Improving Patient & Family Health September, 2012 Rs.10Chief Editor : Dr. Aniruddha Maplani M.D.

The income-tax department would tax the amount pharmaceutical and allied health sec-tor industries spend on freebies for medical practitioners and their professional associa-tions. Those who accept the freebies will also be taxed.The decision follows amendment to Medical Council of India regulations banning doctors and their associations from accepting freebies that include gifts, money, travel facility and hospitality extended by pharma companies and manufacturers of medical devices and nu-traceuticals

If you are being charged more or are getting poor quality service at a hospital — both public and pri-vate -- you can soon get your grievance redressed with the government planning to set up a health quality regulator. The regulator, both at the nation-al and state level, is expected to be empowered to audit heath facilities and standards of treatment in hospitals to ensure quality service at rea-sonable cost. “There is need for much better regulation of both public and private sec-tor hospitals. I am not talking only of big hospitals but also of hospitals with 10-15 beds,” Planning Commission deputy chairman Montek Singh Ahluwalia said. The pro-posal, being discussed with health ministry officials and other stakeholders, will be incorporated along with other initiatives in the 12th five-year plan. Ahluwalia also suggested more autonomy for big public sector hospitals, along with strengthening the professional and managerial capability in such hospitals. Denying any move to privatize health services, he said the role of public sector in health-care would increase in the 12th plan. “Health will be top-most priority of the government in the next five years. The impression that the commission wants to bring down public spending on health is wrong,” he said. “If you see the government spending only on cu-rative health, then it will not be more than 2%,” Ahluwalia said, adding that there were capacity

constraints to absorb the fund. He said providing free medicines, upgrading all district hospitals to medical colleges and expansion of medical edu-cation were priority areas for the government dur-ing the 12th plan. Around 100 district hospitals

across the country could be upgraded to medical colleges in the next five years to meet the acute shortage of trained doctors and medical staff. A provision to provide free ge-neric medicines is also under consideration for the 12th plan period. The medicines would be purchased by a centralized agency and distributed free to patients across the country.

(Source: TOI, Aug 11, 2012)

A blood test can detect the exact bacteria or virus that has caused septicemia — the most common life threat-ening blood infection — in a patient. The new test will take only seven hours instead of four days that the existing test requires.The same test will also be able to tell doctors which antibiotics the organism is resistant to, saving pre-

cious time and increasing the patient’s chances of survival. Scientists from the Centre for Cellular and Molecular Biology (CCMB) in Hyderabad have discovered a DNA-based di-agnostic tool that can identify all 27 organisms that causes septicemia — an infection that leads to a dangerous build-up of bacteria in bloodstream. Mil-lions of patients can be saved.

HEALTH REGULATOR AT HOSPITALS SOON

FREEBIES TO DOCTORS

CCMB-RESEARCH TO SAVE MILLIONS OF PATIENTS

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Colostrum (also known as beestings or first milk) is a form of milk produced by the mammary glands in late pregnancy and the few days after giving birth. Human and bovine colostrums are thick, sticky and yellowish.In humans, it has high concentrations of nutrients and antibodies, but it is small in quantity. Colostrum is high in carbohydrates, high in protein, high in antibodies, and low in fat (as human newborns may find fat difficult to digest).Newborns have very small digestive systems, and co-lostrum delivers its nutri-ents in a very concentrat-ed low-volume form.It has a mild laxative effect, encouraging the passing of the baby’s first stool, which is called meconium.This clears excess biliru-bin, a waste product of dead red blood cells which is produced in large quan-tities at birth due to blood volume reduction, from the

infant’s body and helps prevent jaundice. Colostrum con-tains large numbers of antibodies called “secretory im-munoglobulin” (IgA) that help protect the mucous mem-branes in the throat, lungs, and intestines of the infant.White blood cells are also present in large numbers; these begin protecting the infant from harmful viruses and bacteria.Ingesting colostrum establishes beneficial bacteria in the digestive tract. Premature babies tend to fare better

on human colostrums than commercial infant formulas.Human milk contains special components, called growth modulators, that help the premature baby’s digestive system adjust to oral feed-ings.Research indicates that pre-mature babies fed formula tend to vomit more and con-tinue tube feeding longer than those fed human colos-trum and breast milk.

Ear infections are the most common illnesses in babies and young children. Most often, the infection affects the middle ear and is called otitis media. The tubes inside the ears become clogged with fluid and mucus. This can affect hearing, because sound cannot get through all that fluid.If your child does not yet talk, you need to look for signs of an infection:• Tugging at ears• Crying more than usual• Ear drainage • Trouble sleeping• Balance difficulties• Hearing problemsOften, ear infections go away on their own, but your Doctor may recommend pain relievers. Severe infec-tions and infections in young babies may require anti-biotics. Children who get frequent infections may need surgery to place small tubes inside their ears. The tubes relieve pressure in the ears so that the child can hear again.

A phobia is a type of anxiety disorder. It is a strong, irrational fear of something that poses little or no ac-tual danger. There are many specific phobias. Acro-phobia is a fear of heights. You may be able to ski the world’s tallest mountains but be unable to go above the 5th floor of an office building. Agoraphobia is a fear of public places, and claustrophobia is a fear of closed-in places. If you become anxious and extremely self-con-scious in everyday social situations, you could have a social phobia. Other common phobias involve tunnels, highway driving, water, flying, animals and blood.People with phobias try to avoid what they are afraid of. If they cannot, they may experience• Panic and fear• Rapid heartbeat• Shortness of breath• Trembling• A strong desire to get awayTreatment helps most people with phobias. Options in-clude medicines, therapy or both.

Source NIH

WHAT IS COLOSTRUM

WHAT IS PHOBIA EAR INFECTIONS AND BABIES

20 TIPS TO HELP PREVENT MEDICAL ERRORS

One in seven Medicare patients in hospitalsexperience a medical error. But medical errors canoccur anywhere in the health care system: Inhospitals, clinics, surgery centers, doctors’ offices,nursing homes, pharmacies, and patients’ homes.Errors can involve medicines, surgery, diagnosis,equipment, or lab reports. They can happen duringeven the most routine tasks, such as when a hospi-talpatient on a salt-free diet is given a high-salt meal.Most errors result from problems created by today’scomplex health care system. But errors also happenwhen doctors* and patients have problemscom-municating. These tips tell what you can do toget safer care. What You Can Do to Stay SafeThe best way you can help to prevent errors is to bean ac-tive member of your health care team. Thatmeans taking part in every decision about your-health care. Research shows that patients who aremore involved with their care tend to get betterresults.Medicines 1. Make sure that all of your doctors know aboutevery

medicine you are taking. This includesprescription and over-the-counter medicines anddietary supple-ments, such as vitamins and herbs.

2. Bring all of your medicines and supplements toyour doctor visits. “Brown bagging” yourmedicines can help you and your doctor talkabout them and find out if there are anyproblems. It can also help your doctor keep yourrecords up to date and help you get better-quality care.

3. Make sure your doctor knows about anyallergies and adverse reactions you have had tomedicines. This can help you to avoid getting amedicine that could harm you.

4. When your doctor writes a prescription for you,make sure you can read it. If you cannot readyour doctor’s handwriting, your pharmacistmight not be able to ei-ther.

5. Ask for information about your medicines interms you can understand—both when yourmedicines are pre-scribed and when you getthem: What is the medicine for? How am I supposed to take it and for howlong? What side effects are likely? What do I do ifthey oc-cur? Is this medicine safe to take with othermedicines or dietary supplements I amtaking? What food, drink, or activities should I avoidwhile taking this medicine?

6. When you pick up your medicine from thepharmacy, ask: Is this the medicine that mydoctor prescribed?

7. If you have any questions about the directionson your medicine labels, ask. Medicine labelscan be hard to understand. For example, ask if“four times daily” means taking a dose every 6 hours around the clock or just during regularwaking hours.

8. Ask your pharmacist for the best device tomeasure your liquid medicine. For example,many people use household teaspoons, whichoften do not hold a true teaspoon of liquid. Special devices, like marked sy-ringes, helppeople measure the right dose.

9. Ask for written information about the sideeffects your

medicine could cause. If you knowwhat might happen, you will be better preparedif it does or if something unexpected happens.Hospital Stays10If you are in a hospital, consider asking allhealth care workers who will touch you whetherthey have washed their hands. Handwashing canprevent the spread of infections in hospitals. 11When you are being discharged from the-hospital, ask your doctor to explain thetreatment plan you will follow at home. Thisincludes learning about

your new medicines,making sure you know when to sched-ulefollow-up appointments, and finding out whenyou can get back to your regular activities. It is important to know whether or not youshould keep taking the medicines you weretaking be-fore your hospital stay. Getting clearinstructions may help pre-vent an unexpectedreturn trip to

the hospital.Surgery 12. If you are having surgery, make sure that you,your

doctor, and your surgeon all agree onexactly what will be done. Having surgery at the wrong site (for example,operating on the left knee instead of the right) israre. But even once is too often. The good newsis that wrong-site surgery is 100 percentpre-ventable. Surgeons are expected to sign theirinitials directly on the site to be operated onbefore the sur-gery.

13. If you have a choice, choose a hospital wheremany patients have had the procedure orsurgery you need. Research shows that patientstend to have better re-sults when they are treatedin hospitals that have a great deal of experiencewith their condition.

Other Steps14. Speak up if you have questions or concerns. You-

have a right to question anyone who is involvedwith your care.

15. Make sure that someone, such as your primarycare doctor, coordinates your care. This isespecially im-portant if you have many healthproblems or are in the hospital.

16. Make sure that all your doctors have yourimportant health information. Do not assumethat everyone has all the information they need.

17. Ask a family member or friend to go toappointments with you. Even if you do not needhelp now, you might need it later.

18. Know that “more” is not always better. It is agood idea to find out why a test or treatment isneeded and how it can help you. You could bebetter off without it.

19. If you have a test, do not assume that no news isgood news. Ask how and when you will get theresults.

20. Learn about your condition and treatments byask-ing your doctor and nurse and by using otherreliable sources. For example, treatment optionsbased on the latest scientific evidence areavailable from the Effective Health Care Website (effectivehealthcare.ahrq.gov/options). Askyour doctor if your treatment is based on thelatest evidence.

Doctors know only what you tell them.- Don HaroldAs a patient, you have to shoulder a wide variety of re-

sponsibilities ! 1. You should provide your doctor with accurate and

complete information about your medical history, past illnesses, allergies, hospitalizations and medications.

2. You should report changes in your condition (however minor they may seem to you) to your doctor - don’t keep him in the dark!

3. If you do not understand what your doctor says or wants you to do, you should let him know without any hesitation!

4. You should strictly follow your doctor’s treatment plan.

5. You should keep your appoint-ments on schedule, and if you cannot do so for any reason, let your doctor know well in ad-vance.

6. You should pay your medical bills promptly!

7. You should follow hospital rules and regulations without fail.

8. You should have realistic ex-pectations of what the doctor can do for you. Every-one would like to get well completely, but one should always bear in mind that the doctor is not a miracle worker.

9. You should help your doctor to help you! If you can-not stick to a particular treatment plan, let your doctor know, so that he can formulate an alternative plan.

10. You should maintain good health habits.11. You should participate actively in your medical care.

Patients who are highly motivated get better faster: in other words, help your body to heal itself!

12. You should ask questions to clarify any doubts or dispel any misconceptions in your mind. A doctor or nurse may not know when you’re confused, uncertain or just want more information. Therefore, do not re-frain from asking questions.

13. You should respect the doctors and the nurses. The medical staff deserve your respect and courtesy: treat them the way you would like to be treated by them!

14. You should not ask for false medical certificates or padded medical bills (in order to get additional reim-bursement).

While you obviously have a vital interest in your medical treatment, unfortunately, you lack the specialized medical knowledge and skills to be able to take decisions in this context alone. This is why the concept of a team - which consists of you and your doctor becomes very important. As a patient, your responsibilities are wide and varied. And you’ll need to play several “roles” at various times.Medical Information ResearcherThe more knowledgeable you are about your problem and its treatment, the better are your chances of getting the right treatment. Educate yourself: you need to become an informed participant in your medical care in order to ask the right questions and to participate in making deci-

sions about your treatment. This step will also help you to critically assess media reports about ‘new breakthroughs in medical treatment’, and whether these ‘breakthroughs’ are relevant to your problem or not.Medical Team ManagerYou will have to find, evaluate, select, hire - and some-times fire - members of your medical team. As an enlight-ened patient, you need to remember that you are the one in charge of your body --- and that it’s your medical team you are managing!

Treatment Decision MakerYou will have to decide which treatment to choose among the alternatives. Sometimes the choices are straightforward, but sometimes they can be very confusing. A good doctor will of-fer you all the options and help you to decide, but ultimately, you have to exercise your right (and responsibility!) to select a course of treatment. You cannot afford to leave everything to god, or to the doctor either!Medical Record KeeperYou must keep all your records

safely, and this can be very helpful especially if you have a complex problem a chronic disease, or need to change doctors or get a second opinion. File all your records in reverse chronological order; and number all your docu-ments in sequences. Also prepare a one-page summary sheet of your medical experiences. Software packages are available nowadays, which help you document all medical details very efficiently.Financial ManagerMedical treatment, can be very expensive these days, and you must make it a point to know the costs involved. Many patients are hesitant to talk to their doctor about money matters, but this reluctance can prove to be very costly! Also, if you are claiming reimbursement (either from an insurance company or from your employer) you must make sure that you have complete records of pay-ments made along with their receipts. CommunicatorIt is vitally important that you be open and honest with your doctor. When in doubt, ask questions, listen to the answers carefully and take notes. A prudent measure would be to write down your questions before your ap-pointment, so that you do not forget important matters during the stress of consultation. Remember, the only stupid question is the one you don’t ask! So, to re-em-phasize, don’t hesitate to ask questions! And if you don’t understand the answers, the fault is not all yours; it could be that your doctor is not explaining the facts well! There is no doubt that the one person who will look after his own interests the best is the patient himself. You need to do your homework thoroughly, find out more about your problem , and then discuss the results of your research with your doctor. This is your right, and your responsibility as well! Every honest doctor will agree that his patients are his best teachers!

The Responsibilities of a Patient: Quite a Load!

High blood cholesterol is one of the major risk fac¬tors for heart disease. In fact, the higher your blood cholesterol, the greater your risk of developing heart disease or hav-ing a heart attack. Heart disease is the #1 killer of men and women in the United States. Each year, more than a million Americans have a heart attack, and about half a million people die of heart disease.How Does Cholesterol Cause Heart Disease?When there is too much cholesterol (a fat-like sub¬stance) in your blood, it builds up in the walls of your arteries. Over time, this buildup causes “hard¬ening of the arter-ies” so that arteries become nar¬rowed and blood flow to the heart becomes slowed down or blocked. This may cause chest pain or even a heart attack.High blood cholesterol itself does not cause symp¬toms, so many people are unaware when their cholesterol is too high. It is important to find out your cholesterol num-bers. Lowering levels that are too high lessens the risk of developing heart disease or dying from it if you already have it.Questions to Ask Your Doctor about Cholesterol MedicationIf you’re concerned about why your doctor has prescribed statins to lower your cholesterol, here are a few ques-tions to ask:• Why do you think I’m a good candidate for this

medication?• What will this do for me and my body?

• What are the potential benefits versus the risks to me specifically?

• Will this have any interactions with anything else I’m taking? (Be sure to tell your doctor if you’re tak-ing over-the-counter medications or supplements. Several supplements can interact with statins.)

• What are the long-term goals of therapy? • Can I take a supplement instead of a statin to lower

my cholesterol? • Will supplements interfere with the effects of the

statin?

WHY IS CHOLESTEROL IMPORTANT?

It is a common form of skin eczema that occurs in parts of the body with high oil (sebum) production. Body areas that are commonly affected include the scalp, ears, face, chest, and folds of skin, such as the underarms or the skin below breasts or overhanging abdominal folds. The cause of seborrhea is unknown. A yeast that often lives on the skin, Malassezia furfur, may play a role.One common manifestation of seborrhea that affects the scalp is dandruff. Scalp seborrhea can also present as thick, flaky, localized patches of scale. On the face, seborrhea produces reddish-brown, dry-looking, or thick, greasy scales on the eyebrows, sides of the nose, and behind the ears. Reddish, scaly patches may also appear in the folds of skin mentioned above. Although skin af-fected by seborrhea may feel “dry,” mois-turizing only makes them redder.Scalp seborrhea and dandruff do not cause permanent hair loss. Often, scalp dandruff doesn’t even itch significant-ly. Seborrhea can appear during in-fancy, starting shortly after birth and lasting several months. It may af-fect the scalp or produce scaly patches on the body. Adults of all ages may develop sebor-rhea, too, especially on the scalp and face.Some people who have weakened immune systems, such as those on cancer treatment or those

with HIV disease or certain neurological disorders, may have very severe seborrhea. It is important to emphasize, however, that seborrhea is a very common condition, af-fecting perhaps 5% of the population (with men predomi-nating). People who have it are completely healthy and

have no internal or immune problems.

WHAT IS DANDRUFF (SEBORRHEA)?

After spending around 1% of gross domestic product (GDP) on health in the past five years, the government is proposing an increase in public spending by half a per-centage point to make it 1.58% for the coming five years (2012-17) under the 12th Plan.This is what the draft chapter on health in the Plan docu-ment says. Health experts and activists are up in arms at this meagre increase because even the Planning Com-mission’s high-level expert group and the steering com-mittee on drafting the Plan had suggested at least 2.5% of GDP as the public health spend.But, what happens with low spending? The Planning

Commission’s own analysis of the state of the country’s healthcare system reveals the rot within.The latest available rural health statistics for 2011 show a shocking shortfall of human resources, be it doctors, nurses or other healthcare personnel . According to the Planning Commission’s draft, the country’s government-run healthcare system is hamstrung because the number of doctors is short of the target by a jaw-dropping 76%, there are 53% fewer nurses , specialist doctors are short by 88%, radiographers are short by 85% and laboratory technicians are short by 80%.

A few suggestions, which I think can make healthcare more affordable in our country, are:a) Hospitals should focus on designing cost effective

treatment for patients.b) Major cost is taken up by medicines. Everyone should

contribute in lowering the cost, for e.g., the govern-ment should reduce taxes; pharma industries can lower the prices and doctors may use the generics rather than branded drugs.

c) Social insurance schemes.d) Judicious use of investigations and technology by

doctors.e) Patient education on disease prevention is far more

important and cost effective than cure.Dr A K Dewan Medical Director, Chief of Head and Neck Surgery, Surgi-cal Oncology Rajiv Gandhi Cancer Institute and Research Centre

1. Get a cash memo, for whatever you purchase. Tally the details of purchased drugs from the cash memo.

2. Check the printing of Batch No’s and Expiry date, if it gives an impression of doubt, it may be case of Spurious Drug.

3. Check the bottle/ vial/ ampoule/infusion for clarity and color of solution, if it contains any visible parti-cle or has changed colour, it may be a case of sub standard drug.

4. Check the foil of blisters; it should be of good quality, if it is not of good quality, it can be spurious.

5. If the purchased drug doesn’t give desired results, it is a case of Spurious Drug.

6. Spurious Drugs are sold without cash memos, there-fore avoid purchasing without cash memo.

7. Substandard drugs are those, which fails to meet required standards, while spurious drugs fictitious products and are not manufactured by manufactur-ers purported to be claimed to have manufactured.

Hope If any consumer follows above he will not face any problem. Chandra Bhushan Gupta Assistant Drugs controller Govt Of RajasthanPhoto pharmacy

AIDCOC

SHORATAGE OF DOCTORS-PLANNING COMMISSON REPORT

The All India Drugs Control Officers’ Confederation (AID-COC) has urged the union health ministry to bring the prices of 348 medicines included in the National List of Essential Medicines (NLEM) 2011 under Drugs Price Control Order (DPCO).In a representation to union health minister Gulam Nabi Azad, AIDCOC secretary general Ravi Uday Bhaskar said that the government had promised capping of prices of all essential drugs under NLEM in the pharmaceuti-cal policy 2012, but it has not taken any concrete step towards fulfilling it. He also wanted the ministry to ration-alise the difference between the ex-factory price and the MRP of the medicines as the profit margins are exceed-ing more than 1000 per cent on some of the formulations.

Coronary artery disease (CAD) occurs when the arteries that supply blood to the heart muscle (the coronary arteries) be-come hardened and narrowed. The arteries harden and nar-row due to buildup of a material called plaque on their inner walls. The buildup of plaque is known as atherosclerosis. Some hardening of the arteries occurs normally as a person grows older. In atherosclerosis, plaque deposits build up in the arteries. Plaque is made up of fat, cholesterol, calcium, and other substances from the blood. Plaque buildup in the arter-ies often begins in childhood. Over the time, plaque buildup in the coronary arteries may result in:1. Narrow the arteries. This reduces the amount of blood and

oxygen that reaches the heart muscle.2. Completely block the arteries. This stops the flow of blood

to the heart muscle.3. Cause blood clots to form. This can block the arteries that

supply blood to the heart muscleDiabetic patients run higher risk of CAD due to thickening of

artery walls. In such case, neither bypass nor angioplasty will serve the purpose. The patient will require repeated sur-gical interventions.

WRUDVED is a 100% ayurvedic proprietary remedy to im-prove the myocardial perfusion and functional stability. Manu-factured under FDA licence and sold direct to heart patients at an affordable cost. For more details visit: www.wrudved.com or contact SUBBIES HERBO CARE by email: info@wrudved.com Customer Care No. 09320119741

CHECK THE FOLLOWING- BEFORE PURCHASING

MEDICINES

MAKING HEALTHCARE MORE AFFORDABLE

AYURVEDIC CURE FORCORONARY ARTERY DISEASE

1. AVOID (processed) sugar; unhealthy (vegetable) oils and eat plenty of plant-based foods. The cancer-fight-ing compounds in fruits and vegeta-bles are called: isothiocyanates, in-dols, cumines, phenols and flavones.

2. Reduce your exposure to electromag-netic field (EMF) pollution. Use EMF protectors for your computer monitor; limit cell phone usage; turn “off” the circuit breaker in your bedroom when you sleep and get grounded by con-necting your body to the earth.

3. Stay active - breathing, meditation, walking and Tai Chi are excellent ways to improve your energy. The

higher your (cellular) energy - the less like you are to develop cancer.

4. Eliminate toxic chemicals from your life. Don’t invest your money in poison-ous household cleaners, personal cos-metics or non-organic foods. (to name a few)5. Do NOT smoke, drink alcohol or use recreational drugs. Minimize salt in-take and be sure to get plenty of sleep to help reduce stress and rejuvenate the body.6. Develop healthy relationships. Nev-er underestimate the power of grati-tude, forgiveness and LOVE.

6 ways to prevent cancer - NaturallyThe “ Speak Up “ Program in the USAencourages patients to:• Speak up if you have questions or

concerns, and if you don’t under-stand, ask again. It’s your bodyand you have a right to know.

• Pay attention to the care you arereceiving. Make sure you’re get-ting the right treatments and med-ications by the right healthcareprofessionals. Don’t assume any-thing.

• Educate yourself about your diag-nosis, the medical tests you areundergoing, and your treatmentplan.

• Ask a trusted family member orfriend to be your advocate.

• Know what medications you takeand why you take them. Medica-tion errors are the most commonhealthcare mistakes.

• Participate in all decisions aboutyour treatment. You are the centerof the healthcare team.

This does not mean that you askquestions just for the sake of asking– after all, doctors are busy peopleand do have other patients to see.The trick is to be inquisitive – and todo your homework ! The only stupidquestion is the one you did not ask.Asking appropriate questions aboutyour treatment and medicines willhelp you to acquire knowledge andwill also keep the doctors and hospitalstaff on their toes ( which is good forthem as well !) . The more the ques-tions you ask about your treatment,the more careful they will be aboutwhat medicines they are giving youand how they treat you . Never takeany medicine without asking : what itis, why it is used and what are itsside-effects. Remember, there arelots of patients and your physiciansees many everyday. There arechances that the staff may confuseyour details with another patient. So ,the more involved you are in yourtreatment, the more protection you

get from unintentionalerrors. The moreknowledge you gain,the more questionsyou will able to ask,and the more attentionyou will get!Thanks to the internet,it’s become increas-ingly easier for patientsto find answers to theirhealth-related ques-tions online. Learn touse the internet intelli-gently, so this will helpyou ask smarter ques-tions – and will alsosave your doctor time,because your routinequestions have alreadybeen answered !Don’t worry if you do not understandeverything on the first reading or inthe first sitting. It takes time to absorbthis information, and analyse it. Thegood news is that there are lots of re-liable websites to help you with Infor-mation Therapy. Even better, thereare now many expert patients online,who can help you make sense ofwhat is happening to youA lot of patients are scared to asktheir doctors questions. They areworried that the doctor is too busy toanswer them, and they don’t want towaste his precious time. They arealso secretly worried that the doctormay take offense at their questions,because he may think that they arequestioning his judgment, and thismay cause him to get upset and pro-vide poor medical care.Please remember that your health de-pends on good communication, andasking questions and providing infor-mation to your doctor and other careproviders can improve your care.Talking with your doctor builds trustand leads to better results, quality,safety, and satisfaction.Quality health care is a team effort

and you are the captain ! Becausetime is limited during medical appoint-ments, you will feel less rushed if youprepare your questions before yourappointment.Doctors are not mind-readers , andgood doctors want you to ask ques-tions, because they know that themore you know about your medicalcare, the happier you are going to bewith your treatment. Being well-in-formed will help you to have realisticexpectations of the treatment, and in-crease your satisfaction with the careyou get. Remember that if you wantVIP care from your doctor, you needto become a VIP – Very well-Informedpatient !Here are some useful questionsyou can ask.1. How will the results of this test

change my treatment options ?2. What is the natural history of my

disease ?3. Are there any other alternatives I

can explore ?4. Which is the best center in the

world for this treatment ?5. Can you refer to a website where

can I learn more about my prob-lem ? P

TN

Editor’sDesk

Dr. Aniruddha Malpani, M.D.

Founder Director,

Health Education Library for

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: Eleven doctors from Madhya Pradesh, who allegedly went with their families on a seven-day long trip to Eng-land and Scotland between May 24 and May 31, are fac-ing a probe, with the union health ministry suspecting that a pharmaceutical company could have sponsored their trip.Dr Jyoti Mirdha, a member of parliament (Lok Sabha), wrote in a letter,, to the Prime Minister.“As I’m writing this letter a total of 11 doctors along with their families are holidaying in England and Scotland on a trip financed by Intas Pharmaceuticals Ltd. Details in-cluding names of passengers along with their addresses, ticket numbers, hotels and itinerary are attached for your perusal. Needless to say, acceptance of such trips is in violation of MCI rules,”

DOCTORS UNDER PROBE

SKEWED PRIORITIES IN MEDICAL

TREATMENT IN INDIA:

20yrs ago:

Treatment to the satisfaction of the doctor...Payment to the satisfaction of the patient.........Result: Good quality of treatment at low costs.......

Now:Treatment to the satisfaction of the patient....Payment to the satisfaction of the doctor.....Result: Poor quality of treatment at high costs.........Dr.Ankala Subba Rao MDRajahmundry

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Balaji Hospital, Victoria Road, Cross Lane III, Byculla (E),

Mumbai-400027, Phone No. 022-2374 0000,

022-23745090 balajihospital@gmail.com

BALAJI HOSPITAL

D.L. Vaidya road, Shivaji Park,Dadar(W), Mumbai- 400 028

Phone:0091 (0) 22 2430 4082, 2430 5664Fax:0091 (0) 22 2431 4485

dhanwantari02@rediffmail.com

DHANWANTARI Hospital & Research

Centre (DHRC)

Liberty Center,Opposite Universal Backery and Beside TTD Temple (Kalyana Mandapam),Himayath Nagar Main Road,Hyderabad-29

SWASAAllergy-Asthma Special

Care & Research Center

Some good news for con-sumers might be at hand. You would soon be able to find the most affordable al-ternative to the medicine prescribed by your doctor through an SMS-based ser-vice. The service, expected to be launched by the gov-ernment in August, will be available throughout the country.Here is how it works: Once the person sends a text mes-sage of the prescribed brand of drug to a particular num-ber from his mobile, he will receive two to three options of the same medicine, along with the price differential.Say, a patient is prescribed a popular anti-infective like Augmentin ( GlaxoSmithKline). He types in Augmentin and sends the SMS to the designated number. He would get a return SMS, possibly mentioning Moxikind CV (Mankind), which is substantially cheaper. But sources said that all responses would come with a caution: please consult the doctor before popping the alternative (pill).Sometimes, the price differential between two alterna-tives of the same medicine is huge—up to 10-15 times. “This service would help a patient choose the cheapest alternative available,” an industry source said.The government plans to cover at least two-thirds of the prescription market through this scheme, which would in-clude all widely used therapies like anti-infectives, pain-killers, respiratory and gastro-intestinal drugs.

FOR CHEAPER DRUG OPTIONS, SEND SMS

Stewardship is a process where a physician starts by ask-ing: What is right for the patient? Stewardship certainly isn’t about cutting corners to save a few bucks. The doc-tor isn’t obligated to try some cheaper option if there is a clear indication, based on professional judgment, that a certain treatment is right.However, there might be options available as the physi-cian uses his or her knowledge of the efficacy of treat-ments, tests and procedures, and their costs — both short-term and long-term. Even a treatment that is more expensive up-front could save money and improve a pa-tient’s health over time.Physicians can involve patients and their families in the decision-making, laying out the case for a less expen-sive treatment that would be just as effective as one that costs more. Doctors already are under ethical obligation to avoid performing unnecessary tests and procedures, even if a patient demands them. Ultimately, it is trans-parency and clear communication between the physician and patient (and the patient’s family) that provides the best environment for a doctor to make the right treat-ment decision and make the wisest move as a steward of health care resources.

DOCTORS &STEWARDSHIP

This publication is not intended to provide medical advice, diagnosis or treatment. Information provided here is for creating awareness and cannot be substi-tute to medical advice. Views expressed here do not necessarily reflect those of Publisher or Editor. You should not take any action before consulting with a health care professional.