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Tuesday, 12 November, 2024 at 03:31:50 pm ISTSubject: Failure Notice
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---------- Forwarded message ----------
 Dear Mr Sekar,
It was about 50 days back. For my sprains I had taken injection from a near by 
clinic prescribed by duty doctor.  Within half an hour it worked  and I started 
doing things as usual. After three days again pain appeared. This time more 
severely. I went to the same nearby clinic. But duty doctor had changed, an MD 
now. He examined me. He was the doctor first located the rashes. 

He said- I can take back consultation charges. A skin specialist has to examine 
rashes. An ortho has to see the sprains,take Xray if required. I can go their 
multi-specialty hospital about 9 KM away. Injections given by earlier doctor 
was by oversight sometimes. For a diabetic patient maximum steroids has to be 
avoided. 

Without telling, he didn't prescribed anything other than noting his findings. 
With his notes I went to my famous Hospital and rest already wrote to you.
On reading about GP, I thought of writing this incident.
Gopalakrishnan

    On Tuesday, 12 November, 2024 at 12:57:50 pm IST, 'N Sekar' via KeralaIyers 
<[email protected]> wrote:  
 
 When we grew up, it was only our family doctor, a G P,  who treated for all 
ailments.
But today G Ps play it safe by referring Specialists. Fear of Litigation also 
plays its part.
N Sekar 
Fwd:
*The Rashomon Effect*
The 40 year old gentleman was in deep distress. His wife was massaging his left 
shoulder in a bid to alleviate his pain. 
Within the last 48 hours, he has met three different Doctors (Super- 
Specialists to be precise) and underwent an ECG, ECHO, MRIs of shoulder and 
Neck bone, and a battery of blood tests. The wife's hands were overflowing with 
the prescriptions and the Path Lab reports.
 Being an IT professional, he has been suffering from Neck pain quite often. 
Three days ago, the pain started to gradually shift to his left shoulder and 
arm. 
The patient googled his symptoms which indicated the possibility of an imminent 
Heart attack. The couple had rushed to a local Doctor who performed normal 
blood tests and sent him to a Cardiologist. 
The Cardiologist thought it could still be a Myocardial ischemia and performed 
a 2D Echo Test. It turned out to be normal but to be on the safer side, he 
prescribed a low dose of blood thinners, Cholesterol medications and advised 
him to get an opinion from an Orthopedic Surgeon.
The pain was excruciating and the Orthopedic Surgeon being a Specialist in 
Keyhole surgeries, suggested that it could be a tear in the shoulder tendons 
since the patient was diabetic. He performed an MRI of the shoulder which was 
equivocal. 
He gave the patient some more medications and suggested that he meet a 
Neurologist ‘just in case’ it could be a nerveous problem. 
After examination, the Neurologist too thought it could be Diabetes or viral 
Neuropathy based on the high Blood Sugar level.
He advised a few tests and an MRI of the Cervical Spine. 
Finally, it turned out to be a Slipped disc in the Neck Bone.
What we see here is a common Healthcare problem of late. *Every 
Super-specialist sees the patient and his symptoms, only from his specialized 
narrow perspective*
The clinical notes, investigations and disease Management are tailored to suit 
the Doctor's specialization. This is what is stated as *Rashomon Effect*
*Rashomon* was a famous movie directed by the celebrated Japanese Art-movie 
Director-*Akira Kurosawa*
In this movie, *a Murder scene is described by different witnesses from their 
own point of view. All their views, are very different from one another. But 
they all believed that they are speaking the truth, because it appears True 
from their own individual perspective*
Similarly every Medical Super-specialist has his own approach towards the 
patient, typically focussed on the system in which he has specialized. 
*Upper stomach pain is seen as Esophagitis by the Gastroenterologist, Angina by 
Cardiologist and as Costochondritis by the Orthopedic Surgeon*
If we look at their clinical notes and examination findings, it would match 
their diagnosis since their mind is wearing blinkers.
 The Specialised mind fills the gaps based on his previous observations, 
specialised knowledge and myopic training.
With increasing Super- specialization, the patient is not seen as a whole, but 
only as an affected Organ.
The specialist falls prey to the *Rashomon Effect* and explains the patient's 
symptoms from the perspective of his own Super-specialisation.
 *It is difficult to avoid this in future, since practitioners of General 
Medicine, are on the verge of getting extinct, thanks to current trends in 
Medical Education in India, where there is a craze for Super-Specialists*
*Please consult a good General Physician, before approaching any 
Super-Specialist in Medicine*

Yahoo Mail: Search, Organize, Conquer

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