Sunday, March 3, 2013

When a doctor tells you to come to the emergency......

I was reading an online review of a doctor from a different hospital from a different speciality.The parents of a child thought the doctor to be inconsiderate and inhuman not to call them immediately to the place she was in night(I presume she was at her home as it says that she was trying to make her child sleep) rather than asked them to come to the emergency of the hospital she is affiliated to.To a parent whose child has been hurt it is the emergency of worst sort where emotion overpowers the emotion.
I guess you can relate to doctors in one aspect that they are human beings just like you and also get exhausted,tired,unwell,emotionally disturbed,have to take care of their household.Let me tell you my schedule and then you can may be understand why a doctor calls you to an emergency rather than attend all the emergency oneself.

My OPD at Hospital starts at 10 am and ends at 2pm i.e, 4 hours.In these 4 hours I have to see an average of 20 patients.And this involves a lot of talking and answering......and it isn't blabbering .It involves application of mind to understand your problem and find solutions for it. My one mistake can be quite crucial for you.Now this 2 pm is never 2 pm and gets extended to 3 pm or 3.30 pm.So that is when I am free to take my lunch.Now starts my OPD at my clinic from 5 to 8 pm where I see about 10 patients on an avg.Again a lot of talking.At anyone point of time there are on an average 3 patients in labour........which means calls at regular intervals from hospital regarding their management including in night time.Which also means that if Ladies deliver in night I will be in the hospital with each one of them.And being a gynaecologist I have elective surgery list for fibroids,endometriosis and other common Gynaecological problem.This is no exaggeration.
So now tell me if the doctor attends  and calls all the emergencies at home too, were there is no health care support available,do you think your doctor will be safe enough to take your or your child's care?

Everyday I get call from my call centre to inform me that there are patients who haven't got my appointment for that day and they would like to come in as walk in.Do you think after talking constantly for so many hours I would be able to do any justice to you if you walk in?Even I say if it is an emergency please walk in to the emergency and if it can wait then please take appointment on the next available day.I am working for you and not against you.

Now when you come in emergency of any hospital there is a system in place.The in house junior consultant who works in shift examines you and informs the concerned consultant.Your treatment and investigations are started on an emergency basis and based on the severity of emergency your consultant prioritises that how soon should she/he be present with you.If in case there are two emergencies who should be taken care first and who should get second priority.And believe me that is also the safe option for you.

I hope I have been able to give you a sneak preview of a doctors life and you can understand now that why doctor calls you to an emergency in case of an emergency!!

And before anyone just doubts if it is me writing such a long post.......yes it is me.Today I don't have a single patient in labour and not that I mind :-)


Ankita Bothra said...

Thanks for providing a sneak peek in a doctor's daily life. I think what you say makes absolute sense and 1 person cant't be at different places at a time. In such situations it is best to report at emergency rather than trying to reach the doctor who may or may not be around. The doc can also be on a planned vacation or so. However being patients (which is the case with me) one does not compare a doctor to be less than a God and in a state of panic he just prays that if he can have his own doc there everything will be fine. I feel the sheer presence of the doc and the faith of the patient in her doc cures her by 30%. But I totally appreciate the point you are trying to make through your well articulated blog.

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Anonymous said...

Dr Dwivedi Your post reminds me of a situation I once experienced in my life. I had a doctor in Dubai to whom I grew close. She managed three of my pregnancies though she did not deliver any of the babies, as they were precipitous labors, and not many OBs could have made it in time I don't imagine, even with their skates on! In all honesty it was only the first labor that had me feel I'd have liked some hand holding. The second and the third I probably could've delivered under a tree! But I digress. The whole six years I knew her she told me she delivered all of her babies no matter what time of the day the babies arrived. Now, I sensed this was odd, because a person has to rest/eat/have a life, but she refused to be honest with me (about this being unlikely) despite me telling her I understood her realities, and despite me actually hearing from one of her former colleagues that everyone knew, as head of department, that she did not come in after hours or on her days off unless it was absolutely imperative (I'm just adding that last bit - I assume there must have been exceptions when she did come in, like the Sheikha's baby or some other celebrity!) With hindsight it was a real shame she couldn't have been honest with me, as we had a wonderful rapport, which was undermined, unfortunately, by the fact that she wasn't honest with me. And of course I was a little embarrassed that I believed her. My first baby was delivered too fast - she couldn't have made it - but my second, was born in 2 hours, and the whole second hour of the labor, the nurses were saying 'she's on her way' when she clearly wasn't, but they obviously didn't want to put me off my game. Ahh! And so what did I do? I brought the baby in for a cuddle the next week and didn't mention anything. But it was a shame. And funnily enough, at the end of the day, she seemed really, really sad to see me - like she wanted to break code to tell me that when the nurses called she had wanted to make an exception and come in but had her credibility (with the registrar) to protect. And I know it wouldn't have been fair so I never would have expected it. Please keep up the good work. It is so important to always be honest with your patients. They might not like to hear what you have to say at the time, especially being as they are probably a mess of hormones during/after the birth, but they will appreciate you more as time passes :-)