Are We running out of patients.
I wanted to become a doctor as I thought this is one profession where we are making a change and taking away someone suffering. But over years the trust in the profession and the pride of being a doctor is diminishing.
Before I joined MBBS I wanted to be a cardiologist, after few years into med school I realized there was too many factors in medicine which can change the outcome which are not in your hand. I took up general surgery thinking as I surgeon I would have more control over the outcome than as a physician. During my MS training saw that Fear Tactic was very much part of counseling of patient to get them to agree for surgery ( Indicated or non-indicated ). Having seen multiple mortality and morbidity after surgery which could have been avoided as there was no absolute indication. I decided to take up cosmetic surgery as there is no conflict of interest, I whole heartedly agree the procedures I do are not necessary, Patient asks for a procedure and I have the skills to perform it. Never push patient for procedures, the decision to undergo a cosmetic procedure is completely patients.
A young girl had consulted a few months back for buccal fat removal as she felt her face was little chubby. She had undergone few other cosmetic procedures in past and had features of BDD ( Body dismorphic disorder ) I refused to do any procedure as it was not right for her and advised she lose some weight the face would change accordingly. We gave her a diet regimen to follow so that she can lose 5kgs over 2 months. Today after 8 months she again came for consultation saying she has lost lot of weight and wanted fat grafted in face as it was sagging. On enquiring further how she lost so much weight she said she got Bariatric surgery done. I was shocked she was 72kg before and now 50 kg and she is constantly losing weight every month. Which doctor in sane mind would do Bariatric procedure in a 25 year old who weighs 70 odd kilograms. It was performed at a big hospital in Bangalore and when she went back to surgeon saying she is unable to control weight loss and reaching below 50 Kg she has been advised high sugar diet and ice creams every few hours.
For a person with Hammer everything looks like a nail waiting to be hit. Today we produce so many excess doctors that there are not enough patients. Today a young laproscopic surgeon will fight tooth and nail and say all asymptomatic gallstones need to be operated. A endocrine surgeon will say all lesions in thyroid needs total thyroidectomy. A urologist will say all Ca Prostate will need surgery even if patient 90 years old. A bariatric surgeon will say all need a band around their stomach. An orthopedician will operate all disc prolapse and replace all knee and hips. A general surgeon will eradicate appendix in his area and a gynecologist eradicate uterus. Physicians will reduce the normal values of sugar and BP to make everyone diabetic and hypertensive. A pediatrician will every year get a new vaccine into the guidelines. A psychiatrist will go on inventing diseases from Pediatric Depression to pediatric Schizophrenia. And the worst part is they will come up with science to support their vested interest.
I believe health and healthcare cannot co exist. We as a profession have failed to regulate ourselves , over time general public trust in doctors is reducing. The day is not far when Doctors trust in Doctor will also erode. Its High time we stop this false propaganda of Doctor shortage and regulate our numbers and quality. If associations of each branch do not act now and regulate the profession day is not far when science from medicine will vanish and it will remain pure business.