Hospitals, not Medical Colleges!

I found out yesterday that our consultants will be attending local private hospitals to attend to dengue patients admitted there. This I found very inconvenient. Who wouldn’t? This is effectively saying that the private hospitals and their standards of care are virtually non existent. The paradoxes regarding the decision piled up:

1- If the Private Hospitals are so incompetant, who is the fool who gave them licenses to operate.

2- What? Some have no license? Then who is the fool who has his eye closed to this issue?

3- If they exist, then well, they do. Don’t punish us if they may not be competent enough to handle the load.

4-A form of check and balance should exist to monitor their faulty practices. This is essentially shying away from the issue.

Well I have thought of more paradoxes than I can put on (e)paper. Admitidly the governement is trying all its best but it still seems that they are ignorant or oblivious to the working of hospitals.

Allow me to shed some light on the issue. WE NEED MORE HOSPITALS, NOT MEDICAL COLLEGES. Ofcourse, it goes without saying that a medical college can not exist without a teaching hospital but practically speaking all the teaching hospitals affiliated with these medical college fail miserably when it comes to serving and giving back to the community. In fact, they do such a bad job catering to the needs of their own students when it’s their turn to complete their house job. These students (in majority or minority, I don’t have the figures) flock the existing government hospitals in significant numbers. The private hospitals are doing a better job then these private teaching hospitals.

The dilemma became obvious during this dengue epidemic. I would like to have the opportunity to teach in these private medical colleges, but to practice clinical medicine is still a long shot.

The owners know the reasons to this all too well.


How To Treat Your Doctor And Why?

“I never wanted to become a doctor!”

It isn’t the first time I am hearing this line. It’s actually a staple of my friends and colleagues.

Some really mean it. They studied late into the nights when their fellow 3rd graders were fast asleep, dreaming of castles and dragons. They piped down during college when most of their class fellows were getting a whiff of new found freedom. Each new year in school, college and university began with an innocent promise: This is the last year, after this I am on the easy street. This will continue well until the day they give up their ghost. They are the ones who never intended to become doctors. You will rarely come across this group.

To others, this revelation is only retrospective. When they face the reality that they may be equipped with knowledge but the system essentially bars them from the tools that are instrumental for good health care.  At a point in their lives it was the ONLY  thing that the wanted, to become messiahs of some sort. This was what they worked for with full motivation, without any coercing or “torture” by their peers.

The bottom line is the same for both though. They are unhappy and dissatisfied. They are the ones you find fairly grumpy and dangerously to the point. They don’t beat about the bushes, any bad news is not sugar-coated. Any good news is down played. They smile less often and are often very sarcastic about everything. They expect you to be grateful before they render their services, and if you really want their services you have to give them exactly what they want. They are a hard-working bunch, don’t get me wrong. In fact this is the only thing they can do. After a point this is all that they live for and all that they care for. Their marriages are more often than never a social drama. While a normal person can discuss weather when a formal conversation is required, all they can come up is with the injustice with the system. So much so that you try to avoid them and even label them as being insecure. The only humor they are accustomed to is either sarcasm or dark comedies that send chills to the casual listener. They try to keep their children from adopting the same line of work, even if it is the only thing they want to do.

They normally function as good doctors because that is the only thing that pushes them through the hardship that their life has become. The thing that they forget is to show compassion. They are not the people you would be happy to see peering into your charts and this makes them angrier. They try to make a point that public dealings and medical knowledge don’t go hand into hand. You have a tendency to believe other wise. You claim that demeanor is equally (if not more) important. I said “claim” because if you found out that your sweet talking physician is less competent than he should be, you’d shun him with equal scorn. They find this hypocrisy unbearable and add it to the daily hardships that they have to endure.

No psychologist or psychiatrist can help them because they are usually too proud to ask for help. They can’t help themselves because learnt helplessness comes with the territory. What’s worse is that this feeling is compounded by the incapacitated health care system.  They don’t make friends very easily and very soon the pitch in their voice is gone. They’re word choice become bland and unimaginative. They criticize for the sake of criticism because they don’t expect anything different from anyone.

Their life boils down to three words; pessimism, boredom and paranoia.

Who or what makes these doctors? For one thing parents who recognize the genius of their kids early on and plan to do the kid a “favor” by prompting them to aim high. The only high aim in their opinion is a doctor or an engineer. The biggest culprit however, is the crazy and inept system that surrounds us. The people who think they don’t want to be doctors in retrospect are a majority. They make this statement their dogma sometimes later during their training. Simply saying, ” Stop your complaining, if you didn’t want to be doctors you shouldn’t have!” won’t help because all of this is equally disturbing for them. To become a doctor is what they had worked for. This was before they realized that they will have to work on Sundays without getting a day off in return. Where overtime is not an option, but often a necessity and that too without extra pay. Where an extra job is a norm if one plans to set up a family. Before they realized that they have an extended internship, which may span 4-6 years of their lives. Before they realized that there is a lot more to diagnosis and treatment because much of the health infrastructure that is required for them to do their job is simply not there.

So the next time you feel put off by a doctor yawning at 2 am and you feel like giving him a ‘piece of your mind’ about sleeping on the job, cut the guy some slack. If you want to do exactly that, do so without sounding sarcastic and judgmental. Try to treat your doctor the way you wanted to be treated yourself. For a minute assume that he is a patient and a victim of the poor job conditions that may drive any other person insane. Smile, greet him and tell him your problem. No matter how fed up he is with his life, he is bound to reciprocate your gestures, not just as a doctor but as a human. You as a patient or a relative of a patient also have the responsibility of ensuring that your doctor-patient relationship is anything but strained.

By showing your doctor some respect, you will end up reminding him that he was right to become a doctor. No matter how many lemons life has ready for him and no matter how much manure the system is ready to shove in his face, he will end up smiling and will give you the best care you deserve. Whats more is that he may even go home happy and satisfied. Thats all there is to it, actually.