Sunday, July 29, 2012

In the defense of the unqualified

In recent times the media is awash with reports of medical malpractice and images of unqualified persons handling cases are flashes across the small screen. There were images of a person who is qualified to sweep and clean, giving injections and suturing wounds. There were also reports of doctors performing surgical procedures without taking permission and causing fatalities. These reports received wide spread public reaction mostly directed against the profession.

North India, that too states of Bihar, MP, Orissa, UP, Rajastan are very backward going by the social and economic criteria. That is why they are called BMARU[ILL] states. In many areas of these states, medical aid is nonexistent and any aid is better than no aid. I watched the programme aired by Times Now, a popular English TV channel which showed the sweeper doing the procedure. Instead of getting disgusted I was very impressed with his performance. He wore gloves, drew the local anesthetic well into the syringe, injected the wound and sutured it expertly. There were no nerves at all and this must have been routine for him.

It reminded me of an incidence which occurred many years ago. I was a young subaltern in the Indian Army Medical Corps and was posted to a field hospital. As it was just after a conflict we had a number of casualties and three of us had to do lots of minor and major surgeries. We did have one doctor who was trained in anesthesia but he couldn’t be in four places at the same time. The job of administering anesthetic was left to two nursing assistants [in the rank of lance corporal]. They did the job better than I did! They were so well trained!

What is important is not who does the job but how well it is done.

Even well qualified doctors err. The doctors who did the Kidney and pancreas transplant were qualified and the patient needed it. That it was high risk surgery with very high mortality was not appreciated by the relatives. Here lies the crux of the problem. We doctors are poor communicators. We get so engrossed with the problem that we often neglect the human emotions involved and pay a very heavy price. These days, in corporate hospitals, money too plays its role and surgeries are often done when there is no absolute indication. One such is caesarian section about which I have written earlier.

Therefore, before branding something as demonic and unethical, one must, especially the media, and personalities like Aamir Khan should be careful and understand the realities of the profession in the country.

I have tremendous respect for Aamir and many aspects of his show were true.

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