Some of us are back. Although we are doing good work by individual patients we look after building a healthcare system fir the nation is a different ball game.
Few points 1. Healthcare is not an election issue, politicians will not prioritise it, budget allocation v low
2. Our govt run places are free at point of use, but inadequate, incompetent, poorly manned, not networked - patient is not the focus, bad outcomes are norm and accepted
3. Private sector is not homogenous very shoddy to the best possible Corporate hospitals maybe cutting edge and have best outcomes in the world. But these are businesses with investors prone to free market forces. Out of pocket expense without a good insurance cover is +++
4. Trust deficit. Doctors are deified or vilified. Medical profession has not done much to gain trust of the public but also it can’t be that we are roughed up and beaten up. This merits another thread.
5. We rather have miracle cures than a sound, efficient, compassionate, patient centred healthcare. Quackery hence abounds. Current Govt has legitimatised it with Ayush bunkum
6. The focus is too much (in your tweet too) on the doctor. No, modern medicine is team work. We need to value nurses, med techs, support staff, Asha workers and so on.
7. Healthcare is not a priority. For the public, illness is an unwelcome situation and doctors/expenses a necessary evil. Never an election issue. Politicians will never take it up as a cause - reflection of priorities of the nation
8. We have the lowest budget allocation for healthcare. Added to this, focus is on curative medicine and not preventive. If healthcare were an ailing patient - our current treatment is both misdirected and meagre
9. Doctors returning from abroad may improve quality and outcomes in the small areas of their work in well oiled systems . Some may even be misfits and feel disabled to employ their skills.
10. What is needed is a complete reworking, reallocation and remodelling of healthcare provision. Starting with - can this be a priority for the voting public? Then it may have a cascading effect.
#medtwittter apparently #doctorbashing happening on twitter too!
My thoughts 1/n 1. Refuse exalted ‘you are demigod elevation’ 2. If it’s a time critical/life death situation do not hesitate for a second (if can make a difference)
2/n
3. Do not ‘undersell’ by ‘discounting’ / free follow up /packages 4. Respect your time and space - late evenings and Sundays are for rounding and emergencies
3/n
5. Pvt healthcare is picking up not just business but the burden of an inadequate (sham of a) universal healthcare - but the public will never hold govt responsible
6. Never call it service and never call it a business either: It is a highly skilled job, period
Dr Barrington draws attention to this well written open access commentary #MedTwitter#Neonatology#Disability#QoL A good life cannot be predicted from a brain scan!
Neonatologists often stare at seeming disasters early in the life of a newborn. Parents are distraught and ask how the road ahead would be? We are tempted to carry out tests and scans, lean on our personal experience and give our opinion: This itself has consequences 2/n
Research in keeping with the World Health Organization’s definition of QoL (a child or parent’s perception of their life) shows that disability severity has little relationship to life quality 3/n
#ChildHealthMatters #DevelopingBrain from 18 days post conception to early childhood is surreal #First1000Days = critical for a lifespan of health + wealth of society
Let us marvel at some key facts on Developing Brain (Source: @UNICEF 'Building Better Brains: @TheLancet ) 1/n
The blueprint of the human brain includes 86 billion neurons and around one quadrillion synapses (which enable neural connections), coded in only 10,000 genes (Herculano–Houzel, 2009)
During the first years of life, neurons form new connections at an astounding rate of 700 to 1,000 per second (Shonkoff, 2009). Not even a viral tweet from the Oscars moves that quickly
1/n @BBMPCOMM with area wise hospital co-ordination committees one hopes both public and hospitals will have a seamless admission and discharge process.
suggestions for safe/panic free #bedmanagement 1. SPOC of each hospital + Arogya mithra update bed status every 4 hours
2/n 2. Each and every CCC should have a Covid Hospital overseeing. (govt/pvt) Hub and spoke each big hospital with several CCC in catchment area: Designated hotels, hostels, schools, function halls ( Current BEIC out of city is isolated and treatment escalation hard).
3. Streamline ICU care:
ICU Bed availability dashboard is most crucial/time critical.
a)Network all Major ICUs when 80% capacity is reached, we will need more to be created
b)Ring fence ICU beds for 'NON -COVID' critical care
c) Networking will off-load to step down HDUs
#COVID__19#BengaluruLockdown should open the window of opportunity to ensure 1. We can save more lives 2. We can fight the panic, both interlinked.
If neither nor, then we would have done nothing but harm. @epigiri writes what precisely @BBMPCOMM can do to augment PH measures
2/n @BBMPCOMM@DHFWKA 1. Need experts + feet on ground who can contact trace, crunch data and use it for capacity building 2. Stop spending energy on spraying, sanitising = 100Mi viral particles can fit in on a pin head! 3. Focus on people - triage - get beds
4. Do not demonise any healthcare sector: Find a way of working together 5. Do not lose HCW it will deepen crisis - ensure beds, insurance for them and their families 6. Crowded places = clusters - lead by example go digital for everything from meetings to press briefs