🤔 The Dilemma of Evidence 💡

Therapy A for Medical Condition X was generally recommended by the evidence-based guidelines issued by several professional societies. It was the standard treatment for X for many years. 💊

Five years ago, the guidelines were changed (as often happens) to remove Therapy A from treatment recommendations of Condition X. ✂️

And then, recently, the guidelines were changed again to include once again, Therapy X in the recommendations. (This also happens commonly.) 📝

Now here’s the dilemma.. ⚖️

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🤔 What to do when someone asks you for a curbside consult? 😪

As doctors we often get cornered by people we know, in various social settings, asking for our “quick advice” on this rash, or that pain, or in recent times, the abnormal lab report that has been bothering them. 🥴

Without digging deeper, it’s not possible to determine whether they have already discussed this issue with another doctor (and only seeking a “harmless” quick second opinion from someone they trust). Or this is the first time they’ve ever disclosed this to any doctor! 👩🏻‍⚕️

We don’t want to answer these queries with limited information, as that would be a big disservice to the patient. Most conditions need a painstaking gathering of history, a scrupulous examination, and often some quick referencing of guidelines or other resources. Quick answers are usually wrong in medicine! 🙊

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📝 Salient points from the Telemedicine guidelines for Family Physicians 🖱️

📜 General

  • A Registered Medical Practitioner is entitled to provide telemedicine consultation to patients from any part of India
  • The RMPs should exercise their professional judgment to decide whether a telemedicine consultation is appropriate in a given situation or an in-person consultation is needed in the interest of the patient.
  • The RMP shall uphold the same standard of care as in an in-person consultation but within the intrinsic limits of telemedicine.
Continue reading 📝 Salient points from the Telemedicine guidelines for Family Physicians 🖱️

How to Survive Internship – A Few Pointers for Our Newest Doctors!

Medical education in our country is very mindless and impractical, and this irrelevance reaches a peak during the one year of compulsory internship. In good medical colleges, internship is a grueling affair – collecting samples, chasing lab reports, completing paperwork, and worrying about not getting enough time to study for the looming PG Entrance exams!

Unfortunately, medical colleges are still very hierarchical, and the most boring and the most clerical work is given to the junior-most person on the team, who often happens to be the intern. In the US residency programs, it’s the same, except that there are 3rd and 4th year medical students who show up at 5am every day (or should I say every night?) to prepare the “rounding sheets” for the unit, and the interns have the “luxury” to show up at 6am to supervise their work!

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MBBS Done, Didn’t Get PG. What Next?

Here’s Some Unsolicited Advice from a Docpreneur..

1. For a fresh MBBS graduate, the best option is to become a Family Physician and start your own clinic. The pendulum is swinging from specialists and corporate hospitals to primary care and small clinics. A lot of doctors started their practices right after MBBS, and are doing phenomenally great!

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The Leopard and the Bike: A Story of Two Scars

In the middle of a busy outpatient clinic a couple of months back, I saw two young men, one after the other, for the same complaint. Both had suffered limb injuries a few months prior, and had developed scar hypertrophy with itching. But that’s where the similarity ended.

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Sleep Hygiene: How to Get Good Sleep without Pills

Insomnia or lack of sleep is a very common problem. Most people experience it at some point or the other in their lifetime. Chronic insomnia or lack of sleep over a long period of time can lead to mental and physical health problems such as depression, anxiety, high blood pressure etc.

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The Guru of Jugaad – What the West can learn from Indian Healthcare

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Several of my expat patients are extremely impressed with the private healthcare system of India. They have never experienced anything like it back home! They rave about the efficiency, the cost, and the availability of quality care. Where else would you find a doctor consulting you in the comfort of your home for about the same fee you gotta shell out for a clinic visit back home? They want to know how we’re able to create such a super-efficient system that rivals the developed world in quality!

Here are some of my thoughts, based on my experiences working in India and the US, and my interactions with patients and doctors from around the world.. Continue reading The Guru of Jugaad – What the West can learn from Indian Healthcare