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Feb 21
2010

Live and let die??

Posted by Dr. Sridhar V in Professionalism , Doctor-patient relationship , Dignity

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Dr. Sridhar V

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.

Jul 23
2009

Dealing with The Internet Armed

Posted by Prashant Bhatt in Information Technology , Doctor-patient relationship , Clinical Radiology Groups

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Prashant Bhatt

But in the net, it is written like this?!

Take a read

Around a decade ago, I used to get phone calls from a very smart Neurology registrar (post DM) who after having discussed the case in the ward rounds headed by a Professor, would have the Radiology textbook open in front of him while he quizzed me about the Radiology report and its implications. That inspired me to read some Neurology, to try to keep the balance and take the ball back into his court.

With the information explosion on the net, and informed readers trying to make their own “health maps” one finds questions like...(1) What are the indications of knee transplant? And the types of options available. (Gone are the days when Radiologists could write Implant noted in situ…and get away with it) (2) What is the difference between fibromyalgia and neuralgia?

(3) What is the difference between Fransceschetti’s and Treacher Collin’s syndrome in a case of Mandibulofacial dysostosis?

In coming blogs we can examine some of the issues arising from Clinicians setting the pace to report better/differently and also the new WWW armed New-Age patient who belongs to the Cult of “Latest-Technology-Treatment” who knows a lot of jargon about Thyrotoxicosis, cosmetic surgery and autosomal dominant diseases with variable penetration!

Dec 15
2008

Blinded second opinions

Posted by Prashant Bhatt in Reporting , Doctor-patient relationship , Communications

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Prashant Bhatt
Some clinicians at times give misleading or no history to the radiologist to try to get their ‘independent-unbiased’ opinions on complex cases. They may tell the patient not to give any history of previous therapy, which may have involved hormonal or surgical intervention or even radiotherapy.

 

One has to be alert to this possibility whenever we are looking at any scan. ‘I’ for Iatrogenic should always be kept in mind from the universal differential diagnosis formula of VINDICATE. When you are shown cases in conferences, you still probably stumble around a bit coming up with a plausible differential diagnosis. If you do not do so in case conferences, then it may be because you have recently seen an example of that disorder, or your mother had that disorder, or you read the syllabus or are a Vulcan and so inhumanly smart and organized that you need not read this article any further.