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

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 ?

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.

Father of Gynaecology J Marion Sims : Was his Action Ethical or Not ?

James Marion Sims (January 25, 1813 – November 13, 1883) was an American physician and a pioneer in the field of surgery, known as the “father of modern gynaecology”.His most significant work was the development of a surgical technique for the repair of vesicovaginal fistula, a severe complication of obstructed childbirth. He is also remembered for inventing Sims’ speculum, Sims’ sigmoid catheter, the Sims’ position, use of silver wire as a suture, Insemination and postcoital test, and argued for the admission of cancer patients to the Woman’s Hospital, despite contemporary beliefs that the disease was contagious.

He also advocated a laparotomy to stop bleeding from bullet wounds to this area, repair the damage and drain the wound. His opinion was sought when President James Garfield was shot in an assassination attempt; Sims responded from Paris by telegram. Sims’ recommendations later gained acceptance.

In 1878, Sims drained a distended gallbladder and removed its stones. He published the case believing it was the first of its kind; however, a similar case had already been reported in Indianapolis in 1867

But, Of Late, There are many people who try to intentionally portray him in negative light
Here is one such Facebook post https://www.facebook.com/prettybrowngirls/photos/a.190238547702360/1035669863159220/?type=3

Unthinkable! J. Marion Sims is called the “Father of Gynecology” due to his experiments on enslaved women in Alabama, who were often submitted as GUINEA PIGS by their plantation owners who could not use them for sexual pleasure. Anarcha was an African-American slave woman who was forced to regularly undergo surgical experiments while positioned on Sims’ table, squatting on all fours and FULLY AWAKE without the comfort of ANY anesthesia. It’s been calculated that Anarcha was operated on roughly 34 times between 1845 – 1849. These operations helped Dr. Sims hone his techniques and create his gynecological tools. It would be more than appropriate to credit Anarcha, along with other nameless slave women, as the “MOTHERS OF GYNECOLOGY”.

J. Marion Sims and Ethics

On Reading it, You will immediately Hate the Man because of the following issues

  • //his experiments on enslaved women //
  • //submitted as GUINEA PIGS //
  • //plantation owners who could not use them for sexual pleasure. //
  • //positioned on Sims’ table, squatting on all fours //
  • //FULLY AWAKE //
  • //comfort of ANY anesthesia. //
  • //roughly 34 times between 1845 – 1849. //
  • //hone his techniques and create his gynecological tools.//

So
The impression Any Lay Person as well as Few Doctors with low IQ Gets with this Writeup is that

Dr Sims Made Experiments on a slave, and was cruel that he made it when she was awake and the only reason the slave had to undergo the surgery is for the sexual pleasure of the slave’s owner

But, When we examinite it more carefully it is easy to conclude that it is a rubbish Writeup, itt is biased and written with a perverted intention to make some one hate SIMS



Let us examine the points one by one

//his experiments on enslaved women //
//submitted as GUINEA PIGS //

Guinea Pigs are used in Experimentation for various purposes
The Pigs are usually normal and are sacrificed for sake of trial
If the procedure is not done, the Guinea Pig does not have any problem

But
Clinical Trial is Different
Here the person already has a disease
and undergoes the procedure
WHICH CAN CURE HIM/HER
or
MAIM / KILL HIM / HER

Use of Guinea Pig and Experiments in this write up is malafide

//plantation owners who could not use them for sexual pleasure. //

As if the only indication for VVF is sexual Pleasure
And the woman is otherwise very happy with VVF and RVF?

What is Vesico Vaginal Fistula – It is a condition in which Urine will come via Vagina continously and without any control. What is Recto Vaginal Fistula – It is a condition in which Feces (Stool or Shit) will come via Vagina continously and without any control. Do you think a woman with such condition will like it. Do you think that she will have to be forced to undergo the surgery. Not at all. Women with such conditions were running from pillar to post to get cure. And there was NO CURE Available at the time, and one doctor offered to cure them, but said he also did not have any experience. So What should have been done ? To try the procedure or just to leave the women with urine and feces dribbling continously through their vagina ?

//positioned on Sims’ table, squatting on all fours //

You can also describe Lithotomy and give an grotesque impression to the lay public

//FULLY AWAKE //
//comfort of ANY anesthesia. //

These two lines actually take the cake
These will create immense anger and make blood boil
Isn’t it

But Wait
When were these done

//roughly 34 times between 1845 – 1849. //

Oh
So the surgeries were done before October 16, 1846 and also just two years after October 16, 1846

What is 16/10/1846 by the way
Find it yourself

Then you will understand the height of perversion the author had gone by using the words “FULLY AWAKE” and “comfort of ANY anesthesia”

//hone his techniques and create his gynecological tools.//

This is the only correct line in the writeup

-oOo-

This is how, You can fool an unsuspected reader Hate some one by making normal actions look like Big Crime

By the way
Did you find the significance of 16/10/1846 at least now
Well that was when Ether was FIRST used

So
What does this writeup do
It blames Sims of not using Anaesthesia for an surgery done before Anaesthesia was invented
This is why I call this writeup as peak of perversion and summit of lies



For the Serious Readers, there is a detailed writeup in Journal of Medical Ethics. You can also read it J Med Ethics. 2006 Jun; 32(6): 346–350. doi: 10.1136/jme.2005.012559 PMCID: PMC2563360 PMID: 16731734
I did not see the article when I wrote this post