1. MALPRACTICES DURING DIAGNOSIS
A general practitioner (GP) from a small town observed,
'People have become educated, but there is a loss in that too. Nowadays they have heard of the phrase "Platelet Count" because of the dengue epidemic. The platelet count drops with any viral fever. I identify such patients in the OPD, and call them daily for a platelet count. Very few need to be admitted, maybe one in a thousand. But many other general practitioners tell educated patients, "See, the count is just 1,50,()()0 rather than 2 lakh." They give the patient a saline drip, admit him. If the patient is well-off, then straight to the ICU, and a completely avoidable bill of Rs 25,000— 30,000 follows! 'There is another peculiar practice. Some level of jaundice among newborns is physiological and normal. Very few babies have to be given treatment with ultraviolet light. But the pathologists give a report: Total bilirubin, 10 mg. They present this report on a printed form that is meant for adult patients. The range shown on that chart indicates the patient has jaundice if the bilirubin level is more than 1 mg. This range is for adults bilirubin, 10 mg. They present this report on a printed form that is meant for adult patients. The range shown on that chart indicates the patient has jaundice if the bilirubin level is more than 1 mg. This range is for adults who get jaundice from drinking contaminated water. Almost every newborn has some mild jaundice, and it is dangerous only when the bilirubin level is over 14—16 mg—not 1 mg as in the case of adults. 'Even educated patients are not equipped with the information regarding two different sets of values for the range of bilirubin: one set for adults and one entirely different set for neonates. Instead of using the format meant for neonates, doctors show educated patients the result of a newborn with reference to the adult range and not to the neonatal range. On the adult chart, I mg indicates danger, but the actual count is 10 mg!
regarding two different sets of values for the range of bilirubin: one set for adults and one entirely different set for neonates. Instead of using the format meant for neonates, doctors show educated patients the result of a newborn with reference to the adult range and not to the neonatal range. On the adult chart, I mg indicates danger, but the actual count is 10 mg! In the neonatal range, 10 mg of bilirubin is normal, while with reference to adult range it looks ten times higher! 'Naturally the parents are frightened and agree to have their normal newborn admitted to the emergency ward, and willingly pay the high costs of the treatment. And over and above that, for the rest of his life the patient sings praises of the doctor, as to how he saved the baby!'
Dr Sanjib Mukhopadhyay, gynaecologist, Kolkata, commented, 'Unethical practices begin right from the stage of writing prescriptions. Listing the qualifications of these doctors, these prescriptions mention degrees that are not recognized by the Medical Council of India or degrees that one [can] get just by paying money. This must stop. This amounts to cheating an ignorant patient!'
A general practitioner (GP) from a small town observed,
'People have become educated, but there is a loss in that too. Nowadays they have heard of the phrase "Platelet Count" because of the dengue epidemic. The platelet count drops with any viral fever. I identify such patients in the OPD, and call them daily for a platelet count. Very few need to be admitted, maybe one in a thousand. But many other general practitioners tell educated patients, "See, the count is just 1,50,()()0 rather than 2 lakh." They give the patient a saline drip, admit him. If the patient is well-off, then straight to the ICU, and a completely avoidable bill of Rs 25,000— 30,000 follows! 'There is another peculiar practice. Some level of jaundice among newborns is physiological and normal. Very few babies have to be given treatment with ultraviolet light. But the pathologists give a report: Total bilirubin, 10 mg. They present this report on a printed form that is meant for adult patients. The range shown on that chart indicates the patient has jaundice if the bilirubin level is more than 1 mg. This range is for adults bilirubin, 10 mg. They present this report on a printed form that is meant for adult patients. The range shown on that chart indicates the patient has jaundice if the bilirubin level is more than 1 mg. This range is for adults who get jaundice from drinking contaminated water. Almost every newborn has some mild jaundice, and it is dangerous only when the bilirubin level is over 14—16 mg—not 1 mg as in the case of adults. 'Even educated patients are not equipped with the information regarding two different sets of values for the range of bilirubin: one set for adults and one entirely different set for neonates. Instead of using the format meant for neonates, doctors show educated patients the result of a newborn with reference to the adult range and not to the neonatal range. On the adult chart, I mg indicates danger, but the actual count is 10 mg!
regarding two different sets of values for the range of bilirubin: one set for adults and one entirely different set for neonates. Instead of using the format meant for neonates, doctors show educated patients the result of a newborn with reference to the adult range and not to the neonatal range. On the adult chart, I mg indicates danger, but the actual count is 10 mg! In the neonatal range, 10 mg of bilirubin is normal, while with reference to adult range it looks ten times higher! 'Naturally the parents are frightened and agree to have their normal newborn admitted to the emergency ward, and willingly pay the high costs of the treatment. And over and above that, for the rest of his life the patient sings praises of the doctor, as to how he saved the baby!'
Dr Sanjib Mukhopadhyay, gynaecologist, Kolkata, commented, 'Unethical practices begin right from the stage of writing prescriptions. Listing the qualifications of these doctors, these prescriptions mention degrees that are not recognized by the Medical Council of India or degrees that one [can] get just by paying money. This must stop. This amounts to cheating an ignorant patient!'
No comments:
Post a Comment