Friday, July 7, 2017

Complications are bound to happen, what is important is how you tackle them

Medicine is an art, based on science, yet it is not an exact science. And it is the skills that the doctor picks up first during his education and then as part of his training, which help him to safely and effectively practice medicine. Years of clinical practice then further his knowledge and add to the skills.

No two patients are alike; every patient is different and clinical decisions are tailored to individual patients. Therefore, probability and uncertainty are part of the practice of medicine where complications are bound to occur. But what is of the utmost importance here is to anticipate potential complications and manage them quickly. When any complication is anticipated, one is prepared accordingly to handle it.

It is this ability to anticipate, recognize and the quickness shown in managing any complication that marks a distinguishing characteristic of a “good” doctor and sets him/her apart from others.

To acquire these clinical and procedural skills, a doctor undergoes years of rigorous study and training. Only then, do they acquire adequate knowledge, discernment and develop skills to take the right decision for the patient and adapt to changing practices. But, today quacks are flourishing in our society. They are obviously untrained and lack the ability to diagnose or treat patients, in particular any emergency or complication. They cannot render timely first aid. Although it is their routine practice to refer patients to hospitals or higher centers, but precious time is lost. They can hardly be expected to be aware of the concepts of the “Golden hour” or the “Platinum 10 minutes”. And, the outcome often is patient succumbing to his illness.

Quacks also prescribe antibiotics, which are Schedule H1 drugs. Misuse of antibiotics by quacks fails the very objective of Schedule H1, which is to control the rampant use of antibiotics and anti-TB drugs to check the epidemic of antibiotic resistance.

Schedule H1 drugs, along with Schedule H and Schedule X drugs, are restricted drugs and cannot be sold to just anybody OTC. A valid prescription from a doctor of modern system of medicine is required before they can be dispensed to the patients.

The Govt. is promoting AYUSH doctors to practice modern medicine. Scheduled drugs should only be allowed to be written by MBBS or BDS doctors. The prescription of Schedule H, H1 and X drugs by non-MBBS, non-BDS doctors can cause large-scale harm.

Interpretation of a situation or judgment in the body is governed by chemical reactions and is controlled by the balance of autonomic balance system, which in turn is governed by the interaction of parasympathetic and sympathetic nervous systems. 

Sympathetic mode releases stress hormones and may trigger panic or nervousness, the “flight or fight” response. This prevents a person from taking the correct and decisive decision and increases the chances of mistakes, which in the case of a doctor may be costly. It may mean life or death for this patient.

A parasympathetic state of mind, on the other hand, is quiet and composed enabling rational and Right conscious–based decisions and just the right frame of mind to tackle complications. Doctors should practice medicine in a parasympathetic mode. 

Dr KK Aggarwal

National President IMA & HCFI

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