Wednesday, December 26, 2012

Doctor! Experience with ENT

How best do i capture the incidence today at ENT department of Manipal hospital? Since few weeks mom had been complaining of the sensation of something being stuck in her throat. She had been really concerned and according to her, she also had change of voice on few occasions. The fear in her was because of the fact that a near relative recently had been diagnosed of vocal cord cancer. She had met the relative as the  individual was completing radiation treatment.
Finally, i decided to take her to Manipal hospital today. At the registration they mentioned that Dr.Girish Rai is there. I guess they inform this to know whether we wish for any specific doctor. I could have asked for Dr.E V Raman, whom i have met couple of times but decided that Dr.Girish Rai should be good enough. We waited for our turn. As we entered the examination room, i remained silent, refraining from my usual introduction of being a cancer specialist etc. Also i wanted mom to explain her complaints in her own words. He asked her what is the problem and mom explained. He looked at her throat and her nostrils. Asked whether she has headache. He took a swab and sampled her throat. Asked the junior to order for a CT scan of the PNS. He explained that she has infection in the sinus and will require endoscopic surgery. Mom protested saying that she has nuchal headache. He dismissed her saying all are interrelated. Mom looked at me with eyes pleading for some support/intervention. I was in no mood!
Here was a lady with complaint of something being stuck in the throat and the investigation being asked was CT PNS with Endoscopic surgery being considered a possible solution.
Why am i picking fault or not happy with this?
I did ponder about this for sometime. He must have seen pharyngitis, inflamed tonsils/adenoids which made him to take a swab. Already deduced that this must be a tough infection which will require FESS followed by ?
It is my conservative outlook that my mom needs to be treated with antibiotics first and reviewed which makes me question his approach. Or rather the fact that he did not bother to do IDL, indirect laryngoscopy. Why do IDL when there is infection?
I did not get the CT or the swab cultured. Mom will do steam inhalation, drink warm water and take 5 days of antibiotic. Hope this should make her better.
Any decision with fraught with risks?
As a physician how best do i achieve the objective of getting my patients healthy? Do i need to bother about algorithms? Do i need to have evidence based medicine as a guiding framework? Do i need to take cost into consideration?
I did feel that there is a tremendous need for good family physicians. Their tribe is decreasing and impacting healthcare and nation at a large. Need to back this up with data. Also feel that most individuals are comforted by vising the specialists.
This is one incidence at Manipal, may be there are many.
 I do have to acknowledge that my previous experience at Manipal has been very good. This pertains to the department of Orthopedics, Pediatrics and Plastic Surgery. Will record them later. We are more motivated to give feedback when we are not happy! This creates an imbalance in the kind of reports we read. For me this gives a hint to the mistrust placed by my friends, relatives on healthcare.

1 comment:

Anonymous said...

All these are100% truth about Dr. Girish Rai in Manipal Hospital. I wish I could have read this before i visited him. But realized all these posts already here even before when i wanted to post my experience. Yesterday there was a sudden bleeding from my left ear when i woke in the morning. We called multiple hospitals n found doctor is available in the Manipal. Finally we visited Manipal hospital there we need to register and paid consultation which is too high also they are least bother about patient. Finally we got appointment of Dr.Girish. We were waiting for him for last half an hour and got to know he is in his chamber and will come to see patients in another 15-20 mins junior doctor mentioned. By that time she took me inside and asked for my problem and finally said now Dr.Girish will check. Then after half an hour Dr. Girish Rai came out of his chamber and called me. Before i explain about my prob,i saw ready prescription where everything was mentioned: hearing test(another bill) and some antibiotics. When I asked what is d reason of sudden bleeding from my left ear, he started saying therr is a blood, cant see anything. V need to out you in day care ,give u local anesthesia and need to check using microscope. which will cost us Rs.12000. we were shocked. He has no satisfactory reason for this. Junior doctor took me to another room and performed hearing test. Finally my test results were normal. She only explained me in chart on wall. That doctor didn't even bother to check my ear. He just wanted to loot money and keen to teach junior doctors. Less worried about patient. I will never recommend Manipal and Dr. Girish. Finally we went to Apollo clinic and got ear cleaned in mins without any anesthesia . Prescribed ear drops and antibiotics for not to have infection. Shame on you Dr. Girish.