Missing Dimension in Surgery

1. Missing Dimension in Surgery Dr. Rama Kant MS, F.R.C.S.I., FICS, M.N.A.M.S., F.L.C.S. Director Professor SIPS Superspeciality Institute Managaing Director “PILES TO SMILES” Clinic and Rama Consultations & Training Center, Lucknow.

3. KARO SAFAL AUR PAO SAFALTA

5. I wish to say that I think and feel today, with the proviso that tomorrow probably, I shall contradict it all. - Ralph Waldo Emerson Misra. UPASICON Bareilly

7. SURGICAL INTUITION • A privelage of the expert not a short cut to becoming an expert…

8. Missing Dimension Only thing missing is the tank Misra. UPASICON Bareilly

9. Modern Surgery Ancient Surgery Misra. UPASICON Bareilly

10. Doctor HUMANISTIC INTERPRETATION OF THE LETTERS OF THE WORLD ‘DOCTOR • D = DUTY • O = OATH (M.C.I.) • C = COMPASSION • T = TECHNICAL COMPETENCE • O = OTHER DOCTORS’ SUPPORT • R = REVERENCE FOR HUMAN PERSONALITY Misra. UPASICON Bareilly

11. Making of A Doctor • Ours is a Nobel profession there is no doubt about it. • Expectations of the society are high from us. Because no one else deals with the Human Life as we deal. • But doctor is the product of the same society hence one should not expect him to be different from the rest of the society. Misra. UPASICON Bareilly

12. Making of a doctor : • Entry to Medical College. • P.G. Examination. • Money and Time Spent. • A surgeon is not well compensated for his hard labour, intelligence and time spent. • RELATIONSHIP IN DOLODRUMS??????????

13. Is it worth? It depends on your mental attitude. If you want, a reasonable living, fame, a status in the society and to be of some service to the society- yes. But if the main idea is to earn money then sir your choice has not been correct.

14. Present Social Norms • Indias has become an ocean of filth consisting of • 1- Corruption, 2- Malpractice, 3- Foul Play, 4- Moral Values deterioration, 5- Ethical values degradation • Dominant motive of life is money, earned by fair or / foul means. A few examples are- • Mumbai Municipal sweeper : Rs. 82 lacs • Chairman central board of customs Rs. 5 Crores Misra. UPASICON Bareilly

15. Present Social Norms Contd. • Why ethical prerogative only for those in medical profession. • Why not for school and colleges where you can not admit without donation. Businessmen can stoop to any depth to get their work done. Journalists - they blackmail and blackmail. • Priests and preachers fully exploits the faith and innocence of not only uneducated but educated once also. • Why should any one assume that the doctor should be radically different? It is an unrealistic idea. Misra. UPASICON Bareilly

16. SCAMS BY POWERFUL – POLITICIANS CWG ????? RECENT SPECTRUM SCAM LACS OF CRORES • 1994 Sugar Scam 625 Crores • 1995 Fodder Scam 600 Crores • 1996 Urea Scam 133 Crores • 1996 Medical Scam 1000 Crores • 1996 Telecom 1200 Crores • Money deposited in Swiss Bank of Indian politicians is more than 40,000 crores • SurendraNath (Plane Crash) 60 crores were found with (Ex – Governor Punjab) him during air crash • Central Minister Sukh Ram Rs. 30 Crores were found in his pujaghar Lust has been added to greed (Tehelka)

17. MINDSET AND PERSPECTIVE Hum padavkosamjheymanzil Lakshyahuaaankhon se ojhal Vartmankemohjaal men Aanewalakalnabhulayen Aoo fir se diya jalayen

19. CHANGE YOUR PERCEPTION STILL THERE IS HOPE…………

20. Will these lines ever converge?

21. It is possible . . . .

24. INTERPRETATIONS DURING CLEANING THE HOUSE A FATHER GETS A VERY OLD DAIRY OF HIS SON AND HIS OWN AND STARTED SEEING THE OLD EXPRESSIONS……… AT ONE PARTICULAR DAY SON WROTE: THIS WAS THE BEST DAY OF MY LIFE WHEN ME AND MY DAD KEPT SITTING THROUGHOUT THE DAY FOR FISHING BUT COULD NOT CATCH A FISH BUT STILL I ENJOYED THE TIME OF HIS COMPANY AND FELT THAT THIS WAS BEST DAY OF MY LIFE SAME DATE HIS FATHER HAD WRITTEN IN HIS DAIRY THAT HE LOST THE WHOLE DAY WITH HIS SON WAITING FOR A FISH BUT CATCH NONE….. THIS IS THE DIFFERENCE OF INTERPRETATION….

31. APPRECIATION

32. Professional Surgical Practice • Doctors must remember that patient is their most valuable asset. • Our income, our reputation, our self esteem, our job satisfaction all depends on him. • Doctor is a daily wage earner, he earns only when he works. • Many doctors are professionally competent but unsuccessful in practice because they do not know how to run practice. • Medical practice has two components: Decision making and technical skills and also equally important is managerial functions for which one must have a financial adviser. Misra. UPASICON Bareilly

33. Patient Losing Technique • Interruptions – Repeated telephones and visits by friends, relations and colleagues while a patient is being attended. • Waiting -Make patient wait repeatedly without good reasons and you will wait for him for the rest of the life. • Privacy - Ignore the privacy of patient as we may not be particular but patient is particular about his / her privacy. • Inferiority - Make the patient feel inferior. Let the patient feel that you are his family member. • Impersonal - Treat him as a file and not a human being. • Rude and callous staff • Dirty office • Do not hear complaints • When patient do complain don’t get offended, patient who complain may be more loyal than some one who keeps his dissatisfaction to himself. Patient is the boss Misra. UPASICON Bareilly

34. Likeability Factor • Determines your success. • Need to be liked by others is universal. • An attribute were one creates positive emotions in others. • Physical appearance, dress, common interests, experiences. • Compliment others on there achievements. • Popular – Trustworthy, Motivated, Serious, Decisive and Hard Working. • Unpopular – Arrogant, Conniving, Manipulative. • To improve your likeability at the woekplace, work on these factors: - Be friendly, be open in your communication with others -connect with others, atempt to know more about them. -Empathise with others’ feelings. -Your integrity, hard work should complement your likeability.

35. Things You Don't Want to Hear During Surgery • Has anyone seen my watch? • That was some party last night. I can't remember when I've been that drunk. • Damn! Page 47 of the manual is missing! • OK, now take a picture from this angle. This is truly a freak of nature. • Better save that. We'll need it for the autopsy. Come back with that! Bad Dog! • Wait a minute, if this is his spleen, then what's that? Misra. UPASICON Bareilly

36. Medical Ethics • The words are very respectable but in the changing society they are only – “Decorative from outside hollow from inside. Attractive to here but difficult to follow.” Some of the question are : • Should doctors be allowed to advertise, float their website Yes/No. Well patient has the right to make an informed decision regarding his choice of doctors. Hence doctors Qualification, Specialization, Address should be made available for the benefit of patient. Medical Ethics Matter Misra. UPASICON Bareilly

37. Medical Ethics Contd. • Doctor – Doctor Relationship • Free consultation / service • Accepting a patient of other doctor without his consent? • Family physician behaving like specialist and vice versa • Etiquette in reference • Commission If you practice the profession the way it is meant to be practiced you will earn enough to be comfortable and there will never be a need to resort to any thing that can be termed unethical. Misra. UPASICON Bareilly

38. RESPECT TO ALL

43. ATTACKS ON DOCTORS AND HOSPITALS BECOMING FREQUENT • FALSE LEGAL CASES FILED AGAINST DOCTORS • POLICE INTERFERENCE INSPITE OF SUPREME COURT VERDICT OFTEN LEADING TO ARRESTS OF DOCTORS UNDER DISGUISE OF CHANGED FIRs.

49. ATTACKS ON DOCTORS AND HOSPITALS BECOMING FREQUENT • FALSE LEGAL CASES FILED AGAINST DOCTORS • POLICE INTERFERENCE INSPITE OF SUPREME COURT VERDICT OFTEN LEADING TO ARRESTS OF DOCTORS UNDER DISGUISE OF CHANGED FIRs.