Blame Culture

Our individual and collective psyche has become such that we tend to find fault with others and blame someone or something for any unwanted issue. Same is happening in healthcare sector too. As mentioned in the previous post, complications, untoward incidents, and bad outcomes are part of any healthcare delivery system. These happen in the best of the healthcare facilities too.

Whenever and unwanted incident happens, people are quick to point fingers at doctors and hospitals. In the present-day complex healthcare delivery systems, doctors do not have everything in their control, despite the will to control everything and deliver the best possible. In this blame culture, doctors are the easy and soft targets; for public, media, government and regulatory bodies.

This is leading to doctors being defensive and evasive in their interaction with the patients and relatives, leading to more suspicion. It is rather difficult to explain what is happening and why in a critically ill patient to lay people. Sometimes the doctors themselves do not know fully what is happening. They try to do their best and innovate based on their experience.

If the patients are mature enough to discuss the issues and uncertainties involved, the dialogue will be meaningful, and a proper “informed consent” can be taken. Most of the time the consenting process is a farce. Doctors do not have the time or inclination to take a proper informed consent or the patients are not willing to listen to the list of possible complications. When an untoward incident happens, all the hell breaks loose.

There is no transparency in the system, and it is the general tendency of the doctors and hospitals denying any responsibility. Due to this, small proportion of patients who get complications due to shortcomings in service provision are having to fend for themselves. Most of the times, the mishaps are minor and all that needs is an honest approach and an apology. Most people do understand that mistakes can happen and accept.

Some doctor colleagues tend to make loose comments without knowing the full picture. This may be out of simple ignorance or a deliberate smear campaign. Either way, it does not help anyone concerned. Due to the fear of being held accountable and further repercussions, doctors and hospitals are always in denial mode. Patients who have a genuine grievance are having to go through a prolonged legal battle. Most of them do not have the means or inclination to take the doctors to task.

Many countries have taken the concept of “no blame culture” from the airline industry. Due to the nature of civil aviation, it is especially important to investigate any mishaps, so that the aircraft and passenger safety is not compromised. They have a system of reporting any incident without the fear of being made a scapegoat. All the reported incidents are investigated, and appropriate action taken to prevent similar thing happening again. Many hospitals do have this system, but it is not always thorough and transparent.

It is high time it is adopted in our healthcare system too. All untoward incidents must be reported, investigated, and appropriate action taken. Patients must be informed and offered compensation where necessary. If they are not satisfied, they should have access to a quick and fair grievance redressal system. Till such time, we keep blaming each other and our “world-class healthcare” remains a slogan only.

Mixopathy

It is amazing to see the amount of ignorance people, especially those in power, have these days, despite the number of scientific advancements and knowledge base we have. Recent decision of the government to allow Ayurvedic doctors to perform several surgeries is beyond comprehension. Or it is perhaps the cunningness of the bigwigs to mislead the ignorant public. Or may be a bit of both.

Ayurveda is an excellent system of holistic healthcare. We have deviated considerably from the original thoughts and processes expounded by Sages Charaka and Sushruta. Majority of the Ayurvedic care we have these days is modified to present day situation. If you wish to know more about Ayurveda in its pristine form, please read “Ayurveda Lifestyle Wisdom” by Acharya Shunya, available on Amazon Kindle. https://read.amazon.in/kp/embed?asin=B01N2JWPOM&preview=newtab&linkCode=kpe&ref_=cm_sw_r_kb_dp_65eZFbAS2X3JN

Ayurveda can be followed by anyone who has the inclination. Ideally everyone should be encouraged to follow it, as it is an excellent way to maintain the body and prevent disease. It requires considerable amount of discipline and restraint. It involves following a rigorous daily routine and certain simple practices. It emphasises a lot on what to eat, when to eat and how to eat. The results are not immediately apparent. It takes some time for the body to readjust and manifest the good effects.

Our present-day psyche wants quick results. Both doctors and public alike have gotten into the mindset that some external manipulation in the form of a medicine (tablet or injection) or procedure/surgery is required to restore health. We made ourselves oblivious to the enormous repair and regenerative capacity our body is endowed with naturally.

This natural healing capacity is indeed the reason for some of the alternative therapies to become popular. They are cheap compared to Allopathy and are considered to be “safe”. Whoever uses these alternative therapies have faith in them. It is the mostly the “placebo” effect and the natural healing that is the reason for improvement. As mentioned in the previous posts, majority of the ailments are due to our lifestyle choices and can be corrected by simple lifestyle changes.

Majority of the countries have discarded Homeopathy as it has not been proven to be of use in scientific studies. A 2015 comprehensive assessment of evidence by the Australian government’s National Health and Medical Research Council concluded that there is no reliable evidence that homeopathy is effective for any health condition. Please see the views of National Centre for Complimentary and Integrative Health: https://www.nccih.nih.gov/health/homeopathy

Once the disease manifests fully in the form of a major structural abnormality, it requires surgery. This usually cannot be cured by body’s natural intelligence. In this situation, alternative therapies have a role only as complimentary therapies and not as mainstay of treatment.

Instead of improving the health education, healthcare facilities and promoting research into the usefulness or futility of medical systems, our government’s decision to bridge the gap by quick fix solutions is not good. As mentioned in previous posts, major chunk of the cost of modern medicine is in setting up the facility, equipment, and maintenance. Simply by creating “doctors” and “surgeons” through back door will not solve the existing problems. It simply will create more problems, confusion, and add to the woes of all concerned.