Farewell message by a doctor couple
This is a letter my friends sent to the medical fraternity in the city they have practiced for 40 plus years.
The husband is a Urologist and the wife, a Gynecologist
Hi friends,
We have decided to stop medical practice totally from the first of November 23.
It is a difficult and very emotional decision. We are extremely thankful to the faith shown in us by you and your patients over the period of the last 41 years. It has been a fairly long journey and we are satisfied to walk away without any major mishap in a potentially stressful and risky profession.
Sir Robert Hutchinson has said.... "If you have earned enough for your needs and been able to put aside a little for your old age and if at the same time you have won the esteem of your colleagues and the affection of your patients, you have done enough."
We think at this stage we have achieved this goal to some extent
While introspecting we have realised
1. Though we are fairly senior, at present we are not doing any extraordinary work,
2 We are not involved in teaching juniors.
3 There is no monetary compulsion to work .
.
Hence we don't find any purpose continuing to do the same routine work especially with the changed scenario of Medical practice.
The basis of our teaching and profession was clinical medicine.
Now that is fully replaced by so called 'evidence based medicine'
We were taught to take a detailed history of the patient, then to do thorough clinical examination and arrive at a probable clinical diagnosis and then to do relevant tests to confirm or to rule out the clinical diagnosis.
I am sorry to say the medicine as it is practiced today ignores clinical medicine totally.
The disease is "diagnosed" by a variety of laboratory tests and by other modalities like ultrasound, X-ray,CT or MRI scanning. No one seems to bother to listen to the patients nor examine them.
The new generation of doctors with few exceptions and the patients also have more faith in these reports than in clinical medicine.
In this situation the clinical practice which we have been doing appears outdated..
It is a sorry state of affairs that a surgeon has to get sonography done for a clear cut case of inguinal hernia or else the insurance provider will reject his claim.
In OPD also patients don't come with their symptoms but with a diagnosis arrived after doing various investigations.
The diagnostic centres have come up all over including peripheral villages without any proper standardisation or quality control.
It is not uncommon that a patient is diagnosed with multiple diseases at the same time depending on these reports.
It is difficult to explain the intricacies involved to the patients with their level of IQ and their lack of knowledge or understanding of the disease. More difficult is to ask to repeat the investigation, where the patient may sense some monetary implications.
If the patient has taken treatment from another doctor prior to coming to us, even though that is grossly wrong, one can't comment on it due to professional ethics.
.
By and large the quality of patients has deteriorated over the years. A large number of patients have comorbid conditions like obesity, hypertension, diabetes and IHD.
In such patients the surgical risk increases manifold. To this is added the changed attitude of the patients where there is a tendency to blame the operating surgeon for any complications that develop following surgery. This is despite explaining the risks prior to the procedure. This puts tremendous strain on the Surgeon. As compared to Physicians, Surgeon faces acute stressful conditions during surgery , which are better to be avoided as one grows old.
Obstetrics is a tricky branch in many ways. It expects your services 24/7 all throughout the year. In Obstetrics things can go haywire anytime during pregnancy.
Needless to say, one needs to explain the risks in conducting delivery or LSCS procedures. Your genuine call to do LSCS may be doubted and the consent is delayed due to petty reasons like the consenting person not being present on the scene. The stress can be well understood when the life of the baby or the mother is at risk.
You feel helpless if an Anaesthetist and Neonatologist is not available at a desired time.
Pregnancy has the potential to have unexpected complications during the antenatal period or during delivery.
Hence Obstetricians job is more demanding and risky when compared with that of a Surgeon
In recent years there has been a trust deficit between the patients and the doctors. With a mediocre knowledge of the problem they tend to analyse each of your words with a suspicious mindset and start cross examining you..
.
In addition to all these factors there is added stress to comply with newer Government regulations, waste disposal, fire compliance etc. and also to fulfill all requirements of multiple government schemes and insurance providers.
In spite of doing all this there is a constant threat of media defamation and litigation.
I have not touched upon the controversial topic of Multi-speciality hospitals and their economics, the state of medical education, status of non allopathic branches, doctor-doctor and doctor-industry nexus and the list is endless.
Considering all these facts we have decided to stop medical practice.
We feel at our age we should have our own time.
One can't be expected to be fit and alert all 24 hrs to attend patients. It is essential to ' slow down '
We are already in a grace period and God willing will have a few more years of active life to enjoy the beautiful nature around us, develop or cultivate our own passions, devote more time for personal health and to have quality time at hand.
At times it is but natural to feel emotional to leave our premises which we have developed taking enormous effort and care.
But all good things must come to an end and so must our association with medical practice.
