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Updated: October 10, 2013 18:20 IST

Doctor thatha’s no to tests

SOMA BASU
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Dr. K.A.Srinivasan. Photo: S.James
The Hindu Dr. K.A.Srinivasan. Photo: S.James

Madurai’s oldest practising physician-cum-general surgeon, Dr.K.A.Srinivasan, will be felicitated on Sunday for completing 60 years of service. Soma Basu finds out what keeps him going at 87

The word retirement does not exist in his dictionary. “As long as I am able mentally and physically, I will continue,” says Dr.K.A.Srinivasan, who graduated from Madras Medical College in 1952. Though he belongs to an illustrious family of lawyers from Coimbatore, he simply loves being the peoples’ doctor not enslaved by technology.

His only impediment is his on and off back pain and slightly unsteady steps forcing him to use a walking stick in the last one month.

But that does not deter the distinguished physician from being fully present for the patient and the people he works with.

Dr.Srinivasan lives and works in his own rarefied world that can be challenging to the new generation of doctors. He is believed to be an excellent diagnostician who does not rely on expensive and sophisticated investigations.

“I am extremely sensitive about cost,” he says and promotes the old school thought of providing patients the best possible service at the least possible expense.

‘Every month I save at least a dozen people from getting financially ruined.” he says, “I talk to them, convince them and treat them on the basis of clinical diagnosis.”

“As a doctor you just need to listen to the patient, nothing else,” he adds. “When the patient speaks, the doctor gets the diagnosis.”

The conversation with Dr.Srinivasan, his patients and colleagues from Vikram Multi Speciality Hospital where he has been working since 1997, makes it obvious that he did not set out to become famous or mint money from medicine. His only goal was and is to be of service to the people. What he advocates can make him unpopular within his fraternity, yet he is revered by all.

According to him, 90 per cent of the diseases can be diagnosed correctly without any sophisticated investigation. Only 10 per of the prevalent diseases in the world today require detailed investigation.

“I do not shun investigations but neither do I encourage unnecessary investigations,” he says. He cites a case where a 73-year-old patient with a neurological disorder that was diagnosed three years ago was advised 12 days admission to the hospital and investigations that would cost Rs.One Lakh and still not cure him!

“Did we not treat epilepsy without scans 30-40 years ago? But today every patient is sent for lab investigations,” rues Dr.Srinivasan. He feels sorry for the patients. “Unfortunately doctors are responsible for creating the scare in people and patients also know they are being cheated in the name of sophisticated tests,” he adds.

Known as a doctor who saves his patients from unnecessary investigations, Dr.Srinivasan has a huge following. “At my age and with my experience I can take the patient into confidence and tell him that his ailment does not require an MRI. But the same patient may not listen to a junior doctor saying the same thing,” he points out.

Dr.Srinivasan realises he takes a small risk when he treats on the basis of clinical diagnosis alone. That is why he is very particular about follow-ups. Adequate training, good clinical knowledge and experience as the years roll on usually don’t make you go wrong. “I always call every patient for a review and check whether they have made the desired progress with my prescription. If not (which is rare), only then I recommend them to undergo certain tests and investigations.”

When his generation started practice, there were only ECGs and various types of X-rays, he says, and 95 per cent cases were diagnosed correctly. “Sophisticated investigations started making inroad two decades ago. Physicians have so much in their armamentarium now. There are so many ways to treat cancer, brain lesions or heart diseases,” he notes, and confesses, he has had a hard time with the transition.

“Yet I am happy to be in practice. It feels good to concentrate on your patient. I feel I am doing something good,” he says.

What hurts and worries Dr.Srinivasan is how medicine has become so corporate. Unless doctors practise medicine as a service, health care will never be affordable to the common man, he says and sees no hope for change either.

“The country has too few doctors and the shortage will only get worse over time,” he says, particularly perturbed by what medical students discuss now. They are more concerned about how much money they would make once they get their degrees instead of which primary health centre or village they should work in.

“Service-oriented work is not the primary goal of most youngsters today. When they are compelled into something, they don’t deliver as there is no involvement.”

Dr.Srinivasan’s first job was with his elder brother Dr.K.A.Kalyanam, another leading surgeon in the city, whom he joined as Hony.Assistant Surgeon in Government Rajaji Hospital in 1956 after completing MS from Madras Medical College. From 1971-84, Dr.Srinivasan served as Hony.Professor of Surgery at GH and also ran the family clinic till 1997. “It was our choice not to be paid employees of the government,” he says.

Dr.Srinivasan was selected by the Government of India in 1961 to undergo training in urology in Moscow and upon return not only became the early surgeons in Madurai to use endoscopy in treatment of urological conditions but also took to teaching of Russian language at Gandhi Museum.

It is said that more than half the medicos in Madurai who are in practice today or retired from Government Hospital are Dr.Srinivasan’s students. Many of them are coming together for the felicitation function organised by Vikram Hospital on October 13 as a tribute to his six decades of dedicated service.

He has relentlessly preached and practised to care for the patient. The relationship he shares with his patient matters to him the most. A consummate professional, Dr.Srinivasan believes work is life.

He recalls what the famous neurosurgeon from Chennai Dr.B.Ramamoorthi once told him: “When you can’t pull along, you will be prompted by your inner voice.”

“Sometimes I feel I have done enough,” says Dr.Srinivasan, ‘But I know if I give up work I won’t be at peace.”

Great man! I wish we had more like him. Perhaps we would, if we had not opened the markets under 'reforms' in 1990s.

from:  shahid khan
Posted on: Oct 11, 2013 at 00:53 IST
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