Sunday, November 2, 2008

Watch Dog

My friend has a Doberman pet dog. He is peculiar in his behaviour. Unlike the other dogs of his breed he welcomes guests with a whine and a vigorous shake of his head and tail. When he sees any one from the house hold leaving the house he gets upset and starts barking. If you consider my practice as home and my patients as family members and I as Doberman pincer you will be able to follow what follows. Like my friend’s Doberman I too fail more often than not and the reason you will know why if you read the next few lines.

Most of you watch television and newspapers and you meet friends and relatives. Subject of health, doctors and hospitals is a favorite topic of conversation. Morbid details of someone’s illness and death make very interesting topic of conversation as the conversants are not involved. But there is a lurking fear that they would be the subjects of such conversation at a later date. Then how to avoid this fate? Many believe that periodic testing [called whole body testing in their language] will tell them if they are fit or not. Little do they realize that these tests will only reveal that the tests are normal but will not tell them if they are normal or not. Thus this rush to get annual or bi annual tests done is thoroughly uncalled for and it has become one of my primary duties to prevent my patients from indulging in this foolhardy and expensive venture. Am I successful? Sadly, no. The media pressure and the false propaganda by the interested parties are so strong that I am like a Poodle facing of a pack of Pit bulls.

The other fad is running to consult specialists. This is another foolish and unhealthy activity. We call this compartmentalized medicine. The body is divided into several compartments and each compartment has a specialist. Heart has one, brain has one, nose has one, stomach has another and the list is growing every day. As the joke goes, a patient went with a stuck cotton bud in his left ear to an ENT [ear nose throat] specialist. That specialist refused to see him because his specialty was right ear and not left. It is my lot to see these unfortunates after they do the rounds. A person with chest pain would have gone to a cardiologist and finding nothing wrong would then have gone to lung man and then to a stomach doctor [some times stomach illness can cause chest pain] and then to a psychiatrist [if there is no cause that the other specialists can find, then, there must be something mentally wrong with the patient] and then he deems fit to see if he is lucky, a family physician. He may find the cause to be an injury to the chest wall. Supposing he had gone to the family doctor in the first place, if he [family doctor/General practitioner] had not found the cause, he would at least know where to send him. He would have saved the patient lots of money and head ache.

Another is the health insurance racket. A person who has healthy habits, who takes regular exercise and eats moderately, remains healthy well into his seventies. So why does he have to take insurance? The same premium money he can save up and invest or keep it by instead of loosing it every year to keep the insurance company happy. If you are unhealthy you will not get insurance or there will be an exclusion clause any way. Older people who really need insurance do not get it as they run a high risk of illness and therefore are not profitable for the insurance companies. The whole gamut of insurance business runs on one factor. That is fear.

Recently I have had an occasion to visit a hospital and spent some time at the reception where the patients are initially confronted. One of the first questions asked is whether you have health insurance or not? Why is this question? Will this mean that you get better attention? Certainly not. It will mean you go to a separate bracket where in your charges will certainly be higher. This is my hunch. So I advise my patients to put by some money each month and invest it. When the time comes when you are ill needing hospitalization [which never comes to most as death comes unannounced for many of us who are blessed] mostly in your old age, you have enough to take care of your expenses. Most insurance companies also have a ceiling beyond which they will not pay. In this game the insurer is not the winner; the winner is the insurance company. Do I succeed? You guessed it right? I do not.

I find a large number of my patients swallowing daily, potions of vitamins, tonics, A to Z [there is actually a name like that] minerals, health restorative oils, health foods. Again all of this is utterly useless stuff. But do they listen to me? Yes, they listen but don’t follow.

What is the solution to these problems in the community? Find a good watch dog and look after him and listen to his well intentioned barking.

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