Tag Archives: Politics

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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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

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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 Cult of Good Blood: Superhero Medical Students

The Cult of Good Blood:
Superhero Medical Students
© Dr. Rajas Deshpande

He grew up selling vegetables and fruits grown by his mother. He went door to door and in the village market to sell those. He also walked for two miles every day to catch a bus to a school over 20 miles away. He then enrolled in a private class that waived off his fees, because he had a passion: He desperately wanted to become a doctor.

Atul Dhakne, son of a school teacher Mr. Nivruttirao Dhakne and farmer Mrs. Mandabai Dhakne, with his hard work and merit, got admission in the prestigious B.J. Medical College in Pune.

But he wasn’t satisfied. “What about those like me who are from the poor rural background, those who have no access to good classes and education, but want to become doctors?” he worried.

Good Blood speaks, whichever soul it flows in. Young medical students of different origins, studying with him, decided to resolve this. Ketan, son of a lawyer Mr. Avinash Deshmukh (who mostly handles cases for the non-affording,) wanted to do charity like his father. Farooque Faras, whose father raised a family in one small room, was burning with the desire to give. Many others joined in (names below), and the Cult of Good Blood multiplied. They all wanted to uplift the deserving.

“Lift For Upliftment” was born, formed by the superheroes among medical students.

They printed posters and went to almost all junior colleges in Pune, appealing students from poor backgrounds to join their free tuitions / classes, to prepare for the CET /NEET. In the first round, over 40 students joined. After the medical college hours, Atul and his friends took turns to teach these poor students, give them notes, set question papers, conduct exams, assess and counsel for improvement. All expenses were borne from their own puny pocket-money.

There was no fixed place for the class. One local bakery owner, Mr. Dinesh Konde, decided to help these students. He planned the logistics and took them to the corporator Mr. Avinash Shinde, who asked for only one thing in return of his help: commitment to continue this good work. The Cult agreed whole-heartedly. With him, they approached Mrs. Meenakshi Raut, Asst. Director in the education department in Pune, who helped them get two classrooms in a Municipal school after the school hours. The classes thus became regular, every day, from 6-9 PM.

The cult lacked stationery, the huge backup of notes and question paper sets for 40 students, so they approached Mr. Sanjeevkumar Sonavne from Latur, who runs many educational institutes, helps poor students, and even pays the fees of some who cannot afford college. Mr. Shelke and Dr. Harish from Sassoon Hospitals also joined hands to help.

The results were impressive: from the first such batch, 6 students qualified for MBBS, 3 for BDS, 11 for BAMS and 2 for BHMS.

No one had earned anything, but Good Blood flowed forward. Many medical students from subsequent batches came forward to teach free, imparting their fresh acquired knowledge and skills to those who could otherwise have no access to it.

There is no discrimination while accepting junior college students for their class. They have two batches now with 60 students in each. They have also started weekend classes for poor students preparing for NEET in the extremely backward area of Maharashtra, named Melghat. These medical students go to Melghat with their own expenses, teach the rural junior college students over the weekend, and return to attend the tough schedules of medical college again!

“I learned helping others from my mother. We don’t earn anything, but we learn something precious every day” tells Atul, who has now passed MBBS. Ketan Deshmukh, Abhiraj Matre and Farooque Faras help him supervise the group. Their endless enthusiasm only reminded me of how much more I can do. I came to know of this group “LFU” during the recent “Quest Medical Academy” event arranged by Dr. Sushant Shinde.

They are naturally, perpetually short of funds.
I am not rich, but I won’t feel right about myself if I didn’t contribute. They graciously accepted.

When these students came to meet me today, I offered them dinner at a good restaurant (knowing that they stay in hostels). Farooque said “Sir, we will rather use that money to print some more question paper sets”. Farooque’s father has stopped all celebrations in the family, and sends all the money he can, from his one small room home, for the torch of humanity that his son carries forward!

When they asked for an advice, I had but one small request for them: that a Doctor should be completely free of all political and religious influence at work, in teaching, and especially while treating a patient. They assured me that “Lift For Upliftment” has decided to never be affiliated to a political or religious organization, keeping humanity as their highest ideal.

There is no better lamp than the one which carries the light from soul to soul. There is no better definition of humanity than holding hands of those who need it most. I feel very happy today, that I could contribute to this beautiful, divine cause.

Long Live the Cult Of Good Blood, and may we all find it in abundance within ourselves!
© Dr. Rajas Deshpande

The group “LFU” also includes: Esha Agarwal, Shivkumar Thorat, Satyender, Tanvi Modi, Mayank Tripathi, Nikhil Nagpal, Sitanshu, Arvind Kumar, Nagesh Pimpre, all from the B. J. Medical College Pune.

PS: My heartfelt appeal to all medical students and doctors to contribute by starting similar activity in your region, by teaching poor students who want to become doctors, by joining this group and / or by donating for this cause.

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Doctor’s Fees: A Taboo Topic

Doctor’s Fees: A Taboo Topic
© Dr. Rajas Deshpande
 
A famous industrialist from Pune recently visited my OPD. My Boss called me on phone and told me to waive off the fees, as he was a close friend of my Boss. The industrialist was not only well behaved, but well-read too. He had a complicated problem, had seen Neurologists etc. in India and UK. He asked many questions, and I was happy to have been able to reply to most. The consultation lasted over 45 minutes. He went out, and was told by the receptionist that his fees was waived off. He knocked my door, came back in, and placed three thousand rupees on my table. My usual fees is half that.
“Doc, I don’t believe in taking advantage. You gave me all the time I needed, and I have paid far more to the foreign doctors for a fraction of that time” he said.
 
Just a few days prior, a European patient from Mumbai had visited with her Indian in-laws, and after a detailed consultation, when they went out and paid the usual fees of 1500 INR, she messaged me: that this was far lower for the service they received. © Dr. Rajas Deshpande
 
Two days ago, on Saturday night at 9 PM, one lady rushed in without appointment, an engineer now working in Pune. Quite lavish in her get up and paraphernalia, she told me she had recently delivered a baby in the USA and then returned to India. After we finished the consultation that lasted over 30 minutes, and included many questions and explanations about her “minor” neurological problem, about justification of diagnosis, every medicine, about lactation, and about her prior medical consultations, I was happy that I had answered all her questions, and was able to treat her without any tests. Then she said: “And yes, doc, your fees is too high. Most doctors in my area charge less than that. I want concession”.
 
Earlier it was quite embarrassing for me to discuss money with patients. I felt it was below my dignity to have to talk about money, and humiliating to have to explain my fees. When I decided what I charged, it was after a prolonged thought process, and awareness of Indian healthcare scenario and socioeconomic conditions. While being available for genuinely poor patients, I did not want to resort to any backdoor incomes, and also wanted to give every patient the best of my skill acquired over 15 years of education, and enough time. There are clean doctors, far more senior than me, in my branch, who know this well and charge a lot more as consultation fees than I do (some over 5000 INR for a single consult), for they know their own worth. But there also are few who for their own reasons continue to charge far lesser, some with a noble intention (usually at the fag end of their career), some with alternative plans. It is a personal preference of the doctor, especially specialist. A correct diagnosis and honest /right advise is becoming rare and rare, what with the quality of medical education and an admixture of streams, which aim at the fast, cheap, objective and basic rather than specialized, subjective and accurate. © Dr. Rajas Deshpande
 
In absence of any comparable example, (medical service is not comparable to any other, but to quote an example that most should understand), I have to mention this: when one buys land, home, good food or technology, one pays differently at different places, for different brands. No one argues about the rates of foreign cellphones or jewelry, even about cinema tickets, but the most important service of all: health, is considered a bargainable, perpetually low cost charity. Basic and emergency healthcare doesn’t mean attached super-technology, five star rooms and washrooms and air conditioning, best qualified staff and ancillary services. © Dr. Rajas Deshpande
 
Used to this question very frequently, I told this lady that my fees was the same as that of most super-specialists in larger cities, that it was based upon qualification, experience, skill and time spent. She wouldn’t listen, and refused to pay. I told her she could avail of the free OPD meant for poor patients if she had a BPL card or if she was a farmer. “I can afford, I am not poor. But I want concession, because some doctors in my area charge only XXX”she said. © Dr. Rajas Deshpande
 
A senior doctor had advised me during the beginning of my practice: “Concentrate on the affordability of the middle class. Manage your time with the patient according to their affordability, people are rarely willing to pay the doctor. If your consultation fees is high, you will turn off many patients, because even the rich opt for the cheapest possible healthcare, including the doctor”. © Dr. Rajas Deshpande
 
Of course I did not want to discriminate. But over a period of time I realized that most of the forced free categories keep on repeatedly visiting various specialists / hospitals (a free category patient visits over three consultants for every medical issue) because it is free/ low cost, this is a frustrating scenario. Even the affording class visits many specialists for the same problem because the doctor’s fees is too ‘affordable’.
 
A doctor must always be kind and compassionate, but in India, he / she also needs to be practical to avoid being exploited. Compare to the availability of a free food service at your home for the poor. Check out for yourself how many misuse it, and how often. © Dr. Rajas Deshpande
 
Various pathies and specialties have a different fees structure, and people must be educated that all doctors cannot charge the same. A surgeon or physician with more skill, experience, expertise and good outcomes is definitely entitled to charge more than his peers. After all, what is a few thousand rupees when one’s health is concerned? When filing suits against doctors who commit mistakes, people claim in crores, a fact that must be accounted for when the doctor charges his / her fees.
 
“Your fees has increased” said a patient, who has paid the same fees for last 8 years. When I asked him to name any commodity whose price hasn’t increased in last eight years, he said “But you are a doctor”. © Dr. Rajas Deshpande
 
Among all the inflations happening everywhere, it is only the doctor’s fees that mostly remains unchanged for years. There are excellent charity institutes with great healthcare services , also many government hospitals, but most people want a “Premium / Priority” healthcare service at their lowest rates, refusing to stand in a queue at such hospitals. © Dr. Rajas Deshpande
 
The cut throat competition among hospitals to match society’s low cost healthcare expectations has resulted in a nightmare: most of the permanent staff being hired is low-salary, low qualification overworked, and exploited, many of the consumables used are of a questionable quality. This reflects worst in most critical care units and some surgical units. Very few will understand the true depth of this horrible tragedy.
 
While all cut-practice and other malpractices must end, while every doctor must compassionately aim at resolving the health problem that the patient trusts him / her with, and satisfy the patient as much as possible, it is also necessary that people understand that good healthcare will come at a higher cost. No doctor should refuse emergency /basic treatment to a patient who really cannot afford. Other than this, “Cheaper Doctors are the kindest and the best” is a devastating superstition we must eradicate.
 
© Dr. Rajas Deshpande
 
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The Zen Of a Doctor: An attempt of honest meditation

The Zen Of a Doctor
An attempt of honest meditation
© Dr. Rajas Deshpande

I am now tired, mentally fatigued, I want to recover to joy. I do not want to lie to myself.

I love treating patients, resolving their health problems. I love the feeling of their recovery. I love the gratitude that comes my way. I am proud of this ability to be compassionate, to harbor empathy and to understand and fight suffering of another human being. I am proud, that money is not on the top of my priority lists. © Dr. Rajas Deshpande

But now I am tired of the whining: not the whining of suffering, for that is mine to destroy happily, but the whining by choice of adopting an extremely stressful, dirty, unclean, unhealthy lifestyle, not preparing to change, not preparing to pay for health, and then blaming it all upon a doctor. Women openly suppressed by husbands and large families, children tortured by parent’s whims, men exploited by their own desires and careers, and an orthodox, superstitious society where the most literate and educated believe in sometimes poisoning themselves with unknown medicines, and then have the audacity to question a qualified doctors’ intentions in writing a prescription. © Dr. Rajas Deshpande

They want everything of the best quality, from panipuri to cars, and are willing to pay extra for every luxury, while expecting that only healthcare must come free, and the very doctor whom they cannot trust, cannot tell the truth to, must treat them with best empathy and honesty, give them enough time to ask unnecessary questions and doubts, and then should waive off the fees out of sympathy. © Dr. Rajas Deshpande

I am also tired of the corrupt practices in medicine, and the hopeless scenario that everyone rather tends to believe that the doctors are all corrupt (some indeed are, but so are few in every profession, shut up pseudo Einsteins of argument!) rather than seeing the open markets established by uninhibited corporates who are seen hand in hand with the administrators, some pharmaceuticals and some in power. Corruption by those in high places, that ranges from producing some of the worst quality, inexperienced doctors, to dispensing lower quality everything just because they have understood this trick: people fall for low cost anything, even health. Such a disaster that people do so many unnecessary tests under the “Health Check” scams themselves, but when the doctor advises even one test, suspect him / her of wanting more money! © Dr. Rajas Deshpande

I refuse to be exploited. I can only change myself, not the world. Hence this meditation.

I want to live a good life: not full of gold and diamonds, but of joy, health and inner peace. Of independence, financial as well. Of my own choice and preference, not what the society decides for me. I want quality time for myself and my family too. © Dr. Rajas Deshpande

I do not want to be a busy doctor irritated and shouting at everyone: I would rather earn less and guard my composure. Those who cannot respect this will be given a chance to understand, but only once.

I will continue to stay highest in my principles. I will refuse to compromise on the quality of healthcare I want to practice, just because someone wants a cheaper, faster but less ethical alternative, less correct choice. I will see less number of patients and rather spend enough quality time with each of them, and charge them higher as per time and expertise, rather than hurrying through.

I will choose to encourage trust in my patients with my own behavior and words, but if I realize they are still trustless and question my integrity, I will refer them to their choice of another specialist, because I want to retain my best peace of mind for my next patient.© Dr. Rajas Deshpande

I will not take the extra effort to explain everyone why I do what I do, my duty is to be honest to myself and my God, my patients. I have limited time, now and in life, and I will expect that faith, trust and a level of basic intelligence (that has nothing to do with education) will enable everyone to see clearly that I mean well. That is my promise to myself: I will always mean well to my patients, and offer them my best. That should never preclude my own happiness. This will enable me achieve my inner peace so essential for a doctor.

I feel better with this already.

© Dr. Rajas Deshpande

G-Bhai, The Suicidal Intellect.

G-Bhai, The Suicidal Intellect.
© Dr. Rajas Deshpande
 
G-Bhai is an extraordinary genius, and all that he lacks in the matter of manners, culture, and grooming oneself to a neat and clean appearance is compensated for by his superb analytical abilities and internet access. He was so engrossed in Google all the time, that he was nicknamed G-Bhai by his family.
 
A few weeks ago, he went to his boss, who owned one of the biggest profitmaking multinationals upon earth. The boss was absorbed in his divine meditation about new tricks to lay off more IT personnel in pursuit of that greatest human achievement in today’s world: moolah. G-Bhai, who believed in complete equality, sat cross legged in front of his boss, and scratching his beard, told his boss where all the boss and the company could improve. © Dr. Rajas Deshpande
The boss, amused by free entertainment, asked G-Bhai where he learnt it all.
“Internet” said G-Bhai, and showed some Googled statistics to his boss.
“Thank you, you are fired with immediate effect” said the boss
.
G-Bhai wasn’t affected at all. With his oversized grey T shirt, jeans, slippers and laptop that connected him to all the internet data, he was still the king.
 
He thought of adventure, and went to the Indo-Pak border. The firing and shelling was full-on. He met an Indian soldier who asked him to hide in his shelter. The soldier, who had spent all his life upon the border, was prepared to even die for this citizen, so gave away his helmet to G-Bhai.
G-Bhai was intensely searching the internet, wearing the soldier’s helmet.
“Don’t fire the gun like that” told G-Bhai to the soldier. “This website says the right way to fire is with the gun aimed at oneself”. The soldier ignored him and continued to defend the border. Just as he held a hand grenade to be thrown, G-Bhai held his hand. “Let me search first if you are doing it correctly” he said. The soldier, now in defense of his own life risked, slapped G-Bhai tight and asked him not to interfere. © Dr. Rajas Deshpande
 
G-Bhai proceeded to write a very critical review of that soldier, saying that in his opinion, all the soldiers were doing it all wrong.
 
Then he went to the court and tried to teach the lawyers how to argue, and the Judges how to analyse cases and deliver judgments. He showed them multiple websites from which they could learn law. “We are all equals, why are you sitting so high?” he asked the judges and tried to sit on the Judge’s chair.
After six months in jail, upon his release, G-Bhai went to the police commissioner to teach her how to deal with crime and criminals, based upon internet searches from different countries. He came out limping, and refused to tell anyone why. © Dr. Rajas Deshpande
 
Due to excess stress, his health worsened. He went to the best of the doctors. He demanded that he wanted a complete check up to reach the most correct diagnosis. He was advised tests. He researched the internet and did only the tests he thought were necessary, because he thought all doctors were corrupt. He reached a very reputed doctor with the test results. The 70 year old doctor examined him, checked the reports and told him: “You are a failure in your own life, you have excess stress, and are unable to handle it. You are jealous of everyone who is doing well, and therefore you have developed a complex that everyone who does well is either corrupt or wrong. Go home, exercise, find your own life and deal with yourself” When he tried to show the experienced doctor what internet said, the doctor smiled and asked “Did you also net-teach your parents how to make you?”. © Dr. Rajas Deshpande
 
G-Bhai then went to many doctors in many pathies. Then he researched and tried many home remedies. But his health kept on worsening. He was very upset and started a blog of criticizing that all the doctors. Here, for the first time in life, he discovered success: he was an instant hit, because there was a huge population who agreed with his views. There are more buyers for poison than for wisdom in this world.
 
But unfortunately by then, his kidneys failed due to experimentation with various medicines and various pathies. Now he is undergoing dialysis and posts his anti-doctor articles from the dialysis ward. The old doctor recently visited him with his flock of medical students, and spoke with empathy to the bitter G-bhai, who tried to show the old doctor some more internet references about his treatment.
 
The old doctor then told his students: “This is what I would call a suicidal intellect”.
© Dr. Rajas Deshpande
 
 
Please share unedited.

Gods of Humanity

Gods of Humanity

© Dr. Rajas Deshpande

About four years ago, this brilliant young man entered my chamber. He introduced himself as

Dr. Amod Kale, veterinary practitioner, and said:

“I have a different favour to ask. I have a dog patient with a neurological problem, and am not able to find any references. Will you help me treat this dog? I am not charging anything to the owner. I am doing this as my own hobby” He showed me some videos.

The doggy had some jerky abnormal movements of both hind legs. Some human medicines helped the doggy, and I became friends with Dr. Amod.

Since then, he came with many more cases: rabbit, parrot, cats and dogs who had neurological problems. These animals were either abandoned or orphaned. Dr. Amod not only helped them find a home, but went out of his way to solve their medical problems, mostly spending his own money for everything.

This time he came with a new friend, Mr. Tushar Kale. On 9th March, Mr. Tushar was riding his bike near his home, when he witnessed that another bike ran over a stray dog. The biker who had hit the dog ran away, as the dog lay there in the middle of the road, unable to move.

Mr. Tushar Kale lifted up the injured dog and took him to a government veterinary hospital. As they could not offer much help, he brought the dog home and contacted Dr. Amod Kale. Dr. Amod examined the dog, started with basic treatment, and recorded some videos to show me as he thought that the dog’s spine was broken.

The spinal cord appeared to be severely damaged, there was no movement in the dog’s hind legs. The dog was never going to be able to walk normally again, although some effort could be made for improvement, it would take months. I told the duo so.

Mr. Tushar replied: “My mother said she will take care of this dog, whatever happens, because we cannot abandon the dog in such a condition”.

We started some medicines and supplements.

Mr. Tushar’s mother, Mrs. Mangal Kale, although not educated beyond primary school, has a heart of gold, so rare in today’s world. She has taken such excellent care, that the doggy has shown remarkable improvement now, in spite of some complications like a bedsore, which also is healing now.

In a world where many choose to abandon even their parents, where highly educated brothers and sisters fight for properties but not for taking care of parents, this example of a doctor and a middleclass family caring for a stray dog is so reassuring! An example that Gods of humanity still exist and thrive right in this desert of deteriorating civilisation, mothers like this is what the Earth needs most desperately right now!

Thank you, Dr. Amod Kale, Mr. Tushar Kale and Mrs. Magala Kale, for carrying forward the one tradition that differentiates humans from animals: Humanity.

© Dr. Rajas Deshpande

“Do you want a broken leg, Doctor?”

“Do you want a broken leg, Doctor?”
© Dr. Rajas Deshpande

Three days after he suffered a paralysis, after having tried Voo Doo, Herbal and some other medicines, an old man of 80 was shifted to a big private hospital once he became comatose. The three sons accompanying him didn’t even touch the comatose patient, they didn’t even care about whether he was covered properly or not.
His Blood Pressure was too high, and he turned out to have a bleeding in the brain, untreated till this moment. His brain was swollen badly.

Every private hospital has free mandatory beds for poor patients. This family was asked about their preference and eligibility. © Dr. Rajas Deshpande
“We will pay everything. Don’t worry about the money. He should get the best room and facilities” his son said. They signed the necessary documents about knowing the critical condition of the patient, charging schedules, willingness to pay etc.
Then the sons came to me and said “We don’t care about the money, doctor, but he should get completely cured”.
This was expected, experience teaches a doctor about relatives as much as about patients.
“He is 80 years old and critical. At this stage I cannot guarantee anything. Complete recovery looks impossible, partial recovery may be hoped for if he responds well to standard treatment” I replied.
“But we will pay anything you want” the younger son said.
I involved the PRO, a lady who had far better patience than myself dealing with attitude and arrogance. Explained them once again, and left after the patient was shifted to our Neuro Intensive Care Unit. © Dr. Rajas Deshpande

The patient improved in five days. Started to speak a few relevant words. Out of danger, shifted to Deluxe Room as requested. The only person who ever attended the patient was a 15 year old grandson, mostly the patient was left alone.
The sons had by then submitted some documents claiming a BPL “Below Poverty Line” status, but those were found to be false. A fake letter in the name of charity commissioner was also attempted. The hospital PRO reminded the patient’s sons about the pending bills regularly.

It became clear that none of the three sons who earned well themselves wanted to pay for their father’s treatment. They had continuous fights amongst themselves, the only thing they agreed upon was not wanting their father. The request “He must get completely cured” was not because they wanted his health, but because no one wanted to take home a disabled father to care for years.

The hospital took a stern stand. The bills had exceeded two lacs rupees, nothing was paid. This indeed was burglary with blackmail.

After repeatedly asking to meet the patient’s sons for another three days who did not pick up the hospital calls, I told the attending boy very carefully to please remind his parents to settle the pending bills, also reminding him that nothing in the treatment will wait or change because of bills.

In two hours I received a call. It was a local Municipal Councilor.
“Doctor, do you want a broken leg? Are you a doctor or a businessman? How can you speak about money to a small boy? Just keep on treating. We will do something about the bills through our MLA. If you speak about bills again, remember, there will be news about your hospital on every channel”.

Do I have time, energy to waste, filing a police complaint? Will it be any use at all? © Dr. Rajas Deshpande

In no other industry, not even in govt. offices, will anyone be given anything on credit: even for a paper worth five rupees. Even the poorest of the poor cannot get free food or travel in private industry. But the entire private medical care is expected to go on working in ‘credit’ mode, for everyone who claims to be poor. Emergency is understood, and no hospital or doctor thinks about money in case of emergency. But once emergency is over, those who cannot afford a private hospital should go to a government hospital. A private hospital needs too much investment per bed, and anyone who questions this can please sponsor one bed in any ICU for a poor patient, see for themselves what the actuals cost.

Who will even address this Burglary and Blackmail that happens everyday in every private hospital in India?

There should be an online portal by government / police for doctors and hospitals to report patients dumped by family, families who refuse to pay, those who use threats and intimidation anonymously. Then the ‘other side’ of this story will be clear.

© Dr. Rajas Deshpande

“I Swear”

I Swear
© Dr. Rajas Deshpande
 
“Have you forgotten your oath, doctor?” asked the Hon’ble minister to Dr. Prasad.
 
The fat elderly reporter accompanying the Hon’ble minister laughed. “We must teach these doctors a lesson” he said.
Being a doctor, good language and behavior is essential. So Dr. Prasad swallowed the immediate reaction that had sprung to the tip of his tongue, one that involved references to some passionate human interaction.
 
He then smiled.
“Sir, did you attend any school?” he asked the Hon’ble minister innocently.
The Hon’ble minister was offended. He had not had a respectable academic record. © Dr. Rajas Deshpande
“What does that mean? Do you know who you are talking to?” the accompanying reporter raised his voice.
“Yes, I know I am talking to a patient. A human being with the same organs as me, but not the same merit or intentions” said Dr. Prasad.
 
Before the cunning reporter and the Hon’ble minister could formulate a reply, Dr. Prasad continued:
“Sir, all over India, for ten years, everyone who has attended any school has recited every morning, the National Pledge. That is our promise to our beloved nation. Let me remind you of some sentences in that prayer:
I shall give my parents, teachers and all elders respect and treat everyone with courtesy.
To my country and my people, I pledge my devotion.
In their well being and prosperity alone lies my happiness.
Tell me Sir, are all politicians, ministers, media persons, businessmen, lawyers, and other professionals following this oath that they have recited every day for ten years? If yes, where does violence come from? Not only in hospitals, but in every other home, against children, against womenfolk, against even the elderly”.© Dr. Rajas Deshpande
 
“But you are a doctor, you have taken an oath to serve” said the defiant Hon’ble, expert in the art of diverting discussions.
 
“No, Sir”, replied Dr. Prasad firmly, “I have not taken any oath to tolerate violence or abuse, or to risk my own life or limb. I have not taken any oath to feed with my blood and sweat the deficient and perpetually corrupt healthcare systems. I have not taken any oath to be nice and kind to attacking, drunk, abusive or irresponsible people who enter the hospital with an almost dead patient at the last moment and then expect the doctor to perform miracles. I have never taken any oath to treat Judges and Ministers and Rich VIPs above the poor, really deserving patients. I have not promised anyone that I will neglect my family or my own health”.
 
“I have only taken an oath to honestly treat the sick with dignity, not thinking about money. That most doctors do, some who fail are common in every field. My oath is to help a patient recover. If I fail, try me in a court of law. Send me to a court that understands law better, and appeals people not to be violent, tells governments to protect everyone against violence, rather than asking doctors to tolerate violence as a part of their duty. It is exactly as backward as like asking a wife to tolerate her husband’s atrocities as a part of her duties”. © Dr. Rajas Deshpande
 
The restless tail barked again: “But the public pays for your education”
 
“I beg to differ, sir. No one is obliging anyone by paying for doctor’s education. The country needs many more thousand doctors. And we pay taxes too, to be protected. People pay taxes for a good and cheap healthcare system, please give them that, rather than them having to depend upon private hospitals. A doctor is just a small component in healthcare. Don’t blame him for expecting the same protection that every citizen expects. The infrastructure and policies are pathetic, and an intelligent taxpayer will one day understand that the doctors are not taking home any money as their alms. Everyone knows who gets richer with taxpayer’s money, Certainly not the doctors”.
 
“As for your allegation, respected reporter sir” said Dr. Prasad calmly to the tail, “You are educated, you have a responsibility to heal social ills, not widen the bleeding wounds and survive on that flowing blood. There are so many good examples of reporters / media persons who bring immense good to our society. The ability to sit in one’s chamber with all controls, and bark at everyone, manipulate speech cunningly, distort facts pretending to be holier than others, while your seat is dipped in hidden honey is not reporting”.© Dr. Rajas Deshpande
 
“Doctor, you have too much ego” said the angry Hon’ble.
 
“No sir, intolerance to stupidity is not ego. Every religious ceremony, every professional oath makes us repeat the good we must do, including a minister’s oath of office. . Very few actually do it, but everyone thinks it is only the doctor who must follow his oath” said Dr. Prasad.
 
He then checked the Hon’ble Minister and wrote him a prescription that included weight reduction and abstinence from alcohol.
 
Without a Thank You or a payment, the powerful duo left.
 
“I swear” said Dr. Prasad, smiling to himself, “I will never give them the joy of taking it lying down”.
 
That is the basic oath of every self respecting human being.
 
Jai Hind
© Dr. Rajas Deshpande
 
Please share unedited.