In community health centers ,doctors are the pivot around which the whole health care revolves . Most of the decisions need to  be run by them . But this is not restricted all the time to health care .

The number of other issues where the doctors have to share the responsibility is incredulous .

Pharmacies which are overworked most of the times after Affordable care act , if unable to fill in medications on time “Your doctor does not want to do it “. Only God knows why suddenly doctor would  not want to do it .

Insurance does not want to pay for labs after a certain point .”Your doctor orders too many tests .”

Support staff did not address the issues in time , Blame the doctor .

Housing societies would not let you keep the pet , Ask the doctor .

DMV will not issue disability parking tickets . Take away the license of the doctor with any discrepancy .

The list is endless . Unfortunately patients are too gullible to discern through these excuses .It is  a direct recipe for souring patient physician relationship .

But don’t we all need to blame some one ?Does it ring a bell ?

 

Currently there is an interesting debate going on India about who should be the brand ambassador of Rio Olympics , 2016 .Movie stars are being chosen as they have an insurmountable appeal in Indian society .

It is being argued that brand ambassadors  either contribute , participate or promote the product that they are being chosen for  and  which does not seem justified in the present selection .

Bollywood currently is the largest movie industry in the world .They create magic and sell dreams on screen . Indian masses  identify and eulogize  them . But off screen they are as human  as other  distinguished people from other walks of life .

We need introspection and promotion of other achievements in our society .Our young people should chase real dreams not mirages so that the chasm between non credible India and incredible India is little less .

The pact to tackle climate change woes were signed  as Paris agreement  by the international community but the climate change has already knocked on our doors . It made its presence felt in a big way world over .India is facing one of the hottest summers in 2016. One of its western states , Maharashtra is tackling one of the worst droughts . Water is being transported by trains from other states to one of its worst hit place , Latur .Major reservoirs are showing a 22% decline in their water capacity in India .

All in all situation is grim and dismal . But this is neither new nor one time . Our farmers have bore the brunt of it for a long long time and now rest of the country is facing the heat .

Then why do we always have to wait for the moment of epiphany . Why is it always fire fighting ?

Water conservation is the need of hour . PM , Shri Modiji addressed this issue on his talk show . Ban on indiscriminate use of water  , such as car washing , judicious use in horticulture , fines on leaking taps and most importantly  mandatory rain water harvesting in city and suburb limits

Otherwise action delayed would be results denied

 

 

 

 

We watched a very interesting travel series on CNN in the last few weeks , where they take you to places which might not remain the same in future . One of the place visited was Bhutan . Bhutan is a small mountain country , a close neighbor of India .They have a unique way of improving well being of their people . Gross national happiness index , which has improved to 0.756 from the last years , where people are assessed from being deeply happy to unhappy .There is not much direct relation to the wealth but to  how much  are  people satisfied in the community ;about the culture , knowledge , wisdom

They have a happiness minister in charge of the happiness of the country .

But in the other parts of world , people are dealing with Panama press leaks . No , it is not just a third world phenomenon as  people involved in it are key leaders from the other world . Leaders who have a wee bit of moral baggage left in them are responding in a right  manner by resigning . Others do not care .

Closer home , where the western  part of the  country is reeling under drought and authorities have to be sensitized to  the basic needs of people .They would rather play cricket .

Strange are the pursuits of happiness

 

Very recently in our community , two very busy health care  providers lost their medical license over unregulated  prescriptions of narcotics . It was a very unfortunate incident

The community where it happened largely consists of under served  population . Patients have chronic pain disorders  and almost every body has behavioral health issues, not to mention being the biggest victim of  economic recession .

But it seems it is a vicious cycle that has been going on for ever . As physicians , we are not blame free . When narcotic naive patients are initiated into this cycle ,somewhere in the ER or in the primary care physician’s office,  patients are not educated enough about safer alternative  options or the addictive potential of these controlled substances .Once their bodies get used to the effects of these medications , it becomes a must have for these patients

In community health centers , where we have a large chunk of these patients , regulations are not easy to practice .Most of the physicians are on their visas ,waiting for their green cards and job insecurity always looms on the horizon . Most of these CHC[ community health center ] ,are dependent on grants , which are drying up fast . There  is a constant pressure to perform well as compared to the moneyed players in the fields as most of these big players are accepting all kinds of insurances currently

Administrative coercion , patients’ pressure , economic hardships of CHCs  all play a vital role in this doctor patient narcotic cycle .

In the end either the doctor gets to loose his license or patient, his quality of life .Stricter regulations need to be spelled  out to save the  small pool of qualified health care providers and also patient’s safety.

These days Donald Trump’s impulsive statements  are  running shock waves through the media . It leaves everybody gaping and gawking . He is currently dominating every means of communication .

He likes to call ‘spade  a spade’. Last pole showed that women voters hold him in a very unfavorable light .  Trump behavior does not work in a politically correct adult world .Every thing needs a garb of decency

In real world , women do have to pay a lot for not looking attractive ., as per norms of that particular society .More attractive women get better jobs , faster promotions , better deals in marriage .In my part of the world , lighter skinned women are always preferred over their dark skinned counterpart ; And being’ Fair and lovely ‘ is a million dollar business in my country .

So , sisters , we still have a long  way to go .For now , we have to bear the brunt , overtly or covertly in the mans’s world

Another gruesome bombing in Lahore ,with more loss of blood and lives .It seems that it is the only way of communication of these aliens of the civil world. The blood has not even dried from the Brussels bombing as yet .Due to inadequate surveillance , the bombers could get away from Paris .It is said that because of easy access to Syria and porous borders of Europe it gets easier for the home grown terrorists to commit these  heinous crimes.

Flimsy excuse of non integration does not hold water .The same country that gives them refuge ,a respectable life, opportunities,  becomes the victim of its own benevolence .One gets to practice one’s  faith , live your own lifestyle ,raise your kids in a peaceful environment , be with your friends…, then why is to so difficult to profess allegiance  to your adopted country .

Isn’t  it  surprising  that after almost seventy years of independence from the Britishers ,the country that has given them every thing to the best of its ability ,people  shamelessly explain their anti nationalistic behavior

The other day one of the Republican candidates was complaining that Trump phenomenon was making of the press as  his campaign received extra coverage . It was counter argued by the channel . I agree. Everybody possible in the media has tried every thing except to mix it in apple sauce and spoon feed .

But honestly any kind of press coverage can make non issues into issues . In India a group of university students were issuing anti nationalistic statements .It was their wrong doing .They should have been reprimanded and may be lawfully dealt.

A big political issue was made out of it . Anger , drama . allegation , counter allegation  followed .I sometimes wonder that  this is a tactic to camouflage real issues behind non issues .

Business tycoon running away without giving public dues . Politicians amassing wealth in foreign banks , people getting killed on roadside , the list is endless….

 

Very recently  during my brief vacation in India , we witnessed a protest .Protests are common phenomenon and it turning violent is also not very uncommon in this part . This protest was by a community which is not really poor but on the contrary . Not really cerebral and likes to keep within themselves . They were doing it for job reservation . Job reservation , which is supposed to be for economic poorer section of community .

But the intensity of the protest was surprising . Public inconvenience of all forms so that NCR [National capital region ]  catches attention . Loot , Arson , ransacking of school .water works destroyed , you name it and they did it

With prosperity , tolerance levels , threshold to violence ,lawlessness  has reached new low . Deep distrust in the system is pervasive . every body wants quick fixes and ready to be incited . No wonder we get to see weird political  phenomenons in quieter part of the world !!!!

Environment all over the world is very confounding. Even with the best personnel intentions there are layers of layers of  walls and glass ceilings. Recipes of failures prevail. Corrupt governments, opaque policies, religious fanaticism, individual inertia, societal mores …

Credibility vs  Practicality ,Cunning  vs Honesty ,Right vs wrong packaging ,Experience vs Integrity ,Excellence vs Mediocrity, Pro-life vs Pro-choice , Revolution vs Status quo

Millennials are at a great loss. What kind of path needs to be charted ? Days are coming to an end when you can select your role models. Look within , List your own strengths and weaknesses and chart out your goals. I  am sure there is some place this mother earth has for every one to build their own nests.