Doctors & patients
Medics can't be bullied by ministers. But how medics deal with patients is also a vital part of healthcare
It started with a refusal – correct decision, by the books – by Goa Medical College's emergency department to administer a routine B12 injection to a 77-year-old. She got the jab in the orthopaedic ward. It ended with an apology to GMC casualty's chief from Goa's health minister, who had suspended the doctor in a brazen public show of arrogance on camera. The video of the public humiliation correctly triggered outrage. The minister was not just badly behaved, he displayed an attribute shared by many politicians: pulling rank at the drop of a hat. In April, a UP minister on-camera wanted a Sonbhadra hospital's CMO 'sent to the jungle' because he was not available to 'welcome' the minister on arrival. He too, like his Goa counterpart, believed their high-handedness was 'speaking up for patients'. But they spoke from a point of privilege and ego alone. However, this thread – that patients need 'support' when facing doctors – brings us to another reality of Indian hospitals. One that's barely discussed.
Some doctors are often less than civil with patients in public hospitals. Dismissive behaviour with patients and nurses is not infrequent, but barely recorded in any survey. Neither is its impact on care outcomes studied – starting with patients not daring to clear doubts for fear of a dressing-down. As noted by some TOI columnists, there are various surveys of abuse of doctors but none on doctors' un-bedside manners. The social status of doctors is such that some of them routinely get away with markedly impolite behaviour especially with poor patients. Doctors in govt hospitals are rarely caught on camera – patients have far bigger problems and challenges than to call out 'doctor saab'.
This invisibilisation contrasts with the outrage that follows when a doctor is slighted. Medical fraternity speaks as one. That's a good thing. But dare a patient speak out against a doctor's behaviour? True, the doctor-patient ratio in public hospitals shows how burdened doctors are. But it's good to ask whether that's the complete explanation. Dismissive behaviour by some doctors perhaps comes, in part, from a sense of privilege. That many in govt hospitals are overworked doesn't help. The Goa case isn't one of a kind. Similar miscommunication – where to go for what kind of medical care – plays out daily pan-India. Countries like Australia and UK study doctors' behaviour towards patients in public health systems. Perhaps, that's something India should consider.
Facebook Twitter Linkedin Email
This piece appeared as an editorial opinion in the print edition of The Times of India.
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Indian Express
an hour ago
- Indian Express
Pickle juice: Carlos Alcaraz's quick fix to stave off cramps in French Open final
French Open champion Carlos Alcaraz took sips of pickle juice during the five-hour, 29-minute marathon men's final against Jannik Sinner on Sunday, the longest-ever at Roland Garros. Alcaraz is not the first nor will be the last athlete to take small portions of pickle juice, known to help stave off the onset of cramps. There are many examples, recent and from the aughts. Over two decades ago, when temperatures touched 43 degree Celcius in Texas, the American football team Philadelphia Eagles drank pickle juice to stay hydrated during a game against the Dallas Cowboys. The Indian women's hockey team which finished fourth at the 2020 Tokyo Olympics took shots of pickle juice at the onset of cramps. At last year's UEFA Euros, England full-back Kieran Trippier was seen sipping from a sachet of pickle juice after cramping during the game against Serbia. Decathlete Tejaswin Shankar, the national record holder, Asian Games and Asian Championship silver medalist, swears by pickle juice as a quick-fix solution for cramps. What is pickle juice? Pickle juice is a briny liquid made up of water, salt and vinegar used for pickling. Gherkins, baby cucumbers, are a popular choice for pickling. The acetic acid in vinegar, a byproduct of fermentation, helps provide immediate relief from cramps, experts say. Brine also contains sodium and potassium, electrolytes the body loses through sweating. With it gaining popularity, commercial pickle juice is available in small PET bottles and sachets which may also contain dill oil or starch extracts. What in pickle juice gives relief from cramps? Experts believe that it's the acetic acid which is most effective in stopping cramps. 'Nerve receptors in the mouth detect acetic acid in the pickle brine and provoke a neurological reflex in which the brain sends messages to the muscles telling them to relax,' Anita Bean, a sports nutritionist told The Times, London. Tejaswin, India's high jump and decathlon national record holder, reckons, going by his practical knowledge, that acetic acid is like a silver bullet for cramps. 'It is not just sodium or potassium. We know because it's in electrolyte drinks and when you have it the cramps don't stop immediately. Maybe the brine in the pickle juice, or the vinegar or the acetic acid — one of those triggers a neuro reflex that stops the cramping,' Tejaswin told The Indian Express. Tejaswin uses a band-aid analogy. 'This is like a quick fix. I can't address hydration in the middle of a competition because if I do oral hydration it is going to take time to show results. When you are cramping you need to have something quick, like a pickle juice which puts a band-aid or a pause on the cramping and then you can continue.' What do top athletes experience? Tejaswin usually drinks pickle juice just before or during the high jump, the fourth event in decathlon on the first day. He reasons it is because of two reasons — he is starting to get tired because he has completed three events and also because he is tense ahead of his strongest event. 'I usually cramp right before or during the high jump. If I am cramping too much, I consume two shots but when I run the 400 metres (the event that follows the high jump), I feel really weird in my stomach, and after I finish I throw up for at least 10 minutes. To avoid that I don't consume it, but just gargle it so it just hits the back of my throat and the cramping stops,' Tejaswin said. Other than lack of hydration and loss of electrolytes, Tejaswin says a stressed mind can result in tense muscles that can cause a cramp. 'It comes down to the fact that it is my most important event, and there is some amount of stress that I carry going into the high jump thinking, 'I have to maximise my score here'. When you are not relaxed, your body tends to stiffen up, and those tight spots contribute to make a cramp worse. I am also fatigued by the time I reach the high jump because I have already done three events. All these add up,' Tejaswin said. He also carries a 'dabba' of mustard sauce in his bag as an option because he feels it has a similar effect on cramps. Did the women's hockey team benefit? Yes, ahead of the 2020 Tokyo Olympics, the team's strength and conditioning coach Wayne Lombard went shopping for pickles with gherkin and vinegar. He carried one hundred servings of pickle juice. 'When it was back-to-back games, the girls would drink that after breakfast, or depending on when the game was. And then, at the onset of cramps they would have additional shots if required,' he had told this paper. The bronze-medal match, which India lost narrowly to Britain, was played when the temperature touched nearly 40 degree Celsius. 'There are two ways to consume it. You either have it as a shot or you can gargle so your membranes get it, and then you spit it out,' Lombard said.
The Print
an hour ago
- The Print
Goa health minister's outburst at doctor adds to CM Sawant's troubles amid power tussles in state BJP
Two weeks earlier, Goa Art and Culture Minister Govind Gaude raised corruption charges against the Sawant-led tribal welfare department, triggering a political storm and later backtracking by saying that he was commenting on the department officials, not the CM. Since assuming office for a second term, the CM Sawant-led government has been facing the heat from power tussles within the state unit of the Bharatiya Janata Party. Vishwajit Rane, who has had a history of rows with the CM, is the latest BJP leader to have created a troubling situation for Sawant. New Delhi: After Goa Health Minister Vishwajit Rane was caught on camera publicly reprimanding a senior doctor last week, Chief Minister Pramod Sawant has attempted to stop a state-wide doctors' strike by overruling a suspension order Rane had called for against the senior doctor. The latest controversy arose when Rane visited the Goa Medical College, where he chided the chief medical officer, Dr Rudresh Kuttikar, for what the minister perceived as misbehaviour with a patient and ordered his immediate suspension. A viral video shows Rane shouting: 'Kick him out … you will not be here with your bloody ego and learn to control your tongue. You are a doctor. Put your hand out of your pocket when you are standing before me. I usually do not lose my cool, but you have to behave. Remove the mask [that doctors wear] when I am talking. Give your explanation when an investigation starts. Then, I will consider them, or you will be suspended for two years.' Rane then asked the medical superintendent to issue a suspension order against the CMO. Soon after, the video went viral, and in the absence of the doctor's version of what had happened, it created a political storm. Goa Indian Medical Association (IMA) condemned Rane and threatened to start a strike, and CM Sawant had to step in to limit the damage. Overruling the suspension order, CM Sawant Sunday said, 'I reviewed the issue at Goa Medical College and held discussions with the health minister. I want to assure the people of Goa that Dr Rudresh Kuttikar does not face a suspension.' IMA has demanded a public apology from Rane. However, after Rane apologised, IMA termed it as a 'studio apology', calling for the minister to publicly apologise in the hospital casualty department—the same place where he had rebuked the CMO. Amid the doctors protesting against Rane, CM Sawant held a meeting with the Goa Association of Resident Doctors (GARD) Monday night, when he agreed to accept nine demands of GARD and the Goa Medical College Doctors' Union. Speaking to ThePrint, BJP state president Damodar Naik told ThePrint, 'The minister has made an apology, and the chief minister has made efforts to listen to the doctors' demands, resolve the crisis, and accept most of their demands. Doctors should be respected; there is no doubt about that.' In his latest move, CM Sawant visited the Goa Medical College Tuesday to make peace with the agitating doctors. His assurances made them call off their planned strike, but they are still expecting the health minister to communicate a formal apology for his behaviour. Also Read: Goa's Pramod Sawant govt faces heat from within—files 'handled in secret', tribal bhavan in limbo Vishwajit Rane vs CM Sawant It is not the first time that Vishwajit Rane has caused an embarrassing moment for Chief Minister Pramod Sawant. Rane, the son of former chief minister Pratap Singh Rane and five-time MLA, has been a chief ministerial aspirant since joining the BJP. During COVID-19, when thousands of people died in Goa due to oxygen shortage, CM Sawant took a dig at Rane, saying the crisis was due to the mismanagement of the Goa Medical College. Rane hit back at the chief minister, saying he was misguided and demanded a high court probe into the crisis. Rane also clashed with the CM in a cabinet meeting in May 2021 after Pramod Sawant pointed out oxygen mismanagement. Rane left the meeting midway and did not attend meetings on oxygen supply for several weeks. The Goa High Court reprimanded CM Sawant and Rane during hearings on public interest litigations regarding the pandemic, saying, 'This is not the time for politics.' Again, after the 2022 assembly poll results, Rane's wife, Deviya Rane, also an MLA from Poriem, told the media, 'Her husband, Vishwajit, is ready to take over as CM as he has 15 years of experience.' Rane, who holds a crucial portfolio, visited Delhi and met party leaders to promote his candidature, as well. The BJP high command, however, did not favour him, and Pramod Sawant became CM for the second time. Rane defected from Congress in 2017 when he also engineered defections of two Congress MLAs to the BJP, to cushion the party in the 40-member Goa assembly. After CM Manohar Parrikar died, Rane hoped to get the top post. However, while the BJP leadership considered his name, it selected Pramod Sawant, a Rashtriya Swayamsevak Sangh leader, who had grown within the BJP cadre, for the top post. One BJP MLA told ThePrint: 'The problem of the BJP in Goa is that only a handful of MLAs come from an original RSS ideological background—unlike in other states. Most are from Congress and other parties. They see themselves as chief minister claimants and do not have what is required to follow BJP-like discipline. They also no longer have a figure, such as Parrikar, who commanded widespread respect in Goa BJP. That is why they undermine Pramod Sawant, who keeps a relatively low profile.' BJP vs BJP in Goa Vishwajit and Gaude, however, are not the only ministers to have troubled CM Sawant. His government has been facing opposition from within the party and reeling under intra-party rivalries since before his second tenure started. Earlier, at an event, Gaude said: 'A huge amount of taxpayers' money is allotted to the tribal welfare department. When it fails to organise any programmes efficiently, it shows a lack of government control over the administration.' CM Sawant threatened action against Gaude to dissuade him from further making such statements. Former minister and senior leader Pandurang Madkaikar, this year, told the media, 'All ministers are minting money in Goa. I had to pay between Rs 15 lakh and Rs 20 lakh to a minister for a small task. It is not corruption but loot.' Launching an attack on him, his party colleague, Goa Industries Minister Mauvin Godinho, claimed that Madkaikar was making up the corruption charges. In January this year, former MLA Farrel Furtado brought allegations of a 'cash-for-job scam' in the state, and the Enforcement Directorate is currently investigating the same. Former PWD minister and MLA Nilesh Cabral, in the same month, criticised CM Sawant for stalled projects in Curchorem constituency, where Cabral is the MLA. In March this year, when party general secretary (organisation) B.L. Santhosh visited Goa, some MLAs, including Gaude, complained to him about BJP ministers allegedly indulging in corruption. A month before the 2022 assembly elections, Satya Pal Malik, former Goa Governor from November 2019 to August 2020, said his removal from Goa before the party sent him to Meghalaya had come because of his corruption charges against the CM Sawant-led government. (Edited by Madhurita Goswami) Also Read: Goa didn't choose to become a casino city—now it's a state-sponsored moral gamble
News18
an hour ago
- News18
Bharat Biotech's Nasal Vaccine 'Can Adapt' To New COVID Strains, Regulatory Nod Awaited
Last Updated: Bharat Biotech told News18 that the company's COVID-19 vaccine platforms are enabled for 'adaptation'. However, restarting production needs regulatory agency approvals. Amid rising concerns over the JN.1 COVID-19 variant, Indian vaccine maker Bharat Biotech has stated its preparedness to address the emerging variant with its 'adaptable" vaccine platforms. However, production will only restart with regulatory approval. Suchitra Ella, Managing Director of Bharat Biotech, told News18 that the company is 'actively monitoring the ongoing situation" and remains prepared to respond, emphasising the adaptability of its vaccine platforms to evolving strains. 'We remain committed to ensuring that our vaccine platforms are adaptable and ready to respond to evolving strains," she said. As of 11 June, India has recorded 7,121 active COVID-19 cases, according to the Union Health Ministry's official COVID-19 dashboard. Delhi, Gujarat, Kerala, Maharashtra, and West Bengal report the majority of these cases. Highlighting the benefits of its nasal vaccine, iNCOVACC, Ella told News18 that its intranasal COVID-19 vaccine offers targeted upper respiratory tract protection, ease of administration without needles, and adaptability to circulating strains. The company affirms its proactive monitoring and preparedness: 'actively monitoring the situation and well-positioned to respond effectively if the need arises." iNCOVACC, India's first intranasal COVID-19 vaccine, is available as a booster dose for adults. Its needle-free design, with drops instilled into each nostril, eliminates the need for trained healthcare professionals for administration. Ella confirmed the adaptability of both the injectable and intranasal COVID-19 vaccine platforms. 'However, any decision to restart production is contingent upon regulatory agency approvals. We continue to work in close coordination with regulatory bodies to ensure preparedness always aligns with evolving scientific and safety standards," she explained in an emailed interview with News18. While several countries recommend booster doses for high-risk and vulnerable groups, experts in India have not yet issued such a recommendation. 'Booster doses have been recommended in several countries for high-risk and vulnerable populations. Booster doses in our country are subject to approval from national regulatory agencies." Ella clarified that COVID-19 vaccine production would only recommence if directed by the national regulatory body. She also revealed the extent of vaccine wastage due to declining demand: 'As of early 2022, production of COVAXIN was paused in response to reduced demand and the cancellation of issued purchase orders. Subsequently, we proceeded with the destruction of around 20 crore doses of bulk and almost 5 crore doses of vaccines in vials." A senior health ministry source informed News18 that the recent rise in COVID-19 cases is no cause for panic, likening the current trend to seasonal influenza. While no immediate vaccination is necessary, basic precautions are advised, especially for those exhibiting symptoms. 'Wear a mask if you have a cough or cold, and request those around you to do the same, and people with co-morbidities like diabetes or kidney disease should remain particularly cautious during this period." Although booster shots may not be currently necessary in India, given the mild, influenza-like illness caused by current variants, the preparedness of Indian vaccine companies and their adaptable platforms demonstrate the nation's capacity for rapid response should more severe COVID-19 variants or other pathogens emerge.
