Careers360 in conversation with Dr. Anil K. Rai, Medical Superintendent at Safdarjung Hospital brings you insights on doctors and patients’ relationship. In this interview, Dr. Anil, shares the importance of first interaction of doctors with patients. The Safadarjung Hospital Medical Superintendent also talks on challenges at Safadarjung hospital.
Dr. Rai also shares his mind on lagging of public health in northern India besides encouraging the quality treatment at government hospitals.
Read here the full interview.
Careers360: Why is that trust factor with doctors is reducing in India?Dr. Anil Rai: The major problem is that there is no proper referral system. Like in UK, there is one family physician who knows everything about health of each person in a family. In the last 30 years, there have been a lot of changes in the field of medicine. Just as in shopping, one examines the quality of three things before buying, the patients apply the same theory with doctors. When a patient comes for second opinion, I ask him not to show me all the reports. I tell him, “First describe your symptoms”. Then I will examine and frame my opinion, which is followed by further investigations.
There is also a problem of ethical practice of profession. Suppose a patient gets frequent headaches, some doctor would simply ask him to go for surgery. In many cases, it would be just a case of migraine, which can be treated by medicines. In such a scenario, you can never blame patients. They are bound to take second or third opinions.
Careers360: How do you look at the students passing out nowadays? Dr. Anil Rai: During our college days, internship was all about seeing patients and developing clinical skills. Nowadays, students are simply hurrying up to finish internship to head on for postgraduate courses. They are busy reading MCQs, rather than developing clinical skills. So that’s a very dangerous trend. Sometimes when I make surprise checks in casualty and ask what happened? I get the response, “I have told the patient to get ultrasound done.” There is no answer to my followed question, “Did you palpate?” Even today, I first palpate; analyse the body; make my own finding; ask for investigations; and finally compare it with my own findings to arrive at a diagnosis. Today, most diagnoses are based on scans rather than clinical skill.
Dr. Anil K. Rai Medical Superintendent Safdarjung Hospital
During our college days, internship was about seeing patients and developing clinical skills. Nowadays, students are hurrying up to finish internship to head on for postgraduate courses. They are busy reading MCQs, rather than developing clinical skills.
Careers360: How can we encourage quality treatment in government hospitals? Dr. Anil Rai: Audit is badly missing in India. The way you audit your account, the same way you have to audit your prescription and case sheets. In public hospitals, the doctors are rapidly checking the outpatient department slips. I have given memos to several of them who do not keep xerox copies. The moment you start auditing your case sheets, you can analyse your own performance. In foreign countries your medical assessment is done by the medical record department which will tell you the number of patients you have seen. How many surgeries you have done? How many had overstay or re-do surgery? If every case needs re-do then you are considered as a costly doctor. I feel feedback from patient’s side will play a massive role in improving the status of hospitals.
Careers360: Why is north India lagging in public health? Dr. Anil Rai: NRHM is a fantastic initiative. Some southern states like Tamil Nadu, Karnataka are doing very well. They get full funding through NRHM for cochlear transplant; Tamil Nadu is the topmost for kidney transplantation and organ donation. Sadly, northern states like Uttar Pradesh and Bihar have not utilized their funds well.
Careers360: What are the serious challenges at Safdarjung hospital?Dr. Anil Rai: It’s a vast hospital with tremendous amount of patient in-flow, be it in outpatient department or casualty department. At Safdarjung hospital there is no policy of one patient, one bed. Ironically, we have situations when one bed is occupied by two to three patients. The policy of our hospital is that we cannot refuse admission. It’s an unimaginable situation where you have a 40-bed ward populated by 150 patients. Due to over-crowding, sometimes we miss out on quality care.
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