|
Feb 21
2010
|
Live and let die??Posted by: Dr. Sridhar V on Feb 21, 2010  |
 |
Many occasions we have talked about ‘Difficult Patients’, stubborn patients, Harassing Patients, Blackmailing patients etc etc. For a change how about discussion on Professionalism not from patient's perspective but from Doctor’s point of view. Some of the colleagues shared their experience about “withering professionalism”. I am glad that I never faced these situations.
Dr X, a very busy practitioner with a dozens of degrees faithfully following his name. A much sought after Doctor by all the past, present, immediate present and future diagnostic centers. .
Mind you he never speaks to the other doctors over the phone and considers below his stature and dignity.
(Hell with bearded Hippocrates! Hell with decent doctor to doctor relationship and mutual respect!! ).
With great difficulty our friend managed to get an appointment, courtesy the kind Secretary of Dr X, at 5.00pm. Our friend humbly requested for a meager 5 minute appointment any time between 8.00 pm and 10.00pm, since mentally He can be free once he winds up his centre at 7.30 pm. However the request was turned down and he was asked to come at 5.00.pm.So he left the centre telling his staff that he should be back before 6.00pm and not to give appointment to the patients between 5.00pm and 6.00pm.
He sent his visiting card as soon as he reached in Dr X's clinic (4.45 pm) Luckily not many patients were there and he was hoping to see Dr X fast and reach his center back earlier . To his surprise he was made to wait for 4 hours (by then it was 9.00pm) and when he was given a hint that he might be called next…. By then Dr X came out from his chamber, just saw our Radiology Friend and turned to his secretary and told the secretary to lead our Friend to his assistant’s room, or else tell him to come some other convenient time
(Whose convenient time???). So his waiting time of 4 hrs to see this Gentleman has gone in vain... Just imagine our colleague’s facial expression at that moment.
Is it not a fact that the Dr X is thinking too high of himself? How would he feel if he is subjected to similar treatment?
Give a hoot to the golden rule
“Do unto others as you would have others do unto you”
-------------------------------------------------------------------------------------------------------------------------------------------------
This is about Dr Y another busy doctor whom our friend (lady radiologist) approached way back in 2000
(that means they knew each other for the past 10 yrs) to help her by sending some cases. This doctor told her to charge Rs 200/- for the patient. And advised her, virtues of not being money minded always and how one should serve the humanity and be patient friendly as for as fees concerned... Every year the radiologist used to beg this doctor to permit her to enhance the scan rates as cost of living spiraling and the blunt answer she gets every time ….” If you are greedy, do not expect cases from me”. So the Net Effect…. even in the Year
2010 - she continues to charge just Rs.200 per patient. (At present Charity based centers are charging Rs.350/-400/- per scan)
Here is a glimpse of what Dr. Y’s consultation fee during the same period
2000 - Rs 50/-
2002 - Rs 100/-
2003 - Rs 150/-
2004 - Rs 200/-
2006 - Rs 300/-
2007 - Rs 400
2008 - Rs 450/-
2009-2010 - Rs 600/-
This shows that our Dr Y has hiked the consultation fee 12 times over the first rate, mind you without any investment!!
This works out to be Rs.2400/- in our friend’s case case. Alas! Still she charge just Rs.200/- only, with heavy liabilities in the form of investment etc etc
Now the definition of selfishness is very clear to her
“Selfishness is not living as one wishes to live. It is asking other to live as one wishes to live”
‘Oscar Wilde
-------------------------------------------------------------------------------------------------------------------------------------------------
Dr Z is kind enough to ref the cases to all the available, be sundry or top diagnostic centers. But he has a strange notion that the Report should never be NORMAL. His reasoning is that the patient becomes angry if the report turns out to be normal and that he gets all the scolding from the patient for wasting the money just for a normal report. .So one has to invent and write something in the report.
What nonsense!!
One has to be ‘BOLD’ to face these kinds of nonsense.
‘Fortune befriends the bold’
John Dryden
What an irony!! If one is bold in these circumstances one has to be prepared for the reverse i.e.
Dwindling of ones Fortunes
-------------------------------------------------------------------------------------------------------------------------
Another colleague has this funny experience .
Dr. XYZ is aware of the quality maintained in the diagnostic centre and further he gives immense respect to the reports coming from the center.
Surprisingly he is not a supporter of the center (due to known and unknown causes), in spite of many and repeated requests to send some worthy cases.
Dr. XYZ does not hesitate to call whenever he needs investigations to be done. He even brings Relatives for all various investigations. One can not miss the heaps of praises he makes about Quality.. blah blah. And he never offers any money (at least basic cost of the investigations)..
One philanthropist lamented that human beings have become cold hearted and are Allergic to the word…Charity and he narrated a story where he dressed like a beggar was on a Crowded pavement requesting for a matchstick to light his beedi and behold! no body was Willing to spare a matchstick .This incident shows that nothing comes ‘Free’. Including a single Match stick.
But our Dr. XYZ expects a life long free service.
Fine… it Does not matter
But the point is.. Can’t he not ref at least one case per month?(sounding greedy??) “for the good of the patient” as he himself admits that the reports are of high quality.
Here this Dr. XYZ loves to exploit somebody’s helplessness.
Anybody remembers the meaning of dignity, dignified, mutual respect etc etc etc.
“Under capitalism man exploits man
Under communism...it is just the opposite”
John Kenneth Galbraith
This Dr. XYZ’s sentiments… do you call it ‘capitalism’ or ‘communism’??
-------------------------------------------------------------------------------------------------------------------------
Time has come to change The Phrase…Live and Let live…… to ... Live and Let Die
View all user reviews
Average user rating from: 6 user(s)
Reviewed by Deepak Goyal February 22, 2010
Reviewed by Dr. Rahat Brar February 21, 2010
Reviewed by Prashant Bhatt February 21, 2010
Reviewed by Dr. Muneesh Sharma February 21, 2010
har raah par doraaha hai ...
TrackBack URI for this entry
Subscribe to this comment's feed
Anuj Mishra
said:
 |
... very aptly written Dr. Sridhar. I myself have come across all these situations and many more in my radiology practice and it is indeed 'frustrating' at tmes. To the extent that once I decided to perform echocardiograms myself! (To the distaste of my cardiologist colleagues!). I shall narrate a personal experience here to highlight your point. I had taken up a radiology position as Head in a foreign country and was just getting accustomed to the medical practice there. It did'nt take me long to realise that ultrasounds were not at all being referred to radiologists. Not because there were'nt any, but because none of the radiolgists in that hospital could claim any expertise in ultrasound. Also I realised the plight of patients with renal problems and in need of renal biopsy. So I decided to make things simpler for patients and began performing renal biopsies routinely. I must admit that to do this initially I had to invest my money in buying automated biopsy guns from India. Very soon, the nephrologist who was the only experienced person to perform renal biopsy came to see me on the pretext of seeing my biopsy gun. He had brought his own too which was indeed from 16th century!! He was surprised to learn that I had bought the guns myself. He tried to dissuade me from encroaching onto his 'territory' as he was earning very well by referring those patients to his private clinic. I asked him if he could leave his ultrasounds on me as I could provide more valuable information to him than he would derive on his known. Moreover, I had an edge over him as far as color dopplers were concerned as he could never assess a renal allograft himself. Hence, I continued doing kidney biopsies routinely and made it a very simple and safe procedure that could be done as out-patient case. The nephrologist also got a chance to refine his technique of kidney biopsy from me and he discarded his old guns and began borrowing from me. I still continue to perform most of his ultrasounds, all of his renal graft work-up, and all kidney biopsies referred from everywhere except him and have also done an original article which has been accepted for publication in Saudi Journal of kidney disease & transplantation. The moral of the story is : If we as radiologists prove our mettle, then no clinician or surgeon can belittle us. And this is a fight that each one of us will have to fight by ourselves. One person or a group cannot do this for the entire community. With kind regards to all my colleagues. |
Alok Varshney
said:
 |
... Nice vignettes of human behavior, the interactions between the powerful and ? powerless. Power will not be bestowed, it has to be achieved. In every human interaction, unless one party doesn’t show some spine, the other party will simply bend him till he snaps. |
Prashant Bhatt
said:
 |
... Excellent day-to-day experiences, lucidly documented with Lessons learnt in many layers. One question: Does a "big-guy" usually take appointment to come and do a Radiology investigation... In my experience, even the Secretary of some "Big-Guy" makes a big face if you ask her to come when you are relatively free |
Dr. Sridhar V
said:
 |
... Thank you Dr.Anuj Mishra for your frank narration of how you overcame the bullying tactics of other counterparts.You have once again proved that 'respect can not be demanded but can only be earned' and as we have seen next time no body dare play tricks with us.And Just see the reversal of situation ...You had to teach the Nephrologist the finer aspects of renal biopsy procedures ! It is a pity that Radiologists are always at the receiving end. Looks like Bullying is an universal phenomenon. I also agree with you that 'Respect' can only be earned at individual level rather than by community. |
Dr. Sridhar V
said:
|
... Thank you Dr.Alok, As Dr. Mangal Mahajan has put it things are different for a Radiologist working in an institute as compared to the One running his/her own private Establishment.In private establishment make your skin thicker so that however strong may be the echoes from insults/misuse/harassment/bullying etc...simply these echoes are reflected away. In private practice neither 'Power' can be achieved nor 'bestowed' One has to be 'street smart' by becoming 'spineless soul ' Ref Dr.Prashant daring to tell 'Big Guy ' to take appointment ?? Just replace the word 'customer' ( customer definition as told by Mahatma Gandhi)' with 'Big-Guy' "Big-Guy" is the most important visitor on our premises, "Big-Guy" is not dependent on us. We are dependent on him. "Big-Guy" is not an interruption in our work. He is the purpose of it. "Big-Guy" is not an outsider in our business. He is part of it. We are not doing "Big-Guy" a favor by serving him. He is doing us a favor by giving us an opportunity to do so. As long "Big-Guy" continues to have... be attractive secretary or non attractive secretary or even any number of chamchas, give the same or even greater importance to these categories. Blindly follow the above rule of Mahatma. |
Alok Varshney
said:
|
... “How far do I bow down? - degrees? Like this?” “Think of a sunflower. They bow to the sun. But if you see some that are too bowed down... it means they're dead! You're serving. You're not a servant. Serving is a supreme art. God is the first servant. God serves men, but he's not a servant to men.” A dialogue from the movie ‘Life is beautiful’ |
Prashant Bhatt
said:
|
... How much choice and dignity do working people have in these systems.Can one have a satisfying career and work-ethic with such conformism to "Big-Guy-Bullying"? Or..is it a ..."Let-Die" situation..? |
Virupaksha Joshi
said:
 |
... A bullying clinician is an exception rather than a rule – unless he has employed a radiologist – like in my town. In my town, there are two clinicians who own a full fledge diagnostic machinery, including 1.5 T MRI. One is a neurosurgeon and another is a neurophysician. Both of them have employed a full time radiologist to take care of their diagnostic needs. I know that some bullying definitely goes on there. This is probably because the equation is one of an employer and an employee. “Since I pay you, I am well within my rights to bully you”, seems to be the logic. However, in my hospital, the relationship between the clinicians and radiologists is relatively cordial and driven by mutual respect. Here, clinicians as well as radiologists are employed by the Trust and they are on equal footing – unless a radiologist churns out erroneous reports on a regular basis and thus makes himself unreliable. It is not to say that clinicians do not make any mistakes; they do not document their errors on their letterheads and sign it with a flourish, do they? I must admit that I have had my fair share of bitter experience with clinicians like the ones described by Dr. Sridhar. The only way to deal with such toxic behavior is to ‘intimidate’ them with your professionalism and knowledge as mentioned by Dr.Alok. Phiolosophical approach which comes naturally to most when their hair turn gray is also necessary. Remember, lotus blooms amidst dirt without letting it stick. |
Blogs are a great way to share your experiences ideas with others.
Feedback from clinician is very importantn"Disease dont follow textboooks nowsda...
