The Referral Controversy

Please Note: This article is intended only for Doctors and medical undergraduate and post-graduate students. Non-Medicos please do not read this article.

At midnight, Dr. Anil Kumar (Fictional Name) Medical Officer-In-Charge of the Community Health Centre (CHC), a government hospital at sub-district level, was woken up by a patient. His hand had got injured by Thresher (a farming equipment).

Without bothering about the late night hour, the blood dripping from the patient's in his house's consultation chamber, he attended the patient. As he was having a severe injury, after preliminary care, he referred the patient to Government M.B.S. hospital, Kota.

The patient on his own initiative went to a private hospital and got treated there. He was not satisfied with the outcome. He filed a court case on the private hospital and also dragged Dr. Anil Kumar’s name in it. He complained that Dr. Anil Kumar had referred him to that private hospital; therefore he is also to be blamed for his poor outcome.

As, Dr. Anil Kumar was very clear about his policy of referring only to the government hospital, as he was in government service, he did not come under their pressure. On searching the hospital record, he found a clear mention of referring the case only to Government MBS Hospital, Kota. On producing this record in court, the charges against him were dropped. Maintaining and preserving clear records, with a policy of referral only to the government hospital, helped save Dr. Anil Kumar from undue harassment.

Tip: If you are referring the patient to some other hospital, mention in the patient’s record and in your own hospital’s record maintained separately, the date and time of referral, the place where referred and the reason for referral.

Tip: Also keep a record with you on the condition of the patient at the time of referral.

Tip: Refer only in accordance with your hospital’s policy whether working in private or government sector.

(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 Poor Prognosis Sign

Please Note: This article is intended only for Doctors and medical undergraduate and post-graduate students. Non-Medicos please do not read this article.

In trauma patients with severe injury where chances of survival are bleak, it is essential to get the fact across to the patient. Since the trauma occurs unexpectedly usually in a fit person, the fact that death can occur sometimes does not register in the shocked mind of relatives.

Even if the treating doctor conveys the fact, if death does occur, the relatives sometimes blame the treating doctor. They allege if the doctors had told them clearly that there was a risk of death in their patient, they would have taken the patient to some other center / hospital for better treatment.

Dr. Dev (Fictional Name) met with his friend, Dr. Dharamraj Agarwal, (Fictional Name) a prominent Neurosurgeon, of the city and asked about this problem as he routinely sees many serious cases of Head Injuries with a high death rate.

Dr. Dharamraj said, “In serious cases, I keep on explaining to the relatives that there is the real risk of their patient dying till I know that they have clearly understood this fact.”

“There lies the problem,” said Dr. Dev. “How do you know that the relatives have clearly understood the risk of dying of their patient?” asked Dr. Dev.

Dr. Dharamraj replied, “I just keep on explaining repeatedly until one or two relatives start crying.” “This is one indicator that the poor prognosis has been clearly understood by the relatives. If the attendants do not exhibit appropriate signs, I keep on hammering the facts till it hit home.”

 (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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