Second opinions: Is there a tactful way to handle them?

I gently refuse to give opinion if someone asks my ‘quick feedback’ based on just a single report or a single symptom. And give them the option of a detailed assessment.

If they’re family or a close friend, I try getting the whole picture over phone call, and for this they have to wait till I’m free.

For anyone else, they have to call the appointment number and follow the process. If they feel my advice would be valuable enough to justify the fee and the wait, they follow the process. If they don’t, they stop asking me random questions, and keep looking for some other willing soul.

After the consultation, it’s easy if my Assessment agrees with that of the other doctor. But if there’s conflict, there’s no easy way out of it..

Continue reading Second opinions: Is there a tactful way to handle them?

🧫 Mucormycosis: A symptom of everything that’s ailing our Healthcare System 🏨

💊 Rampant use of high doses of steroids is leading to uncontrolled blood sugar levels in many patients, suppressing their immune system, and encouraging this fungus called mucor to grow unchecked!

🤔 But is steroid overuse really the root cause?

🙈 Why should there be rampant use of high doses of steroids, with no monitoring of blood sugar levels?

🥵 Some of it may be attributable to the panicked patients and overworked doctors. However, there are deeper underlying causes why patients and doctors have been so deeply affected by this malady.

I see three causes:

Continue reading 🧫 Mucormycosis: A symptom of everything that’s ailing our Healthcare System 🏨

कोविड का अद्भुत इलाज

🦠🦠🦠 क्या आपको कोविड (COVID) हो गया है? 😟 चिंता हो रही है? 🙄

🤓🤓🤓 तो फिर ये पढ़ें! 👀👀👀

👍🏽👍🏽👍🏽 और जानें कि कोविड के लिए पूरी दुनिया में उपलब्ध सबसे कारगर इलाज क्या है 🌎🌍🌏 !

👀😳😳👀 कोविड के इस अद्भुत उपाय को जानेंगे तो आपकी आँखें खुली की खुली रह जाएंगी! 🙌🏼🙌🏼🙌🏼

👏🏽👏🏽👏🏽 यह इलाज 95% से ज्यादा कोविड रोगियों के लिए बखूबी काम करता है! 🙌🏼👌🏾✌🏼

💥💥💥 कोई दवा कंपनी आपको यह नहीं बताएगी! 💥💥

💥💥 कोई भी मीडिया आपको यह आसान इलाज नहीं बताएगी !!! 💥💥

🌼🌼 लगभग सभी डॉक्टर खुद यही इलाज करते हैं (आप चाहें तो पूछ कर देख लें) 🌹🌹🌹🕺🏽🕺🏽

😇😇😇 (डॉक्टरों तो पहले भी बताया था, लेकिन कोई सुनना नहीं चाहता था!!!) 👇🏾👇🏾👇🏾

🩺🩺🩺 तो यह उपाय है ..

Continue reading कोविड का अद्भुत इलाज

Who will calm down the patients when the doctors themselves are panicking?

Dear doctors, I can try to empathise with your concern..

Let’s consider a healthy 35 year old..

10-30 out of 1000 in this age group will land up in ICU, about 1 will die.. (ballpark figures based on current situation)..

This is unprecedented for an illness that starts as an innocuous viral URTI..

There’s no way, in the initial 5 days, for me as a doctor to know whether the patient sitting in front of me will be one of those 10-30 ICU admissions..

Does that justify over treating everyone I see?

Continue reading Who will calm down the patients when the doctors themselves are panicking?

Old Strategies for a New Enemy

My big learning in this pandemic is that we need to use what we already know from years of managing respiratory diseases, rather than treat it like something very new.

We know that most viral infections get better with just supportive treatment.

We know that many doctors over investigate and over treat viral respiratory infections, including blood tests, X-rays, antibiotics, oral bronchodilators, alpha-agonists, and what not..

We know that many patients self-medicate, self-investigate, follow random advice from relatives and friends, and have many cultural taboos.

All of the above has just gotten much much more pronounced due to fear on all fronts..

At the same time, I know lots of doctors who are keeping the flame of rational empathetic medicine alive..

In my practice, only two things are new:

Continue reading Old Strategies for a New Enemy

Best Treatment for COVID

🦠🦠🦠 Got COVID? 😟 Worried about it? 🙄

🤓🤓🤓 Read on! 👀👀👀

👍🏽👍🏽👍🏽 We’re going to share with you the best treatment available in the whole world for COVID! 🌎🌍🌏

👀😳😳👀 You won’t believe your eyes when you get to know this amazing remedy for COVID! 🙌🏼🙌🏼🙌🏼

👏🏽👏🏽👏🏽 It works for more than 95% COVID patients! 🙌🏼👌🏾✌🏼

💥💥💥 No PHARMA company will tell you this! 💥💥💥

💥💥 No media will tell you this simple step!!! 💥💥

🌼🌼 But most of the DOCTORS follow these secrets themselves (verified) 🌹🌹🌹🕺🏽🕺🏽..

😇😇😇 (They told earlier also, but no one wants to hear!!!) 👇👇👇👇👇👇

🩺🩺🩺 And the remedy is..


Continue reading Best Treatment for COVID

COVID Diaries

I often ask my patients to record their measurements at home in a diary, and bring them to the next appointment. I find that this improves the self-efficacy of the patients and their family members in taking care of their illnesses, and helps us doctors take better care of them! At the same time it’s an ideal, and reality loves to wash away our best laid plans..

Some patients do check their parameters, some don’t. Some of those patients who do go to the trouble of measuring them regularly, may not record them! And those who diligently record them may forget to bring those readings when they come for a follow-up consultation! And some of those who keep meticulous records, stop after a few months.

I often tell my patients, “Your proper treatment will only start when you start maintaining a record, till then we’re just playing with your illness!” And truly, the home record is vital in adequately managing Hypertension and Diabetes Mellitus, and I’ve found it useful in other illnesses too, like Typhoid fever, and Food allergies.

I keep wondering how to inspire patients and family members to keep better records. I think I got some answers last year..

Continue reading COVID Diaries

🩺 Family Practice in the Next Decade: Leading from the Front! 💪🏽

Last month I got the opportunity to address a virtual gathering of Family Physicians, and share my predictions for the coming decade! 🤔

I believe that Family Physicians will be trusted and valued much more, as we continue to provide humane, personalised care, using appropriate technology and the Art of Medicine! 🤗👀

*Watch the session here:* (25 min, English)

Continue reading 🩺 Family Practice in the Next Decade: Leading from the Front! 💪🏽

🤔 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.. ⚖️

Continue reading 🤔 The Dilemma of Evidence 💡