How objective are we when we counsel our patients with regards to options of treatment. The bias one has as we get older, technology availabilty, expertise, ignorance, financial and other benefits cloud ones Lt. frontal lobe.
The way out would be objective independent audits published by the department for the patient to compare the local results with the best international to make a choice. The science editors in the newspapers follow what the advertising company tells them without an indepedent check. The not so recent advert about key hole knee replacement is an example where even The Hindu Newspaper printed the same. The nexus between service providers and customers (MRI, CT scans, lab tests and commission paid to doctors for referral) are compromising the quality of care.
Orthopedic training to pass the exams are akin to entrance coaching( The license to cut). No lateral or objective thinking. The examiners both young and old still want students to mug up all those lines(Chinnies) and tests like Thomas and Bryants triangle etc which has no relevance today. The discussions on objective management are short and swift. Medical colleges both Govt. and private are not being objective to improve and inspire future doctors. If we do not give the best inspired training we ourselves will be the geriatric guniea pig in time.
Relicensing was talked about some time back. At least mandatory seminars to qualify. Not just holiday trips for chilling, wife's shopping etc.. Lectures given from text books which are ancient as atharavveda. Lecturers selected for their age and contacts,marketing potential and not for quality. Conferences to market, advertise and now to make money as one's primary trade is less renumerative or is it multi tasking. Where are we heading?
Jake
Nice idea to start a forum like this and very happy that we can communicate to you.
ReplyDeleteYou are absolutely right about the way we councel the patients. Most of us usually give options what we know of. And i am really sorry to see a good number of our people talk like sales agents! Not what the patient actually need. But partly i feel it is due to ignorance at our part also. We are getting more and more compartmentalised and being mold into creatures with tunnel vision. Actually at this part only the traditional medicine practitioners win over us. They opt for a more human approach and is able to communicate to the patient in their on language without complicated jargons.
Regarding the training i strongly feel they have to mug up all those tests and clinicall examinations. No sophisticated itechnology will win over the human clinical skill. To become a laproscopic surgeon first you have to be a good open surgeon. Otherwise if you run in to trouble who will come and open it for you. After your basic orthopaedic training and ample experience once you have channelled yourself in to some specific field probably you can afford to forget these "unwanted" stuff. Remember - "we see far ahead because we sit on the shoulders of our ancestors"
Dear Sir,
ReplyDeleteAt one point in my training i did believe that some of the clinical tests are too vague and rudimentary. Yes, they might not help you to plan a total joint replacement, but definitely helps the student in attaining more holistic view of the problem and of the patient.
Inspired Teaching:
Cant get better than that. I did have great inspiring teachers, who encouraged thinking and especially the lateral ones. I blindly owe to whatever I'am to those great men and i do believe that i can deliver good orthopedic service.
State of Medical College I Work in:
Is pathetic.
The HOD dosent turn up, when he does he gets his PG's to do some work for his other committments (Thank god am not a PG anymore).
Poor PG's- The fee structure is such that they pay through their nose and what not.
There is obnoxious nexus between the management and the senior staff like this HOD. The kind that exists only between some bacteriae or viruses.
One more nexus is between the supreme medical body and the medical colleges. And then there is the confusion of recognition.
God save the next generations. On second thought, why involve Him in this when we can do it?
"if i have seen further it's by standing on the shoulders of giants", Sir Isaac Newton.
ReplyDeletePharma reps pushing tools, equipment, paid trips.... and gullible greedy doctors fall right into their traps all at the expense of the poor geriatric guinea pig
ReplyDeleteHi, Great
ReplyDelete