Sunday September 15, 2019

Why patients are not put first in Indian hospitals

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By Dr Aniruddha Malpani
New Delhi: Despite most Indian hospitals claiming that serving the patient is their only priority, the reality is quite different.
Most patients in government-run hospitals are treated very shabbily – and their family members are treated much worse.
Why do hospitals continue putting patients last?
I think there are two reasons for this.
One, of course, is the fact that the hospital authorities can get away with it. They’ve done this for many years, and they feel that it’s not a problem which they need to address.  The number of hospital beds are far fewer than the number of patients, and since they have enough bed-occupancy (and, therefore, enough profitability), they see no need to change what they’re doing.
Their primary focus today is in incentivising doctors ( and other middle-men) to make sure that their beds are full, rather than trying to delight patients. This is a short-sighted approach which will come back to haunt them later.
Times are changing, especially in large cities, where lots of corporate hospitals have empty beds and are no longer profitable. At some point, when they find that their balance sheets are in the red, they will hopefully get their act together.
I think the second reason is that whatever initiatives they’ve tried in order to put patients first haven’t worked very well. Part of this is because they’ve been very half- hearted interventions – for  example, holding a conference;  or adding a few videos on their website.
However, the problem is that no one in senior management has taken ownership of trying to delight patients.  Each hospital should have a chief patient officer, whose job is to make sure that everyone in the hospital remembers that the only reason the hospital exists is to help patients to get better. He needs to champion the cause of the patient if we want things to improve. Ideally, this should be the Chairman of the Board, who can inspire change by taking rounds daily.
Dr Aniruddha Malpani is the Medical Director at Malpani Infertility Clinic
the article first published at docplexus.in

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American Medical Association Urges Americans to Stop Using Electronic Cigarettes of Any Sort

The recommendation followed advice from the U.S. Centers for Disease Control and Prevention on Friday for people

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A man uses a vape as he walks on Broadway in New York City, September 9, 2019. VOA

The American Medical Association on Monday urged Americans to stop using electronic cigarettes of any sort until scientists have a better handle on the cause of 450 lung illnesses and at least five deaths related to the use of the products.

The AMA, one of the nation’s most influential physician groups, also called on doctors to inform patients about the dangers of e-cigarettes, including toxins and carcinogens, and swiftly report any suspected cases of lung illness associated with e-cigarette use to their state or local health department.

The recommendation followed advice from the U.S. Centers for Disease Control and Prevention on Friday for people to consider not using e-cigarette products while it investigates the cause of the spate of severe lung illnesses associated with vaping.

Many, but not all, of the cases have involved those who used the devices to vaporize oils containing tetrahydrocannabinol (THC), the psychoactive component of cannabis.

American, Medical, Electronic Cigarettes
The American Medical Association on Monday urged Americans to stop using electronic cigarettes of any sort until scientists have a better handle on the cause of 450 lung illnesses. Pixabay

CDC officials said some laboratories have identified vitamin E acetate in product samples and are investigating that as a possible cause of the illnesses.

Public health experts have not found any evidence of infectious diseases and believe the lung illnesses are probably associated with a chemical exposure.

Megan Constantino, 36, from St. Petersburg, Florida, quit vaping six days ago after hearing reports of the illnesses and deaths related to vaping.

“It scared me into quitting,” she said.

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Like many users of vaping pens, Constantino picked up the device after quitting cigarette smoking three years ago, and said, “It’s the hardest thing I’ve ever done.”

She added, “I threw the last cartridge away. I took a picture of it and I literally cried.”

Constantino said many people who vape have been “on pins and needles” for the investigation results, and she is concerned that the reports of a link to vaping THC may give people an excuse to ignore the warnings.

E-cigarettes are generally thought to be safer than traditional cigarettes, which kill up to half of all lifetime users, the World Health Organization says. But the long-term health effects of vaping are largely unknown.

American, Medical, Electronic Cigarettes
The AMA, one of the nation’s most influential physician groups, also called on doctors to inform patients about the dangers of e-cigarettes, including toxins and carcinogens. Pixabay

The U.S. Food and Drug Administration has faced mounting pressure to curb a huge spike in teenage use of e-cigarettes, a trend that coincided with the rising popularity of Juul e-cigarettes.

“We must not stand by while e-cigarettes continue to go unregulated. We urge the FDA to speed up the regulation of e-cigarettes and remove all unregulated products from the market,” AMA president Dr. Patrice Harris, said in a statement.

Gregory Conley, president of the American Vaping Association, which advocates for cigarette smokers to switch to nicotine-based vaping devices, said the AMA should be “ashamed of themselves for playing politics with people’s health and protecting the profits of drug dealers.”

He criticized the AMA for “fearmongering about nicotine vaping products” while not mentioning “the very real risks of vaping illicit THC products.”

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Juul Labs declined to comment. Altria Group Inc owns a 35 percent stake in Juul. (VOA)