India happens to be the  world capital of skilled human resource .A lot of India’s improved economic situation is attributed to the diaspora and Governmental policy has  a major role to play  in it . Education is free  or subsidized and since childhood its ingrained in us that for an economically safe life , invest yourself in just education . The whole aim of the nation is to churn out clonal professionals .

But when being the 2 nd most populous country , it performs so dismally at the sports arena , we pause to introspect . 

Though,  there was a silver lining , as our women did us proud  and our nation celebrated them .More so , as we all know that a big part of the society still thinks female child as  a burden .Female Infanticide , grudged education , dowry problems , the social maladies are countless against women .

At this point ,we need government investment economically and policy wise in Sports .Also a  corruption  and  bureaucracy free selection process as countries like US  which has the highest medal tally ,does not  a   sports minister . As per Chinese media analysis , the rural India is   a  big human resource .

Scholarships, jobs , financial rewards would definitely tap an untapped part of society which we are currently loosing to anonymity 

 

 

As  I have mentioned multiple times in my blog ,primary care physician’s job is nothing to envy about .They  work in a pressure cooker environment sandwiched between litigious environment , administrative strangle and overwhelming workload with the lowest compensation

No wonder the burnout rate is maximum

In my residency days we were trained for almost all situations , but it was never made clear to us that a great part of practice would be dodging the lawyers by filling up the forms in a right manner

Every patient needs a form  to be filled up .Surprisingly every department has a form which needs  a countersignature from a doctor

School form , School medication form , school physical form , sports physical form , Grandma has  a problem …needs a change of school form

I  ride a horse ….need a disability parking ticket form , Jog all day , but need a ground floor accommodation form ,Go on vacations but need an electricity discount form , can’t work , don’t want to work ….

This is the icing on the cake

Don’t let my mother in law keep the parrots form

Is there  a give me break form ?????

There was a very disturbing revelation in the media that State of Washington tops the list of teen suicides and it has been the statistics for the last three decades . Among the top causes sited were , substance abuse , poverty and of course mental health issues

Behavioral health facilities have always been  found lacking in tackling mental health issues . There has been a drastic cut in  Federal funding since 1981 . In the face of ever increasing demand , specialized help is never ever received in time and specialists are far and few in between as the compensations are not very great as compared to other specialities .

EMR and meaningful use has been enforced  so that there  is a better justification of federal funding and medicare and medicaid payments . Physicians are  incentivized  and now there is a direct association of physician’s efforts to indicators of patient’s physical health .

But such  aggressive measures are not seen in Mental health . A bill has been introduced in the House of Representative in summer of 2015 for linking meaningful use to Medicare and Medicaid payments but its implementation has not been seen in a wide spread manner

Behavioral health needs more funding as physical health is incomplete without mental health.  A  mentally disturbed society has very tragic social ramifications .

Doping in sports is coming up as a huge stealth tool for winning medals in competitive sports .There was a disturbing news in the media that  a Country runs State orchestrated million dollars program to elevate sports people to winning pedestal .

We live in a period of ‘Overdrive’. We are Go getters  and we get them at any cost .For us no institution is pristine . We fake and fraud with elan .

Our highest offices are bid by  bigots , demagogues and liars . We acknowledge these and then react in a brain dead manner .

We segregate and discriminate .

We spread violence in the name of religion and peace

We have read about medieval  dark ages in history books as scientific knowledge was the deciding factor which was pushing certain nations back in dark alleys

Are we really far from there with all our wealth and  knowledge ???

My  Alma Mater , Lady Hardinge  Medical College ,  witnessed yet another incident of patient rage against physicians . There was a mob attack and the doctor was bitten by  the patient . In response to that , doctors retaliated by a flash strike .

These kind of hooliganism has been on an increase with any unfortunate outcome during the treatment process .

These incidents are always condemned and should never  be condoned

But if we look in depth  there are some facts that we need to take into consideration

There is a lopsided  physician centric milieu in India .How seriously they take their Hippocrates oath is entirely up to their own conscience . Physicians once  out of their medical school are not much under any scrutiny or under any regulatory body .

Medical litigation  are far and few and do not amount to a high pay off as compared to the loss incurred . Patient grievance forums are also not doing much justice to the patients

Again I  reiterate , these forms of violence is reprehensible .

But we need  a platform and an honest conversation about these issues

Primary care physicians are the back bone of US health care system .Currently health care is facing an acute shortage of primary health care physicians [PCP].Predictable shortage by 2020 is about 20,000 physicians Aging population , population growth and Affordable care act , they all contribute to it.Nurse practitioners and Physician assistants alleviate this issue to some extent but the overall picture is grim 

Physician burn out rate is high and ever increasing . In 2014 , Family physician burn out rate was around 63 %. 

Primary care physicians are the default dumpsters of health care .They should be capable of treating all medical issues with the most little help from specialists [Managed Care ]. They should practice corporate medicine with EMR documentation [15 min , each patient ]. They should have an expert opinion about whether patient can drive , keep a pet , lift 20 pounds , climb up to the first floor [anything that can have any remotest legal implication ]. They should be rhino skinned and be ever forgiving to the frustrated patients.

Not to mention the hostile legal environment 

Sad part … There is no legal  platform that addresses physicians issues 

Physicians are life savers but not Gods 

And  human beings do need help 

 

Its  a moment of introspection for all of us .  We witness , societal maladies are overflowing like a river above its danger mark .When the call for justice is not met judiciously , repercussions are not always pleasant .

These  happen in the  world over,  time to time . This time its closer home

We are very lucky that we have freedom of speech and these problems are being openly acknowledged and not  being brushed under the carpet .That  is  a step closer to finding a solution .

The mantra for peace and prosperity is  integration and not segregation

The mantra is love  and brotherhood and not hate and violence .

Science and technology has always bonded mankind .Digital era has  united the humanity .Globalization and free trade has  helped  prospering us .

We need behavioral modifications and de conditioning  .Integration should begin at the most basic level .There should be mandatory  reservations for minorities at the grass root levels like schools ,colleges , training institutes , clubs , jobs,local bodies  and so on and so forth . Those voices should be heard and be made a part of the decision making process

If color of skin is still a criterion in 21 st century then its  most reprehensible and retrogressive .

 

I finished a decade being a H-1 B candidate as I still wait for that magical day when my priority date becomes current . Priority date is the date when US immigration services approves of your presence in the queue for application of green card .Green card is a step closer to  citizen ship .

India is the only country which has  years of back log in the process . At the moment , priority date is current for conversion  to green card for applicants of 2005 .It is even worse for people who do not have a masters or doctorate .

Visa candidates always need sponsorship from their employees which puts them in an unfavorable position in job market . They cannot start a business or own a home as they do not know where the next visa is coming from and so on and so forth….

Most of us are legal immigrants .They are one of the most successful minorities in the US .They contribute in one of the most meaningful way in the US society , both economically and socially .

Then why this antique rule of quota system for each country ?

From what I have gathered it is not even a partisan issue . !

We  need accomplished   and   sane  Americans if  we want America to continue its position  as the World leader . Stumbling blocks do not help in any way.

 

With  the Brexit ,  rest of the World and a part of GB[Great Britain] is sad . Another world wide recession is being anticipated .As per experts , recession can  happen cyclically every eighth year . Such unprecedented events like Brexit can accelerate recession

We are still ambiguous about successful  recovery of US  of its recession .Healthcare is considered one of its topmost culprit .Primary care has a vital role to play in cutting down the costs .

There is  an undeniable funding crunch . Most accessory services are being discontinued like counselling , education , care coordination which is costing us in more than covert ways .

Each community health center has an administrative wing attached to it . Most of the times they have a plush office whereas a physician does not have a decent office to call their own .Their main job is to scrutinize physicians .In some states , they have started pilot cases , where a group of Community health centers  are   under one administrative head .

I consider it a very good idea , where physicians would get a respite from high handed administrators and funding would be rightly channelized where it is needed most.

Electronic Medical Records[EMR ]  is both  a curse and  a boon . It was introduced to be an important arm in Accountable care to provide evidence based quality care . It was supposed to help  to tide over insurmountable cost of health care . EMR   helps with a better connectivity between various physicians , specialists and other medical support systems so that   every body is on the same page and there is no wastage of resources .

But we still do not see the light at the end of tunnel as there is a big piece missing in the puzzle , Tort reforms

This makes physician practice defensive medicine  and put endless burden on health system.

Some thing similar crossed my mind as we all helplessly saw innocent human slaughter , last week , in Orlando by a disturbed man . We again get confounded by the logic of such acts . During the media reporting ,it resurfaced again and again , there were many clues and many chances that concerned authorities could have picked up and could have avoided this massacre

The time is running out . Grass root intelligence need to buck up their act .Social media should take  voluntary responsibility for sharing and processing information As fellow human beings , we all owe it to ourselves to do every thing possible to put a stop to these heart wrenching events .

But as I said , there is missing piece in this puzzle too – I don’t have to spell it out