Category Archives: medical corruption

The “Cheap Competition” among Doctors: a Hidden Cancer.

The “Cheap Competition” among Doctors: a Hidden Cancer.
©Dr. Rajas Deshpande
Neurologist, Pune.

A majority of medical students in India are actually from poor or middle class background. Most students come in this profession for service to the suffering and also for social respect. Every doctor passing out in India does not pay crores of rupees for education. This is a system created and maintained by all governments for their strongmen as a source of huge earnings. Many of these “paying” students also work hard and earn their degree. However some few look at the amount spent as an investment and try to earn it back by unfair means. This is NOT the fault of the majority of good doctors (both non-paying and paying) who work hard to acquire their skills and help the society. © Dr. Rajas Deshpande

As the society expects “cheapest” advice even for most complicated health issues, some newcomers, those who are under qualified, those who do not have a good number, and some who don’t have the confidence keep their “Consultation fees” quite low, and rely upon alternate income: through tests, procedures and surgeries, through percentage in hospital bills. Thus, though the ‘entry ticket’ is low, the ‘hidden charges’ compensate for the doctor’s (genuine) hard work and skill.
However, not all ‘low fees’ doctors are bad, but keep their rates low to be able to compete, no one wants to criticise those who have low fees for ulterior motives. This competition to keep the consultation fees low to attract patients has generated most evils in the medical practice. Unfortunately, this is unlikely to change soon, as most people prefer this.© Dr. Rajas Deshpande

The low “Consultation fees“ model works best for even good, skilled and experienced surgeons and branches with procedures (plasty/ scopy etc.), where the patient usually does not question the charges for the procedures or surgery, just because every patient prefers best skilled doctor. There is also a recent trend to offer even “procedures and surgeries” at a competitive low cost by some hospitals, who employ the inexperienced or inadequately qualified/ trained doctors, beginners, lowest skilled nurses, technicians and other staff and instrumentation, catheters, joints, other prostheses. The whole show will be put up for “short term goals”, risking patient’s life and compromising many aspects of good care. In many “cheap packages”, the long term outcomes may be at risk.

Those who run hospitals have many profit sources: right from the tea sold inside the hospital campus to the room charges, pathology and radiology, nursing, drugs and everything used, they earn profits under multiple headings. This is also why they can afford to keep their consultation fees extremely low. However, most doctors employed at such hospitals are not paid anything besides their own low consultation fees, while they remain the face of the “total-bill” for all patients. This system encourages rich doctors who invest in alternative sources of income than the consultation fees alone. © Dr. Rajas Deshpande

Physicians / specialists must rely only upon their OPD consultation and IPD visits. If a proper examination is to be done in each case, and all questions of every patient are to be addressed, one cannot see more than 20-25 patients in a day. Thus if he / she keeps low fees, it becomes difficult to sustain in any Indian city. So they must see as many patients as they can, only addressing the immediate medical issue, and unable to answer many queries of the patient and relatives. If a good doctor decides to spend more time with each patient, and gives up relying upon the “hidden income”, he must charge a much higher consultation fees to just sustain in a good city.

The social anger against doctors mostly comes from increased expenditures on health and unrealistic expectations. Although there are greedy doctors, a majority are just doing their best to make a good name by offering the best service at a low price. Quality healthcare will always come with a higher price-tag, a good doctor will have a higher fees, and that if one wants the “backdoor / cut / referral practice “ to end, one must be prepared to pay higher fees.

In a country where loud and sweet talk, deception and lies are preferred by majority over genuine service, honesty and truth, it is difficult to change the basic attitudes: on both sides..

There indeed are some honourable doctors and hospitals who know the value of their own service, and offer the best to their patient. But even they are usually considered “Greedy” by the very patients whose miseries they end. There are senior / skilled doctors who charge from three to ten thousand or more per consultation, and most of our powerful and ministers go to these doctors too. Although this consultation fees appears high, the accuracy of the opinion and advice often save the patients lacs of rupees. If a surgeon advises a surgery, he/ she can earn many thousands, but if the same surgeon with his skills and experience treats the patient conservatively, avoids surgery and gets good results, the patient is unwilling to pay even half the price of that surgery for the same result. What would anyone do in such a case? The concept that “A Right Opinion by the Right Specialist” saves the patient huge amounts of money and discomfort is yet to dawn upon the Indian society.

The market of cheap has always survived, but in the long run, cheap options always come with a greater final price tag upon health: often your life.

It is my sincere appeal to all my fellow practitioners from the newer generations to please change this structure. See a moderate number of patients per day, charge according to your skill, experience and time, do not undercharge or bargain, then alone this system of backdoor incomes will gradually change. Of course you must consider concessions for the really poor, and accommodate those who cannot pay by keeping a separate time/ OPD for them.

© Dr. Rajas Deshpande
Neurologist, Pune.

PS:
Many city-based imbeciles without any doctor in their family will immediately say that all doctors should go to villages. Those who suggest that, please make your own children (if you have) doctors (if they have the caliber) and send them to villages. Why doesn’t the government make it compulsory for every mla and mp who draws lifelong financial benefits from the country’s exchequer, to send their kids to medical schools and serve in rural India compulsorily? Why is it not compulsory for the elected members to take all treatment in their own electorate? Every law is bent every which way possible to accommodate the healthcare requirements of all the rich and powerful, whether it is kidney transplant or joint replacement, but when extending healthcare to the poor and unaffording, the same people from various ruling parties conveniently point fingers at the medical professionals!

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एक आशीर्वाद का रंग (डॉ. बाबासाहेब आंबेडकर की स्मृति को समर्पित)

एक आशीर्वाद का रंग
(डॉ. बाबासाहेब आंबेडकर की स्मृति को समर्पित)
© डॉ. राजस देशपांडे
न्यूरोलॉजिस्ट पुणे

दवाई की मात्रा को सावधानी से गिनकर मैंने इंट्रावेनस सोल्यूशन तैयार किया. सुई पहले से ही लगाकर रखी थी. “मैं दवाई का इंजेक्शन शुरू कर रहा हूँ. अगर कोई भी तकलीफ हो तो तुरंत बताइये, मैं यहीं बैठा हूँ” मैंने उस बूढी औरत से कहा. अपने दर्द की परतों के पीछे से वह मुस्कुराई. उसका बेटा, मेरा लेक्चरर डॉ. एसके , वहीँ खड़ा था. उसने अपनी माँ के सर पर हाथ रखा, और कहा, “ये मेरा विद्यार्थी यहीं रुकेगा. मुझे बाकी पेशंट देखने हैं, आज काफी भीड़ हैं. तू चिंता न कर माँ, अगर कुछ जरूरत हो तो इसे बता देना”. वह चला गया.

डॉ. एसके की माँ को कैंसर के लिए कीमोथेरेपी दी जा रही थी. इसमें से एक दवाई का सॉलूशन तैयार करना और उसे इंट्रावेनस (खून की नसों में से) बराबर मात्रा में देना काफी मुश्किल काम था. मेरे गाइड डॉ. प्रदीप (पिवाय) मुळे ने मुझे कुछ दिन पहले ही इस दवाई के बारे में सिखाया था, इसलिए डॉ. एसके ने मुझे बुलाया था. मैं तब एक सरकारी दवाखाने में अपने एमडी मेडिसिन के पहले वर्ष का रेजिडेंट डॉक्टर था.

कुछ समय के बाद मैंने देखा की उस पेशंट की यूरिन बैग (पेशाब की थैली) पूरी तरह से भर गई थी. वार्ड में काम करने वाली मौसी किसी और काम से बाहर गई थी. ऐसे हालात में एक रेजिडेंट डॉक्टर को हर काम करना पड़ता है. मैंने ग्लव्स / दस्ताने पहनकर नर्स से एक बाल्टी मांगी, और यूरिन बैग से उसमें पेशाब निकलकर वार्ड के बाथरूम की तरफ चल पड़ा. तभी डॉ. एसके वापिस आ गए. उन्होंने मुझसे वह बाल्टी मांगी, कहा “मैं ले जाता हूँ” पर मैंने कहा के मैंने ग्लव्स पहने हैं, मैं ही रखकर आता हूँ. मैंने वह बाल्टी वार्ड के बाथरूम के बाहर रख दी, मौसी बाद में उसे साफ़ कर देती. © डॉ. राजस देशपांडे

जब दवाई ख़त्म हुई, तो डॉ. एसके ने मुझे चाय पीने के लिए साथ चलने के लिए कहा. हॉस्पिटल के पीछे ही एक छोटी सी चाय की दुकान थी. थोड़ा हिचकिचाने के बाद उन्होने कहा : “सुनो, ग़लतफ़हमी न हो, लेकिन जब मैंने देखा कि तुम मेरी माँ के पेशाब की बाल्टी लेकर जा रहे थे, मुज्झे अचम्भा सा हुआ. तुम ब्राह्मण हो ना? जब तुम बाहर थे, तो मेरी माँ ने भी मुझ पर गुस्सा किया, और कहा, क्यों मैंने तुम्हे वो बाल्टी उठाने दी. हम बहुजन समाज से आते हैं. तुम्हे पता भी होगा, मैं अपने समाज के एसोसिएशन का नेता हूँ.”.

मुझे पता था. डॉ. एसके के नाम से काफी लोग डरते थे. पर एक निहायत बेडर और आक्रामक नेता होने के बावजूद वो एक अच्छे दिलवाला इंसान भी था. जब भी किसी पर अन्याय होता, तोह बिना जाति-पाती के बारे में सोचे वो उसकी मदद करता. गरीबों के लिए उसे विशेष प्रेम और सहानुभूति थी. किसी तरह का भेदभाव उसे पसंद नहीं था.

मैंने कहा “सर, मैं ये सब नहीं सोचता. पेशेंट तो पेशंट ही होता है, पर यहाँ वो आपकी माँ भी हैं, जो भी उसके लिए करना पड़े मेरा तो कर्त्तव्य बनता है. मैं अपने मन में कभी जाति-पाती का विचार न करूँ, न ही कभी किसी से भेदभाव करूँ, ये ही तालीम मुझे मेरे माता पिता ने मुझे बचपन से दी है”. © डॉ. राजस देशपांडे

“ठीक है”, उन्होंने कहा, “मेरा तुम्हारे बारे में कोई पूर्वग्रह / प्रेज्यूडिस था, वो अब चला गया. अगर तुम्हे कोई भी विपत्ति कभी भी हो, तो बड़ा भाई समझकर मुझे बता देना.” . कितनी ईमानदारी और धैर्य से उन्होंने एक कठिन बात को सरलता से कहा था!
जबतक अपने आप को दुसरे भारतीयों से ऊंचा या अलग समझने वाले हर भारतीय को कोई पश्चिमी जातिवादी (रेसिस्ट) “ब्राउन / ब्लैक” कहकर नीचा नहीं दिखता, उसे भेदभाव का दर्द नहीं समझ सकता.

संयोग से, कुछ दिन बाद ही, मेरी अपने एक प्रोफेसर से कुछ तू तू मैं मैं हो गई . उन्होंने मुझे अपने चैम्बर में बुलाकर कहा ” जब तक मैं तेरा एग्जामिनर हूँ, तू पास नहीं होगा”. मैं परेशान हो गया. मेरी आर्थिक स्थिति तो खस्ता हाल थी ही, पर मेरा बेटा अभी छोटा सा था और मेरे माँ-बाप मेरे वापिस आकर उनके पास रहने कि आस लगाए बैठे थे. फेल होना मेरे लिए बहुत बड़ी मुश्किल खड़ी कर देता. © डॉ. राजस देशपांडे

मैंने डॉ. एसके से मिलकर मेरी परेशानी बताई. वो मुझे उस प्रोफेसर से मिलने ले गए. पहले उन्होंने मुझसे कहा के मैं उस प्रोफेसर से माफ़ी मांगू, बहस के लिए. मैंने माफ़ी मांग ली. फिर उन्होंने उस प्रोफेसर से कहा “राजस मेरा छोटा भाई है.इसे कभी कोई धमकी न देना. अगर ये परीक्षा में अच्छा परफॉर्म करें, तो इसे पास कीजिये, अगर नहीं, तो आप इसे भले ही फेल कीजिये. लेकिन अच्छा परफॉर्म करने के बावजूद भी अगर ये फ़ैल होगा, तो मैं जरूर आप के खिलाफ आवाज उठाऊंगा. बाकी तीन परीक्षकों से मैं पूछूंगा”.
प्रोफेसर साहब ने तब कहा के उन्होंने ज्यादा गुस्से में मुझे धमकी दी थी, उनका मुझे फ़ैल करने का कोई इरादा नहीं था. बात यहीं मिट गई.

परमात्मा कि कृपा, अच्छे गुरुजन और कड़ी मेहनत के कारण मैं अपनी एमडी मेडिसिन कि परीक्षा पहली ही बारी में ही पास हो गया. जब मिठाई लेकर मैं डॉ एसके के पैर छूने पहुंचा, तो उन्होंने मुझे अपनी माँ से भी मिलाया. उस ने अपने बटुए से सौ रुपये निकलकर मुझे दिए ही, पर बहुत प्यार से ढेर सारे आशीर्वाद भी दिए. © डॉ. राजस देशपांडे

अपने स्कूल और कॉलेज के दिनों में मेरे बहुत सारे दोस्त थे, समाज के सारे वर्गों से. विद्यार्थी कभी जाति के बारे में सोचकर दोस्त नहीं बनाते. कॉलेज के दिनों में मेरे डॉ. बाबासाहेब आंबेडकर एसोसिएशन के कार्यकर्ताओं से बहुत अच्छे सम्बन्ध थे, क्योंकि दो बार जब मैं किसी अन्याय के खिलाफ अकेला झगड़ रहा था, कोई साथ नहीं दे रहा था, तब उन्होंने मेरी बहुत मदद कि, उन्ही के कारण मैं अपनी ज़िन्दगी कि दो बड़ी लड़ाइयां जीत सका.

डॉ. बाबासाहेब आंबेडकर के पास दुनिया का सबसे प्रभावशाली अस्त्र था: फाउंटेन पेन. यह भी एक कारण है जो मुझे उनके प्रति बहुत आदर है. किसी और शस्त्र-अस्त्र कि जरूरत ही आदमी को नहीं है! समाज के दो समुदायों के बीच का कोई भी वाद-विवाद कभी भी झगड़ा या हिंसाचार से खतम नहीं हो सकता. एक-दुसरे के प्रति आदर और प्रेम दिल में रखकर साथ चलने से ही हम सारे समाधान खोज सकते हैं.

भाग्यवश, भारत में कोई भी डॉक्टर किसी भी पेशंट के बारे में सोचते हुए जाति-पाती का विचार नहीं करता. जैसे कोर्ट के आँगन में एक जज का अमल सर्वोच्च होता है, वैसे ही भारत के हर मेडिकल कैंपस में इंसानियत ही सर्वोच्च मानी जाति है. ह्रदय हो या खून, दिमाग हो या सांस, ये किसी भी जाति के अलग नहीं होते. बड़े दिमाग कि तरह ही एक बड़ा दिल भी मानव कि उन्नति का एक प्रमुख मानदंड है. © डॉ. राजस देशपांडे

मेरा सपना, मेरी प्रार्थना है कि समाज के विभिन्न घटकों के बीच में विभाजित विचारों के ये काले बादल हमेशा के लिए नष्ट हों. हम सारे एक दुसरे को अपनी जैसा ही केवल एक इंसान समझें, कोई भेदभाव न रहे. विद्यार्थियों में हर दरवाजा खोलने की, हर दीवार तोड़ने की क्षमता होती है, उनसे हमें बहुत उम्मीद है.

किसी भी भेदभाव को न मानते हुए हर पेशंट कि ज़िन्दगी और स्वस्थ्य के लिए दिन रात काम करने वाले वैद्यक समाज में से एक होने का मुझे गर्व है. अपनी प्रैक्टिस से बाहर भी, मेरा ये मानना है के जिस भी भगवान कि मैं पूजा करता हूँ, वही मिझे मिलने वाले हर व्यक्ति में मौजूद हैं.

एक पेशंट के आशीर्वाद का कोई रंग नहीं होता, दुआ कि कोई जाति यही होती. एक डॉक्टर होने के नाते मेरा धर्म, मेरी जाति, और मेरा कर्त्तव्य सारे एक ही है: सिर्फ इन्सानियत.

डॉ. राजस देशपांडे
न्यूरोलॉजिस्ट
रूबी हॉल क्लिनिक पुणे

जरूर शेयर करें.

The Colour Of Blessings

The Colour Of Blessings

© Dr Rajas Deshpande

Carefully calculating the dose and mixing it with the intravenous fluid with precision, I told the kind old lady: “I am starting the medicine drip now. If you feel anything unpleasant, please tell me.”

Through her pain, she smiled in reply. Her son, my lecturer Dr. SK, stood beside us and reassured her too. He had to leave for the OPD, there already was a rush today. “Please take care of her and call me if you feel anything is wrong” he said and left.

Dr. SK’s mom was advised chemotherapy of a cancer. It was quite difficult to calculate its doses and prepare the right concentration for the intravenous drip. Just a month ago, my guide Dr. Pradeep (PY) Muley had taught me how to accurately prepare and administer it, so when Dr. SK’s mom was admitted, he requested me to do it for her too.

The drip started. After a few hours, I noticed that her urine bag needed emptying. The ‘mausi’ supposed to do it was already out for some work. Any resident doctor in India naturally replaces whoever is absent. So I wore gloves, requested a bucket from the nurse, and emptied the urobag into it. Just as I carried the bucket with urine towards the ward bathrooms, Dr. SK returned, and offered to carry it himself, but I told him it was okay and went on to keep the bucket near the bathroom where the ‘mausi’ would later clean it. © Dr Rajas Deshpande

Once the drip was over, Dr. SK invited me for a tea at a small stall outside the campus. He appeared disturbed. He said awkwardly: “Listen, please don’t misunderstand, but when I saw you carrying my mother’s urine in the bucket, I was amazed. You are a Brahmin, right? When you were away, my mom even scolded me why I allowed you to do it, she felt it was embarrassing, as we hail from the Bahujan community. I am myself a leader of our association, as you already know”.

I knew it, to be honest. His was a feared name in most circles.He was a kindly but aggressive leader of their community, but always ready to help anyone from any caste or religion, to stand by anyone oppressed, especially from the poor and discriminated backgrounds.

“I didn’t think of it Sir! She is a patient, besides that she’s your mother, and I am your student, it is my duty to do whatever is necessary. Otherwise too, my parents have always insisted that I never entertain any such differences”. I replied. © Dr Rajas Deshpande

“That’s okay, but I admit my prejudice about you has changed,” he said. “If you ever face any trouble, consider me your elder brother and let me know if I can do anything for you”. What an honest, courageous admission! Unless every Indian who thinks he / she is superior or different than any other Indian actually faces the hateful racist in the West who ill-treats them both as “browns or blacks”, they will never understand the pain of discrimination!

As fate would have it, in a few months, I had an argument with a professor about some posting. The professor then called me and said “So long as I am an examiner, don’t expect to pass your MD exams.”

I was quite worried. My parents were waiting for me to finish PG and finally start life near them, I already had a few months old son, and our financial status wasn’t robust. I could not afford to waste six months. © Dr Rajas Deshpande

I went to Dr. SK. He asked all details. Then he came with me to the threatening professor. He first asked me to apologise to the professor for having argued, which I did. Then he told the professor: “Rajas is my younger brother. Please don’t threaten him ever. Pass him if he deserves, fail him if he performs poor. But don’t fail him if he performs well. I will ask other examiners”.

The professor then told me that he had threatened me “in a fit of rage”, and it was all over.

With the grace of God, good teachers and hard work, I did pass my MD in first attempt. When I went to touch his feet, Dr. SK took me to his mom, who showered her loving blessings upon me once again, and gifted me a Hundred rupee note from her secret pouch. © Dr Rajas Deshpande

Like most other students, I’ve had friends from all social folds at all times in school and colleges. I had excellent relations with the leaders of Dr. Babasaheb Ambedkar Association, and twice in my life they have jumped in to help me in my fight against injustice when everyone else had refused. I love the most fierce weapon of all that Dr. Babasaheb Ambedkar himself carried: the fountain pen!

No amount of fights will ever resolve any problems between any two communities, the only way forward is to respectfully walk together and find solutions. Fortunately, no doctor, even in India, thinks about any patient in the terms of their religion or caste. (© Dr Rajas Deshpande). Just like the Judge in the court premises, humanity is the single supreme authority in any medical premises. Blood or heart, brain or breathing are not exclusive to any religion or community. Just like the bigger brain, a bigger heart is also the sign of evolution.

I so much wish that the black clouds of disharmony between different communities are forever gone. The only hope is that our students can open any doors and break any walls, so long as they do not grow up into egoistic stiffs. © Dr Rajas Deshpande

I am proud to belong to the medical cult of those who never entertain any discrimination. A patient’s blessing has no coloured flags attached! Even outside my profession, I deeply believe that the very God I pray exists in every single human being I meet. If at all anyone asks me, I am happy to say that:

My religion, my caste and my duty as a doctor are all one: Humanity first!

© Dr Rajas Deshpande

Neurologist

Pune

Please Share Unedited

The Extinction of Precious: A Medical Horror Story Happening Right Now!

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The Extinction of Precious:
A Medical Horror Story Happening Right Now!
©️ Dr. Rajas Deshpande

“Sir, we have come from Konkan”, said the father, “to seek your advice and blessings . My son has passed the medical postgraduate exams with national rank 30. He wants to decide which branch he should choose”.

I congratulated the genius. Passing medical entrances with high merit requires great talent. It does not earn the glamour, claps and appreciation of stage and limelight, for we live in a society that only worships looks, muscles, bhashanbazi, financial success and sports (sorry, one sport. Even if someone wins a world gold in any other sport than cricket, they go home in an auto rickshaw when they return to India!).

Speaking with the boy, I realised that he was very sensitive, compassionate and had an excellent logic and reasoning. Besides having a calm bearing, he was also a hard worker. A perfect blend for becoming a great physician or a surgeon, in a world that is fast losing able clinicians. I suggested him to prefer Internal medicine.© Dr. Rajas Deshpande

They looked awkwardly towards each other. The boy garnered some courage to speak.

“Sir, I saw our family doctor being beaten up by a local politician, his clinic was ruined. He was humiliated in the worst language in front of his wife and children, and instead of protecting him, other patients in his hospital kept on recording videos of the incident, which later became viral. He left, we don’t know where he went. I cannot ever think of directly dealing with patients now. I want to choose a non- clinical or para-clinical branch.”

I appealed to the father: “Your son has a great potential and matching talent to become a good clinician, we desperately need many more. It is not necessary that he practices in your own town or even in India. The whole world needs good doctors. Please think about this”.

The father, a simple teacher from a primary school, thought for a prolonged moment. His eyes reddened up.
“I don’t know, Sir. When he said he wanted to become a doctor, his mother and I always thought that he will become a saviour, running around saving people’s lives. We were never interested in only money. But the day that we saw our own doctor being beaten up by a crowd and the local politician, we realised how helpless a doctor’s life is. We knew our doctor for over 25 years, he was like a God for many in our town. All he did in 25 years became a zero in a few minutes, thanks to a hooligan politico and his crowd. We don’t want our son to ever face that. If we had a daughter in his place, we wouldn’t even have made her a doctor, women as doctors suffer a lot more trouble and get no returns, sometimes even from their family. And this is our only son, we want him to stay in India near us.”

Somehow I didn’t want to give up convincing him, he was an ideal candidate for becoming an excellent clinician.© Dr. Rajas Deshpande “Think of the future. Hopefully there will be better laws, he can also consider working in bigger, safer hospitals if he is scared”.

“What would you advise your own son if you were in my place, Sir?” asked the father.

He had bombed my mind.
I was trained by parents and teachers to always do good, be compassionate and kind. My kids had a potential to become great doctors coming from this background. I worry a lot about the extremely critical condition of deteriorating healthcare standards and reducing number of good clinicians that is destined to cause a havoc in a few years. Still, honestly, I did not wish upon my children the insecurities and threats I face. I don’t want them to live under the perpetual fear of being vandalised, defamed, tortured by over-expectation and punished by committees made up of politicians and medically inexperienced judicial experts. I won’t want their lives, work hours and remunerations to be dictated by a corrupt bunch living for votes of free mongers.© Dr. Rajas Deshpande

It would be hypocrisy to advise someone else what I wouldn’t choose for myself. That’s how a doctor makes the best possible decision. With a heavy heart, I advised him what I always advised my children:

“I agree. Please choose what suits your heart most, what gives you fearless happiness in your work and also leaves you with some time for yourself and your family, ensures a good income and is not dependent upon jealous people’s expectations of what you should do and for what price. You have so many options for social service other than becoming a clinician. I am sure you will stay a good human being all your life.” I suggested him two para-clinical branches that offer good scope.© Dr. Rajas Deshpande

The world indeed will have to suffer the gradual extinction of good clinicians. We need many more excellent doctors in para clinical and non clinical areas too, but the face of the profession is the clinician, and we certainly, desperately need many thousand more. It is a fact that in spite of increasing number of doctors, patients still die travelling in an ambulance to reach good healthcare far away from most homes in India. Many federal orphans who cannot even afford government healthcare die at home.© Dr. Rajas Deshpande

The father asked his son to touch my feet. As he did so, the melancholy of my own advice bit my heart. I couldn’t let down the flag of my noble profession.

“Listen, dear. I am speaking this against my own convictions. I am struggling. Think about becoming a good clinician and practising in a safe country, take your parents with you. I will be happy whatever you finally decide, but not everyone has the ability and talent to become a good doctor, it is rarest of the rare traits.”© Dr. Rajas Deshpande

They left. So did a part of my hope for the future of good healthcare.

When the next couple walked in with an infant baby in their hands, I looked at the smiling baby, and forced a smile. She didn’t know it yet, but I had just bought a precious gift for her.

©️ Dr. Rajas Deshpande

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The Right Decision

The Right Decision
© Dr. Rajas Deshpande

“Side side side” shouted the wardboy and relatives running with the stretcher with a bleeding body upon it.
Dr. Amit, the junior resident doctor, rushed forwards, wearing gloves. With a great difficulty he had qualified for the surgical residency, winning in a competition over lacs of MBBS graduates. He wanted to do heroic good, save lives and make the best of every opportunity to do so. This was his posting at a peripheral small hospital. What he couldn’t treat here, and after his duty hours, he was supposed to refer cases to the bigger center about an hour away. His duty hours were over for today, and he was preparing to go home.

The 11 year old boy had had multiple injuries, a fractured leg bone, and also a head injury. He was drowsy, and already had had a vomiting. Dr Amit started an IV line, then began to clean the bleeding sites, applying pressure bandages , while preparing to suture the major bleeders. Simultaneously, he asked questions to the relatives about what happened.

The bike that the boy was riding pillion with his father had slipped, and they had fallen on the road, an autorickshaw behind them had run over the child. The father was almost unhurt. As he told the details, Dr. Amit realized that the father and two relatives accompanying him were drunk.

In a few minutes, Dr. Amit had contained the bleeding. His cellphone kept ringing. It was already 11 pm, but he had informed his wife that his schedule was unpredictable today. © Dr. Rajas Deshpande

The nurse received a landline call and came to him, whispering “Dr. Amit, your wife just called. Your son has a high grade fever and is vomiting, has become drowsy. She is taking her to a pediatrician. She has asked you to call as soon as possible”. Then the nurse said, with a more cautious whisper, “You can refer this case to the higher center, I will complete the paperwork. I think you must attend your son, this is too late for your wife to travel alone”.

Dr. Amit’s heart sank. His two year old son was his life. He couldn’t concentrate. He remembered what every medical teacher had taught him: don’t abandon the patient in emergency, but then he felt guilty for abandoning the duty of a father. He called up his wife, she was already crying. “You should be with us right now, I am worried” she said. “I will try and come asap” he replied. © Dr. Rajas Deshpande

He then called the patient boy’s father. By now, over 15-20 people had gathered with the drunk father. All of them anxious and aggressive, many drunk too. As he explained the child’s condition, one of the inebriated “bouncer-type” man came forward, and shouted, filmy style “If something happens to my nephew, we will burn down this hospital”. The two-strong security staff at the hospital, malnourished and underpaid, added to the pathos of the situation.

They called up their municipal councilor, who came over like the owner of the hospital, and added to the threats in a more dramatic and abusive language. After all, elections were approaching, and public needed impressing.

Dr. Amit saw the crowd. He knew by experience what a drunk crowd can do if things turned critical. Mob mentality becomes the law in lawless Indian towns. © Dr. Rajas Deshpande
He wanted to help the child. He also wanted to reach his own son asap and be with him. He wanted to be the hero and the savior for both. Staying here would mean risking mob anger and life in case things went wrong, for none of his fault.

The society would automatically presume that he must have been rude to the patient, that he must have let the patient die for more money, that he must have abused the relatives etc., and the intellectual b******* in the society would start their sermons about how doctors should learn to communicate compassionately with a life-threatening drunk mob. Legal luminaries would ask him to “accept risk to life or quit job” while delivering judgements from airconditioned offices surrounded by heavy security, working for five hours a day and sumptuous vacations in spite of gigantic backlogs.

Whereas, if he actually was killed by the mob today, none of the above: the govt., the law, the relatives, the media or the society would ever bother to ask what happened to his kid, his family. A dead doctor, like a doctor who is not immediately needed, is an instantly forgotten doctor. His family may go through hell, who cared? There was no example of a good doctor’s family being cared for by the society if something happened to that doctor while saving lives.

The child’s mother came over, and begged him to save her child. He decided to wait, he couldn’t decline. © Dr. Rajas Deshpande

His wife called “The pediatrician has admitted our son. She has sent blood for urgent tests” she sounded terrified. He reassured her.

Just as he spoke upon his cell, another lady, a local politician, started shouting at him, asking why he was not being more pro active, why the patient wasn’t talking, and threatened that Dr. Amit’s name would be mud in the media tomorrow if the child did not improve immediately.

Dr. Amit was now relieved of his dilemma.
He had made up his mind as to what was the right thing to do.
© Dr. Rajas Deshpande

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“Is The Diagnosis Wrong, Doctor?”

“Is The Diagnosis Wrong, Doctor?”
© Dr. Rajas Deshpande

“Doctor, there is no improvement at all” said the angry husband, throwing the case-file upon my table.

Well this is not an extraordinary sentence for any doctor, one must be prepared to openly deal with this. I had been quite polite and well mannered with them, there was no reason he had to cross that line. I could understand though. When they pay my fees, they expect some result or satisfaction.

While teaching my students, I have always insisted that if the patient / relative says that there is no improvement or change with the prescribed medicine, one must first consider the possibility of a wrong diagnosis, a missed condition or a misinterpreted finding. Doctors are humans, and do commit mistakes, or misinterpret findings. This is normal, and happens with every doctor. Medicine is far more complicated than most people think they know. A good doctor knows this and learns, while all the time keeping patients safe, but a doctor with ego kills his own practice, and may cause harm to the patient.

I asked them to sit down and reassessed the case in detail. A 28 years old female. Headache, giddiness, imbalance, palpitations, breathlessness. Lack of sleep and bouts of crying. Past and family medical history not contributory. Physical examination completely normal. MRI of brain normal, Vitamin B12 and D levels low. I had started vitamin supplements, anti-anxiety medicines and an SOS for headache.

She told me all her earlier complaints had improved, but now she had a severe backache. I told the patient that I was trying my best to understand her condition, and to resolve her problem, but her findings and complaints didn’t match. She looked at her husband, and asked him “May I speak frankly to the doctor?”.

Openly agitated, the husband sarcastically offered to wait outside if she needed privacy. However he stood glued to the chair as if he knew her answer. © Dr. Rajas Deshpande

The patient thought for a moment, told him it’s ok he can wait inside, then started to talk. She revealed that she was the only child of her affluent parents, had passed engineering, but now had to quit job and stay at home to raise children. They lived in an extended family, with grand in-laws, in laws and an elder brother, his wife and two children. This patient was the ‘last in the line’ to take orders, all others being senior to her. Her husband and in-laws were perfectionists, and she was tired of their continuous expectations. She had dreamed of making a career too, wanted some free time outside home for herself, but year after year, she didn’t get even a minute for herself. She was tired of it all and there seemed no respite. © Dr. Rajas Deshpande

“I am not averse to hard work, but the continuously condescending and fault-finding attitude makes me feel that I am useless”, she said, and added cautiously: “We were in the same institute and my ranks were always better than him. Look at where I am now” she started crying.

I offered them water and coffee, and waited for her to settle down. The husband became restless and defensive, but his tone was far lower. “I understand her problem, doctor, but what can I do? I cannot leave my family. My work pressures are quite high too, the IT industry is going through a bad phase”.

“I can assure you that she has no neurological problem now’ I replied, “she should improve with lifestyle changes, counseling for the family, and adequate free time for herself. I will refer you to a good counselor” I told them.

The husband laughed. “I can understand, but my parents will not. We will see what best we can do for her”. A bitter tone in his voice didn’t escape me.

‘Sir, she told us what bothered her, and must not be held guilty for trying to speak her mind. It will only help identify and treat the problem better. Please see a counselor together and avoid discussing this at home right now” I requested the husband. © Dr. Rajas Deshpande

There are many reasons why a patient does not improve. Untreatable medical conditions, depression, seeing the wrong specialist are the most common reasons, but there also are patients who want medical leave,those who want to avoid work, who want attention, so will keep on complaining of false symptoms. They do not improve with drug treatment.
On the other hand there are many who keep on taking the wrong medicines for years, those who self-medicate, do atrocious / injudicious dieting and exercises, yoga that doesn’t suit them, and do not follow the doctor’s instructions about abstinence, who keep on indulging salt, sweet, oil, alcohol, tobacco and other drugs freely available in India. © Dr. Rajas Deshpande

A doctor remains a lifelong medical student. A doctor who thinks he / she is always correct is most dangerous. It is not uncommon to meet doctors who are angry / upset with the patient / colleagues when their diagnosis, treatment is questioned. The first thought of a doctor when the patient does not respond positively should be to consider a misdiagnosis, reevaluate the case in more detail, reassure the patient, and obtain a second opinion if necessary. All this done, one must look into other possibilities, with an approach to resolve the issue rather than trying to shove down the patient’s throat their own faults.
We all go through bad patches in life, doctors and patients. If the child is wrong, the parents correct them still with love. A doctor’s attitude should be similar, with due care to also protect themselves. If not the doctor, who will understand the patient whose family refuses to understand them? In so many ways, especially in the Indian society, the doctor must don the role of an elder brother/ sister. Although patronising is legally discouraged in medical practice, and should be refrained from in cases where trust is questionable, one can make exceptions for some cases that need reassurance where the family fails to do so.

The nobility of our profession also lies in reassuring the patients that they are well cared for by their doctor, through the thick and thin of their life.
© Dr. Rajas Deshpande

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Beyond Ridiculous!

Beyond Ridiculous!
© Dr. Rajas Deshpande

A 9 year old child with fits / seizures was taken to a renowned Paediatric Neurologist. He started treatment with one of the most commonly recommended (by almost all textbooks) used medicine in the treatment of seizures: carbamazepine. One of the most effective medicine, used since over 50 years in children, that can cause side effects of rashes in less than 1/1000 cases. Still rarely, the side effects can be very severe, causing extensive damage to the skin.
The doctor explained this to the child’s parents, and then started the recommended doses. Pediatric doctors are the best trained doctors in dose calculation, they are more aware than any other specialty about the side effects in general, because children often cannot even speak and parents may not notice some side effects. © Dr. Rajas Deshpande

Every medicine has side effects. Even vitamins do. Any medicine can potentially cause life threatening reaction, and that’s why the common warning with each medicine: do not use if you are sensitive to this medicine. How will one know whether there will be any allergy / reaction to the medicine without having used it?

Most medicines can cause side effects at high doses, but some can cause dangerous reactions even with the tiniest dose, or test dose. Some medicines (even the one mentioned above) can cause side effects after many months / years of safe use. While the dose dependent (high dose= higher side effect) side effects are somewhat predictable, the ‘idiosyncratic’ (meaning occurring in individual, not all cases, because of the natural tendency of that person) and “allergic” side effects are totally unpredictable, and can be caused by even such common medicines as paracetamol, aspirin, antibiotics or vitamins. Even deaths have been reported after the use of some common medicines, but even in the highly legalized western world, no court holds doctors guilty for the side effects of medicines, if these were discussed and informed to the patient / family. This is against common sense. © Dr. Rajas Deshpande

This child unfortunately developed a rare but well known side effect of this drug, called Stevens Johnson Syndrome (severe skin rashes), had to be admitted and treated, it cost them one lac rupees. While we sympathise with the child and the family, and wish them the best recovery and health, this is hardly the mistake of a doctor.
But the forum, in a regressive decision, held the doctor guilty, fined him 90000 rupees. This is beyond ridiculous. The court observed that “ if the doctor knew that this drug can cause side effects, he should not have prescribed it”. Translated intellectually, that means NO DOCTOR CAN PRESCRIBE ANY MEDICINE! © Dr. Rajas Deshpande

Moreover, what will this court advise for the child now? Every seizure medicine has some rare dangerous side effects. There are no medicines free of side effects. Shall the child be left without treatment now? Which doctor will want to treat such a case? Which court will guarantee that the rarest of the rare side effect cannot happen again in this case, and with such ill-informed forums, the next doctor trying to do good to the child will not be held guilty? © Dr. Rajas Deshpande

Technically, if using a drug that can cause side effects is a crime as per this court, it should hold everyone concerned guilty: the textbooks / medical bodies that recommend this drug, the pharma which produced it, and even the government which allowed it to be sold. Applying the same logic, if some child developed peanut allergy in a hotel or side effects of pollution and dust by travelling on Bangalore roads, will this court hold the hotelier or the city administration guilty and punish them too? Has this forum/ court banned tobacco and alcohol yet, or will it punish the government for the side effects and thousands of deaths caused by these? © Dr. Rajas Deshpande

The IMA, other medical bodies, Neurological society, and intellectuals should stand by this doctor who has suffered the mental agony. This decision must be challenged in higher courts.
We regret that some patients suffer side effects, no one should, but at the same time, the “side effects of medicine” is not the doctor’s fault, especially in this case where he had explained the parents about such possibility.
We need medically educated forums and judges who can refrain from populist tendencies.
© Dr. Rajas Deshpande
PS:
I respect courts. I respect higher courts more. But I refuse to believe that every decision made by every judge is correct, that every decision is impartial, that it is not affected by pressures. This article is solely based upon the attached news clip. I must admit that this reporter Ms. Meghna Singhania has done an excellent and impartial reporting. Doctors must please stand united against this decision.

https://medicaldialogues.in/side-effects-of-prescribed-m…/…/

Fate and The Fatal Healthcare Gamble

Fate and The Fatal Healthcare Gamble.
© Dr. Rajas Deshpande
 
In the rush of a local station, a 25 year old man suddenly shouted in a scary way and threw a fit. His eyes rolled up, his body shaked violently, and he fell down. The jerks kept rocking his body and shocked people around him noticed blood stained frothing from his mouth.
 
Some strong person, too eager to be a hero by the demonstration of gym-built strength, kept his foot on the leg of this patient and pulled his tightened hand to straighten it, till one heard the obvious sound of a bone breaking. Another slapped at the face of this convulsing patient, abusing, and telling the bystanders that the ghost holding this patient must be scared off. © Dr. Rajas Deshpande
 
Yet another, with the confidence of experience, thrust a dirty leather footwear under his nose. Someone else shouted for an onion or chilli, guaranteeing that it will immediately stop this voodoo. This too was then applied to the nose of this patient who was still convulsing. The patient had a lock-jaw, his teeth were clenched together. A spoon was then forcibly inserted between the teeth, and so strong was the effort that few teeth broke and blood oozed out.
 
By this time the convulsion had stopped, and everyone who had thus “treated” the patient proudly explained how each of these tricks always worked.
 
None of them knew that an epileptic attack would automatically stop within a minute and a half, that one should not force open the mouth or straighten the hands or legs, because that will only hurt the patient. The excessive electrical discharge in the brain that causes such fits will not stop by doing anything externally. Within a minute, such activity stops automatically as the brain energy and the currents cannot sustain, and the patient recovers consciousness in most cases. Rarely, such fits go on beyond a minute or two, in which case, only the trained medical practitioners must handle the case, preferably physicians or neurologists. © Dr. Rajas Deshpande
 
This patient was still unconscious.
An ambulance which had the “contract” for that station arrived, and the “paramedics” got the patient in. Relieved that all was well, people, as always after whatever happens, carried on.
This ambulance then took the patient to a “contract” hospital far away, even when there were many good hospitals on the way, thus wasting the most precious time. The patient had aspirated: his blood and saliva had now blocked his respiration.
By the time he was taken to this hospital, he was almost gasping.
 
The contract hospital, owned by an organization that had excellent political links, was designed to hide the deficiency of the most important element in good healthcare: well qualified and experienced, genuine specialists. Being the one to provide the lowest cost treatments, it only employed doctors willing to work on the lowest salaries. Poorly qualified, rarely experienced and already fed up with the workload. But in these days of beautiful, colourful signboards and deceptive advertising, declarations of “world class healthcare”, one rarely questions the training, qualification and experience of doctors. © Dr. Rajas Deshpande
 
The patient was taken into ICU, intubated and ventilated. An orthopedic surgeon attended his manmade fractures.
Legally everything was completed and correct. All forms signed. Critical status explained, understood, accepted. Relatives happy about the charges and the behavior, explanations by the doctors and specially appointed PROs. A qualified Neurologist was called in for a visit, who guided the treatment and went away. He was scarcely in a position to advise the relatives that the basic life support systems require great experience in such cases, and this hospital didn’t have that kind of a team. That would be unethical, plus the hospital had enough connections. That’s what got them the contract in the first place. Also, his calls would stop if he spoke beyond what he was called for.
 
The patient had suffered damage to the brain due to the delay in starting the treatment. He remained unconscious. Then in a week he developed septicemia: infection from the lungs that spread via blood to all his body. © Dr. Rajas Deshpande
The relatives were explained everything, except the fact that the team was inexperienced, ill qualified to treat. They were broken when the patient passed away., blaming their ill fate
It was indeed the fate of that patient to have a fit just there, just then. A young man who could have come back to normal health in few minutes was killed.
 
Or was this fate alone?
 
This death was preventable: a fit generally needs no treatment while it is happening. In this case, people had broken his bones and teeth, forced dirt in his nose, and caused bleeding. The ambulance, due to the obvious “loops”, wasted precious time reaching the “contract” hospital rather than the nearest hospital, the contract hospital took the case in spite of not having well qualified expertise and team to handle the situation, and the relatives did not care much beyond the financial implications. All equally guilty. This was a murder with multiple murderers.
The only thing one can do to help a patient having a fit is to make sure their head does not bang upon a hard surface, remove any sharp objects upon or near the patient, and turn the neck gently to one side, so that the food / tobacco/ anything that the patient has in the mouth comes out and does not block their respiratory pipes. Simultaneously, call an ambulance. © Dr. Rajas Deshpande
 
Remember the 6×6 feet supermarket that sells everything, in the corner of your lane? Something similar is happening with healthcare now. One wants every specialist in the nearest location, with cheapest competitive rates, and so long as their advertisement is good, people are happy when quality takes a backseat. A specialist is a specialist, so long as he / she has any degree, so long as the govt. approves, and especially if they offer concession, nobody cares about tomorrow.
 
The extensive training that goes into making of quality doctors is now replaced by many options: some low quality private medical colleges run by those in power, where money buys almost everything and merit/ hard work doesn’t matter, cross pathy and bridge courses, allowing too many unscientific treatments to take center stage in the country’s healthcare, defaming those who try to improve the system , projecting the philosophy that “all healthcare that is cheap is alone good, costly means corruption” etc. © Dr. Rajas Deshpande
Who suffers when inadequately qualified doctors with poor merit, experience and dedication treat the patients? Who suffers when those who have made their career based upon political support or corruption, treat the patients?
The worst gambling in India is in healthcare. People happily stake their lives to save some money.
 
God save my dear India in this healthcare crisis.
Jai Hind
© Dr. Rajas Deshpande

Are You Respectable, Doctor?

Are You Respectable, Doctor?
© Dr. Rajas Deshpande
 
“Send in the next patient” I told the receptionist.
As no one came in for a few moments, I opened the door. A trembling, shuffling old man in his eighties, standing with the support of his son and daughter in law, was fumbling to remove his sandals outside my door.
“Let it be, it’s ok” I told him.
Smiling, embarrassed that he was unable to move fast, he folded his hands and said ”Namaskar Doctor! You are like a God and your room a temple for me. You give life to so many. I don’t wear sandals in a temple. Let me remove. I am sorry, please give me one minute more”.
It was my turn to be embarrassed. Do I deserve this respect from a stranger just because I am a doctor? © Dr. Rajas Deshpande
 
Mr. Wamanrao, who was a teacher before retiring decades ago, walked in. After examining him, I explained to him and his family that he had a degenerative problem of brain that caused imbalance and stiffness. The concerned family asked some questions earnestly.
 
“Tell them I am old and must leave this world now” said a smiling Wamanrao.
 
Pausing to think for the right words, I explained them the condition, and told him “At present I do not see a reason to worry. I don’t find anything life threatening in your examination, we will also do some tests. But there is no need to think about an end at this time. You should improve, let us try. And yes, it is very fortunate and enviable that your family loves you so much”. It was impossible for me not to remember my own father.
 
In tears, he folded his hands, then blessed me by keeping his hand upon my head, and left.
 
Many patients came in that day, and I kept on thinking: that most of them, especially the illiterates, poor and elderly came with a lot of respect, behaved politely, and followed the instructions well. Some came in bitter with their experiences with some other doctors and hospitals and confessed the reason of their angst. The young, rich and highly educated mostly walked in with a paranoia and refusal to trust. But these were very few, mostly because I don’t dance different for the high class patient. The most difficult class to handle were the uneducated rich and the politico poor, who think everything can be bought, threatened or manipulated, including a doctor. © Dr. Rajas Deshpande
 
This last class offends and frustrates most doctors who work with a feeling of dignity for their profession. Not because they ask too many questions, but because they misbehave, are too arrogant to tolerate, and cannot trust anyone. The last thing that a doctor wants is a trustless patient: it means trouble in future even if the best is done for such a patient. Even if saved from a coma, they will belittle the entire profession and file cases for bills. © Dr. Rajas Deshpande
 
We always claim that some doctors are bad and the good ones bear the brunt, then we must also understand that some patients behave bad, but most others suffer the consequences. The “On-Guard” new generation doctors have now started to become too ‘legally correct’, talking in terms that lack feelings. They are not always wrong, because the law of the land, the crass class of media and many administrators openly badmouth this noble profession that carries the entire healthcare of this country upon their shoulders.
 
However, we as doctors must also think if we always behave respectably. There still is an inherent respect for the profession, in the minds of most. But if a doctor thinks that he / she should be treated like God just because they have a degree, there is a grave misunderstanding. One must be proud of one’s merit, but the patient shouldn’t have to pay the fees for that pride. © Dr. Rajas Deshpande
 
Many doctors are usually well behaved, but we also see very rude, “head in the clouds” type of doctors. A little success, a little affluence, and a ballooning ego is a common picture. Such doctors then refuse to acknowledge the patient (or even their own junior) as another human being to be treated as an equal, with dignity and respect. They will crowd their waiting rooms, make patients wait unnecessarily while they chat / entertain “rich and influential clients” etc. They will behave high handed and rude with patients and juniors, pretend to be in a hurry when the patient starts asking questions and even walk out to see another patient in another room. Many quite senior big doctors actually classify the patients financially, so that the assistant filters out and treats a certain class of patients.
 
Some doctors talk “only the legal” language to patients who are emotionally disturbed, in a state of shock or grief. The other end is the “Always smile and keep the patient in a state of false hope till they can pay bills” type of doctor, who disappears once the patient cannot pay or takes a bad turn of health. Some doctors do not even follow the common decencies of respecting elders and women. Manners and etiquette are fast disappearing among doctors, it is time to remind ourselves that a doctor is one of the highest respected intellectual in our society, and just like the heroes upon the big screen, many, especially children emulate the good behaviors of doctors too.© Dr. Rajas Deshpande. It is sad that our media, movies and comedy shows take pride in belittling Indian medical profession, considered one of the best in the world, but it is also true that some doctors indeed provide them with a reason to do so. © Dr. Rajas Deshpande
 
No one will salute a doctor just for his / her degrees, experience, post or affluence. If a doctor wants to be respected, he / she must carefully learn to respect others, use the right language, and follow manners and etiquette at his end. There indeed are a minority who will mistreat a doctor, who will take advantage and misunderstand manners as weakness or an inferiority complex. Give them a sincere chance to change their opinion. If they are still paranoid, arrogant or rude, then a doctor must move on, politely refusing to see them again. © Dr. Rajas Deshpande
 
In absence of any support from the politicians or media, we must learn to cultivate a positive doctor-patient relationship culture rather than ourselves becoming paranoid. We must learn the new language of “legally correct yet compassionate” medical talk. Patients are an inseparable part of our profession, success and daily life, we cannot be at war with them just because of a few imbeciles.
 
I myself am not free of mistakes, and I want to continue to improve, for the day that I think I cannot improve anymore, that I am the best, I can no more be a good doctor.
 
For my birthday tomorrow (07. January), it was necessary that I reminded myself what my parents and the best of my teachers taught me. The best gift life has given me is the ability to be a doctor, and I must take in stride everything that comes with it.
© Dr. Rajas Deshpande
 
Please share unedited.

The Unholy Medicine

The Unholy Medicine
© Dr. Rajas Deshpande

“Close your eyes and take it. Absolutely no reason to worry. It is excellent in improving mental and physical health. It improves memory, skin texture, hair thickness and even vitality” said the medical shop salesman, winking one eye, handing over a big plastic bottle to the posh middle aged couple.

“It is all natural. These products have zero side effects” he said.
“But it costs nearly two thousand rupees” said the wife.
“What’s costlier than your health, mam,? This product is selling so fast, you will come back again to ask for it once you realize how good you feel without all the side effects”.

I had stopped on my way back from the hospital to buy some vitamins from a large medical store on the way. The shop, like all other medical shops now, had far lesser allopathic medicine . Most prominently displayed were sex boosters, chocolates and beauty products, from various pathies and with pics of different Babas. The next most prominent were various “organic” products, from juices to tablets in blingy packaging. © Dr. Rajas Deshpande

One common factor was prominently printed matter on most such products: “Guaranteed to cure”, “100% natural, free from side effects” “No adverse effects” “100 % Scientific secret formula” etc. Some packets claimed to even cure incurable diseases. Most of these did not have the content printed. Most of these also had valid licenses.

The shop owner and staff didn’t know that I was a doctor. Out of curiosity, I looked for the same bottle on the shelves, and read what it was that the assistant so confidently vouched for. It was a juice of some routine vegetables, with an additional “unspecified” herbal formula. It was made locally, and wasn’t refrigerated. The cleanest ‘Natural” food we cook at home with love, even “Maa ke haath ka Gajar ka Halwa” rots in three days if kept without refrigeration. I wondered what magic formulas kept these “Natural products” free of the millions of microorganisms. But then, I had no right or authority to question the massacre of scientific medicine. I was merely a doctor, not a highly uneducated politician or a religious preacher. © Dr. Rajas Deshpande

Just last week we had in critical care unit, a lady from an affluent family, who was given some precious powder by a “self-proclaimed” natural products expert, (wife of a politico in a taluka place). The 100 grammes powder had cost 45 thousand rupees, and came with a guarantee of “reducing wrinkles and hairfall”. The patient had consumed it for a week, and came to the casualty with a convulsion on the eighth day, found to have poisonous levels of heavy metals in her blood. Few months ago we had a young man who almost died because of clotting in the brain, after taking some injection of a “secret formula” given by his Gym trainer!

Bacteria, viruses and other microorganisms in some of these “natural” products grow for a few weeks, and cause infections, many a times life-threatening. This usually happens after 2-8 weeks or even later, when the patient has long back finished the doses. Some have heavy metals/ ingredients that may cause kidney / liver problems or other diseases months or years after consumption. © Dr. Rajas Deshpande

Wake Up, India! Long gone is the era of “secret formulas”. It is the right of every consumer to know what is the content of every medicine he / she bought. Unfortunately, the “Planned propaganda against allopathy to sell the products of the influential” blinds even the well educated. © Dr. Rajas Deshpande. There is a huge number of people who ask “some medicine” for all their complaints from a medical shop salesperson to avoid paying the fees of a qualified doctor. This qualified / unqualified pharmacy assistant, without even touching the patient, makes his own diagnosis/ conclusion and decides the treatment, the patient happily pays for it, thinking that he / she has saved a lot by not visiting a doctor!

The very governments which cap the prices of allopathic medicines allow other pathies and “homemade remedies and secret formulas” to be sold for the cost of gold and diamonds. Apparently many people have enough money to buy extremely costly herbals, beauty / personal care products, chocolates and sex boosters, but suddenly become poor when a scientific medical product by a standard international pharma company is to be paid for.

In India, movies make 100-500 crores, cricket matches fetch billions in betting and tickets, most of the lawmakers are crorepatis, but everyone seems concerned only about the fees of doctors and cost of allopathic medicine!

The same people in administration who ask qualified doctors to reappear for tests to reprove their merit frankly allow rampant “cross pathy”, babas and gurus, hakims and other self-proclaimed experts to keep on selling health products at unimaginably high prices. Imagine the bribes and commission is involved at all levels in the sale of such “natural” products. What more can describe the paradox in Indian Healthcare where aloe, karela (bitter gourd)and doodhi / lauki (bottle gourd) juices sell at a price far higher than many essential medicines? © Dr. Rajas Deshpande

No surprise we get many patients now a days, who come with early- age blood clots, digestive problems, severe headaches and vertigo, serious allergic reactions, convulsions, kidney, liver and other metabolic problems, thanks to the “secret and purely natural 100 % scientific formulas absolutely free of side effects” that they had consumed weeks / months / years ago.

Is it impossible for the Courts to act here?
What’s the proof?
There cannot be any proof unless each of these products is scrutinized with the same vehemence that once a famous international noodles brand was scrutinized. There cannot be any proof till the scrutiny and people involved in it are completely corruption and influence free. There cannot be any proof till those in power are involved in the sale of such products. Those who have basic deduction powers intact will know it for themselves. From public transport busses and autorickshaws to malls, there are blatant lies in advertisements selling such health products. The word “Scientific” is now used by almost every such product.

The fact that most of those in power use imported phones and cars, and visit foreign countries for medical treatments is enough clue.

As I paid for my vitamins, I asked the salesman what sold most at his shop.
We all know the answer.
It is not any medicine.And sadly, there appears to be no treatment!

© Dr. Rajas Deshpande

Issued in the interest of everyone who likes to be mentally and physically healthy. Please share unedited for the benefit of your patients.
Jai Hind!