Why are doctors Appointments Delayed ?

One of the common Complaints raised by People in India is that Doctors Appointments are delayed

In fact, it is one of the very few True Allegations in Health Care. Most of Allegations against doctors and Hospitals in India are fake and frivolous

The reasons for delay in Appointments are

1. Emergency :
The Doctor would have planned to start the OP at 7 PM. But if a patient in throws fits or becomes unconscious, he has to be attended first. So the OP Appointments will be delayed

2. Emergency Surgeries :
The Doctor would have planned to start the OP at 7 PM. But if a patient from a two wheeler accident is brought at 5 PM he has to be operated. So the OP Appointments will be delayed

Now Comes a useless Question asked by people without common sense “Why can’t you inform”  When called to see a patient who is bleeding, has feeble pulse and requires immediate treatment, the entire focus of the doctor would be and must be on saving the life and not checking the appointment calendar and calling each person

It requires only minimal common sense to understand this
And
It requires Selfishness of the highest order to expect a doctor come to his OP, take his appointment diary, call each of those who have fixed appointment, and inform them and then go and treat the patient.

Health care resources not infinite. They are are scarce. The available doctors time and hospital infrastructure are limited and are not adequate for the demand. Hence, it is the duty of every citizen to share this meager resources with his fellow citizen. If you come to the hospital, please keep away your greed and selfishness.

As I have been writing again and again, most problems in health care in India are because the PATIENTS are GREEDY and SELFISH. They do not understand that a hospital or doctor is for every one. They want immediate and superlative treatment for them. This is the root cause of all problems in healthcare. Sadly, very few understand this. And even fewer people accept this. They are happy to level all blames on doctors and hospitals without even sparing a second to reflect what is the fault from patient’s side that is contributing to the mess

So

It goes without saying that any doctors appointment may be delayed by 2 hours

A Delay of 2 hours is the norm rather than exception

If you are not able to understand this and if you are not able to accept it
Then
Please get treated from Countries like USA or UK
Where
Specialists do not attend emergency on first call, and where you cannot have OP on Weekends and where you need to wait for 2 months to get a Specialist Appointment

In USA
It takes two months to get the appointment date, but the doctor will see you at the right minute

In India
You can see a specialist the same day, or at the maximum next day, but the appointment may be on time, or delayed by 5 minutes to 3 hours

Which is better ?

It requires only minimal common sense to know that the Indian setup is better

-oOo-




3. Patient Coming Late
A doctor may Consult in One Hospital from 5 to 7 AM and the next Hospital from 7:30 to 9:30 PM

A patient who has appointment at 6:30 will call him at 6:40 and say that he is delayed due to traffic jam and is just round the corner and will come by 5 minutes. The doctor will wait. The patient would then start from his home and come by 7:15
So
All the appointments in the Second Hospital will be delayed

Whose fault is this ?

4. Getting Appointment for one person, but consulting for five people
Lots of people get appointment. T for one person, but along with him, four other friends or family come in and they want to become healthy
What do you expect the doctor to do ?

To Treat them
or
To Bluntly Say that “I can see only one. The Other Four Get Lost”

Just ask your conscience ?

-oOo-




5. Patient shouting over 5 minutes delay
In many cases, there would have been a five minutes delay. But one Smarta** would make a big fuss and it will take doctors 15 minutes to calm him

In the end, the other appointments will be delayed by 20 (5+15) minutes

6. If there is a child or old age patient, or a patient with cancer the doctor has the right to attend to them first. If there is a follow up patient he or she may be called first.

So

If you are booking an appointment

1. Expect that to be delayed by 2 to 3 hours in case of unforeseen emergencies

2. Keep Calm. Don’t make a fuss. Don’t call the Doctor on Mobile. The delay is because doctor attending some other emergency. And If you have fixed an appointment for your friend and if your friend says that he or she is waiting in the hospital, please don’t call the doctor to enquire. It wastes everyone’s time. Patiently explain to the greedy and selfish friend and ask him to her to wait

3. Remember that you have come to become healthy. You cannot BUY Health like you buy Mobiles, Cars, Dress. In an hospital, the resources are scarce and will be used to save lives. If you have a big ego, keep it in home. Don’t expect the doctor or hospital staff to spend their valuable time in massaging your useless bloated egos instead of saving a live. And hence do not demand that you will be called and informed about few minutes delay like what they do in Civilian Flights.

What should be done to protect doctors in India from violence?

There are few ways. Let me Explain One by one

( I) Teach the People that their expectation is unrealistic and can never be met and that if their unrealistic and impractical expectations are not met, it does not become negligence

I will explain this first

99.99 % of Our People who criticize Doctors want

  1. 1. All diseases cured in one day
  2. 2. by the treatment of their choice (if they want surgery, we have to operate : If they don’t want surgery, we have to resect meningioma with tablets) [Meningioma : A Tumour inside Skull]
  3. 3. Free of Cost
  4. 4. In the Hospital of their choice (Treatment of Myalgia in neurosurgery OP, Cardiac Bye Pass in Banavaram PHC) [Myalgia : Muscle Pain, usually due to work]
  5. 5. At the time they like (They will want admission of OA Knee at 11 PM) [OA Knee : Knee pain]
  6. 6. All diseases to be diagnosed at once
  7. 7. With the modality of their choice. If they want MRI Brain, we have to take it even when patient is fully conscious following fall from bicycle. If they don’t want, we shouldn’t get CT Brain done even if there is anisocoria
  8. 8. And doctors say what they like. You should always say that the disease does not need hospitalization if they are not ready for hospitalization. You should always not suggest surgery if they are not ready for surgery.

-oOo-

If any one of these conditions are not met , they will say that

  1. 1. Doctors are Negligent
  2. 2. Doctors are money minded
  3. 3. Doctors are not duty conscious
  4. 4. Doctors do not have accountability
  5. 5. Doctors did not tell me anything
  6. 6. Doctors did not explain treatment plan

eg :

If they want the diease to be cured in one day, but it takes 5 days, and even though the doctor has explained everything, they will still say that doctor did not explain me treatment plan / doctor did not tell me anything

eg
When they are told that Open Heart Surgery cannot be done at Banavaram PHC, they will say that Doctors are money minded (they do open heart surgery in their private clinic but not in PHC), Doctors are not duty conscious, Doctors do not have accountability

-oOo-

In this case, They wanted Neurosurgery in the hospital they first come

When it is not there
They consider that the doctor is negligent
and try to kill him

-oOo-

The issues are two fold

  • 1. Lack of resources
  • 2. Over expectation of people

The second is the main issue nowadays . . and when the people are at fault, they have to be blamed
-oOo-

99.99 % of Our Public distrust is because of their wrong, illogical, impractical expectation

The mistake has to be identified and solved

They need to be educated about reality

-oOo-

You please ask 1000 non medical people to list what they consider as 10 problems in health care

You will have a list of 10000 problems

9999 will come under the eight categories mentioned above

Tell straight on the face of the patients that what they expect is unrealistic and that they have to accept the reality

-oOo-

(II) Exclude Health Care from Consumer Courts

Health care is not consumerism
The Customer is King approach does not work here
Health care is NOT Patient vs Doctor issue
It is doctor + patient on one side and Disease on other side

Patients do have a lot of role to play in evolving a good health care system and if the system is in disarray they do have lot of blame to shoulder

Bringing health care under consumer courts is the single most anti people act in the history of health care

Wherever and whenever there is a blame from patient side, blame it is on patient side
Do not blame the doctor even when the patient is at fault

-oOo-

(III) A strict law absolving a doctor / group of doctors or healthcare professionals,, from any legal implications for any act of self defense while on duty

This is also needed (Suggestion by Mix Doc)

-oOo-

(IV) Increase Severity and Certainty of Punishment

Certainty of punishment is more important and helpful than severity of punishment in preventing a crime. This is what Australia Government has done

(V) Stop Defending the Criminal

Few Men rape

  • They do because of perversion and also because they consider the girl or woman as soft target.
  • They are emboldened because they know that there are people who will blame the girls dress as cause of rape
  • It is perversion to find reasons from the girls side in a rape
  • It is stupidity to suggest that there won’t be rapes if all women wear burqa
  • Rape can never be prevented by changing the dress of woman
  • The man is at fault

He needs to be changed.

-oOo-

Few people attack hospitals and health care professionals

  • They do because of perversion and also because they consider the hospital or health care worker as soft target.
  • They are emboldened because they know that there are people who will blame the hospital bill or overcrowding as cause of attack
  • It is perversion to find reasons from the hospital side in a rape
  • It is stupidity to suggest that there won’t be attacks on hospitals if all govt hospitals give Apollo services or if all private hospitals treat free
  • Hospital attacks can never be prevented by changing the hospital bill
  • The attacker is at fault
  • He needs to be changed.

-oOo-

Imagine two scenarios

Scenario 1 :

A pervert finds a girl child alone on the street and thinks of molesting her.

He has read in the news paper about a hundred similar incidents in past few weeks following which the criminal was given bail immediately and no conviction at all. In addition to the criminal being let free by the legal establishment, he has also seen fools / stupids / perverts wearing mask of intellectuals had discussed the various causes like Dress of the Victim, Victim coming alone, the emotion of the criminal etc as reasons and were talking against punishing the previous criminal and suggested that changes should start from victim’s dress and victims behaviour

He gets emboldened that even if he commits the crime,

  • 1. he will come out in bail in one day,
  • 2. he won’t be convicted
  • 3. there will be enough fools / stupids / perverts wearing mask of intellectuals who will support him directly and indirectly

Scenario 2 :

A pervert finds a girl child alone on the street and thinks of molesting her.

He has read in the news paper about a similar incidents following which all the criminals were convicted and are in jail and every one was unanimous is giving 14 years imprisonment to the criminal

He will just back off if that news comes to his mind

-oOo-

Reason for increase in Sexual Violence against women

  • 1. Perverts
  • 2. Low Conviction Rate
  • 3. Fools / stupids / perverts wearing mask of intellectuals who blame the Victim’s dress, victim’s behaviour and suggest that victim should change

Reason for increase in Hospital Attacks and Assaults on health care worker

  • 1. Perverts in Public
  • 2. Zero Conviction Rate
  • 3. Fools / stupids / perverts wearing mask of intellectuals who blame the Hospital Bill or Hospital Waiting Time

-oOo-

Solution for Reducing Attack on Hospital

Legislature

  • 1. Increasing Punishment to 14 years
  • 2. Making Hospital Attacks as Non Bailable Offence

Executive

  • 3. Time Bound Legal Procedure. 7 days for Filing Charge Sheet

Judiciary

  • 4. Trial within 1 month

Civil Society aka Fools / stupids / perverts wearing mask of intellectuals

  • 5. Stop Justifying the attacks
  • 6. Stop Blaming the Victim
  • 7. Stop Finding Imaginary Reasons

(VI) Include the details of these attackers in their Aadhar Card and form a PIBIL

Soon EMR (Electronic Medical Records) will be linked to Aadhar card. Just like CIBIL ( CREDIT INFORMATION BUREAU (INDIA) LIMITED), We need to have a PIBIL (Patient Information Bureau India Limited) linked with Aadhar Number and Entries made in the Aadhar Database of All the patients and attackers who cause trouble in hospital

So that

Other hospitals can use that to anticipate trouble and be prepared

  • First Attack : The Individual Should be banned from entering any health care facility all over India (Govt or Private) for a period of six months
  • Second Attack : The Individual Should be permanently banned from entering any health care facility, even for emergencies

Is this Ethical ?

Yes.
Hippocrates Oath becomes null and void for those who endanger the life of  Other patients in the hospital as well as  Health Care Providers