Wednesday, October 23, 2013

Whom do we sue?

Came across a bizarre scenario today morning..There were few youngmen,police men and our security personnel.A man who suffered a massive heart attack yesterday night was taken to a local nursing home.They brought him to our emergency when nothing much was left but still the doctor on call who is bound to do the CPR,did it.Unfortunately he died,Now the relatives were fighteing with the hospital that why did the doctor try to save the person and they won't make the payment for the medicines etc used.
It is a lost battle for us doctors
If they do a CPR they are still at fault as that increases cost on an almost dead person.If they don't do then obviously they are ' Criminals'

Surgical Count :a team work

To make a Doctor Successful,it is hard work of a complete team including assistant surgeons,Anaesthetists,Scrub Nurse,Circulatin Nurse and OT Techinicians.The chief Doctor is the face of all the activities and the contace point for the patient but the fact remains that to give them a good surgical outcome a complete team is working hard and well coordinated.A lack in coordination can lead to mistakes which can compromise on surgical saftey despite all the competence of the surgeon.
Let me give you an example.To ensure the a surgery goes safely,before the surgeon starts the surgery the Scrub Nurse counts the Mops,Gauzes and instruments and the circulating nurse puts it on a white board in the OT.All the Mops and swabs aren't opened all at once but on demand of a busy operating surgeon who isn't supposed to keep a swab count,the circulating nurse hands it over to the scrub nurse.They count it together.Once the surgery is over and before the abdomen is closed the surgeon asks the scrub nurse to recount and confirm loudly that the initial count matched the second count.Again the scrub nurse with a circulating nurse double checks.Two scrub nurse or two circulating nurse are not supposed to count it between themselves.It has to be a circulating and scrub nurse.If in between scrub or circulating nurse leaves inbetween the surgery the documents are recounted ,documented and handed over all afresh to the new member of the operating team.
After which surgeon starts the closure of abdomen.
Once the abdomen is closed once again the count is correct is asked loudly by the surgeon and is confirmed by the scrub nurse.
After which the Scrub and circulating nurse sign on a WHO recommeneded saftey check list and also tick that the Surgeon has been informed.And finally surgeon signs that she has been informed.
So if next time you hear a story that a doctor left a foreign body inside ,you know it isn't the butcher negligent doctor.She was not supposed to count the mops but to rely on the team with whom they have been working for years..
So a teamwork which is well coordinated is very important for patient safety.


Sunday, October 20, 2013

Thanks to my patients

This post is dedicated to you Priyanka ( if you are reading the post) and to many other such patients who have 'tolerated' me months and years all together,have shown their immense faith and continued to come back to me as a doctor.
Yesterday I was little upset as two of my old patient's decided to go to Fortis Memorial Hospital to deliver for the Glitz and the Glamour of the place.I don't blame them but it did hurt as you know you have done your best as a doctor,given them your time ( ofcourse they have paid me the consultation fees) and they even like you as a doctor but then they still decided to move on.
And then I came across priyanka who now is very close to her date of delivery.Realised she has been visiting me from her 4 weeks of pregnancy and has been so trusting and low profile that I didn't even realise that she was coming to me for so long.And I it gave me immense happiness......I just asked you have been tolerating me for a while now.And her husband sister delivered under your care.There was so much faith and trust in his voice.He had made my day.I had forgotten the disappointment the remaining two patients had caused.For this couple I was more important than any hospital :-)
And then I realised that I have many such patients who have been associated with for last 6 years ( since I started my practice).Who come to me for their smallest problem and I take them fore granted ( not actually).What I mean to say is that I never valued that trust,the faith and reliance shown by them,They had so many options but still they have been following me.
I thank all of you for the immense faith shown in me and it a a genuine heartfelt thanks!!
As I am typing these words so many names and faces I can think of,who deserve this thanks.
Recently I did something which I think was probably not the best thing to do.There is a saloon in DLF phase 1 which I visit for my hair cuts etc.The staff is well behaved,know their job and even go out of their way to keep me happy as a client.And recently I visited them without an appointment to get my son's hair cut,demanded for a particular stylist and when they said that I had to wait 30 minutes,I left the place and went to a new saloon.......just because I didn't wish to wait.They did a good job too but I felt guilty somewhere.There has to be a strong reason to change loyalities.
In today's fast pace world loyality probably is not the biggest virtue but then it is virtue none the less.
So thanks once again to all those who have tolerated me so far and continue to do so...........................