When you approach a doctor with some problem, you are vulnerable. You will readily accept "intervention/treatments".

Sometimes your doctor wil send you away without offering intervention/treatments. Because -
1. It is normal occurrence. No disease.
2. Your misconceptions need correction not your body.
3. It is a self limiting condition.
4. Intervention will make it worse. Better to wait and let it disappear.
5. Too early to identify precise problem. Not enough data. Better to wait for more data to emerge.
6. You get hassled by small issues, need to learn to live with some as long term health strategy.
And some more.

Such doctors are pure gold. Cherish them.

They are turning away a willing to investigate/get treatment patient because they are ethical.
Many patients feel that you are incompetent or don't care therefore u are turning them away.

I would pay more for a doctor who rightly tells me to ignore/wait/come back later/tolerate my issues than the one who jumps the gun readily (but ignoring "masterly inactivity" as option)
"emotional healing" is at the top of list of needs of "patients".

It is a legitimate human need. I agree.

Is it fair to expect it as top priority from a modern medical practitioner everytime you meet them?
Are we getting more infantile as a society ?
Do we constantly need hand holding and soothing ?
Is anxiety THE top problem in every healthcare interaction ?

Please don't quote Osler. He didn't have internet, automobiles and insurance.

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More from @docbhooshan

4 Oct
#Decisionmaking
#Medicine

#Thread

As a trainee doctor working in government hospital, working with poorest in the country, I believed that education can solve most problems.

How wrong I was!

A thread on decision making.
As a trainee doctor I saw suffering of people that I attributed to lack of education. They were superstitious, had bizzare (IMO) ideas about illness and recovery, hardly ever followed medical advice esp about follow up of treatment.
I firmly believed that as more and more people get school education, this will go away. People will have access to good information and they will make better decisions resulting in better life.
Read 18 tweets
3 Oct
#School
#India

Many parents ask me if they should enroll their kids in one of the "new" schools.

Here is my answer about schools that encourage curriculum free learning.

A thread.
Many parents recognise harm of prevalent industrial model of school. They have enough money to explore "alternative" education models.

Are these models good?

I have seen rise and transformation of some of these schools in Pune over last 20 years.
Curiosity directed, teacher guided, self learning is every educationist's gold standard and every parent's dream when they are not anxious.

Madam Montessori pioneered this thinking. Educationists like Gijubhai, Anil Panse worked on similar models grounded in indian reality.
Read 10 tweets
29 Sep
#Thread
#grief
#COVID19

Over last few months many mental health practitioners like me have received requests about grief counseling due to death in family (due to Covid 19)

A short thread on helping kids deal with early days of grief.
First of all - all bereaved persons do not require grief counselling.
Culture and traditions help us deal with loss of loved ones in most situations and then there are time and life , the great healers.

So please don't rush in with psychological help on day one.
When death is untimely i.e. a person who dies earlier than old age, it can get complicated.

Many factors add to trauma of grief in pandemic -

1. Trauma of finding treatment for Covid19
2. possibility of immediate family being sick or in isolation complicates things.
Read 21 tweets
24 Sep
#Thread

Medical Council of India (MCI) - Apex body for all decisions about medical education and practice in India was dissolved 2 years ago.

From tomorrow it will be replaced by National Medical Comission (NMC)
Most of you didn't know this. And you probably are wondering how this slight change of alphabet soup works. Does it make any difference?

A bit late for you to ask this question as everything is set in stone now.

Still, some info for all -
MCI - was not fit for purpose. Corruption, incompetence and nepotism was always a problem and everyone was unhappy.

So GoI got rid of it and replaced it with NMC.
Read 8 tweets
23 Sep
#Thread

Covid19 in India is a watershed event on many fronts.

For stand alone private doctors it will mark an end of support by government, administrators and most importantly society.
Governments (politicians) have always been reluctant to engage doctors.

Administrators as usual have been focussed on power in their hands. We all have seen their "achievements" in last 6 months.
Clueless politicians led by hand by administrators who have neither experience of dealing with challenge of this size nor willingness to engage good professionals outside medical colleges as advisors.

That's summing up of handling of pandemic.
Read 5 tweets
18 Sep
#Thread
Skills for private medical practice in India

It look at long time to realize (it continues as a learning experience) that as a stand-alone medical practitioner, i need skills that are never taught in medical college -
1. Playing each ball on its merit and standing firm like a wall like Rahul Dravid - in a crowded OPD, Dravid like temperament helps you to give your best to first and fiftieth patient as well.
2. Running an excellent well oiled clinic like a McDonald outlet. complete with clear menu and charges, excellent customer service and efficient systems to avoid waste.
Read 9 tweets

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