Sunday, September 04, 2011

Next Doctor, Please

It's been over a month since I last posted and I don't have a real reason for my absence. It was just a case of blogger's block, plain and simple. But nothing resurrects lost blogging mojo faster than a need to rant about something. And rant, I shall.

Over the last couple of months, I have had a few run-ins with the medical community and I have to say that I am thoroughly disillusioned with their ilk. It's not like I was wearing rose-tinted glasses earlier - I posted not too long ago about my earlier run-ins with doctors out to make a quick buck. But three incidents over the last three months have re-opened that particular Pandora's box and made me ever-more suspicious of doctors.

The first happened when Ayaan, pushing an empty swing, got distracted for an unfortunate moment and had the said swing smack into his face. There was not much blood but there was a small cut on his eyebrow and two nasty bruises, both under and above his eye and one on his nose. I was pretty sure it was nothing serious but with head injuries, it's best not to take a chance. So I rushed him to the ER of a reputed children's hospital within quick driving distance of our house.

By the time we got there, Ayaan was clearly past the pain and shock of his injury and was bouncing around in his usual fashion. A doctor came to see him and quizzed us about his injury and my answers to all of his questions - vomitting, dizziness, disorientation - were in the negative. Then he examined Ayaan and announced that, in his opinion, there had been damage to the nasal and ocular bones and since these could cause internal bleeding, it would be best to conduct a CT-scan.

You mention 'internal bleeding' to a mother and she will pretty much acquiesce to anything and before I knew what was happening, I was being ushered over to a counter to sign some forms and fork over a reasonably obscene amount of money. The boy was then made to lie absolutely still and subjected to some radiation so that they could conclude that, surprise surprise, nothing was broken and there were no internal injuries.

At this point, I was a little irked with myself for getting conned into doing the CT-scan but I was still willing to give him the doctor the benefit of the doubt. But get this, we never saw him again. The report was handed over to me by some junior assistant, who reassured me that everything was fine. Along with that, I was handed an ER report which had some medical advice illegibly scribbled on it by the missing doctor. I had to ask the assistant to read it and tell me what was written - an ointment for the wound and advice to return in case of vomiting or excess bleeding - which he did most grudgingly. Obviously, since he had met his objective of fleecing me, the doctor no longer felt any need to deal with me.

Also, my regular paediatrician (who wasn't available at the time of the incident) saw Ayaan a couple of days later and was very surprised that a CT-scan had been suggested at all.

The next incident has been sort of a eye-opening with regards to Tarana's w-sitting and the months of physiotherapy we did in Mumbai. I needed to know whether to continue the same. I met with three doctors here - all highly recommended and successful paediatricians - and all three opined that her physical skills and development were well within the range of normal for her age. They strongly disagreed with the need for any further physiotherapy or corrective footwear. I am totally confused on this front. What the hell was going on in Mumbai then? Were those doctors simply taking me for a ride? Or are these Hyderabad doctors just less experienced with this issue? Having met not one but three of the supposedly best paediatricians here and being told to do nothing (other than favouring closed shoes over sandals), I am a loss to understand this.

The third and last incident happened just last week. I had posted about Ayaan losing his first tooth and I felt that the permanent tooth was coming in a little crooked. I pulled out the number of a dentist that a friend had recommended and took Ayaan along for a check-up. The dentist said that the tooth's alignment was fine but pointed out a black spot on one of the back teeth and informed me that it was a cavity that needed an urgent root canal. Since this was swanky clinic, I was then taken through a power point presentation about root canals (!) and presented with an estimate of 10,000 bucks for the entire procedure. Mind you, this diagnosis was made without a proper x-ray because the oral x-ray probe was too big for a little boy's mouth and Ayaan kept gagging on it before they could get a good picture. Also, when they tapped the tooth, Ayaan felt no pain - a bit unlikely if the tooth was decayed badly enough to need a root canal.

All my money-grubbing doctor antennae were up after this visit so I decided to get a second opinion. And what do you know. Dentist #2, as reputed as Dentist #1 but much less flashy, and his assistant separately examined the tooth and concluded that the black spot was, in fact, not a cavity at all!!! They said it was just a flap of gum that had not grown out of the way and its blackish appearance was a result of blood having clotted there from Ayaan biting down on it whilst chewing. Next steps - do nothing!!!

Now, don't get me wrong. Doctors have as much of a right as the next guy to run their businesses with a profit motive. But profiting through inflated diagnoses and unnecessary medical procedures is clearly and totally unethical. Especially when it means destroying a perfectly healthy tooth or exposing a young child to radiation just so that the hospital can recover the costs of a swanky CT scan machine.

Apologies for the diatribe. I just needed to get that off my chest. And get back into the blogging saddle. Yeah, I'm back, baby! 

27 comments:

  1. Profit motive coupled with a complete lack of regard for a child goddamit, whom you have trained yourself to care for- that is a good enough reason to get riled up!!!

    Good to know that ayaan is fine, and hope your confusion on tarana's varied diagnosis gets sorted soon.

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  2. And are we glad you're back or what?! :)

    I remember this dentist who opined that I needed a root canal, that would cost me Rs. 5,000 5 yrs ago. I got suspicious because he showed me my X-ray on his laptop...how did I know that was my tooth? Plus, the tooth wasn't even painful or inflamed, just chipped. I went for second opinions...4 dentists over 4 yrs dismissed the need for a RC, and I managed to pull along with the tooth for 4 more years before I got it capped (still without an RC). Bah!

    I totally agree with you...this is not acceptable to expose to radiation or mess with some body part unnecessarily. "Don't fix it, if it ain't broke."

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  3. The sad truth is that you can't trust most docs/almost any hospital, any more. On that dismal note, hope you find a good doctor/dentist soon. And, hey, welcome back :)

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  4. Anonymous10:37 pm

    welcome back rohini. quite a cautionary tale of 3 docs there. sad that the ones who fleece give the rest of the fraternity a bad name .

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  5. Hey welcome back! Really missed you! What can i say about docs / hospitals / money making tricks - have had one too many experiences myself - pediatricians and gynaecs! (In the middle of a 2 year period of taking contraceptive pills, a famous and elderly doctor diagnosed me pregnant when I missed a period.... when the test kit showed a negative she insisted it was an tube one)... Hope you find a good and trustworthy doc and hospital soon! Good luck to you......
    and keep them rants coming!!!

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  6. blinkandmiss10:32 am

    What a nightmare it has become - this struggle between using one's intuition and going with some random doctor's recommendation.

    Hope Ayaan's cuts & bruises are better now.

    After a few years of similar experience in Bangalore - we have more or less figured out a reliable system. We found an awesome old general physician who has been recommended by a B'lore based family who have gone to this doc for 25 odd years and love him.

    Also, we have started taking our 3 yr old to him instead of children's doctors. If there is an issue very specific to children, he recommends us to a pediatrician. He blogs here -

    http://badakerecrao.blogspot.com/

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  7. You could in a crux, neglect going to the doctor for yourself. But you can't for a child, and it is unacceptable that doctors should feed off a parent's anxiety. Your rant is justified.

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  8. Yikes Rohini.. that must have been quite the nightmare scenario for any parent - CT Scan, Root Canal.. not words you want to hear within the space of a couple of months !!

    It must be tough in a new city until you find doctors you are able to trust - All the best that it happens soon!

    Good to see you back though :).

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  9. OMG! I cant believe Doctors would do this..especially to little children...Its so scary...hope Ayaan is doing well after the fall
    and yes yes welcome back...waiting for the next post :)

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  10. OMG! whom to trust? Destist - yikes! Poor Ayaan - hope he's doing fine now and hasnt got a scare for them, doctors esp.dentists - sitting in that dentist chair only gives me the scares...

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  11. Omg! hyd is infamous for how commercial the medical practises can get! One fancy hospital in j.hills got a whole body scan done for a hapless friend of minewhen she went with an ear pain! After 10k worth of tests , voila! She has a fungal ear infection! Not that she spent so much so has to have something more but then it was so obvious!
    I most hate it when they play with sentiments of a mother! As if we donot have enuf to deal with! Throwing big medical terms at our lil ones is sooo inhumane!

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  12. [Sur] Yeah, I am a loss when it comes to Tarana. If something needs to be done, I'd rather do it now when I am at home and she's not started school. But I also don't want to go to some random specialist and get prescribed with unnecessary stuff...

    [Starry/ Aparna] Thankfully, at least my regular paediatrician here is very conservative in his diagnosis and medication. When Ayaan had high fever recently, he just said to wait and watch and dose with Crocin as needed and within two days, Ayaan was completely recovered! Most docs would have given antibiotics.

    [Zainab] It is good to be back. i have vowed to be more regular :)

    [Anon] The fleecers seems to be in the majority these days, based on my experience!

    [Sai] Yikes! Yeah, don't even get me started on gynaes. I seriously believe that my first c-section was unwarranted but was done because it was convenient (not to mention lucrative) for the doctor.

    [blinkandmiss] Thanks for sharing the link. Your doctor sounds fascinating! A 70-year old with such zest for life!

    [Banno/ R's Mom] Hain na? Somehow unethical medical practices involving kids seem worse.

    [RS] Ayaan has been blissfully unaware of the dilemna. He quite enjoyed the dentist visits as something novel, except for the x-ray bit. And the CT-scan was a rare treat - imagine going into a tunnel!

    [Sirisha] Gosh! That is crazy. I think I am going to have to be really sick to take myself to a doctor here :)

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  13. Very interesting observations. Been doing various medical tests myself and realised that it is a very thin line that seperates a needed test from a good-to-have to a let-us-fleece-them. And it is so bloody annoying to have to spend so much time in hospitals for not just the ailments but for second opinions. Full sympathies.

    Incidentally, read a doctor's perspective on how these tests sometimes come about (ignoring the let-us-fleece-them category). Check out the book - http://royalvilla.blogspot.com/2011/07/better-surgeons-notes-on-performance-by.html

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  14. Howdy Ro - just read this. I was internet free for a whole 6 days when we went on our trip.
    These things happen here too - my sister and my cousin - both have had to deal with doctors for some issues they had - they just hate the whole medical establishment and the way it functions here. Takes months to get an appointment unless it is an ER situation...also after that when my sis got there, she was checked by the physician's assistant, not the physician. And was told to get surgery done right away - but like you she had had it by then with them all - so she used to research her condition a lot and get opinions from others who had gone through it etc - finally for her back pain simple accu-pressure techniques cut the pain down to more than half the intensity, no surgery needed.
    I am mad that they did a needless CT scan on Ayaan. God how can they subject children to such things unless absolutely needed. Outrageous that he did not meet with you after that.
    Dentist - don't even ask me - I am still looking for a good dentist for myself. Every time I go to one, I come back with more issues than I started with. One told me to come to his main office where he has a 85K equipment to desensitize teeth or some such thing - every tooth would cost me 75 bucks - I asked him - why if there is an issue later I would get a root canal done - but he said - why do you want to wait till that happens! Another one gave me local anesthesia for "deep" cleaning! Before I knew it she injected it into my gums. I was so mad that day. Thank heavens though a million times we have a good pediatrician who will not give even an ointment unless obviously needed. I hope you find a good pede who won't fleece you for no reason.

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  15. Its really shocking to hear your stories.....and I totally empathise with you. As a mother, you would rather be safe than sorry and in all likelihood, I would have probably been conned into the CT scan as well.

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  16. Very scary. I don't think a CT scan for a child is something small... its positively scary for them ... shut in a tube for heavens sake!

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  17. I am very sorry to hear about your experiences Ro and totally totally echo your sentiments. Had a very very rough time with the peds and specialists. Once took Vansh to the closest ENT specialist when he complained of ear pain and after treating it with antibiotics, he called us and told us it would be in his best interest to get operated to get his tonsils removed. By then I had had "experiences" and could almost see through his dishonesty. But honestly its really sad that when it comes to crucial matters like health, you don't know when to trust and when not to.
    About Tarana, I have probably missed your posts on taking her for physiotherapy for her w sitting. Long time back, I had written a post on information that might be relevant for you. We had had a session with a physical therapist in Vansh's school who had shared very useful information about flat feet, correct shoes and correct sitting postures as also simple exercises to be done at home with the kids for the same. Here's the link. See if its of any help

    http://ouralmosteverydayblog.blogspot.com/2008/05/about-leg-pains-and-what-to-do.html

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  18. What happened to my comment? :(

    Anyway, glad your instincts saved the child from an RCT. Grrr. I have many horror stories myself - both in des and pardes.

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  19. Preeti10:57 am

    Wow! Those are really worthy of a good rant!!

    So awful that doctors so shamelessly take advantage of their patients, especially at a time when they may be particularly vulnerable.

    But the scene is the same everywhere, be it hyd, Mumbai (the infamous Lilavati trap) and abroad as well. I guess the best that one can hope for is not to have to have too much cause for medical consultation to begin with...

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  20. aaaaarrrgggggghh!! if they want profit, Ro, they can charge hefty consultation. most of them do. and if you are good i think its fair you do too. but getting people to go through unnecessary procedures is plain dishonest! not simple profit making.

    i am glad you followed your instinct. and i am glad i read this. i will be more careful too.

    and good to have you back! :)

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  21. [Anita] Thanks for the book reco. Will check it out.

    [Noon] It's great that your sister was smart and well-informed enough to avoid the surgery. What makes me mad is that there are millions of other patients who put their blind faith in the medical profession only to be fleeced like this :(
    Have found a good regular paed now who I am very happy with. Very 'do-nothing-unless-absolutely-necessary' types

    [Lawyeramma] They know that and they prey on a mother's anxiety. :(

    [Aathira] Ayaan thought it was a grand adventure to be in a tunnel :)

    [Neera] Thanks for the link. That exercise sounds very doable. And am preferring sneakers for her these days unless we are in the sandpit where crocs make more sense.

    [Chox] Almost everybody does. Which shows how rampant this stuff is.

    [Preeti] Yeah but kids you need to take them for regular check-ups and can't avoid doctors beyond a point.
    How are you doing? How was the move? All settled in?

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  22. Hi Rohini,

    I'm a Hyderabadi currently in Chennai.

    I recommned you visit Dr. Sainath's clinic in Punjagutta. It's a very simple yet clean no-frlls clinic and his rates are quite reasonable compared to the other dentists I've been to in Hyderabad. My whole family including my grandmother has been visiting this dentist for the past few years.

    This is his cell number: 9949283636

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  23. Glad you're back, unnerving to read about so many "fleecing" experiences---wish the kids good health and well being! Am going through blogger's block too--i shall look around for a rant, too!

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  24. Anonymous3:23 pm

    From the other side...I'm shocked at how mercenary my profession has become..exposing a child to the radiation of a CT scanner is unacceptable in my book where a good clinical exam and maybe overnight observation or in the case of an educated clued up mom like yourself, watching him carefully at home would have sufficed!I'm so ashamed!

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  25. Grrr. What everyone else said. Grr.

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  27. Anonymous2:59 pm

    Rohini your post is an eyeopener specially for mothers who get easily worried if her child is hurt or in pain and fall prey for such doctors who are just in this profession to earn money.
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