Wednesday, April 3, 2013

Hippocrates Thinking of Changing "The Oath"

"If we had to live with 99.9 (success rate in industry), we would have 2 unsafe plane landings per day at O’Hare, 16000 pieces of lost mail every hour and 32,000 bank checks deducted from wrong bank account every hour" (W. E. Deming)

Hi Everyone,

When I was in school there was one class which I did not like very much - Hindi poetry class or commonly known as Hindi II. But one thing from a poem I read in that class stuck with me for some reason - To get a human life a soul has to go through 850000 different birth forms and only then one gets to take birth as a human being. Given the number I feel that we as human beings have an obligation to make our life count towards something and when I say something I mean what we achieve personally and what we do for others also in the same life span.

The reason I bring this up is because of the increasing number of deaths due to medical negligence and malpractice. Doctors in India and other nations too are considered second to God. When a person goes to a hospital or doctor he leaves everything in the hands of the doctor even if the chances of survival of the patient are very low and prays that the doctor will do some miracle and save their kin. But when a person/ patient dies because of some negligence of the doctor it becomes a crime and should be treated as such. So being a human being and more importantly a doctor  the responsibility towards the care of  people under them increases many fold and should be discharged as such.

Just few days ago I came across a news where a rash bike driver hit a person alighting from the bus. Both got injured and no one was coming forth for help. Then a 17 year old kid forced a cabbie to take them to a very good hospital. The doctors refused to admit the biker because they said that he was very serious and could not be saved. Now what shocked me here was that not even an effort was made. Both the persons died shortly. Some time back in a hospital in J&K two newborns died because the hospital staff did not switch on the generator when the electricity went off and the infants were on ventilator. I have read cases of doctors discriminating between patients based on their caste, religion etc., I have read news on doctors delaying treatment in the middle of the procedure because the patient did not have enough money.... I can go on about the cases and the list will not end. I will give some shocking facts** on the deaths caused due to medical negligence in drug administration: 

1.Of all visits to the medical emergency department 6 per cent are drug-related.
2.There are around 720,000 AE (Adverse events) and around 400,000 deaths due to ADR (Adverse Drug Reaction)
3.47% of the time the prescribed drug is unnecessary, 19% times irrational and 11% times hazardous
4.Of all the ADE (Adverse Drug Event) 18%-30% are because of negligence on part of the doctors
5.And finally below is an interesting breakup of ME (Medications Errors)
Now where is the fault? As per current surveys and studies the percentage of faults in medical profession have almost reached to 1% which is way higher than the tolerance limit. Just to give you a perspective a 99.9% accuracy rate is considered very poor in medical profession. And there are various reasons behind the problem, the most prominent being backdoor entry into the medical colleges. This not only leads to a poorer quality of medical professionals emerging from the system but it also leads to the deaths of the patients because the doctor was not knowledgeable enough to deal with the situation.

Every doctor takes an oath when he comes into the medical profession - The Hippocratic Oath - where they swear to - treat all patients equally, give the judgement as per their ability and leave what they do not understand to someone who does, not give bad counsel to anybody and keep the details of their patients secret. Sadly enough all these tenets of  the oath are being violated now a days, if the increasing number of deaths by medical negligence and malpractice are any indication.

Seeing the current scenario of the medical professionals Hippocrates must be thinking of changing the oath cause people don't seem to follow it anyway. This is a really sad situation and needs to be addressed. I ask the readers to come forward, engage in a debate and suggest plausible SOLUTIONs which can be taken for this PROBLEM.

Genie Signing off

** Thanks to Dr. Arun D. Bhatt for the numbers
** The numbers are a bit old but the current numbers are much higher that what are presented above so you can easily understand the gravity of the situation