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.

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


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

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

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

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

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

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

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

“Silver lining to #Doctor-assault”: for enforcing law – Poor advertisement for #private-expensive-medical-seat


 

Doctor assault is definitely a poor advertisement,  to take note by  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 also 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 seat. It 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.

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.

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   individuals. whatever way  they choose to react ,  the slightest reaction may  invite the ire of many unknown people, may be mighty and    revengeful.

Doctors  are being treated as  punching bags for venting out emotions of the bereaved relatives. they are just a front man for revenge, for an inept and insufficient system, which has failed to take the real responsibility. Nothing and really nothing can justify this barbaric act. Emotions should not be allowed to take such a demonic form.

Such apathy towards doctors will continue till businesses associated  and dependent on health care take a hit.  Possibly  demoralization of doctors consequent poor health system  will not affect any one, but affecting money generation may  force establishments to act against doctor assault.   One of  such business is private medical education. Killings or assaults of doctors may not be a effective deterrents, but “loss of business”  definitely can play wonders.

 

 

Pay millions to be a doctor?: welcome to “ring on fire” #NEET


Being a doctor has become a disadvantage in itself, thanks to our media and celebrities projecting the saviors  in bad light. They are now seen as harbingers of death. Morale of doctors has been at rock bottom and community is devastated.  A society that believes more in fairy tales told by “Reel heroes” has turned prejudiced and preposterous towards “Real  heroes”.  The medical profession reeks of desperation and desolation with apathy from government, indifference from courts and silence of human right commission to salvage them from decrepit state. At the best, they have been reduced to punching bags and scape-goats for inept medical systems or cheap labour to industry.

Problems faced by doctors are not only innumerable but are also so exceedingly complex and diverse that they are difficult to be analysed. It is common to listen doctors discussing these problems whenever one of these crop up. If so many doctors feel so disgusted about the entire system that they do not encourage their children to take up this profession which until now was one of the coveted ones, there must be something going terribly wrong with the profession. The challenges in this profession are too many and difficult to analyse.
  1.     Medical courses are Comparatively lengthy and expansive study course and difficult training with slave like duties: that I have discussed in one of my previous article on “enslavement of doctors”.
  2. Uncertain future for aspiring doctors at time of training: Nowadays, doing just MBBS is not enough and it is important to specialize. Because of lesser seats in post graduation, poor regulation of medical education, uneven criteria, ultimately very few people get the branch and college of their choice. They have to just flow with system ultimately.
 3. Hostile environment for doctors to begin: Suddenly young, meritorious and bright children who came out of training find themselves working in a hostile environment, at the receiving end of public wrath, law, media for reasons they can’t fathom. They face continuous negative publicity, poor infrastructure and prejudiced  beliefs of society.

  1. Difficult start of career of doctors: After a difficult time at medical college, an unsettled family life and with no money, these brilliant doctors begin their struggle. Even before they start earning a penny, the society already has its preconceived notions because of negative media publicity and half treats them as cheats and dishonest. Their work is seen with suspicion and often criticized.
    5.The fear and anxiety about the actual treatment,  favorable and unfavorable prognosis of patient, keeps mind of a doctor occupied.
    6. Doctors are blamed for all malaise:The society gets biased because of the media reports and some celebrity talking glib without proper understanding of inept medical system , administrative failure and complexity of medical industry.  These lead to formation of generalized sentiment against all doctors and are then unfortunately blamed for all the malaise in the entire healthcare system.
    7.Doctor’s personal and family life suffers: Large number of patients with lesser number of doctors is a cause of difficult working circumstances, and the frequent odd hour duties have a very negative impact on the family and personal life of the doctor.
    8.Risk to doctor himself:     Repeated exposure to infected patients in addition to long work hours without proper meals make them prone to certain health hazards, like infections which commonly include tuberculosis and other bacterial and viral illnesses. Radiologists and interventionists get radiation exposure. Because of difficult working conditions, some doctors are prone to depression, anxiety and may start on substance abuse.  21 risks to doctor and nurses
    9.Unrealistic expectations of society: Every patient is not salvageable but commonly the relatives do not accept this reality. Pressure is mounted on doctor to do more while alleging that he is not working properly. Allegations of incompetency and negligence are quite common in such circumstances. These painful discussions can go to any extent and a single such relative  is enough to spoil the mood for the day.

10.Retrospective analysis of doctor’s every action continues all the life-It could be by patients and relatives every day in the form of “ Why this was not done before” ? Everyday irritating discussions, arguments, complaints, disagreements add to further pain and discontentment, in case the patient is not improving. Or it could be by courts and so many regulatory bodies. 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.
In these court cases, the doctor is at disadvantage since his decision which is now being questioned was taken at that time in good faith using all his wisdom. The decision in retrospect may not turn out to be the best one, but later retrospective analysis along with wisdom of hindsight over many years, may label it as faulty if a fault-finding approach is used. This along with general sentiment and sympathy with sufferer makes medical profession a sitting duck for punishments and lawsuits. Even if the doctor is proved to be not guilty, his harassment and tarnishing of reputation will be full and almost permanent. No doctor has time to pursue such things all the time. Even if such events don’t happen to everyone, the very fear of such possible scenarios and their possible complications always lurks in the back of their mind.
11. Physical assault , routine instances of verbal abuse and threat  happen for no fault of theirs. Many become punching bags for the inept medical system and invisible medical industry. The threat of physical assault is quite real as well. 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.  Even female doctors  are being assaulted.
12. Medical industry may be rich but not the doctors: The belief that doctor’s is a rich community, is not correct. Although decent or average earnings may be there, but earnings of most doctors is still not commiserate with their hard work viz-a-viz other professions. Doctors who also work like investor, a manager or collaborate with industry may be richer. But definitely most of doctors who are just doing medical care are not really rich.
13. Windfall profits for lawyers and law industry at the cost of doctors is a disadvantage for medical profession: I have seen zero fee and fixed commission ads on television by lawyers in health systems in certain developed countries. 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 is a major disadvantage for medical profession.

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

With so many adversaries, the situation is like sailing a small boat in a tornado.
At present, with this mind-set, the losers are the doctors and medical profession. But the society should be able to foresee its overall loss in the long run if these practices continue.

 

Burden of Mistrust: A Curse generated by media for medical profession


Every news item presented on TV about medical profession creates an anxiety in minds of doctors. As almost always, these  are  cooked for media business to  create sensations. Medical profession can not fight with media power and remains  at receiving end always.  Painful burden of mistrust against them grows further.

News article or TV programs are created so convincing  and so capable of  sway public opinion against  doctors. while the fears in the minds of patients  is not without basis, but risk to life of patient does not really comes from doctors, but it is from mistrust generated from inexorable creep  of media into our lives.

Even the most enlightened humans have biases. Media by negative publicity enhances and multiplies negative bias and propagates mistrust, beyond reasonable limits. These negative and uncertain prejudiced feeling in the mind of patients is difficult to identified , and more difficult to correct and treat .

Prejudice against doctors 

While the news being aired, gave an impression like a judgment  is passed, which is unable to take into account, the large good work being done by the medical community at large. As if the treatment done and life saved every minute is of no consequence.  Such judgments are not based on any objective measurable data, and therefore they are highly susceptible to human biases. Unfortunately, a vicious cycle of mistrust and misfortune and more bias is created and   there is no circuit breaker or any assessment of the  mistrust thus  promoted, whether it was good for society  or  patients. It can be at the best a late or remote  afterthought by few wise ones.

Growing awareness about risk of medical interventions or its limitations, has not slowed the rapid ingestion of toxic negativity into the fabric of society. We are living in times, where media  tends to influence what people see, hear, feel and buy. Spread of negative news rapidly spreading into nooks and crannies of minds of masses, but in the guise of magical optimization of medical profession and treatment. Masses rely on the one example presented before them, without knowing it was one of millions, a rarity rather than routine, without factoring in the biases and problems underlying that one patient. In majority of such cases, biases are hidden, hindsight analysis are baked, submerged and woven into an emotional fabric that is wrapped around  business under the banner of  better medical services optimization.

These  sensational news, promoting mistrust against medical profession,  if unchecked will put lives of patient more at risk than real benefit to society. People will suffer because of  a relationship of mistrust with doctors, will refrain from seeking treatment. But still no one will know that it is  “a curse  generated by media”.

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