The medical profession is noble! But are we?
Doctors feel
· I work hard and I deserve nice things.
· I save lives and I’m smart; I deserve to be well paid
· All are making money! Why should I not?
· I have specialized. I have spent a lot of money. I have worked hard. I deserve to be rich and famous!
· I have a family to take care of!
· Nobleness of a profession is not synonymous with sanyas or sacrifice.
· A doctor should be committed to his profession. I am committed to my profession. I deserve to be paid and paid well.
Normally the white coat and the doctor in it convey a reassuring, comforting calmness. They radiate stillness and stability. Their presence provides solace. Their behavior offers hope. It’s the perfect antidote to the concern or even panic in your heart. The Tone and voice- it’s gentle and soothing. It shows attention and concern.
There is a hue and cry from all quarters that the medical profession is no longer “the noble profession it was! True, it has become a business. People accuse doctors of malpractices, exaggerated expenses, and unnecessary operations and of even stealing organs from patients for transplantation for the well-to-do with diseased organs. The avoidable invasive interventions and irrational prescriptions and substandard care are the talk of the town! The patient contacts have become cursory, and lack of communication has created a massive trust deficit between the doctors and the patient. With the rise in cases of medical negligence, the common man is becoming more cognizant of his rights. The litigations have made the doctors practice Defensive medicine escalating the costs.
Yes, often many do not go to rural services. The medical profession cannot be compared with the selfless service of the military, which is a specialized job that involves fighting for the security of the country. Postings on borders mean living a life where you may be away from your family for months & years. Military people have special privileges and they richly deserve every bit of it as the job involves sacrifice and risk and uncertainty of life.
Doctors prescribe medicines of which they know little, to cure diseases of which they know less, in human beings of whom they know nothing- Voltaire’.
We do business in the name of medical practice! But we are still the kindest among all professions! Doctors as living Gods are extinct! We are struggling to be human! Medicine today values intervention far more than it values care. Patients are not monuments of disease. Remember that there is a person and not just a pathogen infecting a host. He needs your help!
Medical error is not medical negligence!
To Err Is Human — the problem is not bad people in health care — it is that good people are working in bad systems that need to be made safer. It includes the whole range of innocent mistakes and honest errors of judgment despite good care and competence!
Nearly 138 million patients witness harm caused by medical errors every year — WHO. Medical errors are the third leading cause of death and morbidity. A significant burden of disease is comprised by surgical errors and 50% of the complications are avoidable.
Patients are overwhelmed with their illness and sickness! Most people fear death. Whenever there is fear they pray to God. A medical doctor is given that status. We as doctors should prove that we deserve to be remembered that way! We learn the “science” of medicine but the practice of the “art” of medicine gets a stepmotherly treatment. Prevention is not a priority anymore! There is no money in prevention. Healing can take a backseat.
Doctor’s Day is an opportunity to rededicate ourselves to the practice of the science and Art of medicine. It is a time for us to reflect on the responsibility we bear to the ethical path of healing. Healthcare has been sick for decades, but the illness has progressed rapidly in recent years. In my mind, the doctor-patient relationship is sacrosanct. There is no relationship where the bond of trust should be so strong. Trust has many components. Compassion, Communication, Consistency, and Competency: These four drivers of true trust are missing to varying degrees in the current day practice!
Doctors are busy and many have no time to spend with their patients. The alarming part is how fast doctors’ empathy wanes. There are countless cases of substandard care, overlooked diagnoses, bureaucratic bungling, and even outright antagonism between doctor and patient.
The medical profession has failed to regulate itself. Doctors resent being policed. They treat the imposition of regulations as a personal affront. The media always gives the benefit of the doubt to anyone who has a grouse against doctors but doctors are never given that benefit.
Zero tolerance to violence against doctors. Years of hard work to be just worthy of that white coat. We give our best to save patients’ lives. In spite of the best try we may not be able to save a critically ill patient. Then we struggle to save our own lives from the attackers. We are here to take care of our patients. But who will take care of us?
2018 study in the New England Journal of Medicine- the trust in doctors has declined from 73 percent a decade back to the present 34 percent. IMA has revealed that 75 percent of doctors have faced at least some form of violence. Still, violence against doctors remains an under-reported phenomenon, with many doctors falling prey to frenzied witch hunts.
Most Government Hospitals are at least 10 yrs. behind the state of the art of medical care. Only 20 percent of the registered allopathic doctors are in government services. Medical treatments have taken a huge leap in private facilities.
Doctors and investigations are the de facto revenue centers in private hospitals. Governments have made medicine a business. Corporate management has ensured that it is not a service. Medicine is not the same as engineering or hard science in terms of mathematical predictability and reproducibility. The patient complains — about his perception of what he is suffering from! It is for the doctor to decipher what it is or what it could be with the help of his experience, investigations, and technology!
Most Doctors are intellectual, introspective, and inquisitive. They are curious, methodical, and rational. They are analytical and logical. Many of them are kind and generous and caring. Medicine is a hot mess of human anatomy, physiology, Psychology, pathology, drugs, hope, and compassion.
In the medical world “To err is human” is not accepted! Admitting that someone was hurt by a mistake that you made can be a personally daunting experience. Many simply do not admit errors altogether for fear of retaliation, losing the respect of peers, and even loss of job!
Any error by a doctor that was unavoidable given the circumstances, and that another doctor would have made in the same situation, is simply an error. Medical malpractice is when a mistake is made as a consequence of carelessness and negligence. In complex system, there are numerous latent errors — errors waiting to happen.
For most of human history, we struggled with scientific ignorance. We didn’t understand how things worked or what caused illnesses and how to treat them. While science has increased our knowledge dramatically, we still often fail. The reason — It’s the enormous and ever-increasing complexity of many fields today. We struggle to apply knowledge the right way at the right moment. Under pressure, we make simple mistakes and overlook the obvious.
Hospital care is increasingly complex, especially critical care. It is an increasingly large part of what hospitals do. Over a normal lifespan, most people will end up in an ICU at some point. The average ICU patient requires 178 actions or procedures a day.
What do doctors really want?
The short answer is Respect and Autonomy to treat the patient. They want better staff- trained to handle the continuum of care. Put simply, they want all things that contribute to better patient care and outcome. We need to indemnify them against potential backbreaking litigations or violence when things do go wrong, as sometimes they will. They need to be supported for continuous training and educational initiatives that enhance the scope and scale of their services and clinical expertise. Unexpected death is universally heartbreaking!
First of all, it’s a miracle that we don’t make more mistakes. Emergency departments are constantly flooded with a bizarre mixture of everything from infected nails to aortic disasters. We spend our days at breakneck speed sorting through the thick cloud of unknown factors. And all the while, we save lives and ease suffering.
In the course of your career, even a short career, you will save, help and comfort vastly, astronomically more people than you will ever harm. And you will show more kindness than most people ever imagined possible
How can those in the medical community avoid the avoidable errors that sometimes cost patients their lives? The answer is — a checklist. Establish protocols! Ignorance or lack of knowledge, and Ineptitude are not acceptable!