WHO WILL PROTECT PATIENTS?

IT has been announced that 40 policemen will be posted at GMC to protect doctors. The police teams have to be posted at Casualty, at the OPDs, at the ICUs, and Dean’s Office. Who do the police protect the doctors against? Let me remind the new dean of the GMC, Dr Jay Prakash Tiwari, and doctors that they were insulted and humiliated not by patients but by Goa’s Minister of Health Vishwajit Rane.
They were not bullied by the media but by one single reporter of the Gomantak who instigated the health minister to sack the CMO, Dr Rudresh Kuttikar. We may also point out to the guards and the consultants that it was the media which forced Health Minister Vishwajit Rane it made better sense to apologize.
Now, apparently, the media is banned from the GMC, even as patients. Never mind that newspaper managements do not offer any medical help and newspaper employees do not get medical insurance from their employers. This is unlike government employees, who get unlimited medical benefits including the dean, whose medical expenses are reimbursed by the government without any limit.
THE larger issue is who will protect patients against doctors. Doctors in India and particularly in the Goa Medical College & Hospital believe in their gods. They act as though patients do not have any rights. Least of all the right to know. The right to ask questions about their treatment. The concept of informed consent, which is the rule abroad, does not exist in government hospitals.
Recently, I have been advised to do an MRI to check on the status of my spinal TB, for which I continue to be treated at a GMC outpatient a year-and-a-half going on. I have been told that before the MRI is done, I will have to undergo a kidney function test to check the creatinine levels, which are an indicator of how well the kidneys are functioning. I was not told why I needed a kidney function test.
Only when I checked with ChatGPT I learned that the contrast dye used in MRIs can be harmful to kidneys. Apparently, the contrast dye contains gadolinium (heavy metal) which can cause damage to people with kidney issues. Doctors of course, will not tell you that any form of radiological intervention, from the simple X-ray to scans and MRIs, exposes you to a lot of radiation. It is not true that MRIs do not expose you to radiation.

RADIATION PROTECTION
YOU must have observed that even in the case of simple X-rays the operator stands behind the screen in his own overalls aprons to protect himself from radiation. Doctors themselves do not undergo scans and MRIs unless they are strictly necessary. But of course, patients are not even informed of the risks of exposure to radiation no matter what their age. Senior citizens being most vulnerable presumably.
This is not an isolated case. Steroids are the favorite medicine prescribed by lazy doctors who want to give you a quick relief. Whether it is respiratory problems like asthma or skin allergy, you will immediately be put on steroid injections or tablets. I know of a very popular chest physician who thinks that steroids are a wonder drug. None of them will tell you the terrible side effects of steroids.
THE most tragic example of the side effects of steroids is Anant Ambani, the younger son of Mukesh Ambani. Apparently, young Anant was given large doses of steroids as a child because he had a severe asthma problem. The puffiness and the heavyweight stature of Anant Ambani is entirely due to steroids. In theory he can detox like I did. But there is a major risk and apparently, doctors do not want to take any risk with Anant Ambani. Instead, the family has gifted him jumbo elephants so that Anant Ambani can happily de-tox himself in his own father’s animal hospital farm.
There are a number of other medical conditions where ignorance can be fatal. Take a simple case of falciparum malaria. Unlike the less complicated cases malaria falciparum affects the lungs. So much so, patients with falciparum have to be admitted to a hospital with an ICU. Very often, they are admitted to nursing homes and maternity homes that do not have an ICU. One of my colleagues at the OHeraldo way back in the late 80s, died because he was admitted to a nursing home without an ICU.

PLEASING PHARMA
THERE are also cases where doctors promote unnecessary medicines and procedures to favor pharma companies. It is well established that diabetes in the early stages can be controlled by lifestyle changes. While excessive drinking, particularly in Goa, is a major contributor to diabetes, diabetes may take over your life even if you don’t touch alcohol. If you have no control over your sweet tooth, you are bound to get diabetes. The best barometer of diabetes is the blood sugar levels.
During the mango season almost every Goan’s blood sugar hits a high. Many doctors believe that diabetes starts in the kitchen with the housewife. However, sadly, many so called diabetologists get patients addicted to insulin. I recall a former HOD of Medicine who colluded with a Swedish insulin manufacturer to get Goans get addicted to insulin. The doctor is to organize a diabetes camp where patients would be put on to insulin and later get dependent on it. At the camp, free insulin was given.
Later on when the patient is out of hospital, he has to purchase the insulin which is very expensive. If you have a insulin resistance of outright diabetes problem, your best bet is to quickly make an appointment to consult Dr Ankush Desai, HOD of Endocrinology at the GMC. He is against getting patients hooked to insulin and has cured thousands of patients, including chief ministers of Goa, by getting them to make lifestyle changes successfully. The problem is always that one needs the discipline and infrastructure to bring about lifestyle changes at home and out of it.
YOU should also be very cautious of surgeons who are anxious to cut you up at the slightest opportunity. There is an organ in the human body called the appendix. At normal times it’s said to be insignificant, but if it gets swollen or infected, it can create havoc. You’re better off without your appendix. But even when an appendix is not causing any problem a doctor may operate on you to remove it.
That probably will not do you much harm, unlike in the case of needless caesarean procedures for delivery of babies. Natural deliveries have become very rare in our maternity homes. Admittedly, the mothers-to-be are also to be blamed for they seek painless caesarean deliveries out of vanity reasons. The educated women don’t much like the idea of undergoing labor pains. Most will opt for the easy way out and ask for a caesarean delivery for their babies. However, they run the risk of caesarean babies paying the price later on if it’s an unskillfully done caesarean. But since all parents are satisfied with one child or at the most two, the focus is more on instant delivery rather than the pains of a natural birth.
An even more popular option among the bold and beautiful, rich and powerful now is in vitro fertilization. In this procedure, a fertilized egg is inserted in the womb. You are under risk in so much that you may end up having twins or triplets or quadruplets or more. All the Nita Ambani children and that of her daughter Isha Ambani are reported to have been conceived through IVF.
IVF is actually meant or originally developed to help couples who have fertility problems. But there is a huge demand for public hospitals like the GMC to set up a department for this instant baby delivery factory or so to speak. The GMC IVF department is undoubtedly managed by Goa’s best fertility doctor who is Dr Kedar Phadte.
BUT in conclusion we think patients have a right to ask questions although many don’t know what the right questions to ask are being ignorant. Significantly, even when a minor procedure is done, patients have to fill in a consent form. In the case of surgery or operation a patient has to give written consent even for the use of anesthesia, and the surgical procedure.
Orthopedic doctors are very happy to recommend full knee replacements. Because there is more money in replacing the knee than partial repairs which are less expensive. Likewise there is a big racket in the treatment of gall bladder stones. In most cases this affliction can be treated with ultrasound and do not require expensive surgeries. The biggest racket in Medicare is to do with the slew of diagnostic tests.

TESTS GALORE
DOCTORS have forgotten or do not want to take the risk of conducting any procedures without forcing you to undergo a dozen investigations. All this is to happily add up the hospital bill to make hospital managements happy. In private hospitals the number of tests you have to undergo and the type of surgery recommended are determined on how much revenue it will fetch the hospital. It may be pertinent here to mention that in China they have made epidural injections, an aid to natural delivery, free to encourage mothers to avoid caesareans.

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