Tag: media

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


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

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

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

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

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

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

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‘A doctor who always operated on ear, irrespective of problem’: Role of media in Fortis and Max hospital Delhi incidents


        During my  days as medical student, we laughed at a story wherein a doctor always operated on patient’s  ear for all their ailments. Whatever may be the problem in the body, it was only the ear which received the cut always.  Similar treatment is being given to doctors by media.  Now-a days, for every progression of the disease and for genuine poor prognosis or death of the patient, media  is prompt to start the  blame game of doctor- doctor. Media even does not try to verify the facts. The real medical issues in treatment of these cases are still not emphasized by media, like whether these cases were salvageable or not.  For example why so many preventable disease like dengue, malaria happen every year   to thousands of people every year and are still progressing?  Take the case of foetus at 22 weeks…… how many have survived in India or in  the  world? In this case and that of  the complicated dengue case, the survival chances were quite dismal, even in developed world medicine.  Inability of media people to analyze the difficulty on scientific parameters, unwillingness of people to accept the real poor prognosis and political class to flow with populist opinion has done irreparable damage to medical profession. Just a blame game and the word ‘negligence’ are in the air.

    Outcome in these cases is not uncommon or unanticipated by any yardstick in the world. But no one is concerned about that. And in the end, what are the losses?

    Discouraged medical fraternity, low morale of doctors, and talk of leaving this profession have become smaller issues and do not affect anybody in media or Government. 

   But larger issues remain: how to prevent thousands of death due to poor control of communicable and preventable diseases. Proper delivery of health care will not improve by playing the blame game on doctor.  Media bashing of doctors may divert attention from the real issues and  media people   will earn money and fame. Doctors will be punished  as a result of  populist revenge.  But this approach of media is not going to save patients or provide better health care to masses in future.

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Save the doctor to save yourself: An era when genesis of diseases is not punished, but treatment is.


            “Young girl killed by doctors at Fortis Gurugram” and “alive baby declared dead by doctors at Max Hospital Delhi”. These two news items  have recently jolted everyone in medical fraternity. Doctors have  yet  to come to terms with harsh reality  in order to   realize about the  harm   that can happen to themselves, when they just  say yes to treat the complex cases. A worst form of dengue already complicated, or a premature delivery at 22 weeks. I am sure doctors will know, how many patients and pregnancies have survived at this stage in the world, in both of these conditions.

     We have all kind of preventable diseases happening around us. Thousands of people suffering and many loose life, just because of worthless causes. Even healthy people are killed because of preventable calamities like open pot holes, floods, heat or preventable fires, accidents and so on. But strangely when disease happens and gets complicated in one patient, death due to these complications in the hospital is taken very severely. Although it may  have been  just untreatable at some point, but whole burden of death and punishments are  passed  over to doctors very conveniently.

   In both these complex cases, there are no clear cut guidelines by government. In whatever way doctor will act, he can be blamed easily on some pretext or another. By such yardsticks,  all complicated cases and subsequent  deaths happening in hospital settings can be termed as ‘ negligence’ by a fault finding retrospective approach. Now doctors have become scared  to treat complex cases.  

   It is sad to see that our leaders, media and all stakeholders have no knowledge of complex medical issues. I do not see any solution to these kind of exploitation and extortion of medics in near future.  But   are all complicated cases and deaths in hospital are Negligence?  This is going to be tough time for doctors but subsequently for patients.  These are worst days for doctors, where genesis of disease is overlooked and unnatural death of hundreds is not taken care of. But doctor who is working with intentions to treat the complex situation is being punished.  But society should be able to count its losses after few years, if such trend continues.  Good doctors will easily quit or shift to safe positions. Society has to save doctors, if it wants to save it’s people.

     

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Max Hospital Delhi handed over dead baby : Is “ Lazarus syndrome” a possibility?


 

        There are lot of discussion going on about live  baby handed over to parents by Max Hospital  Delhi, as dead.  Every one including  media has as usual  jumped on to the favorite  topic of  doctor bashing.  Facts are still under investigation. But as a doctor, I can not reach conclusions without scientific discussion, least possible by media  talking superfluously. There can be number of possibilities, which we will  know with time after proper investigation. But whatever the result, doctors bashing had already been done by media , with or without knowing facts.

Life and death are still far beyond the reach of science and obviously  of doctors as well. There are still a lot more unknown than known story about human life. I just wish to draw the attention of my readers about an entity, which is quite mysterious.  Condition is  called     “ Lazarus syndrome”. Also known as auto resuscitation after failed cardiopulmonary resuscitation, is the spontaneous return of circulation after failed attempts at resuscitation.

A little bit about  this rare phenomenon.      

 

Lazarus syndrome, also known as auto resuscitation after failed cardiopulmonary resuscitation, is the spontaneous return of circulation after failed attempts at resuscitation. Its occurrence has been noted in medical literature at least 38 times since 1982. It takes its name from Lazarus who, as described in the New Testament of The Bible, was raised from the dead by Jesus.

Occurrences of the syndrome are extremely rare and the causes are not well understood. One hypothesis for the phenomenon is that a chief factor (though not the only one) is the buildup of pressure in the chest as a result of cardiopulmonary resuscitation (CPR). The relaxation of pressure after resuscitation efforts have ended is thought to allow the heart to expand, triggering the heart’s electrical impulses and restarting the heartbeat. Other possible factors are hyperkalemia or high doses of epinephrine.

Cases

-A 27-year-old man in the UK collapsed after overdosing on heroin and cocaine. Paramedics gave him an injection, and he recovered enough to walk to the ambulance. He went into cardiac arrest in transit. After 25 minutes of resuscitation efforts, the patient was verbally declared dead. About a minute after resuscitation ended, a nurse noticed a rhythm on the heart monitor and resuscitation was resumed. The patient recovered fully.

-A 66-year-old man suffering from a suspected abdominal aneurysm who, during treatment for this condition, suffered cardiac arrest and received chest compressions and defibrillation shocks for 17 minutes. Vital signs did not return; the patient was declared dead and resuscitation efforts ended. Ten minutes later, the surgeon felt a pulse. The aneurysm was successfully treated and the patient fully recovered with no lasting physical or neurological problems.

-According to a 2002 article in the journal Forensic Science International, a 65-year-old  deaf Japanese male was found unconscious in the foster home he lived in. Cardiopulmonary resuscitation was attempted on the scene by home staff, emergency medical personnel and also in the emergency department of the hospital and included appropriate medications and defibrillation. He was declared dead after attempted resuscitation. However, a policeman found the person moving in the mortuary after 20 minutes. The patient survived for 4 more days.

-Judith Johnson, 61, went into cardiac arrest at Beebe Medical Center in Lewes, Delaware, United States, in May 2007. She was given “multiple medicines and synchronized shocks”, but never regained a pulse. She was declared dead at 8:34 p.m. but was discovered in the morgue to be alive and breathing. She sued the medical center where it happened for damages due to physical and neurological problems stemming from the event.

-A 45-year-old woman in Colombia was pronounced dead, as there were no vital signs showing she was alive. Later, a funeral worker noticed the woman moving and alerted his co-worker that the woman should go back to the hospital. A 65-year-old man in Malaysia came back to life two-and-a-half hours after doctors at Seberang Jaya Hospital, Penang, pronounced him dead. He died three weeks later.

-Anthony Yahle, 37, in Bellbrook, Ohio, USA, was breathing abnormally at 4 a.m. on 5 August 2013, and could not be woken. He was given CPR, and first responders shocked him several times and found a heartbeat. That afternoon, he coded for 45 minutes at Kettering Medical Center and was pronounced dead. When his son arrived at the hospital, he noticed a heartbeat on the monitor that was still attached. Resuscitation efforts resumed, and the patient was revived.

-Walter Williams, 78, from Lexington, Mississippi, United States, was at home when his hospice nurse called a coroner who arrived and declared him dead at 9 p.m. on 26 February 2014. Once at a funeral home, he was found to be moving, possibly resuscitated by a defibrillator implanted in his chest. The next day he was well enough to be talking with family, but died fifteen days later.

Implications  The Lazarus phenomenon raises ethical issues for physicians, who must determine when medical death has occurred, resuscitation efforts should end, and postmortem procedures such as autopsies and organ harvesting may take place.

Medical literature has recommended observation of a patient’s vital signs for five to ten minutes after cessation of resuscitation before certifying death.

In Popular Culture

In the TV show Grey’s Anatomy, a patient had a heart attack and after 42 minutes of resuscitation efforts they declared her dead. And 20 minutes after death has been declared, the patient vital signs returned and regained consciousness.

Source

Lazarus syndrome. (2017, September 2). In Wikipedia, The Free Encyclopedia. Retrieved 16:51, December 4, 2017, from https://en.wikipedia.org/w/index.php?title=Lazarus_syndrome&oldid=798456668

https://en.wikipedia.org/w/index.php?title=Lazarus_syndrome&oldid=798456668

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Silence of lords is a death sentence to the medical profession:#Doctor’s assaults


 

      Every one when sick, always seeks help of a doctor and invariably help is provided. But strangely, when a doctor needs help, there is no one. Even those people, whose life had been saved, have not returned the favor.  A   strange phenomenon has happened in few years of accusing the doctors for all the ills in society and holding them responsible, without even looking at the root cause.  Everyone has found an easy scapegoat to blame.   Human rights of medical community has been grossly violated by physical assaults. More painful is to see the authorities  who are  supposed to take action have maintained a silence in all these years about this issue.  There has been countless incidences, recent being in Kalyan and Jaipur.

 

If this trend is not checked in an effective manner, it will be difficult to even treat a single patient in coming times. The way media and prominent people have put all doctors in bad light, it seems that a normal and good advice is also not taken in a correct perspective. Even patients do not understand, that this advice is for the  their betterment only.  It is because of prejudiced minds against doctors. Our films and film stars have shown in films that it is okay to assault and bully the doctor to get treatment  in an effort  to impress the gullible masses and make some money. They may be successful in making some money, but by creating mistrust they have put the lives of gullible people on risk. The media should have a more sensible approach and do some basic research before highlighting sensational news against doctors, hospitals and healthcare professionals.

Just imagine, what that gynecologist did to the patient to  earn a slap, for no reason. In this  manner, forget about serious patients and surgeries, doctors will be afraid to do even routine surgeries as well. Here the situation is that even before surgery, doctor was slapped. Imagine, if a complication happens during or after surgery, doctor would have been killed. But strangely our government, human right commissions, police and courts have behaved as if they do not exist to help the doctor, but they expect the doctor to help everyone. This kind of inaction and  silence of  authorities is appalling.

       Obviously good doctors will try to shun the system. Government, human right commissions, police and courts, media have done their contribution to kill a profession, which was of great help to them.  I am sure we are civilized and wisened up enough to recognize these flaws in the society and have some corrective measures before it is too late………….too late to change the perceptions which will settle in the young impressionable minds of the children who till now think of it as their dream career. Otherwise no brilliant child would ever like to enter this profession out of their fear. Nor the parents would like their children to be working for uncivilized society.  The government needs to enact reasonable laws to use  healthcare systems,  to the best interest of people  instead of  unfairly victimize the doctors, just to impress the gullible masses.

It is not a doctor, which was assaulted. Silence of lords is a death sentence to the medical  profession as a whole. One person may realize the folly, but if we wait for realization to come to  whole civilization, it may be too late.

Again I will request the people to introspect, who rue the scarcity of good doctors “ do they deserve to have good doctors?”

 

 

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Misplaced priorities of media in Dengue death: negligence in prevention of thousands OR complications in treatment of one very sick?


Prevention is better than cure.  There is lot of discussions going on about dengue death in newspapers and media. It is all about again, about  ritual of  doctor bashing and ill things said  about treatment  and so on. Although doctors have realized to live with such painful criticism, which is largely unjustified but truth of this era.  But some one with more wisdom and specially media has to realize that they are targeting  a wrong cause. Without proper root cause analysis,  problem will not  be solved, rather they will destroy the possibility of correction as well.

            I just want to draw the attention, that so much of furor  by media is directed to the wrong pole. If media has  thought of in rational way and  invested  same kind of  their energy and zeal  on the root cause of dengue it self,  they could have saved thousands. That is the prevention of dengue fever. Times of India shows on the side of this news, another column on the same page  that is about  8549 dengue cases in Delhi alone . Actual figures may have been higher.   Going by simple common sense,  if we had done something to prevent dengue or mosquito control, the problem of patients visiting hospitals in sick state and unfortunate situation  of so called negligence and treatment related  problem will not arise. A lethal disease was generated and allowed to progress.

 Strangely,  treatment details of a very sick patients, after the disease has already struck and   trying to  find  some thing wrong are of great interest to media and public.  No body is worried about the strategies that should have been adopted  to prevent thousands from the disease,  by timely preventive interventions. Real cure lies in preventing mosquito to bite rather finding problems with treatment protocols of doctors after disease has progressed, who are already hard pressed in such difficult circumstances.

            Public  and media will have to  understand the basic priority, whether they want  the prevention of the root cause of sufferings of thousands of  patients or want  some  scapegoat among  those who were trying to save the patient.   Consequences of negligence  in preventing   of such diseases are   huge and  massively destructive to thousands of lives. Once disease has  struck,  one can  foresee futility of this exercise  of blaming  the doctors. Excessive  and unjustified criticism of  the  saviours is   not doing good to any one. A  good strategy to  prevent  such  common diseases will save more people . But if current trend of blame  game  continues, there will be doctors in future but  no  saviours in real sense.        

        

       

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Aberrant Evolution of medical profession: will it help the patient?


With advances in medical science, simultaneously there has been aberrant evolution of medical profession, education, regulation and medical industry. By provoking controversy about doctors for varied reasons, medical industry and law has been positioned between the doctor and  patient and  taken a center stage in health care. Till now, doctor patient interaction was the central point of the health industry, a core around which medical industry revolved. But now   this interaction, treatment and  almost everything is controlled by industry and regulated in some manner. There have been technical advancements to promote better treatment and diagnosis but these, at the same time, increase the cost of treatment, involvement of industry and hence dependence on investors.

 There has been advancements, but are they in right direction?

Discouragement  of medical fraternity:  The adage “To err is human” probably does not apply to the doctors anymore. Doctors are definitely regarded different from rest of the humans and are not supposed to have privileges that other persons of humankind are guaranteed. Hence they are harassed often for any adverse clinical outcome even though it may be because of poor prognosis of patient. They work under continuous fear and stress and are punished for each small or big error.

Commercial evolution of medical education: medical student are now forced to pay exorbitant fee with lower standards of education.  

Evolution in medico legal  procedures:  extensive and complex communication, technical advancements and legal interactions has taken a toll on the doctors. But more importantly, how that has improved the patient care or  doctor patient relationship? I feel, it has created fear in mind of doctors and deterioration of doctor patient relationship.

 Evlution of Doctor patient relationship and Trust :In all the complexity, trust between doctor patient has taken a hit. A good paternistic relationship, now has been converted to more of a legal one. Trust has been replaced by  mutual fear.

Evolution of Complex medical regulation and documentation: There has been overzealous regulation of medical profession. Time and resouces which should have been utilized for treatment of patients,  has to be used for complex documentation.

Evolution of media and social media: Painful retrospective analysis of work of doctor by media, courts and public contuse. Decisions which doctors has to take in moments are analysed retrospectively by everyone with wisdom of hindsight over years, without understanding complexities involved.

Evolution of Insurance sector: increasing cost of treatment and  medicolegal component has made both patients and doctors paying to insurance companies.

            This kind of aberrant evolution of medical profession has increased the problems of doctors and patients and it is not helping anyone. Ultimately it will help everyone except doctor and patient. Ultimately discourage the excellence in medical care.

 

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