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Wednesday, June 10, 2009

Corporate Efficiency or Losing the Plot?!?!?!

The past week has been a revelation in terms of corporatization and efficient productivity. We've been on a roll in terms of planning plans, implementation of plans, installing various means of easing our lives (or is it complicating our lives), sending professional sms's, getting investigations organised etc etc.

So, everything is getting computerised, which is a good thing in terms of the amount of trees we may save in the end by sparing paper. The system is that we are trying to get all the pre-op reports delivered to us by email. What this amounts to is that the patient has to come meet us once, his/her first visit, decide what surgery he/she wants to do, talk about the payment and leave. Then, we send someone home to collect blood, send the contact details of the patient to the investigations lab, and vice-versa so they can go and get their X-rays, USG's, etc done there if needed. Everything comes back to us by email, we go ahead and schedule surgery, the patient gets admitted, operated the next day, discharged the next and the story repeats.

Now, in all these major events in the patient's time with us, the doctor is seeing the patient a grand total of once before surgery, once during surgery (maybe if we reach before anaesthesia induction) and once when we tell the patient all if fine and its time to go.

Where is the doctor - patient relationship in this? What happened to talk to your doc and let him know your feelings? What happened to half the healing that happens only on talking to your doctor? Where is the 'connect' that is sooo important that we have ethics committee's telling us spend time listening to the patient?

I think we're losing this very important quality that makes patients want to come to doctors instead of us having to go to them. In the corporate world, time is money, so this system would work, as it leads to the best possible use of time and resources. No doubt about it. However, in the medical world, time is not as much money as a patient is livelihood! If you don't have patients coming to you and 'Bonding' (to use a word my wife has made me understand, thankfully) it's just not going to work.

Let's see how this goes. Any inputs are welcome.

Thursday, June 04, 2009

Bombs away.....

Hello hello.
Here's the latest in the world of obesity surgery. We just did a sleeve on a guy weighing 201 Kgs (442 Pounds). Now this guy is fairly young, smokes, drinks, and obviously enjoys eating. Unfortunately for him, he is short - 160 cms which is roughly about 5'4". I wuold urge you to streeeeetchh your imaganation to view this person in your third eye (chances are he won't fit)

The question in my mind is that most people get overweight and start doing something about it (gym, walk, diet something). What was this person thinking, going on drinking, smoking, eating etc etc.

The answer I think is more mental than physical. By the time they hit 120-130 kgs they've given up hope on ever losing weight, running, sleeping well, enjoying life and the only thing that gives them pleasure is drinks and smokes (lets face it you don't have to move too much for either of the above)

Now that philosophy is over and done with, let me tell you the problem I had which brought this particular case to the blog. I was to insert Jonac suppositories into the guy (pain relief). For the uninitiated, a suppository (looks like a white melted torpedo) goes into your rectum and is absorbed from there providing good and sustained effects. This guy was really big see, so he would not be done with one but needed three. The problem I had was like entering a dark damp cave with no end in sight. By the time I could actually find the rectum I was in upto my wrists and basically feeling my way through the process. It was not a happy moment, let me tell you. To be honest, I was still wondering, as I washed up for the case, as to where exactly did I put those damn torpedoes.
Fortunately for me, he wasn't complaining of pain after coming out of anaesthesia so they must have hit the target!
Bombs away.....

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