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Showing posts from July 26, 2015

Subcontracting

In one of my recent blogs I had talked about a person who wanted treatment for TB in our center and Diabetes elsewhere and how I had asked him who takes care of him, if the different diseases are being taken care of at different centers. Over last few weeks, the number of patients who are on treatment for their various ailments from different practioners or institutions have been many. A typical example is this 50 year old man who was brought to us by his wife and daughter. He did not seem too keen to see us. He had a bipolar disease for the last 20 years on treatment form Patna, has a chronic alcohol dependent stage, for which he has been to many doctors, and he has a psoriasis, for which he is on treatment from a homeo-physician. We evaluated him and found that he is in moderate liver failure, due to the chronic alcoholism. We asked, what is that you expect from us? They wanted treatment for Psoriasis only. After going through the initial discussions we told him, unless he stops al…

What is missing

Quite a number of the patients who come to us are the in the geriatric age group. The lady about whom I wrote earlier, her issue on further reflection and questioning was, one of comfort than cure. The family was quite keen to explore options for cure, but what she was asking was for comfort and care. The health care systems they have been to, including ours is not built for comfort or care, but for cure. Comfort for an elderly is, the family around, people to care for her and basic amenities taken care of. She was not sure, once she goes home if she will get the comfort she was experiencing to some extend, in the palliative care ward where she was. But even what was being provided was not enough. Institutions do not allow family to be around to provide care and comfort in a hospital context. We want less disturbance to do the curing. We want all the relatives (other than may be one) out during rounds and nursing care. This is best provided at home, but will Medical care be possible …