The scope of dealing with all kinds of
medical and surgical ailments that affect the public can be precisely and correctly addressed with the help of the most modern technology at an affording level for the common grass routes and the elites by the medical faculty and the update and state of art hospitals of Mumbai. I have no doubt in my mind as a practitioner in the city of Mumbai for four decades at the prestigious Bombay Hospital that this city can be the centre of health tourism of the other countries of the world. This movement must be addressed as a total mega project by joint efforts with the Ministry of Health Government of India and like minded Ministries of Health of USA, UK, Europe and Middle East countries.
The specialities covered would be cardiac, chest diseases, orthopaedic, neurosurgery, cancer, ophthalmology, gynaec and dental at a price and package that includes travel, treatment and a holiday of sight seeing.
It is well known fact that the cost of treatment of Heart Surgery, Neuro-surgery, Cancer, Ophthalmic, Dental is exorbitant in the western countries. The common citizens find it difficult to accept and afford these without the help of medi claim and other agencies. Those who do not have any access are left out of the stream and look to other countries like India and China. Travel to India with a package deal of medical treatment has most certainly opened new doors to certain ‘hospitals like Apollo Groups who have their own procedures and methods for patients from abroad. Similar methods and projects for other Private Institutions with Hospitals of Mumbai e.g. Bombay Hospital, Wockhardt’s, Lilavati, Hinduja and Jaslok where state of the art treatment is readily available. They all can cater to the huge influx from overseas if planned in the access by air and land. Five Star and Four Star Hotels, Excellent Medical faculties and English speaking guides with world class doctors and private hospital care. Why can we not do it?
What need doing is a ‘Movement’ of Health Tourism with a slogan “India Destination of Health Tourism at Low Cost”. Awards, money and fame follows them.
Practice in Cities, Shanty Towns, Slums and Rural Areas of Mumbai
There are three different areas of Medical Practice with the help of General Practitioners and specialists of Bombay that must be demarcated on very practical approach.
- The elite and higher income groups, State Ministers and officials who can well afford all kinds of treatment at higher cost in Private Hospitals - Suites, Deluxe and First Class. Doctors and diagnostic labs are easily available to them in Bombay Hospitals. They have the money power to get the mediclaim to their rescue.
- Middle Income groups of second class have to be careful what they can afford and get the proper and precise treatment they need. This is a very vital group of well educated, self conscious and intelligent who want the best at a reasonable cost and delivery system. They do question and have debate with Doctors and judge their depth and capacity.
The doctors of hospitals and GP’s have high responsibility to address them as patients and also reassure the relative. There is no doubt in my mind after a long hours and years of practice that an ideal practitioner or a specialist is the one who not only treats a patient but also reassures him or her by good humour, right directions and frank discussions spending time with the relations in a peaceful atmosphere. No matter the crowd and paucity of time the message of treatment and after care must be relayed to both the patient and relations to get their trust and confidence, the former is the most important. Money and cost are the secondary importance in any practice. Money follows. A patient pays for the trust plus treatment - both and one cannot be isolated from the other.
Failures in treatment are teachers while successes are the awards. Most of doctors of the city of Bombay who have achieved highest public and peoples eminence as teachers and practitioners have worked day and night in practice with people at low cost.
General practise of the Grass roots and low income groups who have the high incidence of sickness, ill health, bad hygiene, malnutrition and the most complicated disease called ‘poverty’. They need care and help of a simple medical practitioner and affordable public hospital or health centre. The paradox of the city of Mumbai for that matter any city in India is that the poor and needy are deprived of timely medical care in this city.
The city fathers of The Bombay Municipal Corporation and the state run Government hospitals are not able to meet the demands by standards laid down by low for the guardians of health. This is a sad affair and continues to evade any solution. Those who live in slums, and rural suburbs must be approached by Health Officers of the BMC and by mobile vans all over the city with equipments and simple laboratory investigation measure to park at strategic points. These so called mobile health care vans must have tele communication and mobile phones displayed. Eye camps are conducted on similar lines. Why not medical camps for health checkups for simple disease of chest, stomach, ENT, cataract, hypertension, diabetes, etc. Those with complication of heart, orthopaedic, eyes, cancer, children’s diseases, gynaec and obstetrics, neurology can be sent to referral hospitals.
Practice of ophthalmology and Ophthalmic Sciences in the city of Mumbai
Eye Care - Simple methods
Cataract, Glaucoma, Retinal and Vitreous, Child Hood Blindness from Birth, Error of Refraction, Amblyopi, etc.
Infections of all kinds
Injuries
Diabetes, hypertension
AIDS
Brain diseases
Tobacco, Alcohol
Myopia, Astigmatism, Hypermetropia, Laser therapy.
Practise
The psycho analysis of all cases coming to an eye practitioner has the following factors:
- The fear of loss of sight either due to any cause - Simple infection or complicated diseases of eye is the most stressful factor that scares any lay person visiting an eye Doctor in an eye clinic.
- Redness, pain, watering, itching, burning of eyes may sound trivial to many but for a person who has these give sleepless nights, distress that needs instant relief. These are the most common in practice of ophthalmology.
- I have come to a conclusion that when confronted with a surgical corrective disease that can be put right e.g. Sac infection, a Cataract, Squint, Glaucoma, Retina and Vitreous an assurance must be positive with words of solace e.g. Please do not worry, everything will be “O.K.”. This gives confidence, trust and a faint smile on the face of a patient and relatives. I strongly object words like “thing might not be as expected”. We will try. God will come to our help, etc.
This can put off and depress all. If a problematic disease with guarded prognosis e.g. Amblyopia of birth Advance glaucoma, Phthisis bulbi, Retinal Detachment - long standing -optic nerve diseases, retinopathy of diabetes grade III, IV, corneal scars extending till the periphery and other surface diseases of cornea etc. are areas that require a frank sympathetic and emotional dialogues with patient and relations telling them that the best efforts will be put; spiritualistic and Godliness will help. The last sentence is very reassuring to a lay person. In these cases the patient knows from other opinions of Doctors which often are taken for all diseases with guarded prognosis. Sufficient time be given to this discussion. The ophthalmologist who is frank and says he will do his best after these talks will be rewarded with the trust and ‘go ahead’ signal from the relations. A patient appreciates frankness in eye diseases with guarded prognosis. Last but not the least the best efforts and after care must be put forward by the ophthalmic surgeon.
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