Clinical Medicine is the gold Standard: Dr. H B Rajasekhar

Excerpt of the interview with Prof. Dr. H B Rajasekhar, Director of KLES Health Science Institution and Director, USM-KLE International Medical Program, Belagavi on the occasion of Doctors Day.

Dr. H B Rajasekhar is an astute Physician, medical administrator, and teacher par excellence. His dedicated medical profession spanning over five decades is a standing testimony of his contribution to enriching medical education in this part of Karnataka. As a Principal of prestigious J.N Medical College for close to 2 decades, he has taken the institution to the pinnacle of success. Over 16,000 medical graduates have passed out from the institution. He is also the recipient of Dr. B.C.Roy National Award as Eminent Medical Teacher in 1989 and Karnataka Rajyotsava Award in the year 1991. An upright, highly respected teacher and enjoys huge followers of the medical fraternity.
He spoke myarogya.in team on the occasion of Doctors Day-2019

What is the significance of Doctors Day?

Dr. H B Rajasekhar: Doctors day is celebrated in India to commemorate Dr. Bidhan Chandra Roy’s birthday. Dr. Roy was an eminent physician, educationist, philanthropist, freedom fighter and politician who served as the Chief Minister of West Bengal from 1948 until his death in 1962. He was one among very few in history to have obtained F.R.C.S. and M.R.C.P. degrees simultaneously. In India, the National Doctors’ Day is celebrated in his memory every year on 1st July. He was awarded Bharat Ratna on 4 February 1961, India’s highest civilian honor. By being Chief Minister of West Bengal he used to practice medicine and treat patients free of cost. He is a role model for all of us.

Do you subscribe to the view that the medical profession is noble in the present context?

Dr. H B Rajasekhar: Yes very much, it is a noble profession. But deteriorating values and ethics of the society has taken a toll on the medical profession also. Majority of the Doctors are noble to the true sense. There are sporadic incidents in the recent past have brought a bad name to the profession.

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Why is the increasing violence against Doctors?

Dr. H B Rajasekhar: Violence, rude behaviors and manhandling Doctors is a sad affair. Such incidents are happening for the last 5 years. The expectations of patients from doctors are too much. Doctors try to do their best unmindful of their personal comforts. Society must realize that Doctors is also a human being. The priority of any Doctor is to save a life; unfortunately few patients succumb to death. One must realize, Doctor is not a god and present generation of Doctors are working under tremendous stress. He immediately noted that patients reach a hospital very late with multiple complications. Particularly tertiary care hospitals treat a large number of complex cases and they are brought/referred to hospital with multiple complications majority of the patients get well but unfortunately few of them die in ICUs. It becomes difficult for the relatives to accept the death of their dear ones among them few resort to violence.

Sir, You being the pioneer in the medical profession over 5 decades, what are concrete solutions to build trust and confidence between Doctors and patients/attendees?

Dr. H B Rajasekhar: I would suggest a few points which every practicing doctor must ponder and practice to quell the violence and build trust between patients and attendees. Lack communication is a major concern, every treating doctor must set aside quality time to an attendee and explain in the language they understand. Medical jargons are complex and common men will not understand. A doctor must go down to the level of them and explain in the language that relatives understand. Complications of the treatment, outcome and side effects must be explicitly explained to them. Communication is an art, unfortunately, nuances of communication are not taught in medical schools. An additional aspect is listening is an art, listen with rapt attention. Loss of faith and suspicion are other areas of concern Doctor should engage in continuous dialogue with relatives, clear their apprehension. Patient on a mechanical ventilator and prolonged ICU stay, post-surgical complications, increase in hospital bills, poor service by support staff, poor or confusing message leads to unrest among relatives. Build trust, do not hide anything, be straight and clear. If relatives want second opinion/change of Doctors and shifting to other hospitals must be given honest considerations. Lastly, I urge doctors to give quality time to the patient/attenders. Even if the outcome is worst, relatives must carry home the message that Hospital staff and Doctors did their best. I strongly feel humanities, communication, and basic management skills should be part of the curriculum of medical education.

What are opinions on the increase in the treatment/diagnostic cost?

Dr. H B Rajasekhar: Ever since stepping in of Corporate Hospitals in the country (1985-86) Clinical Medicine and bedside practice has slowly disappeared. Glorified medical technology, state-of-the-art medical gadgets, expensive laboratory diagnostics have changed the health scenario in the country. Unfortunately, clinical acumen is slowly disappearing. I strongly believe, relevant/genuine investigations are necessary. But, the majority of our sick population comes from poorer segments of the society who cannot afford expensive investigations. In such cases, the Clinical Medicine is the gold standard. The skill, knowledge, intelligence and the lessons learned from medical schools must be followed by all Doctors and carry out bare minimum and essential investigations. He also added, Health is a state subject, Government seriously think and upgrade the facilities in PHC/UHCs to take care of all primary illnesses.

What are your Words of wisdom for young medicos?

Dr. H B Rajasekhar: I only suggest do honest, compassionate, quality professional work. Medicine is not a business, it is a noble profession. Get abreast with professional skills, update knowledge in medicine. As a doctor, you should display sympathy, compassion, love, and concern for fellow human beings. Particularly be considerate to poor and downtrodden. We must treat disease to the best possible extent. I hope the young Doctors follow the above said basic principles to avoid unpleasant situations in their practice. I wish all the fraternity a Very Happy doctors Day. Good day, and Thank you.

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