Jaane bhi do yaaron....

I was observing the RMO take consent the other day for a vascular procedure.

Name of the procedure- arteriovenus fitsula. ...she wrote

She forgot to mention the name of the consultant doing the procedure (and wrote her name instead) and did not fill the column which states that the consent was explained in xyz language. On asking her about the procedure (the way she spelt it I was sure she hadn’t heard of it before) she stated that it’s done somewhere in the rectum or anal canal (she wasn’t very sure but said it’s a 50:50 between the two sites). I was amazed coz today I knew who was referring anal fistula pts to my opd for av fistula surgery.. initially I thought the pts had got to the wrong room coz the colorectal guy sits one room to my left in the opd complex. But no..this was the secret I didn’t know bout!

Frankly,I am really flustered by this rich new breed of mbbs students passing out every year from the rich private colleges from this part of the world. On paper they re qualified to practise medicine. And with 65000 mbbs seats this was bound to happen. You may ve not studied seriously ..may not know a word bout most of the diseases ..but you ve been made to pass the exam.. thanks to some help from somewhere.

I asked her.. we ll play Q n A .. just gimme a few answers..
-What’s philadelphia chromosome?
No answer...some chromosome discovered there.. she mumbled at last. (I’m happy she didn’t say it s a fossil discovered in philadelphia)

-What is varicose vein?
She answered it promptly.. dilated veins.. I was happy she did know it.. but then she went on to say ..dilated veins on the scalp.. and that it was difficult to put a veinflow in those varicose veins! (If I do commit suicide someday pls catch hold of these rmo s. .godd)

-I asked her what is Murphy s sign, de Musset sign...Rebound tenderness.. how many pages does Harrison have..and did she read Bailey and love ?
All her answers were in the negative.

Clearly these days they read just to pass exams.. ask them any concept and you will realise how hollow they are. The private classes and some colleges are indeed taking us down. Students are mugging to pass the exams.. this cannot happen in a branch that deals with the human body. No wonder we read jokes on fb about the doc explaining to his pt that his disease is from the chapter that he had left as an option during his exams!
And the saddest part is that these people re well connected. They want to become consultants and earn the same salary. And surprisingly they do get to that.

I just read what goes on with this new hospital at a twin city in our state. The hospitals guys ve just set up their new PET scanner and in a month of being operational have done 50 pet scans. That’s a huge number for a start up ! Then I hear that they ve hired a private passout medicine doc who with his wonderful knowledge of the subject doesn’t decide the cause of pyrexia, but labels it pyrexia of unknown origin and subjects the pt to a pet scan.. so amazing ain’t it!!

That is why I wonder what will happen when the seats are increased further. The way the colleges are thriving these days.. I need not say more. In the last 6 mths I haven’t seen even 2 vada pav shops come up around my hospital ..but 4 new hospitals ve been added to the list.
65000 mbbs seats and 15000 pg seats that’s how it was till now.. but now they want to increase the pg seats.. go ahead.. I would be happy if they had 35000mbbs seats and 25000 seats,but they demand 65000 pg seats, one for each!isnt that way too many? Quality is indeed getting compromised for quantity and the end result won’t be good...obviously!

I suddenly get a call as I write this write up.. it’s the same rmo .. she had a rank of 19000 plus in neet but she happily states that she has secured MD Radiology at a private college in Pune. Good.. I’m happy.. the way things re moving she ll soon join a corporate hospital as a consultant in a few years from now. And I know what to expect in the reports...expect the unexpected..ha ha!!!!

Moving away from rmo s let’s go on to the next level..

I ve this consultant who gets many referrals coz he gives referrals...err.. if you know what I mean.. he keeps his referring physicians happy.. and I ve never seen a pt treated by him happy ..but then who cares.. it’s a game of numbers.. n he s making maximum numbers in 'the maximum city'..haha! A physician referring to another substandard one just for reasons known best to him. And then the “chakravuyh” takes over.. the pt with a stomach ailment finds himself going to an ent , neuro, urologist, pulmonologist, etc for no reason. This really bugs me. And then when I see the pt with a whole bunch of radiology investigations for a condition which is diagnosed by simple clinical examination..I’m stunned! as i say this just to confirm it, my Apple manager friend calls up to say that he was suspected to have an inguinal hernia and had a sonography and mri done to confirm it, at a 5 star hospital in the suburbs.and he was so happy that he got investigated...![God who s a bigger fool...the doc or this patient?]

Next I see that a young deserving superspeciality doc being turned away by a big corporate. The reason being that she is young and has no patient base in this region. And the position is given to a mediocre guy from another regional hospital with 15 yrs practise in the region..with a big patient base. And I thought that good clinical skills and good knowledge will fetch you the job.. obviously it doesn’t work that way! But to her luck ,she was picked by another hospital and her good work has earned her a few accolades.. !

Being a guy with contacts can be really resourceful. A critical dept head has to be a senior with amazing experience. And the other day I heard a story bout a newly appointed head with no great record but good contacts..n how even one challenging case could not ve the desired result and ve always had a vertical transition..I just kept mum.

See since we all understand cricket ..the cricket crazy nation that we are.. let me use this example.
You can use your influence and money and get yourself a place in the playing team. But ultimately you will have to deliver a star performance. And then you know that you can’t cover it up for long.. it will show up and the truth will be exposed in the long run... same with the ones investing in pg seats and consultant posts in hospitals when they know they don’t deserve it. And for the people who can see this happening.. well you ve to behave like Tubelight as the new hindi movie proclaims.. coz without back up you can be easily toppled ...forget your experience, knowledge ,hardwork and degrees.. without contacts you re just a chicken waiting to be devoured by the Wolf !

We want world class options in every field.. but we don’t want to work hard to get there! After all these years we just ve 2 squash players and a handful of badminton players who have made the cut. What s wrong with billiards,table tennis, wrestling.. what happened to gymnastics after that gal put up a great show in olympics? If you expected better training and new centres ..it has not happened and in all probability won’t. .until and unless someone finds a vested interest in doing it. The current breed of cricketers joking and smiling after a brazen defeat at the hands of our arch rivals says it all..the new culture is.. leave it.. just enjoy ur life.. live carefree... once ur a name you can kick anyone out ...especially if he raises a voice bout the indiscipline and lack of commitment in the present era!
We re a country of people running around from the time we learnt to walk.. we run around in trains,buses ..run after gals.. run after money.. run after fame.. (you may be a jack ass but still want to be respected and be famous..what shit!) ...then why don’t we ve a single world class runner representing us in world championships? If you look at the runners most look undernourished and don’t ve enough muscle for the job! Then where do the crores invested (Atleast on paper) go..

I just feel sad for the soldiers martyred each day..they give up their lives for a better future ....not knowing that the future is getting exploited at the hands of non deserving rich fools.. and most don’t want to do anything bout it and remain oblivious coz it doesn’t affect them in any way.

Hope things change.. adios!!!!!!