The Fracture Reduction

Forget the ancient period when the knowledge was shared only among a few select persons, often in a secretive society or cult; even just a few years ago, there were many who were secretive about their knowledge or techniques. 

Dr. Ashok Tiwari, senior professor of orthopaedics, in Kota Medical College, recalled the scenario just a few years ago giving the example of treatment of fracture. 

After fracture of the bone of the limbs, depending on the bones involved and exact place they are broken the distal or lower part of the limb may become deformed. In health, there is a complex system of muscle surrounding the bones, fulfilling their function and balancing the action of each other. With fracture, this coordinated action of the muscle becomes unbalanced, causing the distal/lower part of the arm or leg to take a deformed position. Just putting a simple plaster cast or splinting the fractured limb may result in the bones joining in a deformed position, causing cosmetic and functional problem to the patient. 

The distal / lower part of the limb has to be manipulated in a precise sequential manner, depending on the site and type of fracture to bring the limb in normal position, known technically as 'reduction of facture' before applying a plaster cast. Some orthopedicians used to practice great secrecy about their technique to bring the fractured limb in proper position. They did not want other to learn their methods so that they can have a monopoly. 

Some orthopedicians used to ask other doctors and staff members to leave the room when they would do this manipulation to bring the fracture in the proper place. One orthopedician used to throw a heavy cloth or blanket over the fractures arm or leg then manipulate it blindly covered with the blanket so that others including the nursing staff assisting him do not learn how to bring the fractured part in proper position.

In contrast, now when Dr. A. K. Tiwari goes to medical conferences, he notices that the best orthopedicians from India and abroad, freely talk about their methods and techniques to various orthopedic problems, and demonstrate them by an on-screen presentation.

As Dr. Tiwari had so aptly said, ‘In old times surgery used to done behind the screen. Now it is done on the screen!’ or ‘पहले सर्जरी परदे के पीछे करते थे अब सर्जरी परदे के ऊपर करते है!’

This is true in almost all fields now. There are many workshops, courses, classes, seminars, etc. available nowadays in almost all subjects. With the advent of internet, YouTube, bloggers, Wikipedia like sites, there has been a tremendous change in the knowledge and information available to any person with desire to learn something new. There are lots of educational resources available on internet such as video lectures and online courses both in orthopaedics and diverse subjects from medical and engineering science, arts, craft, technical and vocational subjects and what not.

The present students should be thankful that they live in such an open society. Please use wisely the available resources to increase your knowledge and expertise to enrich your life and better serve humanity.

(Based on allegedly true incidents)

— ND

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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you 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 purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you 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 norm. 

The Judge and the Junior Residents

Sometimes back there was an incident involving a senior neurologist of SGPI Hospital and High Court Judge. This jogged my memory of somewhat similar incidence involving two General surgery junior residents of Kota Medical College.

A little background first. There were only six junior residents in the department of general surgery in Kota Medical College at that time. With two residents going on rotation posting in the neurosurgery and the urology department, there were only two junior residents in First Unit and only one junior resident each in the other two units. 

A married female patient with 60 to 70 % burn was admitted in the Burn Ward under General Surgery department. Due to the high probability of her death and to rule out dowry and marital violence, it is the rule get her dying declaration (statement) recorded by a court judge. But before the judge can record her statement, a doctor has to certify that she is mentally competent and physically fit to give a statement. The junior residents of the concerned unit were usually called to certify this.

When the session court judge reached the Burn ward, in the afternoon, he asked the staff to call the doctor to certify that the patient is fit to give the statement. When the ward staff called the junior resident Dr. Danny (Fictional Name), he happened to be suturing (stitching) a wound of a patient admitted in the early morning in the emergency ward. Once he completed the stitching he checked his phone and found the missed call from the burn ward staff. 

On learning that the session court judge was waiting for him in the burn ward he rushed there, but the damage has already been done. The judge had got quite angry at this delay and scolded him for making him wait before recording the patient’s statement. He threatened to put him in jail for ‘contempt of court’ by making him wait. Efforts to placate his anger by Dr. Danny were of no avail. 

Next day, Dr. Danny received an arrest warrant by a policeman to bring him to the judge’s court. Leaving his work, Dr. Danny went with the policeman to court. The judge made him wait for 2-3 hours, then he called him to his seat. Again the judge expressed his displeasure and threatened to put Dr. Danny jail for ‘contempt of court.’ Dr. Danny pleaded with the judge and was allowed to go after he tendered a written apology.

Dr. Danny shared his experience with his fellow residents who got angry with the judge’s behavior.

Sometimes later, another patient of severe burn got admitted in the burn ward. Again the same session judge came to record her dying declaration. Dr. Vicky Rao (Fictional Name) was the lone junior resident posted in the concerned unit. After being on 24-hour emergency call duty the previous day and after finishing his morning ward work, Dr. Vicky went to the hostel to take a bath and freshen up. Being in bathroom Dr. Vicky did not hear the calls coming on his mobile phone from the burn ward staff to come and certify that the patient is fit to give a statement.

As expected the judge got incensed at Dr. Vicky’s non-appearance and demanded to talk to the Unit Head. On receiving the phone call from the burn ward and learning the matter, Dr. Dev (Fictional Name), the Unit Head rushed to the burn ward from his office. 

Dr. Dev hurriedly certified to the patient’s fitness and apologized profusely to the judge for the inconvenience caused to him. But he also explained to the judge that Dr. Vicky is otherwise a hardworking respectful resident, but due to a shortage of staff he is very overworked and he must be busy in some important work to be so delayed.

Dr. Dev phoned Dr. Vicky, explained the situation to him, including warning that this is the same judge who had dealt with Dr. Danny previously. 

Few minuted later Dr. Vicky reached the burn ward accompanied with 10-15 fellow junior residents. Seeing their angry faces, Dr. Dev got worried. Dr. Dev immediately stopped the group from approaching the judge and said that “If you respect me as your teacher, you will please maintain decorum and not shout any slogan or get physical with the judge.

As expected the judge started scolding Dr. Vicky for his delay in coming and that his action constitutes obstruction of the work of the court and he can be held in contempt of court. But due to the presence of the fellow residents, he was not as vocal as he was with Dr. Danny in the past.

Once the honorable judge had left the hospital, Dr. Dev warned Dr. Vicky that there is still the danger that the judge can summon you with an arrest warrant to court and take action against you.

Forewarned, Dr. Vicky contacted his family friend who was a prominent lawyer of the city. The lawyer informed that the judiciary system expects the judges to have a very high standard and if you have a genuine grievance you can give a written complaint to the honorable District Judge (DJ) and the matter may be forwarded to the High Court (State headquarter) for inquiry and disciplinary action.

Dr. Vicky with the help of the lawyer wrote a complaint letter against the judge and gave to the District Judge. The District judge called the Hospital Superintend and Dr. Dev to explain the matter to him. They went to the DJ court, explained the matter to him including the difficulties faced by everyone due to the shortage of doctors. 

After listening to the grievance of everyone concerned an agreement was reached. Dr. Vicky apologized to the judge for any inconvenience caused to him and in return, the session judge apologized to Dr. Vicky for any hurt caused by him. On apology by the judge, Dr. Vicky withdrew his written complaint against the judge.

(Based on allegedly true incidents)

— ND
© Author. All rights reserved. 
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 DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you 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 purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you 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 norm. 

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Resident Doctors: Angels or Devils?

Resident doctors from Rajasthan (India) Medical colleges were in news once again due to their strike, alleged mis-behavior and alleged negligence in patient care. Forget the public, even local doctors sometimes wonder about the truth of these allegations.

Are resident doctors truly incompetent, lazy, and arrogant or are they just misunderstood, misrepresented hardworking component of the medical care of medical colleges?

Some genuine factors, which may be working against the resident doctors, should be kept in mind by the general public and medical fraternity before passing any negative comments on them.

Maximum contact: Resident doctors come in maximum contact with the patients. As the traffic density increases on the road, the probability of accident rises, similarly the chances of confrontation and friction with patients and their attendants increases with the high contact hours between the resident doctors and the patients. If we take into account the hours of contact between serious patients and their attendant and the resident doctors, the rate of conflicts will appear quite low.

On the spot availability: Resident doctors are on the spot and therefore, paradoxically, frequently their work and efforts are not appreciated by the patients. They do not feel satisfied with them.

One incident which occurred with one senior surgeon will be illuminating. He was doing Casualty Medical Officer (CMO) duty in MBS Hospital casualty and was also the on-call consultant for that day. One serious patient of RTA (road traffic accident) came to casualty and he was well attended by him.

But his attendants insisted that you call the on-call consultant by ambulance to see the patient. His effort to explain that he is the on-call consultant and ambulance will bring him only was simply not believed by them.

Patient’s attendants attach special charisma to doctors coming from home to especially see their patient. Resident doctors, unfortunately, lack this charisma by being readily available on the spot.

Non-local: When Jhalawar Government Hospital got upgraded to Medical College, it was in news just sometimes later that a senior resident doctor was man-handled there by some patient’s attendants. This may lend credence to the public and even some doctor’s view that the level of hospital falls once it is converted to medical college leading to increased incidence of bad incidents between the patients and the doctors.

This alleged increase in bad incidents once resident doctors come to hospitals attached to medical colleges can be well explained that the fact that the majority of resident doctors are not non-local, sometimes even from outside the states, selected through All-India Pre PG exams.

Local doctors recognize local troublemakers and provide special treatment to them. Even trouble makers stay away from local doctors. Local doctors have found that if attendants start getting heated up, just talking to them in the local accent/ tone/ language to them work wonders, and most automatically calm down.

Sometimes trying to act smart with local doctors can turn out very embarrassing for the troublemakers. Once a local public leader phoned one local doctor. In an angry abusive tone he asked the doctor, ‘why are you not paying attention to my patient. Don’t you know who I am?’ The doctor replied: ‘I quite know who you are. You are the same person who was badly beaten in Jubilee Hostel 2 years ago.’ The public leader instantly disconnected the phone and never again phoned him or came in front of him.

 Similarly, one brash young man told the treating doctor: Don’t you know that I was the president of student’s union Government College, Kota 3 years ago? The doctor who had studied for graduation before joining MBBS course, in the same college, replied: ‘Don’t you know that I was the president of student’s union Government College, Kota for 2 years, when you were sucking your thumb in diapers.’ Hearing this reply the youth instantly mellowed and said meekly: ‘You are from Kota? Sorry, sir, I thought you were someone from outside.’

Once Dr. Dev (fictional name) was on CMO duty and a patient of serious head injury came to casualty in MBS Hospital. Dr. Dev started the treatment but it was clear that the patient was unlikely to survive. A mob of his relatives and well-wishers had collected in the emergency. Shortly afterward the patient arrested, i.e. the heart stopped working, and cardiopulmonary resuscitation (CPR) was started by Dr. Dev and his team. In between CPR, Dr. Dev received a call by a local leader who was known to him on his mobile. He asked Dr. Dev about the condition of the patient. On hearing that the patient had cardiac arrest and unlikely to revive, he himself advised Dr. Dev to get away fast from emergency after declaring that the patient has expired as his attendants may get emotional and try to manhandle him. Although he promised that he will try to keep them as calm as possible which he did.

Therefore being non-local is quite disadvantageous to resident doctors but it is something they cannot help. By the time they become recognized locally, their 3 years tenure gets over and a new batch comes.

Overworked: Resident doctors are frequently overworked especially on emergency call days. Being less in numbers works to their advantage as they get maximum clinical exposure and experience but chances of committing mistake and giving vent to angry outburst increases. One study in the west found that doctors towards the end of sleepless night duty have decreased mental responses equal to someone who has drunk 2 bottles of beer.

Youthful appearance: Old age in worshiped in medical profession both by the public and medical fraternity itself. The youthful appearance of resident doctors works against them, and even with the correct treatment, they do not feel satisfied by the resident doctors.

One resident doctor who had come to do Post Graduation in surgery after a gap of more than 5 years after MBBS, and looked quite mature in appearance as compared to his age, told me that whenever he attended any call he was never asked by the patient’s attendant to call someone senior to see the patient. Due to his mature physical appearance, the patient’s relative assume that he was a consultant surgeon and not just a resident doctor.

Satyamev Jayate: Due to their young hot blood and idealistic view of the world, resident doctors frequently say things bluntly in a straightforward manner which they believe is true, while older doctors frequently gauge the mood of the mob and act accordingly.

Resident doctors believe that ‘right’ is always ‘might’ but the older doctors know that today the ‘might’ is ‘right’.

The Label of student: Resident doctors in many places, such as Rajasthan, have given the label of students and they are not officially recognized to do even things that any MBBS qualified doctors should be able to do.

A Medical Officer (MO) posted in a village can look after Medico-legal cases, treat RTA victims and poisoning cases independently, but the same MO if comes as a resident is not deemed competent to deal with the same type of cases, as he is labeled an under-training doctor now. This label of trainee also leads to decreased patient satisfaction even when they may be getting the correct treatment.

This is in contrast to Delhi and other states where resident doctors see officially all cases, sit and independently in separate chambers, even prepare MLC reports, and go to court to give evidence in cases of related to their specialty.

The aspect that resident doctors are proper MBBS qualified doctors having equal right and knowledge as any Medical Officer should be highlighted to raise the public’s confidence in resident doctors.

No favors needed: Most resident doctors do not plan to settle down in the place where they are doing PG. They do not have the fear of transfer from one hospital to another. Therefore, they are not impressed by local politicians and administrative officers and do not feel any need to maintain good relationships with them. This frequently antagonizes them and they may not be supportive of the resident’s side if a conflict occurs between the residents and patients.

Poor media management: Resident doctors frequently underestimate the role of media and do not actively manage the news floating about them. In today’s media dominated world neglect of this aspect can create an unfavorable image in the public’s eye.

So, friends, there are diverse factors responsible for the bad publicity for residents and not just any true negligence on their part. Resident doctors are humans and mistakes can occur by them, but frequently true mistakes go unnoticed and some alleged mistakes get highlighted spoiling their reputation.

(Based on true incidents)

— ND
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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you 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 purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you 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 norm. 

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The Party President

Dr. Jolting (Fictional Name) was the only assistant professor in the surgical unit C in the Medical College, Kota for some time. As the post of the senior resident was also vacant in the unit, he was the first on-call faculty member all the time.

Once when he was sitting in the Surgical OPD, two patients of road accident came accompanied by a mob of attendants. After primary treatment, they had been referred from a Primary Health Centre (PHC) from the rural area. Dr. Jolting promptly started examining the patients.

One of the attendants of the patient came forward and introduced himself as the Block President of Party XYZ. Blocks are small area compromising of few villages. Although it was one of the national parties of India, the name is not important as this was the individual person’s action and not representative of the party.

From his tone of speech and his body language, it appeared that he was doing a great favor to Dr. Jolting by speaking to him. Although Dr. Jolting was on friendly terms with his party’s officials much higher in rank than him, yet he decided to pamper his ego and not unnecessarily antagonize the party president. With an expression of joy and gratitude Dr. Jolting warmly responded, “I am very pleased to meet you. It is such a great honor.”

The Block President did not think that Dr. Jolting’s response was commensurate with his status. With a meaningful menacing look in his eyes, he told Dr. Jolting, “You must have heard that a group of our party workers had beaten a doctor in the PHC Sultanpur a few days ago. I was the leader of that group. So better take good care of these patients.”

Dr. Jolting looked at the party president and said, “Due to the shortage of staff I have been on continuous call for the last 30 days and have not been able to take even a single day off. I am giving the best possible treatment to your patients. If you are still not satisfied and want to beat me up then do it fast. I will be able to take medical leave and have rest for at least 10-15 days after the beating.”

The block president was stunned by Dr. Jolting’s response and stammered, “No, No. I did not mean anything like that. You please carry on with your treatment.” and faded to the background.

Sometimes verbalizing the opposite person's intentions can change the whole dynamics of the situation.

(Believe it or not but based on a true incident)

— ND
© Author. All rights reserved. 

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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you 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 purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you 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 norm. 

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The Useless Doctor

100^th Post

To write what is worth publishing, to find honest people to publish it, and get sensible people to read it, are the three great difficulties in being an author. — Charles Caleb Colton

One patient came to the surgical outdoor and said he was suffering from fever. The surgeon sitting there requested him to consult the physicians in Room No. 104.

Sometimes later he came back saying that his wife is suffering from backache and so write some medicines for her. The surgeon sitting there asked him to consult the orthopedicians in Room No. 120.

Again after some time, the same patient came with his young son saying that he is suffering from a sore throat and nasal discharge. The surgeon sitting there asked him to consult the ENT specialist in Room No. 124.

At this, the patient looked suspiciously at the surgeons sitting in the Surgical OPD room and angrily demanded, “Do you treat anything here or just send patients to other room?”

No matter what your qualification or skill is unless you can satisfy the need of the patient or client standing in front of you he will consider you useless and behave accordingly.

(Based on true incident)

— ND
© Author. All rights reserved. 

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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you 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 purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you 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 norm. 

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The Eczema Side-Effect

One afternoon, Dr. Dev (Fictional Name) received a registered letter from a lawyer. The lawyer claimed to represent a patient Dr. Dev had operated, three months ago in the government hospital for fissure-in-ano. The lawyer had written, as a side-effect of the wrongly done operation, his client had developed intractable eczema which had made his life horrible.

The lawyer instructed Dr. Dev to pay his client INR 50,000/- as compensation for the cost of treatment and the mental agony the patient is facing because of eczema developed due to the faulty operation. In comparison, Dr. Dev’s entire pay for one month was INR 35,000/- at that time. Also as the operation is done in the government hospital free of cost, Dr. Dev did not receive any extra money for doing any operation there. Dr. Dev was also surprised by the allegation of developing eczema after fissure-in-ano.

For Non-Medicos:  In fissure-in-ano, a small cut develops in the sensitive inner lining of the anus. This is very painful at the time of passing stools. In the operation for the anal fissure, the anus is generally dilated manually or by dividing the muscle surrounding it, making the anus wide which helps in healing of the cut. The side-effect of the operation is generally incontinence, i.e. the patient is not able to voluntarily control his act of defecation or passage of stools. There is also the chance that the cut may not heal in few patients, who may then require further treatment. Eczema developing as a side effect of the operation for fissure-in-ano was not possible.

Dr. Dev tried to remember if he had operated on any patient with fissure-in-ano and eczema. He recalled that he indeed had seen and operated on a patient with fissure- in-ano who was suffering from chronic eczema long before the fissure developed. With the patient’s name from the letter, Dr. Dev searched the hospital record and got a certified copy of the patient’s entire case-record from the hospital.

On-going through the record to his dismay he found that in the inpatient case-sheet the ward in-charge junior resident had only written; Diagnosis: Fissure in ano; History: Painful defecation x 2 months, no bleeding per-rectally; On Examination: Fissure in ano at 6’ O’clock position; Operation done: Anal Dilatation under spinal anaesthesia. The junior resident had not recorded the presence of the previous eczema in either the history or the examination of the patient.

Not losing hope, he went further through the hospital record. Going further, he found attached the patient’s consultation slip when he had consulted Dr. Dev at his clinic. In Dr. Dev’s personal note made at the time of consultation at his clinic, it was clearly mentioned that on examination of the patient Dr. Dev had found that along with fissure-in-ano, the patient was also having perianal and buttock region eczema skin disorder. On enquiring the patient told that he is having the eczema for many years which cause itching and occasional bleeding and pain, which was also recorded in the OPD slip. 

Dr. Dev asked the patient to first consult a skin specialist before the operation of the anal fissure. He also recorded the fact in the patient’s OPD slip that the person is suffering from chronic (long-standing) eczema for which skin reference had been advised. In meanwhile he advised some medicines for temporary relief for the fissure.

Sometime later, the patient again consulted Dr. Dev. He showed a skin specialist consultation sheet in which the dermatologist had given clearance for surgery, as the eczema was allergic and not infective. This fact was also recorded in the OPD slip.

Armed with this evidence, Dr. Dev consulted his lawyer. The lawyer sent an official reply to the patient’s lawyer that the patient is misrepresenting facts. He was suffering from eczema long before the operation. This fact has been recorded in the OPD slip. The patient will not get any money from Dr. Dev. In fact, Dr. Dev is considering a defamation case against the patient.

A meeting between the two lawyers was done at which Dr. Dev’s lawyer produced the copy of Dr. Dev’s OPD slips as a proof. Faced with this evidence the lawyer decided to withdraw the case against Dr. Dev. Instead of going in further litigations and wasting his time and money in court, Dr. Dev also agreed to not file a defamation suit against the patient.

Tip: Always record any pre-existing illness or condition in the patient’s case-sheet; however it appears unrelated to the patient’s present illness. This is valid even in non-medical situations. When you join some organization or project, do an active ‘witch-hunting’ and report all pre-existing problems at beginning so that later you may not get blamed for them.

For example, when a new CEO of a nationalized bank joined as head, in the next quarterly report there was a sudden jump in the non-paying borrowers and bad loan reported by the Bank. What happened was that the CEO setting strict standard declared the entire previous borderline or under review borrowers and loans given during the previous CEO’s period as non-paying borrowers and bad loans at the onset of her tenure. This will prevent these bad loans and borrowers from showing in her tenure if declared later on. So the first quarter result declared under her was very bad, but she did not got any blame for it.

Tip: Even though it may be work of your junior to complete the case sheet or basic workup, do keep a check on them and make a complete record yourself if necessary. In the above-mentioned case, it is Dr. Dev’s comprehensive notes which saved him. The junior resident had treated the case as only a simple minor case and wrote only a minimal basic record.

Tip: When confronted with any legal notice or litigation, it is better to let your lawyer work as a mediator and not deal directly with the opposite party even in a case clearly in your favor. This may increase your cost but creates an atmosphere that you are serious about confronting the opposite party in court if necessary. There is also a lot of legal jargon that which we are not familiar with.

Tip: Have a personal insurance cover even when working in government sector, as the court or patient may hold you personally responsible for any compensation.

(Based on true incident)

— ND
© Author. All rights reserved. 

If viewing from Mobile, switch to Webpage view to see a list of popular posts and index of topics of previous posts.

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you 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 purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you 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 norm. 

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