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Old 5th August 2009, 10:59   #241
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Originally Posted by Tejas@perioimpl View Post

What's wrong with you??? Are you a doctor and have seen such things?
I know so many cases of CPRs being given in ambulances, in the lobby of hospitals, etc.

PLEASE BACK UP THIS BLANKET STATEMENT YOU HAVE MADE WITH FACTS
sorry doc if I hurt you, but I am speaking from my own experience where somebody in my family died with heart attack and I saw no urgency in the hospital staff, this was after another doctor simply forwarded us to the bigger hospital fearing the worst (I guess), not even gave a blood thinner. Also I also suggest you look at sankar's thread (May 17th crash and my second life!) which had me say the same.

When I said how many CPRs, I didn't mean there are none. But it's the urgency in the staff that is lacking to save a life. And I was strictly comparing it with caliatenza's home country.

I agree that there are good doctors and you are probably one of the very responsible ones, but travel to any smaller clinic and you will understand what I mean.

And I still maintain that it's in our culture. ticket window was the best example I could think of, But in general, because we work on volume, it's difficult for anybody to exchange pleasantries when he has to handle thousands of transactions a day, any govt office can be taken for example. And I am not saying it's wrong, I am also a part of it. Just that I also have seen the other extreme.

I did not know a word about CPR until i landed in this country a few years back. How could I have administered when I had not seen one. but I expected the staff that handled my family member to know at the least.

EDIT: Ratan tata makes a statement in everything he does, that's why he is Ratan tata. You are an exceptional human being. I also have a little bit of superiority complex myself . But I am talking about the rest of 100 crore indians who have to rush everything they do everyday.

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Old 5th August 2009, 12:34   #242
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sorry doc if I hurt you, but I am speaking from my own experience where somebody in my family died with heart attack and I saw no urgency in the hospital staff, this was after another doctor simply forwarded us to the bigger hospital fearing the worst (I guess), not even gave a blood thinner. Also I also suggest you look at sankar's thread (May 17th crash and my second life!) which had me say the same.

When I said how many CPRs, I didn't mean there are none. But it's the urgency in the staff that is lacking to save a life. And I was strictly comparing it with caliatenza's home country.

I agree that there are good doctors and you are probably one of the very responsible ones, but travel to any smaller clinic and you will understand what I mean.

And I still maintain that it's in our culture. ticket window was the best example I could think of, But in general, because we work on volume, it's difficult for anybody to exchange pleasantries when he has to handle thousands of transactions a day, any govt office can be taken for example. And I am not saying it's wrong, I am also a part of it. Just that I also have seen the other extreme.

I did not know a word about CPR until i landed in this country a few years back. How could I have administered when I had not seen one. but I expected the staff that handled my family member to know at the least.
Getting back to your earlier post, i havent yet been in a situation where i've had to give CPR or seen it being given. Thats obviously not to say that it isnt being given. Yes i know the volume is overwhelming, but it isnt a reason not to be courteous or nice to a patient. Hospitals in the major cities of the US (LA, New York, Boston, Chicago, DC) probably have the same load of patients that Indian hospitals in major cities do. I havent been to any hospitals in those cities, but every time ive come home ive worked locally both in Private Practices and Hospitals and i will honestly say the working culture is almost completely opposite from India. Whether that is a bad or good thing, i dunno. But i can say that doctors in the US take time to be with the patient and respect them and dont talk down to them, even if the patient doesnt show the same attitude towards them. Not once have i seen anything else.

Coming to the quality aspect, i think both India and the West both offer quality. Maybe at this point in time the West and in particular the US has the edge over India, but India is rapidly catching up. Right now i dont think India is superior because of the lack of basic medical infrastructure in rural and some urban/semi-urban areas. Yes, in some remote and rural areas of the US, medical infrastructure is lacking, but you can always call in a Medvac and get that person to the nearest suitable facility (i just saw a case last week). I have never seen a Medvac helicopter in India or moreover trained, professional EMTs. But i will say that docs in the US are forced to run uneccesary tests many times because of the litiagatous nature of the society. Thats something that the government is trying to change right now, will it be successful?, thats up to the people and politicians to decide. I think in india, things need to be streamlined and made more effecient. I know there are litterally a billion people, but it can be done. If China can do it and start improving, so can India. Increased usage of computers and mobile devices, both rurally and urban, will definetly help. None of this is a knock on the clinical skills of Indian Physicians, which are excellent. Its more directed against the working culture and attitudes towards patients, students, etc.
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Old 5th August 2009, 13:10   #243
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Originally Posted by CaliAtenza View Post
Hospitals in the major cities of the US (LA, New York, Boston, Chicago, DC) probably have the same load of patients that Indian hospitals in major cities do. I havent been to any hospitals in those cities, but every time ive come home ive worked locally both in Private Practices and Hospitals and i will honestly say the working culture is almost completely opposite from India.
Sorry to butt in. But are you comparing private practice/hospitals in US to govt run hospitals in India?

I can only tell you about my personal experience with one private hospital here, i.e. Wockhardt. I have found their doctors to be not only very courteous and caring, but also knowledgeable and very proficient in their respective lines of medicine. However, at the same time, my neighbours did not have a good experience with them.
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Old 5th August 2009, 13:28   #244
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Originally Posted by CaliAtenza View Post
But i can say that doctors in the US take time to be with the patient and respect them and dont talk down to them, even if the patient doesnt show the same attitude towards them.
All i am aware of is the way 'House M.D' speaks his patients and colleagues

PS - jut kidding, I am sure most docs in US and India are respectful of their patient.
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Old 5th August 2009, 21:24   #245
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Sorry to butt in. But are you comparing private practice/hospitals in US to govt run hospitals in India?

I can only tell you about my personal experience with one private hospital here, i.e. Wockhardt. I have found their doctors to be not only very courteous and caring, but also knowledgeable and very proficient in their respective lines of medicine. However, at the same time, my neighbours did not have a good experience with them.
"Your Mileage May Vary", i think, is an apt term to describe the hospital culture in India. Im not doubting the quality of care at Private Hospitals in india, but im just relating to what ive seen at my teaching college (which is private) and its axuillary areas (its new hospital for "the rest of us"). Ive heard great things about Manipal, Wockhardt (i believe they have an exchange program with Harvard Med), et all. More money should be towards upgrading government run hospitals in india. I think if the basic work environment was improved, then attitudes would improve. I know Docs working there are a harried lot, but their lives could be made just a bit better. Everywhere the main problem is money, and how wisely it should be spent. I know our teaching hospitals handles probably a thousand patients on any given day, but it wouldnt hurt for docs to perk up and smile at least..and not have an atrocious attitude towards patients. Me and my friends get most affected being students (as if we werent already :( ). A good attitude can go a long way in finding out the truth of the problem and arriving at the correct diagnosis and subsequent treatment .
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Old 5th August 2009, 21:27   #246
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All i am aware of is the way 'House M.D' speaks his patients and colleagues

PS - jut kidding, I am sure most docs in US and India are respectful of their patient.
House is awsome! the crazy stuff on that show is mindboggling. Its nuts how he comes up with the diagnosis and Rx in the end
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Old 6th August 2009, 00:23   #247
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Originally Posted by CaliAtenza View Post
House is awsome! the crazy stuff on that show is mindboggling. Its nuts how he comes up with the diagnosis and Rx in the end
what i also like is how well the stuff is researched and believable - and i have been told this by some docs too
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Old 6th August 2009, 01:15   #248
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Thanks for the reply, Abhishek.
His cataract doesnt have any complications, as far as i know!!

Any advice on what are the lenses available for cataract treatment?
Look,officially I can not give you advice for it,though I know the answer,as I am not a Ophthalmologist but a General Surgeon with Urosurgery as superspeciallity.

But,unofficially I can say you,Manual phaco or Phaco with Posterior chamber Intra occular lens implant is the procedure of choice.But,I can not tell you the brandnames or the price for them-as I really dont know.Your Ophthalmologist will clear your doubts.

It is better to go for the surgery through personal appointment in a opththalmologist's chamber-you can have the easy going smooth relation with your doctor directly.
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Old 6th August 2009, 02:36   #249
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I am supporting Tejas@perioimpl and CaliAtenza .
It is totally off topic for that reason,the thread name is calling doctors/dentists/speciallists to provide free consultation
Is it not the fact that some members appeared here to spit on the face of the Specialists and Superspecialists from India?

And regarding the Quality,Just go through the Royal Society of
Surgeons,Physicians,Obg/Gynae,Otorhinolarngology Fellowship list and the list will tell you about the Indian doctors position.Many a times,from pre 1947 we have been the toppers (including me) in differnt fields of medical science.And yes,in US check the USMLE result list to see the name of Indians.
Have you ever seen the contributer's name in the post graduate level text books of Surgery like Sabiston Text Book of Surgery?Do you Know,Or have seen the Preface written by whom for the text book of Pathology by Dr.HarshMohan?Have you seen the Robbin's Text book of Pathology Current Editors' name?She is an Indian and the book is nearly a Bible,which is regarded as text book in your US and worldwide.Do you know the Indian doctors contribution in medical research field?
CPR is not a Magic to be performed before the audience.I know very well how to give CPR and when and to whom is to be given.How many of you know the indications,contraindications of the procedure?
It is very easy to comment from the gallery than to play in the field.
Indians excel far better in certain knots is well known by the world.How many of you know that, how many Surgical procedures are named after the Indian doctors?
It is very painful for me and all the doctors present here,I think,to hear that Indian doctors are bad performance wise or less responsable than their western counterpart from an Indian (If one think himself)-for that,I have passed nearly three decades of my life in the field of surgery including teaching,writings and research work,but never heard such critism from any English Doctors,American Doctors or German Doctors some of them,who are milestones of in the Field of Surgery.
I am Proud to be an Indian.
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Old 6th August 2009, 06:10   #250
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Originally Posted by abhishek_bmw View Post
I am supporting Tejas@perioimpl and CaliAtenza .
It is totally off topic for that reason,the thread name is calling doctors/dentists/speciallists to provide free consultation
Is it not the fact that some members appeared here to spit on the face of the Specialists and Superspecialists from India?

And regarding the Quality,Just go through the Royal Society of
Surgeons,Physicians,Obg/Gynae,Otorhinolarngology Fellowship list and the list will tell you about the Indian doctors position.Many a times,from pre 1947 we have been the toppers (including me) in differnt fields of medical science.And yes,in US check the USMLE result list to see the name of Indians.
Have you ever seen the contributer's name in the post graduate level text books of Surgery like Sabiston Text Book of Surgery?Do you Know,Or have seen the Preface written by whom for the text book of Pathology by Dr.HarshMohan?Have you seen the Robbin's Text book of Pathology Current Editors' name?She is an Indian and the book is nearly a Bible,which is regarded as text book in your US and worldwide.Do you know the Indian doctors contribution in medical research field?
CPR is not a Magic to be performed before the audience.I know very well how to give CPR and when and to whom is to be given.How many of you know the indications,contraindications of the procedure?
It is very easy to comment from the gallery than to play in the field.
Indians excel far better in certain knots is well known by the world.How many of you know that, how many Surgical procedures are named after the Indian doctors?
It is very painful for me and all the doctors present here,I think,to hear that Indian doctors are bad performance wise or less responsable than their western counterpart from an Indian (If one think himself)-for that,I have passed nearly three decades of my life in the field of surgery including teaching,writings and research work,but never heard such critism from any English Doctors,American Doctors or German Doctors some of them,who are milestones of in the Field of Surgery.
I am Proud to be an Indian.
Excellent post. I think like maybe 10-15% of the docs in the US are Indian or of Indian Heritage. My dad is a Doc, im gonna be one soon, my sister is applying to med school; So me and her will be contributing to that figure. Robbins is like the Patho Bible, but according to my dad, Harsh Mohan is not so great :(. Most of OBG/YN was like invented by Indians, just because of the conditions and neccesity present in that part of the world. Indians are famous in medicine, this much is true . I guess we have a natural knack for it.

My knock is against the working culture in indian hospitals and health centers, not against the doctors. Every Indian doctor ive seen upto this point has excellent clinical skills, but many of them just have sad attitudes towards their patients, which again, like i stated before, translates into their attitudes towards nurses, students, interns, etc. Indeed, some of the indian docs in the US still show vestiges of it. Can it be that difficult to address all of your patients with a simple, "hi, how are you", "what can i do for you today?", "im Doctor so and so", instead of bassically yelling at them and barking orders. Being pleasant with the patient goes a long way in getting them to trust you. Abhishek Sir, im sure you know this as well as any doctor here. As a Student i see this attitude and i think, why..why are they acting like this??? This unfortunetly makes me respect them less as a person :(. I know doctors are/can be stressed out, pissed off, upset, etc, etc just because of the sheer volume of the patients in India, but i dont see why they cant at least learn to put all that stuff aside and put on a good face for their patients and charges.
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Old 6th August 2009, 08:24   #251
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Is it not the fact that some members appeared here to spit on the face of the Specialists and Superspecialists from India?
If you are referring to my post, then it's taken out of context. I have clearly mentioned that doctors are not different from a bank cashier or a ticket clerk, and that it's a cultural shock (more like work culture shock) that caliatenza is experiencing. I discussed details only because they were relevant. I can also discuss in detail the gory practices of bank and rail officials, but that would be totally off topic. As far as specialists and super specialists are concerned, I have met some very fine people in that category. But out on the street that will make a microscopic percentage of medical proessionals. I will leave it to caliatenza to determine the %age from his exprience.

We discuss bad IT companies, bad car tuners, lawyers and what not, and still we have some very qualified professionals who love to discuss their field of expertise on this forum. I never anticipated that anyone will take my post personally just like I don't take a post aginst an IT worker personally. but since I have sensed it's not the case, I will refrain from posting any further on this topic.
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Old 6th August 2009, 09:07   #252
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@abhishek - is urosurgeon also a urologist. Would you or anyone else on this forum be able to advice on kidney stone.
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Old 6th August 2009, 11:54   #253
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I wish the discussion on the quality, ethos and culture of medical treatment in India could be taken to a different thread. It is interesting to follow, but just pours mud into the water of this thread, which is meant to be of a practical and helpful nature.
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Old 6th August 2009, 12:16   #254
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Guys, cool down. As Thad rightly suggested, let us not turn this thread into discussing medical treatment quality. It varies a lot across India, no point making a sweeping statement. Cities generally get the best of facilities thanks to the volume and money, while smaller towns suffer in that aspect.

My younger son a speech problem, he hardly says a word at 2.5 years. After getting thoroughly disappointed with local facilities, we have planned to seek further help in Bangalore. If we were still living in Bangalore, we could have got high quality help almost a year back. Now we will have to visit Bangalore regularly for this and it is going to be a logistics nightmare for my family.
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Old 6th August 2009, 12:42   #255
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If you are referring to my post, then it's taken out of context. I have clearly mentioned that doctors are not different from a bank cashier or a ticket clerk, and that it's a cultural shock (more like work culture shock) that caliatenza is experiencing. I discussed details only because they were relevant. I can also discuss in detail the gory practices of bank and rail officials, but that would be totally off topic. As far as specialists and super specialists are concerned, I have met some very fine people in that category. But out on the street that will make a microscopic percentage of medical proessionals. I will leave it to caliatenza to determine the %age from his exprience.

We discuss bad IT companies, bad car tuners, lawyers and what not, and still we have some very qualified professionals who love to discuss their field of expertise on this forum. I never anticipated that anyone will take my post personally just like I don't take a post aginst an IT worker personally. but since I have sensed it's not the case, I will refrain from posting any further on this topic.
Indeed its a "work culture" shock, as well as a culture shock. Its been a shock for like 4 years now, lol !. I would say about 70% or more of the doctors at my teaching hospital/college have a atrocious attitude, both in the classroom and in front of patients. For example, on our surgery posting one day, our proff was removing stitches from a lady who had half her jaw removed because of oral cancer. He drops a instrument (i think it was forceps), and what does he do next..sticks the damn thing back in her mouth! Uh, hello!! do you not care about sterility??! His answer was that, "her mouth is already dirty, it doesnt matter". This is the kind of stuff im talking about. Just because she made a mistake in her life and has oral cancer now, doesnt mean the patient should be treated like she is subhuman or a piece of meat that you can just poke and prod with an obviously unclean instrument/s. Yes, India has like probably the world's largest poor population/disadvantaged/etc, but that is NO excuse for treating them like an animal, or a subhuman species, or even talking down to them or thinking that they are dumb and dont know anything.

I know we were all students once, but me coming from a different culture entirely, even after 4 years, even at almost the end point, its still tough to adjust :(. I think most of this is the inherent culture of india, where students are taught by the rote method and grow up to be, well, not so well rounded people. The education system does not encourage free thinking or creative thinking to any great extent. Doctors also are not taught communication skills during training. I know after my first year a pilot project was started in the physio dept in order to improve the communication skills of medical students, but it never really went anywhere because 1. The proff who started it was offered a job out of the country and 2. No one in the dept had any sense to continue it. These kinds of projects only benefit students. This sort of thing is truly mindboggling.
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