Sunday, June 16, 2013

Food for thought

It seems there are two ways to identify a patient's disease or to know what abnormality is affecting his/her body – the first one is by asking him/her relevant questions and the other is by observing the symptoms. For example, if the doctor feels that the case might be of cataract, he might ask you questions like:
  • Is your vision declining stridently?
  • Is there a burning sensation in your eyes?
  • Do the eyes water quite often?
  • Is there a feeling of irritation?
  • Do you sense something when exposed to bright sunlight?
and come to a conclusion or using the other method, he might go for laboratory tests and detect the issue.
 
A doctor is always taught to first go for the Question & Answer session so that the diagnosis is economical to the patient. But most of the doctors today do not go by this rule. They want to start the treatment as early as possible, which is not a wrong thought process but most of the times it doesn’t send the right message to the suffering patient and he feels that the whole treatment is nothing but a commercial exercise by the Doctor. When a patient goes to a Gastroenterologist and says 'My stomach is not behaving the right way these days and I have trouble digesting food' and when the doctor doesn't ask much but instead writes all the blood tests to be conducted, a Sonography, an Endoscopy, a CT scan, etc. only to tell you that 'Everything is all right. Just take these 2 pills for a month and tell me how you get along’, one would feel cheated.
 
I have lived in different cities and in various parts of the country and there are some obvious differences that I have noticed. I’m sure some of you may have felt the same at different points of time in your life. Sorry to say that I do not have numbers as references and I will be sticking to only what I’ve heard and felt. I have seen people rushing to the South of India to seek medical consultation, to get operated. The primary reason is that the doctors in the South are better informed. Both North and South India makes doctors where they don’t enter colleges based on the marks they scored but a hefty payment made by their angel investors who need people to run their hospitals. I’m not saying that such doctors are inferior or they lack the skills and art to operate on patients, no they don’t. They learn the science after all by being at college and they have hospitals where they can refine their art.
 
If you compare Apollo Chennai and Apollo Kolkata, you would choose Chennai any day. Vasan eye Clinic - Madurai vs. Delhi - Madurai any day. I did my internship at Apollo Specialty Hospitals, Madurai. By talking to different people in the hospital, I realized that it was a place for the masses (contrary to my earlier notion that it was only for the affluent class) and the doctors who visited there plus the care offered by the nurses from Kerala was incomparable to any hospital in the North. I keep this as an example and think of AMRI in Kolkata (2011) where so many people died because of sheer negligence by the authorities.
 
Recently, I heard about the medical facilities in the US from a friend and a relative. They had different issues but something that demanded immediate attention. D told me, 'I’m unable to buy medicines and my problem is becoming severe because I’m not taking the regular doses. Firstly I need to buy a Medical insurance'. That's all wrong - is it more important that you get treated on time (before the problem becomes complex) or that you buy an insurance? V told me, 'As the pus came out on a Sunday, I had to rush to the doctor immediately and Sundays are considered emergency cases here, so I was charged double the normal'. It was a startling yet a true discovery for me. So, things are funny ‘everywhere’!
 
As I had aspired to become a doctor during my school days, I wrote a few entrance exams in Class 12. One of them was for a Deemed University named Annamalai - situated in Chidambaram, a township in Tamil Nadu. The written paper was so easy that I thought why it was so. The second round was an interview and I thought that I was very lucky to have been called for the interview only to figure out discussions of 18L or 20L INR going on while sitting outside the interviewer's room. I was invited inside and the doctor asked me a few questions on Vitamin B and C, the diseases caused due to the deficiency of Vitamin B12 (Cyanocobalamine) and a few others. Students waiting outside for the interview told me that all that was an eye-wash and for a few days I could not sleep well. I cursed myself for having scored a 1000 something rank in the medical entrances in the state and realizing anyone above 500 in the Open Category doesn't get a seat. May be it was because of me that my younger sister took things to her heart and said she was to become nothing but a Surgeon. I have experienced my sister and father having a debate about Women as Surgeons. He asks, 'Would you have sent your mom to be treated by a lady surgeon' and she replies, 'Why not? The fact is that I don't find anyone capable on the streets!'
 
I wonder why doctors forget the economies learnt during the graduation and the post-graduation days. After all, 'Healthy living is for all' and they write in bold letters inside and outside the hospitals: ‘It is Not about living but living healthy'. They don’t live up to what they say.
 
This is my perfect example of a care-center.