In New Delhi , the national Capital region , we get a lot of students from other developing countries who are interested in pursuing higher studies .India is a cheaper destination and this endeavor gives them a head start to pursue other things in life .As to my knowledge, ingenious population is very  diverse and very friendly

But lately a disturbing fact was noted that students of African nationality were being the object of racism by a certain section of populace .

It was the most  bizarre  news to  swallow

Till date , Indians themselves have been the victim of racism wherever they have been as economic immigrants .Then how can this  type of behavior be encouraged ?

We had a very appropriate reaction from all the vocal part of the society . Politicians , media  elites have all condemned this openly .Strict disciplinarian actions were announced against those who were perpetrating such acts .

Education , awareness and strict regulations need to be called for such shameless acts .These stray incidents should never get  to become norm in one of the most tolerant countries of the world

 

In India , when a child  is accomplished and is expected to have a bright future , it is prophesied , Oh ! You will go to America and have a good life .

If any one is not getting their dues in adult life in their respective field , there is hope that he can make a life  in America .

There is a destination and possibly a pot of gold at the end of rainbow .

There is a country which is held at a financial pedestal .ethical pedestal and regulatory pedestal  and one is willing to invest all ones intellectual property in it .

But the current political scenario  seems  to be contrary  .Most unconventional nominees are surging ahead and the world gawks .

Would the only hope wither away

Well , the time will tell .

The  doctor patient relationship is considered fiduciary . Doctor should have only patient’s welfare in mind and the patient is supposed to have  faith in doctor’s judgement .

The real picture is very different

There is a deep distrust in the air ,as every where .

As there is no tort reform , doctors have to practice defensive medicine . Patients are sometimes viewed as potential litigators .Doctors have to deal with EMR ,extensive documentation , administrative hassles ,shortage of manpower .

On the other hand , patient are caught unaware about newer regulation about controlled substances .As doctors are the face of these multiple agencies like insurance companies , Corporate hospitals , physicians are viewed as an allies to them . Unfortunately , that is far from truth .

Some times the anger and frustration is so extreme that they would not even stop using cuss words for the doctors

Back home in India , they go a step further .

If there is an unfortunate outcome , they would take law in their own hands . Violence against doctors , arsons at the hospitals  are not infrequent

We need to redefine and retrospect on this fiduciary relationship .

A  Physician is  not God  or Santa

Wish lists cannot be always  granted

 

During my last years of residency , not too long ago , when I was job searching , I was made to feel guilty again and again for asking for a decent pay packet as I was inexperienced . I was not supposed to expect much as I  was  wet behind the ears .On top of that , I was a visa candidate .

Over the years , visa status has not changed . India is the only country languishing in the queue for priority date to become current . But the demand for experienced primary care has gone down .

Fresh MD’s are being welcome with open arms They are ready to book you in your final year of residency with a stipend . All the more better if you are a Nurse practitioner .

After a few years in your job , your job demand does not resemble your old contract any more

In the end , Its Money , Money , Money ;Its the bottom line , Honey ;All that matters to a Compaaa…ny

 

 

Drug menace is omnipresent in the world . In America , drug overdose deaths resurface time and again . CNN dedicated its prime news hour to this issue which was  moderated by distinguished panel . Thanks , CNN

As physicians , specially as primary care providers , we have a major role to play as most of the time it is in  their office where this problem is initiated . Community health centers get to see this cross section of population who use , misuse and may be sell on the streets .

But not too long ago , physicians were answerable to dropping  patient satisfaction , decreasing patient numbers and all in all non impressive  bottom line . Physicians are sandwiched between patient’s  wrath and unaware administration .Even if one of the physicians join administration , they do not take time to change colors .

More public awareness , stricter guidelines , more grants for behavioral health issues are required for this ongoing public menace

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.