Sunday, May 1, 2016

Incompetence and Rip-Off in Medical Profession

May 1, 2016
By Saeed Qureshi
There is an uninhibited field day for the medical practitioners in United States. Once you are attached with a PCP (Primary Care Physician), you will seldom get rid of him or her and your ailment minor or major may seldom cure. Your personal accounts could be siphoned off. We have known some patients who turned paupers and their medical afflictions never or partly came to end. In many cases those rather accentuated with the passage of time.

If you are the recipient of Medicare or Medicaid, these departments would keep paying your bills round the year.  In recent years we have read in the press about quite a few fraudulent doctors who milked millions of dollars from Medicare and Medicaid on fictitious or fraudulent billing.

A PCP facilitates the treatment of the patients without wasting their time in the long queues at the hospitals. He refers the cases to other private departments for additional or complimentary services. Yet there must be a code of conduct or strict watch over the PCPs if they manipulate their pivotal role by overcharging or calling the patients more times than needed.

The PCPs may resort to overdosing which may temporary relief but could be harmful in the longer run. Same is the case with the privately run hospitals and nursing homes. Although these may offer between atmosphere and facilities yet overdosing or over-billing has also been complained about them as well.

There could be several reasons for this professional incompetence and financial rip off. The medical students get huge loans from the banks and the financial institutions for payments of their fees and other heavy costs on books, residence and even transportation. These loans could range from half a million to beyond a million with interest bulging with the time passage.

After graduation the first and the foremost urgency or priority for them is to pay off their loans which if not paid, they can lose their credibility and cannot get any loans for the future. These student doctors have no option but to keep their inflow of patients on some pretext or another. This is peculiar to those doctors who are from less privileged sections of society.

The PCPs maintain their links with other counterparts and exchange or share the patients for various procedures. They may be knowing each other for being batch mates or from the same background or working in the same hospitals.

There is a whole range of tests such as for kidneys, prostrate performing MRI or X-RAY, radiology chemotherapy , physical therapy, check up of  heart, eyes, ears and so on. Thus they help and support each other and enable everyone to share the booty. 

It is not with all the PCPs but the number of upright physicians could be limited. The treatments and tests keep going on and the patients keep paying from their own pockets or out of the government insurance schemes.

We are witnesses that the hospitals run by city or county or state or by private entrepreneurs are always overflowing with the patients. This is particularly so in case of the privately run and group-owned hospitals. 

There is a common observation that in such hospitals the doctors dispose off their patients for ensuing visits for a variety of procedures and tests. In case of cancer patients they have to keep visiting the hospitals or the clinics for years or indefinitely. I am not sure how many are finally cured or ultimately pass away.

 If a patient is rushed to the emergency section of a private or even the government hospital and later cannot pay the hefty bills his case is referred to the collection agencies which plunges them into another unending nightmare till they get rid of that burden by selling their properties or assets.

When the medical technology had not advanced or the latest gadgets for various checkups and fast procedures had not come into being, the rate of recovery was higher and the cost was not as astronomical as it is in the present times.

There is continuous research going on for improvements of the medical equipment, instruments treatment and procedures as seen in the hospitals and clinics medical centers. But woefully while the number of patients keeps growing, the rate of cure or healing is correspondingly not rising. One wonders while all the deadly diseases and ailments are now cropping up despite easy detection and prompt testing. Yet the situation in the past was as desperate as it seems now.

This is perhaps due to the perceivable factor that the more illness the more income for the healers. The senior doctors pass on a part of their jobs and responsibilities to the budding doctors who occasionally seem flabbergasted before the patients and cannot offer a plausible or convincing explanation about the nature of the malady or the procedure they would be performing.
The Health sector both public and private needs a thorough overhaul for removing the deficiencies and drawbacks besetting it.  There should be high powered commission that should look into the rising cost on medical treatment, overdosing and over-billing and less rate of recovery from the illness. Some mechanism needs to be put in place to gauge the performance of each and every doctor, department and ward of the hospitals.

Besides the conduct of the physicians and the para-medic staff in their dealing with the patients who come from different ethnic and racial backgrounds, has to be watched. It has been seen that the para-medical staff especially nurses remain overworked and occasionally try to shorten the procedure and show lack of involvement needed in serious cases. The performance and expertise of doctors particularly the new inductees should be kept under strict watch for ensuring the veritable treatment to the patients.

In big and renowned hospitals one can see the plaques of dedication and acknowledgment of the doctors who donated money for constructing patients’ wards, lobby, surgery rooms, or even a complete hospital.  It’s a great humanitarian gesture and demonstration of service by those physicians for the people at large. But at the same time it shows the wealth of the physicians who had retired and are living or passed away. Most of the hospitals that I know are in the   name of famous physicians or governors of the past.

There has been a great deal of negligence or carefree attitude of doctors in the overcrowded hospitals. The patients with serious ailments are seen occasionally by the under-training doctors. The patients are disposed of by prescribing some medicines or in case of wound a fresh bandage. The emergency sections of the main hospitals remain full of patients with extremely serious problems. To be admitted in an emergency ward and get a bed sometime takes takes hours and even after waiting for a full day or night.

That defeats the very purpose of being seen without loss of time in emergency wards. I have seen that inside the emergency departments many patients are kept in corridors till a room was available. I have also seen the scores of patients waiting in front of particular emergency portions to be examined by the doctors. But invariably they are ushered in after an excruciating long wait.
Let me narrate the case of my wife as to give you an idea how she had to spent many years in visiting the hospitals, confronting the casual attitude of the attending doctors and finally culmination in the amputation of her right foot all five toes that was avoidable in the beginning which was ten year earlier. Let me narrate the whole painful saga.

There was a lingering problem of blood circulation in the right and left legs of my wife. It was negligible in the beginning. She has been visiting the Parkland main hospital and its affiliated branches in other cities for several years. Each time after excruciating wait in the lobby, she would be ushered in and after a kind of Doppler test or on few occasions the computer testing she was discharged with some pills or lotions.

When we moved to Tarrant County we started visiting the JPS hospital and its affiliated branches. After a few months the PCP of a local branch at Arkansas Lane referred her to the main hospital for further check up.

She visited Pediatric and Vascular sections umpteen times. The young doctors led by a seemingly senior doctor would appear and let her off by writing some antibiotics. In the meantime her right foot fingers started blackening. The PCP of the local branch, in her SOS reference notes, pointed out gangrene. But in her several subsequent visits, the cardiovascular doctors or those of podiatry showed no panic or urgency and kept her on lotions or small bandages.

I the meantime her all five fingers turned black and started rotting. Twice we had to rush her to the emergency room (not the main emergency section) of the hospital where the attending doctor was horrified to see the foot. She got a prompt x-ray taken and told us that the bones of the foot were still safe from the onslaught of the gangrene.

She ordered her admission in the main emergency ward of the hospital where she lay down the whole day and had to come back without any treatment. We rushed her second time to the emergency department but remained in a precarious condition in the corridor for the whole day without any inspection by a doctor.
It was many days later that the angiography was recommended and Dr. Anderson the head of cardiovascular sections performed the angiography first on the left leg and after a few days on the right leg. It transpired on the second angiography procedure that there was only 5 per cent blood circulation in the right leg while the left leg was in better condition.

A stent was put in her right leg and she was discharged. Thereafter one night at home she lost her body control and started falling down. In the morning she was rushed to the local emergency hospital called emergency room. In view of her serious condition, the doctors rushed her to the Plaza Medical Center in Fort Worth where through a post haste surgery her all five toes or fingers of the right foot were removed. She remained in the Plaza Medical Center for 15 days.

Had the angiography been done at the very outset to determine the blood circulation, her toes could have been saved. But look at the time difference. It took doctors almost ten years to decide about angiography and that too by chance.  That delay cost her five fingers but saved half of her remaining foot.

She limps now and cannot walk without support. I am not aware how many others like my wife could have been the sufferers due to lack of timely detection and immediate follow up action to cure them for their respective health issues.

By that time, although, the meager blood circulation had started but the fingers had decayed and couldn’t be saved and could have affected the rest of the foot if not amputated. I wrote several letters to the high ups but no one was prepared to hold anyone responsible for that gross negligence and medical impropriety.

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