Saturday, February 16, 2008

Wounds can be healthy too !!

“Wound kaffee Achcha hai”, remarked the assistant to the doctor as he was dressing the fist-size cavity created by surgical removal of an abscess a few days ago from my body. Even in that moment of excruciating pain, I could not burst out laughing at the way each one of us looks at things from a different perspective depending on which side of the line we are. The assistant was puzzled and elaborated this time in English, “ I mean it is a healthy wound”. Still seeing the remnant of laughter etched on my pain-contorted face, he added “ I mean it is not infected. But you have to be careful.”

I could not agree more with the doctor’s assistant, not so much about the post-operative care procedures but more so on being careful in avoiding getting admitted into a corporate hospital. The crass commercialization and complete lack of robust processes in patient care are frightening.

It all began a week back. The young, sweet and confident looking doctor had one look at my condition and recommended immediate surgery to remove the abscess. I agreed. Then he leaned back and with doleful eyes oozing pity, asked me if I had insurance. The look implied that if I didn’t have a policy, I would for sure lose my shirt. Little did I realize how true it was, until the insurance section chief of the hospital gave me a rough estimate of the total cost for the minor surgery and a 2-day stay. The cost was equivalent to 3-month take home pay of my wife after 18 years of service in a bank or 2 years’ income for a medium land holding farmer back in my village. Startled, I expressed my concern at the cost. “ But you will get reimbursement”, was the answer I got. I paid the money and waited for an hour-and-a-half for the allocation of a room. Obviously, some other patient must have been discharged to accommodate me.

Two hours later, I was wheeled out of the room on a stretcher and I assumed it was to the Operation Room. Not so quite. I was parked outside the operation room still on the stretcher as the room was getting cleaned. I learnt later that the hospital has multiple operating rooms. I could see two others waiting in the same fashion but they were moved to Post-Operative recovery room after 20 minutes or so after two patients were moved from the recovery room to their respective beds. I was amused. The conveyor belt manufacturing process was being implemented for surgeries in such a robust way that Henry Ford would have gaped in wonderment. Finally, I was wheeled into the operating room.

The anaesthetician looked too young for me to allow him to inject anaesthetics into my spine without getting a second opinion. So I called one of my friends who is an anaesthetician himself. He assured me that my paralyzed lower half of the body will come back to normal after 3 hours. The surgery having completed, I was moved into the recovery room without any waiting period. My index finger was clipped to a machine to monitor the pulse rate and other essential metrics. There were about 4 others in the room. What do I do with 3 hours with an active mind and a paralyzed body. I began toying with the index finger and realized that if I wag it vigorously the monitor goes into a tizzy with its keek, keek , keek beep. The nurse rushed around the room the first time and zeroed in on me by the second time. When I repeated the prank the third time, she coolly walked to my bed side and in the guise of adjusting the saline, dropped the bottle on my crotch, gave a half apologetic smile and walked away. That has put to rest all my pranks.

I was wheeled into my room after 3 hours. I was discharged 2 days later. During the 2-day stay, I had to periodically remind the nurses of the medicines I need to take. If somewhere, these were recorded, at least several of the nurses were not aware. And everything is to be back to square one when the nurses change duty. It is apparent that the robust processes of conveyor belt model are being followed only for surgeries and not for post-operative care.

What struck me was the fact that less than two hundred million people have medical insurance in India. And all these corporate hospitals cater majorly to these insured people and prosper on insurance money payouts. Anyone without an insurance ever dares to enter these portals, be assured that the last drop of the financial juices will be slurped.


FunTimes said...

Very true Ramana.During my Insurance Career in United India, i wrote a paper on how Insurance Premium is to be considered an investment and worked out a ROI model where one would earn more than 200% return over a 10 year period.In any case the episode with the naughty nurse was very interesting.I am sure you that would have brought you back to action. Baba

Rajesh Kumar said...

Get well soon Ramana, we need you back in shape. And the point about medical cost and insurance is absolutely valid.

Anonymous said...

right.but still there are genuine doctors and more genuine treatments too.u are one of the fortunates to get such naughty experience.imagine one constipated snobbish nurse dropping a scissors!man u r lucky