# RKS: IS THE SKILLED DR BEING SIDE-LINED BY CORPORATISED HOSPITALS? - Are Skilfully Marketed Corporate Hospitals Superseding The Expertise Of Doctors In Battle For Cure?
# RKS: IS THE SKILLED DR BEING SIDE-LINED BY CORPORATISED HOSPITALS?
- ARE SKILFULLY MARKETED CORPORATE HOSPITALS SUPERCEDING THE EXPERTISE OF DOCTORS IN BATTLE FOR CURE?
DOCTORS vs HOSPITALS
CHOOSE THE RIGHT DR EVEN AT EXPENSE OF DISREGARDING A REPUTED HOSPITAL
Dear Reader,
Doctors and hospitals are all about getting well. One is sick and hence the need of the hour is to get treated by a doctor at a hospital. See the sequence - treatment by a DOCTOR at a HOSPITAL. So who will cure the patient? The Doctor or the Hospital??
ENDING OF AN ERA
Traditionally when one is unwell he / she approaches the friendly family General Practitioner (GP) doctor for advice. The GP usually manages most illnesses unless there is evidence of criticality. In such cases, he / she guides the patient to the best specialist as per his / her knowledge, experience and feedbacks garnered. The patient too trustingly seeks advice as per the GP's directive and goes to the concerned specialist whichever part of the city, county or globe the referred Doctor may be located! The balance of getting well was more tilted in favour of the patient since he had two doctors backing him - one the treating specialist and the other, the morally responsible GP.
But then came the digital revolution, and Internet services were launched in India on 15th August, 1995 by Videsh Sanchar Nigam Limited (VSNL). It only proliferated and in less than two decades the Indians were raptured by digitised information. The medical profession was not spared either.
Information on doctors and hospitals was in-depth captured and became an open book free for accessing 24/7 by any Tom, Dick and Harry. The Gen Nxt, being internet savvy, questioned wisdom of friendly GPs and preferred to choose and pick specialist and / or hospitals based on their survey which relied on star ratings and reviews.
Such shift in loyalties from the GP to digital choosing have only the patient himself / herself to blame if the equation between disease and treatment does not expectedly fall in place.
DOOM or BOON?
Was the digitalization a boon for the patient or spelled doom for their tribe? I am of the firm belief that relying solely on the internet in choosing specialists and hospitals could spell the difference between life and death in critical patient situations. Most admitted patients survive hospitalization since many diseases and disorders are easy to manage and treat, and also the God-gifted body's mechanism are just amazing. It is the critical cases, with patients fighting for life, wherein the treating Doctor will make all the difference. But the layman patient will never ever understand this since for him all cardiologists are supposedly bestowed with same expertise, all gynecologists bring the same skillsets on the table, all rheumatologists will tackle the disease with mirror-image treatments, etc.
Ignorance is bliss and this is so truly applicable in the above mentioned scenario. When the patient is, or becomes critical in the hospital what will matter is the knowledge, experience and skill set of the attending doctor. Of course this is presuming that the hospital is a well-equipped and is a fully staffed and a functioning treating centre.
Establishing the infrastructure of a hospital is a purchasable commodity but the expertise of the medical professional is priceless, and dictates the course of patient recovery, or otherwise.
HOW DOCTORS MAKE A DIFFERENCE - EXPERIENCES
In my 40 years of limited experience there have been interesting outcomes which are worth sharing and pondering upon. In fact, there could be lessons to be learned. The names of doctors and patients (all from Mumbai) have been veiled.
# Patient No 1: 60 year old male patient - DD suffering from cancer of intestines. After visiting a famed cancer hospital for over 3 months DD was given an uncertain date for operation 3 months away. It was suggested to DD that the best alternative for robotic surgery would be by Dr PV located in Tamil Nadu. After pondering, and much against the resistance of family members, DD decided to go ahead with the suggested option and I was the only one who accompanied him (even his wife preferred not to travel al the way)! Fantastic surgery - no need for interim stoma bag, undamaged anal sphincter (with no disturbance in stool control) minimal scarring coupled with meticulous removal of ALL of the diseased intestine (as evidenced by now a 5-year lapsed normalcy period). Incidentally, one premier South Mumbai hospital, DD was considering, the very same doctor had operated upon someone we happened to meet by chance narrated how he had undergone torrid time and a critical postoperative period for the very same surgery by the very same doctor in the concerned hospital. The doctor does matter and not the hospital.
# Patient No 2: 45 year and thereafter 65 year old male patient - GV with single vessel and then 5-vessel disease insisting and requiring angioplasty. He was advised in the first instance by Dr DP to fly to US since the Mumbai's interventional cardiologists expressed inability and advised bypass surgery. GV flew to US and came back after a successful angioplasty which survived for two decades. At the age of 65, GV underwent another successful angioplasty in the capital city since six out of the seven cardiologists consulted in Mumbai expressed impossibility of stunting due to tight nature of blockages of the heart arteries. After Dr AS very smoothly and effortlessly stented the 4 critically blocked areas, GV flew back to Mumbai and in less than 48 hours was sitting in his office doing his normal chores. The grafts remained patent for a decade. The doctor does matter.
# Patient No 2: 75 year old (same) male patient - GV having a 5-vessel coronary disease. He was advised to get a heart bypass surgery by the best surgeon but he went on exploring options in a cost-saving exercise. After convincing his son, the bypass surgery for heart was done by Dr SB and 4 grafts were put but all were accommodated exclusively from the two arteries in the chest region. Usually, when many bypasses are done an extra blood vessel is usually required and taken from the leg (a vein is harvested) but this was not required for GV in view of the skill of Dr SB. In 15 days GV was sitting in his office executing normal duties. Incidentally, two other famed heart surgeons operated on three other patients of mine, who decided to disregard the very best suggested (because of reviews and feedback), required to use even the leg vein for the same number of grafts. All the three other patients thereby an d even, ended up with minimum of 3 months recuperation period post-surgery. The doctor does matter.
# Patient No 3: 40 year old female patient - LD with septicemia. LD was admitted in one of the best corporate hospitals for uncontrolled urinary infection but, being an uncontrolled diabetic, landed up with the complication of septicemia. In spite of the multiple latest antibiotics her condition deteriorated to the extent that she was declared as highly critical. LD was then referred to the physician with the best brain, much against the policy of the hospital and wishes of the intensivist. When the concerned physician Dr VJ assessed LD he added a single additional antibiotic. The very next day to the surprise of everyone, including the unhopeful intensivist, LD was sitting on the ICCU bed sipping tea! The doctor does matter and not the hospital.
# Patient No 4: 30 year old male patient - RG with obsessive compulsive disorder (OCD). RG treated for over half a decade in Kolhapur, Pune and Mumbai by various psychiatrists but with little success. Once his father happened to mention the history to me and RG was immediately referred to the psychiatrist Dr SP whose expertise awareness precedes him. The father persisted with Dr SP, the costs and inconvenience to travel from one city to another for each appointment notwithstanding, since he had never seen RG so submissive to advices of a psychiatrist ever before. The very gradual improvement progressed upwards to a superb control of the OCD over the next couple of years even as RG, on the advice of Dr SP, was shifted from his hometown to US. At the present, RG not cleared his specialisation but is also gainfully employed in a reputed firm in the US. A nightmare turned into a dream for the parents of RG. The doctor does matter.
# Patient No 5: 55 year old male patient - XX with terminal liver cirrhosis. XX approached myself and was referred to a knowledgeable gastroenterologist. On scanning the reports, Dr VD informed me to tell the patient to go to his village and enjoy the balance days of his life - meaning there is nothing much available to rectify the cirrhosis state. Since I was aware of alternative therapy, it was suggested to XX to take certain nutraceuticals which could give him a paltry 15% chance of reversal of liver cirrhosis provided he takes the large dose of ten capsules daily religiously. XX abided and it was surprising that he became gradually better health-wise and even his blood enzymes revealed a positive correction in a very few months. XX was given less than 6 months but he survived for near 3 years - his ultimate demise was not due to the liver disease but another cause. The doctor does matter.
There are umpteen other examples which many of my fellow doctors and colleagues could share but few of the glaring personally-experienced / participated ones have been elaborated. One simple way to understand is if there is a diabetic patient at home, or in family, or neighbourhood, or in workplace need to investigate how many of these have leg pains, heart problems, suffered a stroke, experienced eye issues and kidney function disruption. If the blood glucose (fasting and 2 hours post-food as well) are meticulously controlled, just like the readings a non-diabetic exhibits, there is never a possibility of any of the mentioned complication of diabetes. The doctor does matter if a diabetic is sans complications, or otherwise also.
TAKE-HOME LEARNING
The bottom line is the doctor does matter. For all those who decide to choose their health providers based on mere digital data be wary of your decisions. Sometimes these could misguide you in your choices and one could pay dearly for the consequences. Also those who trust large multi-speciality hospitals blindly and are swayed by the infrastructure could, if be unpleasant sways in health condition during the hospitalisation period.
HERE'S WISHING ALL THE VERY BEST FOR DIWALI AND A SAFER & PROSPEROUS NEW YEAR AHEAD!
DR R K SANGHAVI
Prophesied Enabler
Experience & Expertise: Clinician & Healthcare Industry Adviser
You have hit the nail on its head when you say Medical profession is very intricate and not a straightforward mathematics. Yes doctor does matter very much but so does the nursing care
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