Aayog


A chaotic and non-uniform system, after years of neglect cannot be corrected overnight or by change in piecemeal policies. It needs to be revamped from the roots. To do it from grass root  level especially with financial constraints,  it will need a  sincere will to develop  the system.

                     India’s top think tank said Thursday that the country’s healthcare system resembled a “sinking ship”and desperately needs more private participation in smaller towns to run the government’s ambitious Ayushman Bharat program efficiently.

“We would require all hands on deck, as they say,” Niti Aayog adviser Alok Kumar said at the Healthcare Federation of India’s Sixth Annual Summit, referring to the poor state of healthcare in India. The Ayushman Bharat’s insurance program, Pradhan Mantri Jan Arogya Yojana (PMJAY), has been facing constraints in smaller cities due to a dearth of hospitals.

“We can’t have all the patients being transported to tier-1 and tier-2 cities for treatment because that is not a model which is sustainable,” Kumar said.

The Lancet, the world’s oldest and most prestigious journal, had last year ranked India’s healthcare system at a dismal 145 out of 195 countries, worse than even North Korea and Syria. The ranking was worse than its smaller Asian peer Philippines and neighbour Sri Lanka, a fact also pointed by Kumar.

Kumar said that a number of hospitals in smaller cities, including those run by public sector enterprises, are under-utilized even though there is strong demand for their services in these regions, especially because of the insurance program.

“Singrauli, for instance, the power capital of India, has hospitals of NTPC, Coal India Ltd; all of them underutilized (like) shells standing. Railway hospitals (are like) shells standing but not being utilized efficiently enough,” Kumar said.

He urged large private hospital chains to manage the hospitals run by state enterprises better by widening the scope of their services to beyond their own employees.

The PMJAY was introduced last year, and aims to provide health insurance cover of 5 lakhs per family per year for secondary and tertiary care hospitalization to over 10 crore poor and vulnerable families, which would total around 50 crore beneficiaries.

Ayushman Bharat is the umbrella program, with PMJAY for secondary and tertiary hospitalization, and health and wellness centres for primary healthcare facilities. Under the Ayushman Bharat, the government aims to create around 1.5 lakh health and wellness centres.

While the Indian government aims to increase the share of public health spending to 2.5% of GDP by 2025 under the National Health Policy, currently it is still only around 1%.

Another major problem for the poor state of the sector is the lack of health insurance for patients, leading to an out of pocket expenditure making up for 61% of total health expenses for households, as of 2015-16, latest National Health Accounts data showed.

To reduce out of pocket expenses, the government introduced the Ayushman Bharat insurance scheme, but large private hospital chains have shown resistance to participating in it due to ‘low package rates’ for various treatment procedures. Kumar said that the government was willing to listen to hospitals and other private entities and make changes to policy if they were ready to invest in the sector.

 

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


 

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

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

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

         Doctor   should consider these factors before joining at unsafe places.

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

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

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

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

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

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

 

21  occupational-risk factors – for doctor and nurses

Real story of female doctor assault- serving uncivilized society

Work life balance problem for female doctor and nurses

Disadvantage of being a doctor

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


 

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

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

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

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

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

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

        May  the departed soul rest in peace. 

       Doctor   should consider these factors before joining at unsafe places.

 

 female  doctor  assault ; serving uncivilized society

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

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

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

 

 

 

How to implement bridge course, if necessary: A suggestion #NMC


Crosspathy is dangerous to human race and potential global catastrophe because of antibiotic resistance.  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 or lac   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.

   Although it appears to be an avoidable decision, but still if required can be done by creating “doctors for area of need.

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 sub-optimal 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.

Each and every seat of AON and its doctor needs to be identified , earmarked and  trained for the particular seat.

  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  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 .
  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.

 

Black coat vs white coat: medical profession vs law industry


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

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

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

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

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

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

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

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

what if money is taken out of medico-legal cases

Myths and facts about ICU ventilator: small boat in sea storm


 

 Some one who is drowning, a small boat can  save his life, till sea storm settles or the victim reaches a safe land. The boat will not settle the sea storm, but enough to save a person from catastrophe. In reality, ventilator is the invention, which should be worshiped. But contrarily, due to wrong projections and misguided perceptions, it has been hated despite saving lives.

     Although doctors and ventilators are in a similar situation, projected in a wrong way,  hated in spite of doing good work and saving lives. They are hated and despised, despite the only ones of help in life and death situations. Following are few myths and fact about ventilator.

  1. Myth : Once on ventilator, patients do not survive: common myth is that  once the patient is placed on ventilator, he will not survive.  Human body,  when  gets severely  diseased or  under stress, heart and lungs need to be supported for saving the life, till ailment    So, when the battle for saving live is ongoing, almost all the patients will have to be placed on the ventilator. It is a last ditch attempt made to save the patient’s life. However when the patients do not survive people feel that it’s the ventilator which has caused death, rather than a rational thought about severe disease as a cause.

             In reality, it is the severity of disease and possibility of death, when ventilator is required. It is necessary to support life.

  1. Myth : Ventilator is a modality for mere prolongation of life: every disease has a spectrum. Every disease can progress  from a reversible  to irreversible state. As an effort is ongoing while waiting to reverse the process, the patient will need  ventilator to sustain life. Unless the disease reaches a stage of  irreversibility,  ventilator is indispensible  for an  absolute need to maintain life. Since in serious condition, it is an uncertain prognosis.  In retrospect, combined with application of an average wisdom, the time of uncertainty and institution of ventilator   can be  interpreted  as a mistake.  As the whole exercise is labeled as futile and expensive by relatives.   it’s a grey area and the  negative thoughts are fuelled because of retrospective wisdom in hindsight.  The real prognosis can not be predicted in real time.

In reality, Ventilator is a machine which just  supports respiration and not  responsible for  heart beating. Therefore it   buys time for healing and treatment of primary disease.

  1. Myth : Ventilator will cause death:

one can understand this simple logic on the basis that patients are placed on dialysis when kidneys fail. Patients are placed in cast when bones are fractured for a fixed predefined period of time. Similarly patient is placed on ventilator when lungs fail. Ventilator is used till the time  lungs recover and become fully functional.

                        In reality; Risk is because of disease, which needs ventilator and not vice versa. Ventilator is a friendly machine which helps people who have failed lungs.

  1. Myth : Doctors and hospitals keep dead patients on ventilator for financial gains

Fact:  placing patient on ventilator is a very critical decision, taken in best interest of patient to buy time, to so as to treat the disease.  A patient needing on ventilator is actually so sick, that not  instituting ventilator will risk the patient’s life. Knowing all these facts, doctors take a decision to keep the patients on ventilator.

         As once the patient is on ventilator,  it is a stress for the doctor to take the patient off the ventilator. As such ventilator is a SANCTUM SANCTORUM life saving machine,  to be used only in life and death situations.

 

  1. Myth : Its miracle if the patient placed on ventilator survives.

Given the fact that placing the patient on ventilator on scientific facts. There are clear indications  for putting the patient on ventilator.   A much larger patients put on ventilator are actually saved and go home.

Fact:  Everyday thousands of patients are placed on ventilator and sent home to lead a normal life: Any patient who is given general anesthesia is placed on ventilator in the operation theater and then taken off the ventilator at the end of the surgery. In these cases patients are placed on ventilator so as patient can be put to deep sleep (called anesthesia) during which surgery on desired part can be carried out. Soon after the surgery patient are taken off the ventilator and soon thereafter discharged for home after few days of healing.

 

  1. Myth :Doctors place patients on ventilator at their own will:

Fact:   there are scientific parameters which decide when the patient should be placed on the ventilator and when the patient should be taken off the ventilator. So the decision to place the patient is scientific and based on objective parameters.

  Contrary to this popular myth, it is a compulsion for the doctor to put patient on ventilator to prevent death in serious situations.  Doctors are usually thinking several steps ahead of lay person about medical science.

  1. Myth :All patients placed on ventilator are unconscious:

 

Fact: this is not necessary. Usually patients are sedated  for their comfort.  they can be made to walk, write and even perform small tasks when on ventilator, depending upon their lung condition.

  Patients are also put on ventilator in case of airway failure when unable to protect their airway for various reasons. Another reason why patients are placed on ventilator is inability of the patients to protect his or her airway. Conscious and alert patients can swallow normally formed mouth secretions.  When patients consciousness level is dulled the ability of the patient to protect his airway is lost or compromised. This causes secretions from mouth to enter into the lungs trough the airway i.e. trachea causing infections in the lungs. The only way to prevent this and protect the patient’s lungs is to place a tube in his airway and then place them on the ventilator.

 

  1. Myth: Patients can be kept alive by placing on the ventilator:

General masses  have a feeling that patient can be kept alive by keeping them on the ventilator. Even  a dead person can be kept alive by placing on the ventilator, which is not true.

In reality:  It is machine used only for breathing and not heart and brain.

  1. Myth : Ventilating the dead patients:

    this is a common allegation on medical profession.  This is no truth in this projected and perceived hearsay.

       Facts: Assumptions are based on thoughts of lay persons. Patients on ventilator, may look like dead, because of the disease, sedation and paralyzed by drugs. But their heart and brain are working, so they can not be declared dead.

    If there is some incident, it  needs to be proved by medical personnel. In reality, it can  be a very rare and remote  exception. These untrue projection are creating lots of mistrust about life saving machine.

The problem is about correct projection and  majority of people without  knowledge of medical science  do not  even  know the large  number of lives  been saved by the ventilators.

In nutshell: serious conditions  and life threatening situations need higher technical interventions, to save a life. If correct projections are made, ventilators are life saving machines.

About ventilator

History of ventilator

Breathing OZONE # rising Pollution


 

Rise in ozone levels is considered as one of the triggers for respiratory ailments. Irritation can occur in the respiratory system giving rise to coughs and an uncomfortable sensation in the chest. It may reduce lung function and make breathing difficult. There are no data available in the country to establish a direct correlation between mortality and high levels of ozone.

Oxidizing substances, such as oxides of nitrogen and oxidants from automobile exhaust, react with Sunlight to produce ozone.

Ozone — a pollutant that cause respiratory ailments, damage crops and forests — has been the highest in Delhi among the NCR cities of Gurugram, Faridabad, Noida and Ghaziabad for the last three years.

highest Ozone pollution in Delhi among NCR cities in last 3 years .

Compared to Delhi, Noida experienced 49 days on which ozone was high, Gurugram recorded 48 days, Faridabad encountered 11 such days, and Ghaziabad encountered eight days of high ozone, in the last three years

Data submitted in the Lok Sabha on Friday by environment minister  revealed that “between 2016 and 2018, Delhi encountered at least 95 days, on which Ozone was found to be as one the ‘prominent pollutants’ in the city’s air”.

“Usually, it is the level of particulate matter (PM10 and PM2.5) that remains high in Delhi,” an official of the Central Pollution Control Board (CPCB) said.

Compared to Delhi, Noida experienced 49 days on which ozone was high, Gurugram recorded 48 days, Faridabad encountered 11 such days, and Ghaziabad encountered eight days of high ozone, in the last three years. Even though ozone in the upper reaches of the atmosphere is good for humans as it absorbs the sun’s harmful ultraviolet rays, when it is generated on the ground level, from vehicular and industrial fumes, ozone undergoes a chemical reaction in the presence of sunlight and turns harmful.

“This year, till May 31, Delhi has already encountered 23 days of high ozone. Faridabad has recorded the highest number of days this year so far, at 55. Gurugram and Ghaziabad recorded six and three

such days, respectively, while Noida didn’t record any such day so far,” the CPCB official said.

Safar, a pollution forecasting agency under the earth sciences ministry, had been issuing warnings of ozone pollution over the past two weeks. The Centre for Science and Environment, a Delhi-based NGO, released a report last week, which also showed that between April 1 and June 5, ozone levels were high on at least 16% days this year, compared to 5% days in 2018.

The highest concentration in 2019 went up to 122 mpcm, which was 1.22 times higher than the eight-hour average standard.

“This is a serious trend as ozone can have an adverse effect on those suffering from asthma and respiratory conditions. If this trend continues or worsens, the graded response action plan will also have to be enforced to address the precursor gases that form ozone — NOx, hydrocarbons etc — and crack down on vehicles and industry,” Anumita Roychowdhury, executive director (research and advocacy), CSE, said

 

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


 

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

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

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

 

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

 

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

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