Medical ethics: Fleecing the patients

This story is about what happened to me during the last few days:

- Nov 6. At a relative’s house I take a step without noticing the difference in floor levels and lose balance. I turn sharply on my left foot and avoid a fall.

- Next day. Slight pain and swelling on the left foot.

- Day 3, Saturday. Heavy swelling and pain. I go to a major hospital in Chennai. The top ortho doctor not available. A junior takes a look at the foot and says the ankle is fractured and/or twisted and it has to be in a cast for three weeks. Then he sends me for an X-ray.

- The (Rs.500) X-ray does not show any fracture, says the doctor. He adds that ligaments must be torn and that would show only on MRI. He does not insist on a scan but decides to go ahead with the cast.

- We buy the materials the doctor wants and the cast is done. Actually it is a ten minutes job for a good paramedic.

- The doctor prescribes some medicines and tells me to buy a pair of special boots from a particular shop.

- I am billed Rs.2500 for the Chief Doctor’s time. That man was not present!

- On Tuesday I meet a leading Ortho of Chennai at his new hospital. He looks at the X-ray and points out to what appeared to be a fracture. It was at a corner of the image. A new X-ray (Rs.150) confirms the fracture at the base of the small toe.

- The doctor tells me to keep the cast anyway because it was already on and happens to protect the affected part also. His charge is Rs.250.

What the glamour hospital did was criminal. The young doctor was incompetent and negligent. He was signing in the name of his boss. I was charged for the services of the Senior Doctor who was not even there. The amount was exorbitant.

I have to keep my feet up for a few days and no computer work. My mailbox is piling up. For publishing posts I have to take help from others. Really, I feel the need for a laptop now.

Lessons learned: 1. Always find out the charges before agreeing to a medical procedure. 2. With some hospitals and doctors making money seems to be the primary objective. Healing is incidental.

Also see:

The greatness of human nature – a true story

Medicine men of Olavipe

Savage Kerala continued

Last evening’s Malayalam news on TV chanels and today’s Malayalam papers prominently (front page four column) carried reports about the woman who was beaten up by a mob at Edapal on the 7^th of this month (see Savage Kerala).Her name is Malathi. She had disappeared from the hospital where she had been admitted after the assault.

On a tip off, the police picked her up yesterday along with a child near Kottakkal from the bus in which she was traveling to Calicut. Malathi was questioned and then taken to a hospital for a pregnancy test. A lady doctor had a scan and urine test done on her and pronounced that she was not pregnant. The doctor went on to explain that the bulging of the woman’s abdomen was because of a fatty tumor in her stomach. Now the world knows the medical condition of the woman who was savagely attacked. Malathi and the child were sent to a Rescue Home reportedly after informing the Women’s Commission.

I find all these shocking. There is no pending case or evidence against Malathi. She is the aggrieved person and a witness, not the accused. The police can pick up any person any where on pretexts that can range from terrorism to what not. But what was the need for the pregnancy tests? And under what provisions of law were the woman’s personal details made public? Obviously the police and the doctor did not follow the law and ethics.

Malathi, it is said, belongs to a poor nomadic group. However she claims that she was staying at a colony near the West Hill Railway Station in Calicut. All that is secondary. Her privacy is inviolable under law. Her personal details cannot be placed in the public domain by any one. Her rights, like that of any other citizen, have to be protected.

I hope that the Human Rights Commission or the High Court would also take cognizance of the matter.

Ends.
Also see:
Updates

‘Master’ Surgeon on the run, his parents arrested

Dhileepan Raj, 15, The 'Master' Surgeon who did a Caesarean section on his cousin at the hospital owned by his parents, is a smart one. The moment he saw police at his doorsteps on Monday (June 25) morning, he scooted. So far, there is no trace of him. The police have formed a special cell to track him down.

In the meantime, Dhileepan’s parents, Dr. Murugesan and Dr. Gandhimathi who were present when the boy performed the operation, have been arrested. The police have thrown the book at them. They have been charged under different sections of the Indian Penal Code, Medical Council Act, and Pre-Natal Diagnostic Act. They were produced before the judge who remanded them to Judicial custody. The Ethics Committee of the Indian Medical Association (IMA) is also conducting an inquiry into the incident.

The procedure, which took place four months back, was arranged by the parents reportedly with the intention of getting their son into the Guinness Book of World Records as the youngest surgeon in the world. The operation was recorded on video and shown at a recent meeting of the Local Chapter of the IMA. There were immediate protests from the doctors present and, when they came to know about it, by the public. The District Collector promptly ordered an enquiry. The preliminary report reveals that the boy has conducted twenty surgical procedures so far!

The Law, of course, will take its own course. But look at the other side of it. Here is a boy who apparently has excellent surgical skills. The Caesarean section he performed in this case was successful. If he had gone through the prescribed drill and entered an operation theatre as a properly qualified doctor, he could have probably become one of the world’s top surgeons.

What will happen to him now?

Ends.

Also see: Medicine men of Olavipe

The 'Master' Surgeon

Caesarean operations hardly make news. But suddenly one such procedure that was conducted four months ago is in the headlines.

The scene of the operation was Mathi Surgical and Maternity Hospital, Manaparai, Trichy, Tamil Nadu. The theatre was ready, nurses on their toes, the patient was on the table, Dr. Murugesan and his wife Dr. Gandhimathi, owners of the hospital were waiting, and a bit oddly, a video camera was there to record the proceedings.

And in walks the son of the owners, Master Dhileepan, all of 15 and a high school student. He bends over the patient who is his own cousin, goes through with the operation and takes out the baby! All recorded by the video camera. At least this is what the media is saying.

The world would never have known about this unusual operation but for the proud father, Dr. Murugasan. He wanted everyone to know how clever his son was. In fact, the whole exercise was, reportedly, to get the boy into the Guinness Book of World Records. Dr. Murugesan showed the video of the surgery at a recent meeting of the local chapter of the Indian Medical Association (IMA).

There were immediate protests and the story was suddenly all over the media. Dr. Murugesan was quick to explain that he did the operation and his son only watched.

Even if that were true, questions remain. Was it proper to allow a minor boy to be present in the theatre to watch a Caesarean procedure? As The New Indian Express commented editorially, “… the only place for a fifteen-year-old in an operation theatre is on the operating table as patient”. Another question is, if it was an ordinary Caesarean section performed by Dr. Murugesan, what was so great about it to be taped and shown to other doctors?

The District Administration has ordered an enquiry into the incident. The report should be out soon. In the meantime, Malayala Manorama has come out with a photograph of the 20 year old woman who underwent the operation carrying the baby. Both look fine.

This incident reminds me of a story that I read somewhere long ago. An American was filling in a form for a government job. He got stuck at the question ‘Are you a natural born U.S citizen?’ After some hesitation he answered, ‘No, by Caesarean section’.

Ends.

Also see: Medicine men of Olavipe