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The dilemma of doctors

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With the need for medicare through out the year, how do doctors find time to relax?

Picture this. It is a Sunday evening. It has been a six-day wait for Dr. Ramesh's family. They are just leaving for the evening show of "Vetaiyadu Vilayadu", when there is a knock at the door. A couple carrying an obviously sick baby walks in. The doctor in Ramesh relents, and he examines the baby. Already late, his family heads to the car only to be cornered again by a few more patients. It is a tussle now for Dr. Ramesh, a moral duel. If he examines the patients now, he will surely miss a sizeable portion of the film. On the other hand, there is a sick person seeking his help... it is the doctor's dilemma unfolding. Successful general practitioners like him have to deal with this dilemma often. It is easy to take the moral high ground and say that the doctor should opt to treat the patient and give the film a miss. But this is not a one-off occasion in his life. And doctors too need their share of free time, rest and entertainment. "For the patient, it is just a question of the doctor sparing a few minutes for him. But the doctor is losing yet another Sunday evening, taking care of non-critical patients, who could have either come earlier or waited till the next morning," says Dr. P. Parthasarathy, a general practitioner. There is a need for medical care 365 days a year. Says V. Rajan, "Why do all general physicians need to take the Sunday evening off? They could rotate their off-days, like other professionals who are in vital services." R. Rajan, who recently had a frustrating experience of trying to find a general practitioner on a Sunday when his son had a wheezing attack, says, "It is only a family doctor or a general practitioner who can understand the patient's condition and medical history best, especially, in the case of a sick child or baby." "It doesn't make sense to head to a specialty hospital when we run a temperature or have a spell of aches and pains," agrees Visu Nagendran. "None of us would say no to an emergency or refuse to attend to a critical condition at odd hours. But when we see non-critical patients coming up well beyond consulting hours when you have other plans or wake us up at midnight with a request for a non-critical injection, it gets really frustrating", says Dr. S. Deepak, a GP. Adds Dr. K. Kumar, another GP, "Patients should understand that the doctor has a life and family too." There are also GPs like Dr. P.K. Rajiv, who do not mind sacrificing their personal lives for their profession and say, "I have never rejected seeing a patient, even when it is not an emergency". "The life of a general practitioner can be highly stressful. Not just the pressure on his or her personal time, a doctor has to face many common but disturbing situations such as dealing with highly distressed people and tired and frustrated patients after their long wait at the clinic. To deal with a plethora of human despair, doctors need their share of rest and relaxation too," says psychologist Bhuvana Shankar. The lack of family time may take a toll on their personal lives, she warns. " The conflict arises when doctors identify too much with their profession. Doctors should remember that they have a family cap to wear too, and need to balance their lives. Doctors should also not pander to the ego-gratifying sense of being needed and definitely not encourage their patients' dependence on them," says Dr. S. Vijayakumar, consultant psychiatrist. "The GP should determine whether it is an emergency and not be carried away by the patient's feelings."Another cause for concern is the decreasing number of family doctors in the city. This is the era of specialists, an era where we see the sprouting of specialty hospitals that casually burn a hole in your pocket insisting on hi-tech tests for the most innocuous of symptoms. "We need more family doctors who can connect with patients, take care of their primary care, and perhaps coordinate their more complicated medical treatments, if and when the need arises," says Dr. G. Thamaraiselvan, a GP. Perhaps, more family doctors can ease the pressure on the available family physicians. Or perhaps, GPs in an area could just organise themselves into a group and rotate a working Sunday among themselves, so that it is a win-win situation for both doctors and patients. HEMA VIJAY

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