Patient diagnosed with depression, blames Bajaj Finance.

Mumbai: In an incident which has perplexed even the learned psychiatrists in the country, a young patient diagnosed with depression has shockingly blamed and sued Bajaj Finance for it.

The 30 year old male Mr. Loande has sued Bajaj Finance for discrimination, on the grounds that he had not received even a single phone call from the company ever!

It is a well known medical fact that being the target of discrimination can stir up a lot of strong emotions including anger, sadness, and embarrassment; and people often get stuck on episodes of discrimination, because they’re not sure how to handle those experiences which can lead to depression.

In an exclusive interview with the Quackdoses, Mr. Loande said, “All my friends get multiple phone calls every morning from Bajaj Finance, HDFC Bank (k behalf pe), Just Dial, etc, for pre approved loans or free credit cards, but they have never called me so far. My friends often boast of how they now relieve their stress every morning not by doing Kapalbhati with Baba Ramdev, but by giving mother-sister swear words learnt from Virat Kohli to those Bajaj Finance marketing executives. Because of them, I have to now pay a psychiatrist for his expensive and critical analysis about myself, which my wife anyways gives me for free, daily.”

Unconfirmed sources have now claimed that Bajaj Finance has now ordered an internal enquiry to investigate how Mr. Loande’s number was missed out, and have instructed their executives to strictly ensure he gets a call for loan, before he pulls his pants down to use the washroom every morning.

Doctor caught red handed, was watching CME slide photos.

Mumbai: In an incident which has sent shock waves among the medical fraternity, a city based doctor, known for clicking photos of almost every slide in all CMEs he ever attended, was caught red handed reading them at home.

It is a well established fact that, these days, most delegates often click photographs of the important slides shown during a CME, but never refer to them ever again. Also, every medical CME in India has at least one such character (ectopic) who while sitting in the front rows, ‘irritatingly’ clicks photos of every single slide shown during a talk, making others nervous if they missed something important.

In an exclusive interview with the Quackdoses, Dr. Photuwala's wife said, “My husband is well known in the medical circle, to be the only person awake during all post lunch sessions of the CMEs. Many CME organizers specially invite him so that at least 2 people will stay awake during the full talk, the speaker, and him. His phone has more photos of other people’s PPT than mine or our kids, including the ‘Any Questions’ and ‘Thank You’ slides. I was in utter disbelief when I saw him actually going through the slides of the last CME he attended, something which had never happened in the past.”

Unconfirmed reports have claimed that Dr. Puchle, famously known as the attention seeking ‘Question Bank Doctor’ has also announced his retirement from asking dumb questions during CMEs, and will no longer be attending any future talks due to his ill health.

Professional Rules for happy life

More than 70 % of my colleagues / juniors from Emergency Medicine are working in UK, and the others too who chose to work in India seem to be making frequent job changes where they're prioritising 'Career Growth over loyalty'. 

Employee attretion has over the years also become an issue in the country, especially in the healthcare sector. This can also to attributed to the fact that there has been a change in the way the current generation wants to lead there life. The generation of our grandparents worked for 'Survival', the generation of our parents worked for 'Standard of Living', and the current generation works for 'Quality of life & work-life balance'.

Over the last few days, I have often wondered if based on my experience in various organisations, if there were any pearls of wisdom I'd like to share with youngsters / freshers / budding doctors of tomorrow / working professionals. 

Today, I decided to jot down my PERSONAL PERSPECTIVE on what should be the professional rules for a happy life.

Note: No offence to anyone. You're free to have your own perspective.

1. Work with Honesty – Dedication – Devotion – Discipline - Sincerity. Always do the right thing, even if no one is watching. Remember, there are no shortcuts to success.

2. Avoid gossiping about work or any colleague with anyone – not at work, nor at home. Come – do your Job – Get Paid - Leave. (This includes any informal chats on Whatsapp with colleagues; screenshots are often being used as evidence these days).

3. Be Punctual – Come on time, leave on time. Don't get into the habit of working overtime. It will only increase your work, not your salary package.

4. Do not take work back home. Learn to disengage & disconnect as soon as you step out of your workplace.

5. Do not work to please an individual or for appreciation. Let your results talk for themselves.

6. Do not get involved or affected by workplace politics. It exists, it will always exist. But always stand up for what is right and against your core values & principles.

7. Do not always be a ‘YES’ man. Sometimes, you have to say ‘No’ also to maintain discipline, dignity & self-respect.

8. Never get involved in relationships at workplace. It will always backfire one day.

9. Do not trust everyone at work. Not everyone is your friend, or wants good for you.

10. Do not share personal problems with colleagues at workplace. Half of them will want to know only because they’re curious, rest will be glad you have them.

11. Subordinates / acquaintances should be considered a Team – Not family. Correcting people or taking difficult decisions can often become difficult then.

12. Unless urgent, do not call or message your colleagues for work related queries, out of official working hours.

13. Never stop involvement in training & academics. Pass on your knowledge and skills to youngsters, you’ll grow with them.

14. No matter how busy you get, take out 1 hour of your every day, for your health, hobbies and personal space.

15. Plan and utilise your paid leaves – travel – go on vacations. It is extremely important to unwind and energise yourself.

16. Never be afraid to take the risk - go where you are appreciated and valued. There are brilliantly talented people everywhere who aren’t receiving the recognition and reward they deserve. But once they feel confident, start valuing themselves and leave from an environment that isn’t serving them, they thrive and grow. 

17. Never end on a sour note with your previous organisation / boss / Colleagues. You never know when you might need them for guidance or future references.

In the end, nothing matters except family, friends, home, health, work life balance and peace of mind.

I’ve found my inner peace, are you searching for yours?

Tum aur Main

Ret main ban jaunga, O Sanam,
Tum ek lahar banke ana,
Bharna mujhe aise baahon mein,
Apne sang lekar jana

Ishq ki, gehrayi ka, andaza tha na mujhe,
Darr hai, k dooba hun, main ab tere pyar mein

Kyun na tum aur main, bann jayen hum
Kyun na tum aur main, bann jayen hum

Waqt main bann jaunga O sanam,
Tum ek lamha banke ana,
Tujh mein main phir beet jaun,
Tum bhi mujh mein guzar jana

Tera yeh, jo saath hai, ek alag sa ehsaas hai
Zindagi, bitani hai, par ab tujh bin nahi

Kyun na tum aur main, bann jayen hum
Kyun na tum aur main, bann jayen hum

Meri ruh jaisi tu, ban mera sahara
Tera dil hi toh hai, mera kinara
Ban meri parchayi tu,
Kabhi mera, sath na chod jana

Jab roothegi tu, toh mana lunga main,
Bin kuch kahe tujhe, seene se laga lunga main

Kyun na tum aur main, bann jayen hum
Kyun na tum aur main, bann jayen hum

Citing rising unemployment, General Surgeons pitch to rebrand their specialization.

Mumbai : The General Surgeon’s Association of India (GSAOI), in its standing committee meeting today, approved the rechristening of their branch of specialization. Surgeons performing ‘non organ specific’ surgeries will now be called ‘Lumps & Bums Surgeons’ instead of ‘General Surgeons’.

Over the years, with more patients now seeking surgical treatment from super-specialists, there has been a drastic drop in ‘cutting’ practice of general surgeons. Euphoria over the name change had already caught up with them last month, when their association had sought suggestions from its members.

In an exclusive interview with the Quackdoses, a sobbing general surgeon (who did not wish to be named) said, “Plastic Surgeons have staked claim to the breasts, Orthopedic Surgeons have captured all bones with limbs, Neurosurgeons the brain, CVTS surgeons the Heart & lungs, Uro surgeons the kidney – ureter - urinary bladder, Gynaecologists the uterus – ovaries with the fallopian tubes, and Gastrointestinal surgeons have taken over of what’s left in the abdominal cavity. What have our fellow surgery colleagues left for us to operate on? How will we survive in this cut throat world when even a local GP calls himself a ‘Physician and Surgeon’?”

Unconfirmed sources have claimed that the plastic surgeons plan to oppose the renaming on the grounds that since they already do body contouring surgery, the 'bums' are already taken. The Oncosurgeons also don't wish to give away the 'Lumps', which has left many general surgeons with bleeding piles.

Speaker pushed off stage by moderator, hospitalized.

Mumbai : In a never before seen incident in the history of medical CMEs, the moderator of a CME pushed the speaker off the dais, surprisingly drawing cheer and celebration among the audience. It has now emerged that the moderator was upset that the speaker (identity withheld) did not stop presenting his PPT even after the warning bells.

It is a well known fact that many doctor speakers tend to keep ignoring the time frames, ignoring the signals, and keep talking well past the “safe-zone” (added extra time) of their presentation time, making the event organizers uncomfortable.

In an exclusive interview with the Quackdoses, the brave moderator Dr. Pushkar Dey said, “Already the audience looked bored and disengaged listening to him read paragraphs of texts – word to word from his slides. Even after my multiple warning bells, he kept on saying “last few slides, since we’re out of time, I will just take 2 minutes more, etc”. Most speakers take the hint and stop talking when a moderator visibly stands up and moves towards the stage. In spite of me directly going up and standing next to him, it did not deter him from talking. Amid growing audience impatience, I then had no option but to push him off the stage. A speaker who trespasses on the time of following speakers is far more impolite than I was. On the bright side, though sarcastically, but I did thank him on mic after the push, and also informed the audience that perhaps our speaker would be willing to answer additional questions offline during our break. But he was not”.

Unconfirmed sources have claimed that the speaker had to subsequently be admitted to a local hospital for his injuries, which were sustained not due to the fall, but after forgetting his wife’s birthday which happened to be on the same day.

The Gift of Blood, Is the Gift of Life.

A young 17 year old student going to college for an exam was rushed to the Emergency after an accident on the highway, with a truck running over his pelvis and both lower limbs.

A young 25 year old, brought to the Emergency with a history of gunshot wound to the abdomen, and bleeding profusely.

A 65 year old elderly female, wheeled into the Emergency with profuse bleeding from a cancer which had spread to a large artery in the neck.

A young 29 year old female, recently married, rushed to the Emergency with acute pain in abdomen and diagnosed to be a ruptured ectopic pregnancy with massive hemoperitoneum (pregnancy outside the uterus, with large blood collection in the abdominal cavity).

A 53 year old male, local politician brought to the emergency after vomiting large quantity of blood.

All of these above mentioned patients are just few of the examples of the clinical cases I’ve witnessed and managed over the years, and are a common daily routine for Emergency departments all across the world.

A thing common to all of them was that they were all brought in a very critical condition – either with a very high or a low heart rate, low or non recordable blood pressure, breathing difficulty, confusion (alterations in mental status), cold limbs, and other clinical signs – all pointing towards varying degrees of life threatening shock – which can rapidly become fatal, even with immediate medical attention.

Another thing common to them was that they all survived – because they all received the timely ‘Gift of Life’ – Blood.

Every year millions of lives are being saved because of donation of blood and blood products. Apart from life threatening conditions like accidents & trauma, blood donation supports various major surgical, complex medical procedures (like patients with cancers related procedures such as chemotherapy, pregnancy complications, and those with blood disorders like sickle cell anemia, thalassemia and hemophilia), etc.

To state few facts about the requirement of blood in India - At every 2 second someone somewhere needs the blood - Every day more than 38,000 blood donations are needed - Each year a total of 3 crore blood components are transfused - On an average, we requires 5 crore units of blood every year. Unfortunately, only a meager of 2.5 Crore unit of blood is available.

Patients always thank doctors, appreciate hospitals. But seldom do we recognize and appreciate the vital role of the unsung heroes when in need – The Blood Donors and the Blood Bank staff.

On this occasion of ‘World Blood Donors Day’ today, I would like to take this opportunity to personally thank all of them, without whom it would not be possible to save the many lives that we do in emergency (and in hospitals), and encourage the masses to be a blood donor.

After all, there is no substitute present for human blood.

Donate blood, save a life.

Nurses Day 2023

When sickness and ill health come to hound,

Nurses move from patient to patient without a sound

Between a life and death they'll always stand,
And fight hard to give that life back, not leave your hand,

When no one seems to give or care,
You can count on our nurses, they're always there.

Tujhe Chahne ka...

Main bechen sa rehta hun,
Tu rahat jaisi lagti hai,
Khota hoon jab sapnon mein,
Tu andar mere jagti hai

Tuhi soch hai har subah meri,
Tujh se hi meri sham hai,
Yeh kaisa rishta hai k,
Har saans pe sirf tera naam hai

Tujhe chahne ka, hi toh jurm kiya tha,
Pal pal tadapne ki, tune saza de di…

Tum jitna soch nahin sakte,
Utni mohabbat karte hain,
Tum dikho ya na dikho fir bhi,
Didar tera hi karte hain

Na chand ki hai ab chahat,
Na hai taro ki farmaish,
Har janm mein tum hi milo mujhe,
Bas itni si hi hai khawaish…

Tujhe chahne ka, hi toh jurm kiya tha,
Pal pal tadapne ki, tune saza de di…

Wada hai jab tak jinda hain,
Sirf tujhko hi chaahenge
Dil se tumhe pyaar karte hain,
Poore dil se hi hum nibhaayenge,

Tujhe chahne ka, hi toh jurm kiya tha,
Pal pal tadapne ki, tune saza de di…
Ek baar tu aake, mera haath thaam le, 

Yeh dhadkanein chalti hain, ab tere naam se.

Tu Pehla Pehla Pyar

Deewanon sa, haal hai mera,
Kaisa jaadu yeh, tune kiya,

Kyun mujhe, tum satati ho,
Aake mere khwabon mein,
Dil par na, ab zor hai,
Kho gaya hun teri yaadon mein,

Tu pehla pehla pyar mera, Tu hi iqraar mera,
Tere bin main kaise jiyun,
Tere khayaalon mein, Raaton ko jagun main,
Chain na hai, na hai sukun.

Chadh jaye to, utarta nhi,
Ye ishq bhi, nashe se kam nhi,

Yeh kaisi, khwahish hai,
Mit ti hi nahi,
Ji bhar k tujhe dekhun main,
Nazar phir bhi hat ti nahi

Tu pehla pehla pyar mera, Tu hi iqraar mera,
Tere bin main kaise jiyun,
Tere khayaalon mein, Raaton ko jagun main,
Chain na hai, na hai sukun.

Dhunde tujhe, meri nazar,
Rehti nahin, mujhe apni khabar,

Uljha rehta hun sawaalon mein,
Kab sath honge hum,
Phir iss qadar tujhe, pyar karun,
K yeh zindagi lage kam.

Tu pehla pehla pyar mera, Tu hi iqraar mera,
Tere bin main kaise jiyun,
Tere khayaalon mein, Raaton ko jagun main,
Chain na hai, na hai sukun.

CME invitation goes viral, Knowledge thirsty doctors register in hordes.

Mumbai : In a revolutionary idea which might usher in a new era of medical CME invitation, the Quackdoses Multispeciality Hospital (QMH) sent out a symposium registration flyer stating ‘Applied for Cocktail Approval’, sending doctors into a frenzy on social media, Twitter and all medical Whatsapp groups in the country.

It is a well known fact that most CME invitations in Maharashtra now have ‘Applied for MMC (May-be Medical Council) points’ mentioned on them, as bait and in the hope that more doctors will pay and register for the conference. Also, it has been observed that, with or without credit points, CMEs where registration-invitation flyers mention ‘Dinner followed by cocktails’ always draw huge crowd and are a hit among the knowledge thirsty doctors.

In an exclusive interview with our Samwadata, the organizing secretary at QMH Dr. Kabhi Mat’bann™ said, “For our symposium titled ‘Alcohol is the medicine to life, and joining medicine is injurious to health’, we were yet to get formal approval for hospital sponsored cocktails from the management. Though it was a minor human error, where instead of ‘Applied for MMC points’, the typist mentioned ‘Applied for Cocktail approval’, our registrations are now full even before the last closing date. It truly reflects the enthusiasm among the doctors to interact with our distinguished speakers and panelists.”

Unconfirmed sources have claimed that maximum registrations were from NEET PG aspirants, in the hope of getting unlimited ‘neat’ fluid boluses.

Patient undergoes Robotic Circumcision, refuses to pay surgeon.

MUMBAI: In an incident which has sent shock waves in the surgical community, a patient admitted at the Quackdoses Multispeciality Hospital refused to pay the surgeon’s fee after undergoing a robotic circumcision.

Robotic surgeries, although facing stiff resistance from the insurance companies, is now slowly becoming the preferred choice for most surgical procedures. With the advent of the fast-growing AI based technologies and robotics, surgeons are already scared that they might soon become an extinct species in the coming decade.

In an exclusive interview with the Quackdoses, patient Dis’Kount Dey said, “The surgeon had offered me 3 methods of circumcision – by open method, laparoscopically or by minimal access through the testicles, and by robotic surgery. He counselled me that robotic surgery offered the fastest recovery, hence at the insistence of my wife, I opted for it. During the surgery, I was shit scared that the robot might cut off more than what I had consented for. To my dismay, I was shocked when I realized that ‘Robodoc’ ⟨™⟩ did my complete surgery, while the surgeon was busy playing some video game on his hi-tech gaming console. What should I pay the surgeon for, for playing on his joystick while ‘Robodoc’ dangerously played with mine? ”

Furthermore, rubbing salt on the surgeon’s wound, the patient gave 5 star rating on Google reviews to ‘Robodoc’ instead, with a special mention about the elderly assistant nurse who let him see the excised foreskin after surgery and politely asking him, “Sir-come-see-son.”

Unconfirmed sources have claimed that after knowing that the patient only paid for the consumables, OT charges and for the anesthesiologist’s coffee, the disgruntled surgeon has refused to do the patient’s follow up dressings.

Patient Safety in India

We all know that 'To err is human', but did you know that a recent study by the Harvard University showed that more than 50 lakh patients die in India every year due to medical errors triggered by lack of practical knowledge among the doctors and nurses to handle patients when brought to the hospital.

India is an economy where government spends less than 2% of its GDP on health (with government hospitals characterised by chronic overcrowding, under-funding, and facilities perpetually stretched to the limit), lack of access to hospitals, lack of awareness, there is poor doctor-patient ratio (less than one doctor per 1,000 people), ill-equipped hospitals, insufficient number of labs and diagnostic facilities, absence of medical records of patients, etc. The picture of other healthcare workers, including nurses, is equally appalling.

Though most of us are well aware of these ills plaguing the healthcare sector in India, what is not often talked about are adverse events in ‘patient safety’.

Patient Safety is defined as a freedom for a patient from unnecessary harm or potential harm associated with provision of health care, including hand hygiene, surgery, injection, medication, blood transfusion, infection control and hospital waste management.

Not only in India, it is increasingly being recognized as an issue of global importance. 100s of incidents compromising patient care occur daily in hospitals across the country, but I personally believe that less than 1% of such potential harm actually get reported.

Let us look at few examples (which are just few of the incidents from the best of hospitals across the country I’ve worked with / know about), which I’m sure you’d have read nothing about, in any newspapers or on social media.

• A young patient operated for an abdominal surgery comes back to emergency after 5 days with pain in abdomen. Patient is sent for X-ray abdomen to rule out intestinal obstruction or perforation. X ray technician sees a scissor in the abdomen – informs emergency doctor – informs surgeon – patient is counseled for emergency surgery, without counseling for the diagnosis – No X-ray abdomen showing the scissor is handed over at time of discharge.
• An overzealous emergency physician thrombolysed a patient with an acute infarct, without waiting for the full MRI scan which shows a ‘hemorrhagic transformation’ & patient dies after a massive bleed in the brain – MRI cuts showing the hemorrhage on the initial MRI are not handed over the relatives.
• 2 patients die after ‘colorless’ Chlorhexidine is given as flush, instead of normal saline after inserting a central line.
• Patient becomes hypoxic and dies due to wrongful intubation in the esophagus, instead of the trachea.
• A young patient gets his arm amputated as a result of wrongful ‘direct’ injection in the ‘artery’ instead of a vein without the use of IV cannula.
• A patient has a urethral rupture after a young resident inflates the bulb of the catheter without inserting the catheter till the ‘Y’.
• An elderly patient’s gangrenous hand is amputated under local anesthesia (instead of general anesthesia) since the anesthesiologist on call will take some time to come and the surgery resident does not want to miss out on the 'cutting'.
• A senior doctor’s son, freshly graduated, is allowed to insert a central line. He inserts the guide wire all the way inside the jugular vein. CVTS Surgeon is then called to troubleshoot.

Such cases where patient safety is compromised hardly get reported by ANY hospital, unless patient files a medical negligence case against them. Things are only retrospectively discussed in internal hospital disciplinary or morbidity / mortality committees but never acknowledged, to avoid any dent in hospital's reputation and medico-legal litigation.

Hospital staff also voluntarily do not report errors or adverse events (with doctors themselves being reluctant participants), because when things go wrong news spreads fast like wild fire, and the search to find who is at fault is on. This can all too easily develop into a witch hunt, with the blame game shifting culpability from one person to another, who might then feel threatened in reporting such events.

Most of the Quality Accreditation bodies in the country also have their primary focus on checking only for policies, systems and documentation in the hospitals, with ignorance towards patient safety, and are slowly losing their credibility. In the private sector, attention to promotion of quality of care has been mainly driven by the business interest.

Also, external committees incorporated to investigate ‘medical negligence’ cases can usually be manipulated, and are often unfair & biased in their report due to the ‘contacts’ of hospitals & doctors.

Over the last few weeks, I’ve been thinking a lot about focusing on some of the PRACTICAL SOLUTIONS rather than the problem, and decided to jot them down.

• Delineation of patient safety and Quality, as they are both empirically different from each other.
• Once a problem is recognised, it needs to be talked and openly discussed amongst all the stakeholders - doctors, nurses, technicians, internal committee as well as the staff at all levels in a health facility up. The solutions are likely to emerge from sustained communications and dialogues.
• Every facility should develop a plan for training of staff, with regular workshops and training on Infection Control, hand hygiene and Patient Safety.
• A culture of reporting, discussion and learning from mistake needs to be developed at hospitals. We need a system for reporting errors and lapses of discipline even when no adverse event has occurred.
• Ensuring that patient safety processes are clearly communicated to patients and caregivers prior, during and after the medical intervention using different communication means such as videos, mobile apps, etc.
• Introduction of anonymous reporting system in healthcare facilities to be used by healthcare facility staff, students, residents, patients and families, or with the use of a ‘Ballot box’.
• Integration of web-based grievance system and toll-free helpline for Patient Safety.
• Implementation of standard treatment guidelines and treatment flows.
• The training need on patient safety for graduate curriculum for various cadres of health staff including doctors, nurses, laboratory technicians and pharmacists.
• Accreditation of healthcare facilities and strengthening quality assurance mechanisms.
• There is a shortage of trained medical personnel in rural areas. The only way to address this is to greatly increase the number of government medical colleges, increase government financial allocation and spending.
• Establishment of a safety culture and improving communication, patient identification and handing over transfer protocols in healthcare facilities. Mistakes are common and can be devastating when they occur.
• Robust analysis of the data and feedback mechanism on what is happening after implementing accreditation / quality improvement activities in relation to care and safety.
• In India, the Consumer Protection Act serves as a check / incentive to modern medical practitioners to provide high quality health care. Unfortunately, even this legal mechanism is not accessible to the poor.
• The ill-advised move of the government of India to allow graduates in Ayurveda to practice surgery must be stopped. It is impossible for Ayurveda to incorporate surgical techniques while ignoring the other domains of modern medicine. An epidemic of catastrophic complications, disproportionately affecting the poor can be expected if surgical procedures are performed by the poorly trained.
• Also, today’s medicine is increasingly becoming technology driven. New technologies create new methods for producing errors and constant vigilance is required to track these.

In the last 10 to 15 years, many initiatives have been taken by the Government of India and hospitals to improve quality of healthcare services and strengthen patient safety, yet, a lot still needs to be done.

By and large, patient safety errors occur because of bad systems and not bad people.

When the above measures are part of daily practice in an organisation, we can say the seed for a culture of patient safety in an institution is sown.

We must not forget that, patient safety is knowledge, it’s intentional, it’s a habit, it’s a way of life, and when it influences a group behaviour, it becomes a culture.