Monday, January 27, 2014

You Realise it, when You Suffer from it.

“Doctors now spend more time with their computers than at the bedside. That seemed true at both the ICU and Spaulding. Reading the physicians’ notes in the MGH and Spaulding records, I found only a few brief descriptions of how I felt or looked, but there were copious reports of the data from tests and monitoring devices.”
Massachusetts General Hospital
Massachusetts General Hospital (Photo credit: Wikipedia)

This is the expression of a faculty member of Harvard Medical School, Arnold Relman, who got admitted to the Massachusetts General Hospital after breaking his neck bone and was carried to the hospital in a bad shape. He spent 10 excruciating weeks in the hospital to get discharged live. His views published in the Foxnews that can be accessed here.
The essence of the article is that though there is expertise, there is no personalized care, both from doctors and nurses. More attention is paid to investigations, which includes unnecessary ones also.
Those were the days, when we as medical students running after teachers to learn some clinical findings. Teachers also were taking us to patients, “listen one by one, this is called crepitation.” Now, if a patient of respiratory infection comes, at least X-Rays chest will be ordered immediately, even without going for clinical examination; thereafter a battery of investigations, like CT, MRI, Sputum examination etc..
Nobody denies to order these investigations, but what matters is that, there should be investigations just sufficient to support clinical findings reliably and pin-point the diagnosis.
Another thing he noticed is poor record keeping and doctor patient relationship. When a doctor holds hand of a patient and calls by his name to know how he is, that infuses a lot of confidence in the patient; contrary to the non-touch technique of examination and ward round.
I was taken aback, when I was told by some of my doctors that they never write findings of the clinical examination in the case-sheet and do not know, how to write. What can be more ridiculous than this?
There is definitely a lack of concern for the patients on behalf of the doctors and nurses. Can you do same thing or behave in the same way, if the patient would happen to be your own relatives? Hearts are to change, no amount of force can change it. 
However, things are taking shape in the right direction slowly.
Let us hope for the best to come. You realize it, when you suffer from it.
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