The Partying CTVS Surgeon

After coming from the rotation posting in the CTVS (Cardi-Thoracic-Vascular-Surgery) Department of AIIMS, New Delhi, Dr. Dev (Fictional Name) shared the tales of the CTVS surgeon’s demanding lifestyles and long work hours with his friends. 

Read the ‘The Two CTVS Surgeon’ for details https://agnipathdoctors.blogspot.com/2020/05/the-two-ctvs-surgeons.html

Some of his friends did not believe him. To prove their point, they showed him newspapers with photographs of a prominent Cardiac surgeon of New Delhi who was having his own large private Cardiac Surgery Centre. The newspapers featured him regularly on page 3 news while attending parties and hobnobbing with the rich and famous celebrities in the evening. 

The Cardiac surgeon was also doing CABGs (Coronary Artery Bypass Graft or Heart Bypass) surgeries on the rich and VIP patients of India. As he was in the private sector, his earning was directly related to the number of patients who get admitted and operated by him.  It was expected that he will be putting in more extra care to attract more patients than the cardiac surgeons of AIIMS, who in government service, receive a fixed salary regardless of the number of patients they admit and operate. And yet here he was having more free time than AIIMS cardiac surgeons.

Dr. Dev did not have an answer to this apparent paradox at that time. Sometimes later he met a doctor who was working in the famous cardiac surgeon’s hospital. Dr. Dev asked the doctor about the secret behind the apparently free lifestyle of the famous surgeon.

A Warning: As Dr. Dev had never met or worked in the hospital of the cardiac surgeon, what he heard might be entirely untrue. 

The doctor said that their chief has a very strict policy. Whenever a patient comes for an operation to him, he makes it very clear to him/her before admission that he will not attend any emergency call or visit the patient after 7.00 pm. He has qualified doctors working in the hospital who will attend and respond and take care of the patient in the evening and night in case of any emergency. Only if they agree to his terms and condition that he used to agree to admit and operate on the patient. 

The cardiac surgeon used to follow this strictly and his personal mobile phone number was kept secret and was known only to the most senior doctors on duty in the hospital to be only contacted in rare exceptional cases once he leaves the hospital in the evening. 

So now the patients had a choice to get admitted under the cardiac surgeon’s terms and condition getting operated by him in the slick 5 stars like private hospital or going to the government AIIMS hospital with a long waiting list, crowds, and other problems. As expected, most patients agreed.

So the cardiac surgeon was able to operate on the rich and famous and yet have free time and a balanced life too.

Lay out the terms and conditions clearly before doing anything so that the patients (or in your case client/customer) do not have any unrealistic expectations or feel cheated after their admission or beginning of the relationship with your company.

Be not afraid to lose your patients/client/customer due to your lifestyles, as there would have been some patients who after hearing the surgeon’s way of working, would not have got admitted and would have gone to some other hospital for further treatment.

Keep well-qualified juniors/subordinates to handle emergencies in your absence and trust them to take care of your patients/clients/customers in your absence.

But remember, all this was possible only because the cardiac surgeon had created a name for him as one of the most qualified cardiac surgeons in India, leaving little choice to the patients. 

Became so good and qualified in your profession that there is no other alternative to you so that your patients/clients/customers are forced to choose you even after agreeing to your terms and conditions.

 (Based on allegedly true incidents)

— ND

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DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norms. 

The Two CTVS Surgeons

Dr. Dev (Fictional Name) when he was a junior resident (JR) in the Department of Surgery, AIIMS, New Delhi, was posted on rotation posting to the CTVS (Cardio-Thoracic-Vascular-Surgery) department.

He was to report daily to the operation theatre (OT) at 8.00 am and do alternate day ward duty in the evening and night. 

A Warning: Unlike, Dr. Shahid Hasan (Fictional Name) in The CTVS Selected Doctor https://agnipathdoctors.blogspot.com/2020/05/the-ctvs-selected-doctor.html, before the rotation posting, Dr. Dev had limited exposure to the CTVS department and the Surgeons working there. Even there, he was on the fringes, not privy to the life and thinking of the surgeons working there, so his impressions are at the least incomplete if not entirely wrong.

Professor P. Venugopal was the head of the CTVS department at that time and Dr. Dev was initially posted in Professor Balram Airan’s OT and then later posted to Prof. Venugopal’s OT. 

Before his CTVS posting, Dr. Dev thought that only the JR in surgery were the most hard-working doctors in AIIMS. 

He was shocked to see even the senior cardiac surgeons in the CTVS department working 14 to 20 hours a day. First, there were the pre-OT rounds to see the patients operated the previous days, then the long OT hours with the operation going late in the evening, then the ward rounds and in between the urgent call to see any serious patient or re-exploration for some complication in a patient operated before. This was in addition to the Out-Patient clinics, and the teaching classes and the research activities and, last but not the least, the administrative work. 

The stress, the tension, the long work hours was just unimaginable. Watching them work continuously where sometimes one-day changes to another workday without a break makes you feel that all cardiac surgeons are aliens or robots. 

After a few days, Dr. Dev noticed that not all cardiac surgeons are following the same routine of work, work, and work. 

While Dr. Dev was assisting Dr. Balram Airan in the first case of the day, a CABG (Coronary Artery Bypass Graft, or ‘Heart Bypass’), a senior cardiac surgeon entered the OT. As Dr. Dev later learned, he was Dr. A. Sampath Kumar. 

Looking around he remarked, ‘Oh, CABG. Looks quite complex.’ Midway in the operation with the most difficult part underway, Dr. Airan just made some acknowledging sound and kept on working. The Mch senior resident, perhaps to sound civil to his teacher, asked, ‘How are the cases in your OT, sir?’ Dr. Sampath replied, ‘I am going for lunch. The senior resident is closing the last case in my OT.’ 

This was a moment of epiphany for Dev. He started looking around and observed things that were a revelation.

Most cardiac surgeons in AIIMS used to post either a single case of CABG in their OT or in combination with a simpler (relatively) case like heart valve repair/replacement or ASD repair so that their OT finishes by early evening. Dr. Venugopal used to run two OT simultaneously and used to operate a minimum of one CABG case in each OT with sometimes even 2 cases in one of the OT. He had two teams of supportive surgeons, which will start and finish the cases while he goes from OT to another without taking a break. Sometimes his operation time gets extended to the night.

In contrast, Dr. Sampath used to post only a maximum of two or even one cases of heart valve repair or replacement in his OT.  He used to finish both cases before other surgeons used to finish their first case of CABG. So, he was able to have a leisurely lunch and have the rest of the afternoon free for his other work, while other surgeons were toiling in the OT. This enabled him to even have time to go to the college gym in the evening and play a game or two of badminton.

There were other differences as well. The patients for CABG were usually elderly, well connected, rich, or VIPs. The patients posted in Prof. Venugopal’s OT were usually big politicians, senior bureaucrats, the ultra-rich, or their relatives. The patients with CABG usually had other co-morbidities such as hypertension (Increased Blood Pressure) or diabetes, requiring much more close watch and care in the post-operative period. So, the surgeon performing CABG had to do frequent hospital visits and do close personal monitoring of his patients, keeping them busy and worried, and leaving them little personal time. In fact, even with a well-qualified team of doctors to take care of his patients, Dr. Venugopal used to stay for almost 18-20 hours in the hospital.

In contrast, the patients coming with a defective heart valve were usually from a poor socio-economic background. They were generally not so choosy or demanding as the patients coming for CABG. They used to get satisfied by the senior resident taking care of them and not demand the senior cardiac surgeon to attend them personally in the evening or night time. So the cardiac surgeon operating on them had a relatively relaxed mind and more free time in the postoperative period. 

But the opportunity for fame and fortune was in operating on the rich and VIP patients with CABG. Cardiac surgeons skilled in CABG operation were in high demand in the private sector with big pay packages.

So, choosing what surgery to do, how many to do, what kind of patient he will serve, Dr. A. Sampath Kumar was able to strike a work-life balance.

When it comes to your profession or work, what are you? Are you like Professor P. Venugopal or like Professor A. Sampath Kumar?

Whatever it is, remember: It is a question of your choice.

 

Don’t blame your job, your career, your industry, your profession for the lack of your time, or ill-effects on your mind or body. 

It is you who have chosen to give or not give the extra time to your work.

It is you who have chosen to relax or work hard for progress in your life or career.

It is you who have chosen to have success or peace from your profession.

It is you who have chosen to earn fame and fortune or obscurity and paucity from your profession.

It is your choice.

Love it or Leave it.

Please also read 'Where is the Time' https://agnipathdoctors.blogspot.com/2020/05/where-is-time.html

(Based on allegedly true incidents)

— ND

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DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norms. 

The CTVS Selected Doctor

If you ask the students newly joining medical college what they want to ultimately do in life, chances are that you will get the answers that; they will like to cure cancer, became a cardiologist or neurologist, or a cardiac or neuro-surgeon. As time goes, many lose their passion or set their sights on something more mundane or achievable, but some keep the flame of their passion burning throughout their career.

One such person was Dr. Shahid Hasan (Fictional Name). A highly brilliant student, Dr. Shahid wanted to become a cardiac surgeon since the day he joined as an MBBS student in AIIMS, New Delhi. 

After clearing his first year, where they were taught only the non-clinical basic sciences, the second year started which had a mix of basic sciences like Pathology and also clinical postings. While most students in the second year restrict themselves to going to the wards during their clinical postings, Dr. Shahid started visiting the General Surgery minor operation theatre. By the 3^rd year, he started visiting the main operation theatre and by 4^th year he had started assisting in the major operations in the main operation theatre, a task reserved for the interns after clearing their 4 ½ year MBBS course. This was all the while having a brilliant academic record in all MBBS subjects.

During his one year internship, he started visiting the Cardiac surgery center to get an early start in learning cardiac surgery. There is no direct admission to the Cardio-Thoracic and Vascular Surgery Mch course (at least in India). One has to join and get a degree in General Surgery (MS) to be qualified for admission in the three years CTVS Mch course, which was also thru an All India level entrance exam.

 After completion of his internship with the extra CTVS experience as a bonus, Dr. Shahid joined as MS General Surgery junior resident (JR) in the Department of Surgery in AIIMS, New Delhi. Even when working as JR in the surgery department, Dr. Shahid took time out of his busy schedule and kept on visiting and learning in the CTVS department. 

Finally, the much-awaited moment arrived. In the final months before his MS general surgery exam, Dr. Shahid filled the form for the entrance exam for admission to the Mch CTVS course. As the course starts almost as soon as the MS general surgery course ends, the entrance exam was held sometime before the final MS exam. In the All India level exam with only limited seats, with both written and practical exam, Dr. Shahid, as expected was selected with flying colors. 

Once the result was out, Dr. Shahid’s joy had no bound. After all his lifelong goal was about to be realized. He was on the way to become a great cardiac surgeon like Prof. P. Venugopal, who did the first heart transplant in India. Shortly after the Mch entrance exam, there was the formality of the final MS Surgery exam which had to be cleared before he can qualify to join the Mch CTVS course. A joyous and confident Dr. Shahid appeared for the MS exam.

A few days after the MS exam, the result was declared. Dr. Shahid had failed in the MS Surgery exam. He could not join the CTVS Mch course as he did not have the qualification of MS Surgery. Dr. Shahid had to appear and clear both the MS Surgery exam and the Mch CTVS entrance exam again after six months.

Now the exam hall, including the practical exam ward, is a closed confidential area, so what exactly happened for this highly unexpected result is anyone’s guess. But there were rumors that Dr. Shahid got too confident about clearing the Mch entrance exam and took it for granted that he will pass the MS Surgery exam. His taken for granted approach, that as he had cleared the national level CTVS Mch entrance exam, he will easily pass in his final MS Surgery exam, hurt the sentiments of the General Surgery faculty members. A faculty member is believed to have allegedly made the remark while commenting on Dr. Shahid's result, ‘First learn general surgery before learning cardiac surgery’. 

No exam is too small that you cannot fail in it. A student, whoever brilliant, is never bigger than the examiner taking the exam. 

कोई भी एग्जाम इतना छोटा नहीं होता की आप उसमे फेल नहीं हो सकते, और कोई भी स्टूडेंट, चाहें कितना भी होशियार हो, अपने एग्जामिनर से बड़ा नहीं हो सकता। 

 

Be very careful in the twilight period between leaving your old position and joining a new one. Even though in the inside your heart may be jumping with joy on the prospect of joining the new course or position lying ahead of you, it is better to portray that you are saddened with the prospect of leaving your old position or institution till you get away with your full clearance or degree. 

This is especially important if your present teacher or employer can affect the joining of your new post. Have a balanced act and never in any way, directly or indirectly, belittle your present position, department, teachers, or employers in comparison to your future prospects.

But don’t lose hope. Dr. Shahid after successful completion of his Mch CTVS course from AIIMS, New Delhi, migrated to the USA where he is a very successful cardiac surgeon. Don’t let temporary hurdles discourage you as life is like a cricket test match and not a 20-20 match.

(Based on an allegedly true incident)

— ND

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DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norms. 

Where is the time?

Whenever a doctor advises his/her patient to do some exercise, do some relaxation and meditation, take better care of his/her body, the common excuse we hear is that, ‘I don’t have the time’. 

I received a WhatsApp message a few days back that stated,

‘After this lockdown, if you don’t come out:

With a better body, a new degree or skill,

Then it was never a question of lack of time

But a lack of discipline and will power.’

True?

Although the work of many essential service providers like doctors and other para-medical staff, the Police, the administration, etc., might have increased, many others are indeed having extra spare time on their hands due to the lockdown to contain the coronavirus infection. Even those working from home are saving time in traveling to and from their offices. Out of these, how many have done the things they had justified not doing previously because they did not have the time?

Deep down I knew it to be true, as I had seen this in action right in my post-graduation (MS) days.

Dr. Dev (Fictional Name) was MS Surgery Junior Resident in AIIMS, New Delhi. This is the same AIIMS whose junior residents had challenged Indian Prime Minister Shri Narender Modi Ji to work a single day like them. Under the pressure to complete the Sisyphean task of the ward work to the perfection of the senior resident and consultants, Dr. Dev and his fellow junior residents like Dr. Murari (Fictional Name) struggled to find time to eat even a single full meal in a day.

In contrast, on many nights, the same unit’s final year junior resident, Dr. Robert Gupta (Fictional Name), even before the evening round started had done half the work, finished most of the work within few minutes of completion of the senior resident’s evening round, and then giving a list of the remaining work to be completed to Dr. Dev and Dr. Murari, he will be off to dinner with one of his lady friends.

While Dr. Dev and his fellow junior residents struggled to have a decent meal a day in the hostel mess, Dr. Robert was able to find/create time to take his lady friends to dinner in restaurants. So it was a question of prioritizing, smart work, short cuts, delegation, not running after the impossible target to complete the ward work to perfection and not just lack to time, which Dr. Dev was too stupid to realize at that time.

Wait! You are probably shouting now. A young male under the influence of his male hormones and driven by the passion of love can accomplice impossible tasks. The same cannot be applicable to doing things like exercises and self-improvements.

For that we will have to hear the story of another junior resident, Dr. Biplab Mishra, who joined as a junior resident in the Department of Surgery, AIIMS, New Delhi, around the same time period.

During the residency, the junior residents are posted in different departments of AIIMS, such as CTVS, Neurosurgery, Urology, Orthopaedics, etc. Since the junior resident is seen as a visiting doctor on their rotation postings, some department gives some more free time to the junior residents on rotation as compared to the parent general surgery department. Instead of wasting this relatively free time in just watching movies and TV, Dr. Biplab, when on rotation used the free time to do the basic course of Meditation and Pranayama (Yogic Breathing Exercises) and Sudarshan Kriya® of the Art of Living Foundation.

During the course, the instructor highlighted the importance the doing the yogic exercises daily without a gap of even a single day. If the person misses doing the daily Kriya even for a single day, the cycle gets broken and the beneficial effects on the mind and body get interrupted. A person has to start counting again as day one when he restarts doing this yogic practice once again. Also, the entire breathing exercises, which take around 40 to 45 minutes, have to be completed without any interruption; not even opening the eyes or talking to someone.

Unperturbed, Dr. Biplab resolved that he will do the pranayama and Sudarshan Kriya® daily without any gap. When people learned of his resolution, they thought that it is impossible to find the uninterrupted 40 to 45 minutes daily to do these yogic exercises while working as a junior resident in the Department of Surgery in AIIMS.

With the great determination that there should not be even a gap of a single day, Dr. Biplab Mishra managed to do this Pranayama and yogic exercises daily even when working as a junior resident in AIIMS, New Delhi. Even now, while working as Professor in AIIMS, New Delhi, Dr. Biplab takes time out from his busy schedule to practice his daily yoga exercises.

These two example shows without a doubt that it is never lack of time, but your interest, your priority, your time management skills, your dedication and discipline that determine if you do something or not. Don’t justify your laziness and lack of interest by labeling it as a ‘lack of time’.

On a lighter note, when next time I ask you, ‘Have you read my blog?’ and you say, ‘I did not have the time’ ……. 

(Based on allegedly true incidents)

— ND

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DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, leg,al and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, leg,al, and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norms.

The Metropolitan Patient

One of Dr. Jolting’s (Fictional Name) old patient phoned him as he wanted to show his younger brother’s son for some stomach problem. The young lad was born and bought up in Bengaluru (Bangalore) and had come to visit him after a long time. Dr. Jolting asked his friend to bring the young man to the hospital where he was working.

Dr. Jolting hospital was situated in a lush green area with lots of open space and open windows. This had a near-zero pollution environment but also left it open for entry of dust and other things to the wards and OPDs.

When the young man came to the hospital, he looked around with curiosity as he had never been to such a down to earth hospital setup previously. His visits had been to only shiny city corporate hospitals in the past.

Dr. Jolting asked the young man to lie down on the examination couch and Dr. Jolting started examining his stomach. 

Suddenly, pointing at the roof, the lad cried out with fear, ‘Lizard!’ 

 

Dr. Jolting looked and indeed a wall lizard was crawling near the roof and appeared to be looking curiously at Dr. Jolting and the young man.

Used to the sight of the lizards moving around in the warm tropical open spaces, Dr. Jolting was unfazed. But at the sight of the young man trembling with fear, Dr. Jolting with calm and reassuring voice replied, 

‘Don’t be afraid. It is a pet.’

We take many things for granted as we are so used to it. It takes some stranger to jolt us out. In a similar way, we may be shocked by things different from what we are used to. Learn to look at things from others' point of view also.

And remember, like Dr. Jolting, be ready with a quick explanation when someone points out something which appears strange to him, but normal for you.

 (Based on an allegedly true incident)

— ND

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DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norms

The Chronic Ulcer Lesson

Dr. Dev (Fictional Name) was sitting in the surgery OPD when a patient entered the room followed by 9-10 persons. Even before he came near him, Dr. Dev noticed that he was having a small ulcer, around ½ inch in size, just below the elbow crease, covered with dirty slough material. 

When the patient sat on the patient’s chair, Dr. Dev took the old OPD slips from his hand and inspected them. Dr. Dev, who used to speedily cram heavy medical textbooks on the night just before the college exam, quickly noted from the patient’s old record, that as he had suspected, the patient was having the wound for around 15 days, which occurred when he received an intravenous injection at the common site near the elbow crease, which unfortunately spread outside the vein and caused the ulcer. Also, he was diabetic and the last recorded sugar in his slips was also high. 

Making a diagnosis of delayed healing of the ulcer due to uncontrolled diabetes and movement of the ulcer site as it was near the elbow joint, Dr. Dev asked the junior resident sitting with him to take the patient to minor operation theatre and under local anesthesia remove the necrotic slough from the ulcer, do a good dressing, write antibiotics and pain-killers and refer him to the physician for the change of drugs to control of his diabetes. He directed the patient to go with the junior resident for further treatment. The entire sequence occurred in just 1-2 minutes.

On hearing the patient turned livid and angrily shouted at Dr. Dev, ‘You doctors don’t want to work at all. You are advising me treatment without seeing me properly and just shunting me away!’

Dr. Dev tried to placate the patient, saying, ‘I have gone through your records and read the full history and treatment given previously which was correct. Your wound is not healing because of high blood sugar, which the physician will treat, and the movements of your elbow joint, which you will have to restrict. The minor surgery I advised is very well done routinely by my resident. There is no question of negligence on my part.’

Dr. Dev's words fell on deaf ears. The patient continued his harangue, with the persons accompanying the patient joining in by making aggressive gestures and sounds of resentment.

To defuse the situation, Dr. Dev got up, put on pair of sterile gloves, slowly palpated the patient’s ulcer and the surrounding areas and moved his forearm in different directions, all the time, with a look of intense concentration on his face. 

Dr. Dev did not want to do this palpation in the first place as it was painful to the patient and its finding was not going to make any difference to the treatment. 

Once he felt that the patient looks satisfied, he stopped the examination and removing the gloves he wrote the treatment of the patient by his own hand in his OPD slip. This was the same treatment that he had asked his resident to write and then requested the patient to please go to the minor OT with the resident.

It is logical that the time you devote to a patient or a problem should be in proportion to its seriousness. But in actual life, you have to devote time in proportion to the size of the ego of your patient/client/customer. If you appear to be devoting less time than their ego demands then you may face resentment and retaliation, for being ‘superficial’ or ‘not serious enough’.

It is not enough to just provide the treatment or solution to most people. Most people want their doctor or service provider to listen to them, empathize with their hardship, devote time to them and provide the treatment or solution only after due deliberation. 

If you skip any of these either due to lack of time, work overload or the minor nature of problem according to you, then your patient or client is not going to be satisfied, even with correct treatment or solution.

Remember, you may see someone’s problem as minor, but to most persons, their own problem appears to them as the biggest problem on earth.

It may not be true in other professions, but when a crowd accompanies a patient to the hospital than the patient and the crowd either think that the patient is a VIP or that he is suffering from a very serious life-threatening disease. So be ready to respond accordingly to avoid any unpleasantness.

(Based on an allegedly true incident)

— ND

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DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norms. 

The Complete Knee Checkup

One doctor who was posted in the Community Health Centre (CHC) Ballabhgarh which was affiliated to the AIIMS, New Delhi, recounted his experience there. 

An aged woman came to the OPD with the complaint of pain in her right knee. The doctor examined the patient and made a diagnosis of age-related osteoarthritis and prescribed some medicines for her.

The patient looked at the doctor with dissatisfaction and implored him to check her knee properly before writing the medicines. The doctor replied, ‘I have properly checked your knee and then only wrote the medicines.’

The unconvinced woman countered, ‘But you have not used this to check my knee!’ pointing at the stethoscope (steth) hanging around the doctor’s neck. 

As most of you know, the stethoscope is used by doctors to listen to your breath and heart sounds. As most of the patients used to come to the OPD with chest complaints, cough and cold and fever, examining the chest with a stethoscope was done in almost all patients.

When the doctor had logically not applied the stethoscope to her knee, the patient felt the doctor was not examining her properly as compared to the other patients causing her distress.  

Bending to her request, the doctor applied the stethoscope to her knee, acted as if his listening carefully to sounds made by her knee, and then said, ‘I have now done the full examination, but there is no need to change the medicines already written. Take them and come next week for follow up.’

A now satisfied patient happily left with medicines.

When the doctor did not use the stethoscope to examine her, the woman felt that the doctor is not taking due diligence (proper care) in treating her leading to her dissatisfaction.

It is not enough to be conscientious in while taking care of your patients/customers / clients but you should also appear to be doing so to their satisfaction, even if you may have to indulge in showmanship at times.

(Based on an allegedly true incident)

— ND

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You can receive a notification on latest post by subscribing via clicking on the bottom of the page on the Subscribe to: Posts (Atom)

DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norms.