Two recent events made me think of the good old days, yet again.
Early in my training, I was awestruck by the excellent clinical acumen that some of the surgeons had acquired in the course of their training. A surgeon or even a registrar in training for surgical examinations would just roll the hand gently over the abdomen whilst looking into the patient's eyes and stirring up a conversation will point blank make an accurate diagnosis of acute appendicitis even when the clinical manifestations would be far from that described in most medical textbooks. Believe you me, most of the time, the would get full marks for their diagnoses without the need for sophisticated imaging techniques. In fact, the registrar used to tell his trainees that the mark of a good surgeon is the ability to correctly diagnose acute appendicitis clinically.
Two recent events queried the competence of surgeons these days.
#1. An anaesthesiologist friend of mine was fretting about his ever increasing work load of working early morning (starting late nights) to surgeries of 'white appendix'!
#2. A friend's 11year old son with painful abdomen was almost operated upon for appendicitis. Second opinion suggested that it was probably musculoskeletal related and the young boy escaped the knife.
Now, what is happening?
Is it that doctors nowadays have lost their clinical acumen? Or the drive for financial remunerations supersede their earlier oath to serve mankind etcetera etcetera? Or is that he is worried that somebody else would make their killing and steal his rice bowl? Or somebody else will diagnose correctly their patient? Remember the patient who shopped around 4 doctors in 3 days to sing praises of the last doctor after she was correctly diagnosed her to have dengue fever after a blood test?
Early in my training, I was awestruck by the excellent clinical acumen that some of the surgeons had acquired in the course of their training. A surgeon or even a registrar in training for surgical examinations would just roll the hand gently over the abdomen whilst looking into the patient's eyes and stirring up a conversation will point blank make an accurate diagnosis of acute appendicitis even when the clinical manifestations would be far from that described in most medical textbooks. Believe you me, most of the time, the would get full marks for their diagnoses without the need for sophisticated imaging techniques. In fact, the registrar used to tell his trainees that the mark of a good surgeon is the ability to correctly diagnose acute appendicitis clinically.Two recent events queried the competence of surgeons these days.
#1. An anaesthesiologist friend of mine was fretting about his ever increasing work load of working early morning (starting late nights) to surgeries of 'white appendix'!
#2. A friend's 11year old son with painful abdomen was almost operated upon for appendicitis. Second opinion suggested that it was probably musculoskeletal related and the young boy escaped the knife.
Now, what is happening?
Are the doctors' succumbing to client's express lane attitude in remedies to maladies in life? Has the plans of leaving market forces to decide on medical need led to doctors taking short cuts? Now that medical education is now is now a multi million industry, the good doctor may still be paying for his education! Maybe it is the system where doctors are not gatekeepers to the health system but are just pawns in the system controlled by businessmen and insurance companies.
Everything is a money making business! Even making babies too, they go by kilos like mutton!
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