Dr Maya: Protecting You Protecting Us
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About this ebook
Humanity is now facing mortal enemies that surpasses our intelligence. A tiny microscopic enemy has ripped apart families, bankrupting nations and brought us to our knees. As the death toll mounts, our greed, over enthusiastic urge to encourage consultations, perform tests, procedures, hospitalisation and addiction to antibiotics escalate at an alarming rate. More than 95% of patients with symptoms of COVID-19, were prescribed antibiotics resulting in Superbug Pandemic in tandem, that can kill 10 million people every year by 2050.
This book was written to share information about common symptoms and provide information to reduce anxiety, wasted consultation, cross infections in hospital or clinics. Delay in consultation due to fear of infections, cost, and false assurance offered by family, friends, nurses, and chemist often result in a devastating complication and death.
Dr Maya App will teach how to use three symptom combination to help differentiate well from unwell, make informed decision to go to hospital, speak, consult a doctor nurse or chemist only when necessary.
The content of this book provides general information about common medical symptoms and signs. We are updating our information in Dr Maya App. Please download the App, register and empower yourself to protect your family, friends and you. You should not treat this book or our App as a substitute for medical advice offered by your doctor.
Dr. Kadiyali M Srivatsa
Doctor, inventor and publisher who worked in acute and intensive paediatric care in internationally respected hospitals in UK. In 1996, he published a letter criticising the use of preprinted questioners, clinical algorithms and managing patients using protocols. In 2003, he started working as a doctor in family practice, teaching nurses to diagnose common illness and prescribe antibiotics. He was assessing nurses prescribers in a pilot nurse-led practice. Here he identified numerous problem and raised concern about the quality of care offered by nurse prescribers and practitioners. Health secretary in UK ignored such warnings and smashed the demarcation barrier between doctors and nurses in 2006. He collected and compiled a list of symptoms that make people anxious and rush to hospital or a clinic. Using the data, he created a simple tool that will reduce access, educate people to share responsibility and reduce the culture of dependency. He integrated his innovation and created “Dr Maya” to initially identify infected individual and isolate them to protect healthcare workers and people. He believes these Apps will break the barrier created by healthcare providers, ease doctor patient communication and systemise healthcare.
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Dr Maya - Dr. Kadiyali M Srivatsa
© 2016 Dr Kadiyali M Srivatsa. All rights reserved.
No part of this book may be reproduced, stored in a retrieval system, or
transmitted by any means without the written permission of the author.
Published by AuthorHouse 11/23/2020
ISBN: 978-1-5246-2971-7 (sc)
ISBN: 978-1-5246-2969-4 (hc)
ISBN: 978-1-5246-2970-0 (e)
Any people depicted in stock imagery provided by Thinkstock are models,
and such images are being used for illustrative purposes only.
Certain stock imagery © Thinkstock.
Because of the dynamic nature of the Internet, any web addresses or links contained in
this book may have changed since publication and may no longer be valid. The views
expressed in this work are solely those of the author and do not necessarily reflect the
views of the publisher, and the publisher hereby disclaims any responsibility for them.
CONTENTS
INTRODUCTION
1. About This Book
2. Preface
3. Tears Of Happiness
4. About The Author
CHAPTER I: HEALTHCARE
1. Family Physician
2. Knowledge Of Health Is Knowledge Of Life
3. Loss Of Human Face Of Medicine
4. Free Will Of Doctors
5. Protecting You And Us
6. Nurse-Led Practice
CHAPTER II: INFECTIONS
1. Three Decades Of Infections
2. Antibiotic Resistance
3. Environmental Pollution
4. The 21St Century Crisis
5. How To Prevent 21St Century Crisis
6. Why Are We In This Situation?
7. What Are The Problems?
8. Epidemics & Pandemics
9. Are We Prepared For This Crisis?
10. Protecting Humanity
11. Microscopic Enemies
12. Doctors Duty, Ethics, And Service To Humanity
13. Why Access To Doctors Must Change
14. Pandemic And How To Prevent Them
15. Last Resort Of Scoundrel
16. Creating An Ideal Condition For Spreading Infections
CHAPTER III: SOLUTION
1. Dr Maya
2. Why Trust Dr Maya?
3. How Does This Work
4. Why Is Dr Maya Important?
5. Dr Maya Prevent Epedemics And Pandemics
6. Access To Healthcare
7. Dr Maya & Maya Dr
8. Advantage Healthcare Providers
9. Advantage To Doctors
10. Benefit To Patients
11. Illness Or An Illusion
CHAPTER IV: SYMPTOMS
1. Common Symptoms
INTRODUCTION
ABOUT THIS BOOK
When your child, parents, partner or you develop a symptom of a medical illness, do you start getting worried and ask for advice and help from family and friends? search for information using the internet, and spend sleepless nights, tossing and turning, thinking about all the horrible things that may or may not happen?
If YES, this book is for YOU.
The Internet is now saturated with information about COVID-19, medical illnesses, diseases, drugs, and helpline advice that makes you more anxious. WHY? Because the articles published in a blog is often written by a non-medically trained person and is usually not correct. Following such advice may often result in delayed diagnosis and treatments that may result in devastating complications. Unfortunately, rushing to hospitals, or asking a nurse or chemist is also not an option, but can result in cross infections and antibiotics abuse.
In 2013, an editorial in the medical journal states, There were no okay-validated tools to help the general practitioner (GP) identify children with potentially serious illness in primary care.
(Arch Child, May 2013; Vol 98, No5).
I was not pleased because medical education and training must have declined in the UK after introducing a pre-printed assessment sheet in 1996. If doctors need a tool to differentiate familiar from a serious illness, use the internet to help diagnose disease, protocols, and guidelines to offer treatment, then why can’t I share my knowledge and experience to show you the tool. I collected and compiled a list of common presenting complaints and created MAYA (Medical Advice You Access).
The World Medical Association (WMA) claims, A physician must have complete clinical independence in deciding upon the care of a person for whom he or she is medically responsible,
but we cannot.
The healthcare provider, hospitals, and people in power expect doctors to follow protocol, perform tests and investigations, claiming it is Evidence-Based Medicine.
A doctor who does not follow such protocols will be harassed, humiliated, and often ostracised. Doctors who challenged this method and criticised institutions, for allowing nurses to work as doctors in primary care and forcing doctors to follow guidelines were humiliated and often ostracised. The WMA state motive, whether personal, collective, or political, shall prevail against this higher purpose, but they do not support doctors.
We doctors have now lost our FREE WILL
to share our knowledge and experience to offer the best care to a fellow human. This book, I hope, will help you acquire the knowledge you need to make an informed decision, take responsibility, and get rid of the Culture of dependency on doctors.
PREFACE
To understand why, how, and what is going on in the medical profession, you must be a qualified doctor, pass examinations to prove you are safe to examine, diagnose and treat fellow humans as patients. To master the art of clinical medicine, you must work with critically ill adults and children in the hospital for almost forty years. Offering medical advice and treatment is an art that takes years to master and not one that you can acquire reading books, following guidelines, claiming it is based on evidence-based medicine,
created using statistics.
Mentioning the word, COVID,
or just virus
makes people shudder with fear and quickly move away. Lockdowns, quarantine, and social distancing have become the new reality of the human race. News channels and social media are bombarding us with stories that look like a sci-fi horror movie.
No matter how rich, famous, educated, or healthy you are, the virus may attack you unless you are staying in a bubble made of plastic. In America and the U.K., all that you have to do is cough three times in public, and you will be forced to stay at home for a couple of weeks. It’s not easy to visit two meters away from healthy adults nor choke on the mask.
Healthy educated adults like you must not be afraid of viruses, bacteria, or infections because you have been living in an ocean of these bugs all your life, and your life depends on them. The lockdown, quarantine, and media hype ripped apart families, bankrupted nations, and made millions of people like you paranoid. Some are wasting time and money listening to counsellors and paying people who promise to alleviate their anxiety, phobia about bugs, and infection.
Well, doctors working in intensive care, respiratory medicine, and emergency care in COVID designated areas may have proved to be heroes, but not all. More than fifty per cent doctors and hospitals think of this dilemma as an opportunity to cash in. Healthy adults were advised to get tests and investigations and forced to stay at home when the test was positive (false positive), and patients with symptoms who were negative (false negative) were allowed to continue to work.
More than 95% of patients were prescribed antibiotics knowing it was not necessary. The quantity of antibiotics used during the COVID-19 pandemic has exceeded that of any previous pandemic. Respiratory viral infections such as influenza and SARS-CoV-2 have proven themselves to be a precursor to secondary bacterial infections that kill millions.
I can’t blame the doctors or the patients, but blame the institutions like WMA, BMA, and the GMC, for not protecting the doctors. The national medical council and the courts often imposed a punitive sanction for not following protocols and guidelines that have destroyed the lives of numerous doctors.
People are too scared to go to the hospital, but the ones who went are made to wait in the car and not sit inside A&E, knowing seven to eight people rushing to consult primary care did not have any illness that requires clinical examination or tests to diagnose. I published this book to share information that will educate you to reduce wasted consultation, cross infections, and antibiotics abuse.
In 2006, the secretary of state for health licensed nurses to diagnose, request tests, and prescribe drugs. I, as the trainer and assessor who was working in the Pilot Nurse-led clinic,
raised concern and soon punitive sanction was imposed to conceal the truth. The torturous conspiracy resulted in post-traumatic stress, financial difficulties that destroyed my family. Living on my own in Germany, with no friends or family, I started writing all that I knew about common symptoms and searching for answers that I did not know. I then published my book, Maya Bring Tears of Happiness,
to help protect you from wrongdoings.
This book will help you learn how to differentiate minor from serious illnesses. I believe in Knowledge of Health is Knowledge of Life,
so this book shares the information that will help you de-mystify medical jargon.
The knowledge and experience about health and well-being has made me strong and healthy. I am not scared nor worried about infections or disease, nor worried about cost of consulting a doctor. The knowledge you acquire will help you reduce wasted consultations, cost, time, and also encourage you to consult a doctor early when you must. Soon you will find it harder to find a doctor because they are scared of getting infections too. The number of healthcare workers contracting infection has increased.
I have updated, symptoms and signs in the Dr Maya APP. The information will help you to combine three symptoms, and a color-coded method to differentiate common from a serious illness, including infections. This Book will help you acquire the knowledge, the app to help you decide what you can do to get better. I sincerely hope hope my contribution will reduce the culture of dependency in modern medicine.
I have also created a closed group on Facebook called Virtual Doctor Maya,
to discuss, ask questions, share information, and teach the skill you need to empower yourself.
We must destroy the culture of dependency on the healthcare profession and start taking responsibility, to protect our family, friends, and our lives.
Please join our FACEBOOK GROUP: VIRTUAL DOCTOR MAYA.
Download Dr Maya App from: App Store or CALL111.COM
According to Darwin’s Origin of Species, it is not the most intellectual nor the strongest that survives; but the ones that are able best to adapt and adjust to the changing environment in which it finds itself will.
TEARS OF HAPPINESS
I believe we humans are here on earth to experience emotions, enjoy life, be happy, and love one another and not inflict pain and suffering on animals or plants. When a person asked me what I do, I always said: I sell happiness.
My definition of happiness is, mental and physical well-being,
and so my role has always been to make sure people who trust and come and ask my help returned home with tears of happiness in their eyes.
A person, whether poor or rich, successful, young or old, healthy or not, can be happy, only if he knows he is loved and feel secure. People are searching for solutions to be happy, reading books, join groups, go for counselling, or spend weeks in retreat, but soon realise they are not happy. I watched a video published in YouTube, Oprah and Gretchen Rubin discussed what being happy truly means and how to achieve it. I was hoping to hear the definition but was disappointed when Gretchen Rubin said she did not know.
To learn about what happiness is, you have to understand how your mind and body interact and know how to attain a state of equilibrium. I have always said that good history taking in medicine have for generations been the main methods of diagnosing illness, offering a solution, and not a prescription. Once I label a person in family practice as stressed, depressed, hypertensive, diabetic, or having cancer, I discovered that I had not helped them but hindering them by controlling their FREE WILL
. No person, who has been labelled to have the medical illness, will be happy. Ignorance is Bliss, and it is very true because you will be happy forever.
As a doctor, I was lucky to have had the opportunity to observe and learn what happens and how people react. Labelling children having a severe illness in a critically ill child is not difficult. The majority of parents are only concerned about saving the life of their loved ones. I found it hard to see parents shed tears of happiness when I tell them their child is now stable on the ventilator. They thank me profusely for saving their child’s life and not giving any importance to what I say afterwards. They are ready to accept serious brain damage and long-term disability, organ failure, or physical injury, but will not be happy and cope all their life if the child dies.
A full evaluation of the history of the patient’s complaints, knowledge of the illness, and excellent clinical examination skills is crucial in making a correct diagnosis before prescribing drugs. Knowing drugs seldom cure, we spend the rest of our professional life relearning skills to make the right diagnosis and offer the best advice or treatment in the interest of our patients who trust us.
In 1996, I realised what the politicians are doing and so published a letter, warning doctors not to use the Pre-printed Assessment sheet
. This method will make us (doctors) loose our Free Will.
Unfortunately, not many doctors took notice because the politicians had brainwashed them to achieve their goals by paying incentives to make them happy. Healthcare was Big Business
. Physicians like me were spending more time, listening to patients, trying hard to offer the best care, or raised concern about how the quality was penalised
The knowledge and experience I acquired working as a staff doctor managing acute and ill children in the hospital, train junior doctors, nurses, paramedics, and as a triaging doctor in an emergency and out of hours is the Wealth in Abondance
that I have, and I can share this knowledge to help protect you and healthcare workers.
I was cringing when my friends and classmates whom I had admired stopped talking about the quality of care and giving more importance to target the money they earn. Not many gave any importance to the treatment-resistant bacteria threat. I felt the doctors forgot their role, their ethics, and their contribution to humanity.
The doctors who worked in transplant surgery, plastic surgery, IVF, and joint replacements surgeons started earning more money. They were hailed as great surgeons, honored with titles, and recognised as pillars of modern medicine. After returning to work as a doctor in the U.K, I could see how the moral of doctors, patients’ satisfaction and quality of care offered had declined. To make the situation worse, spreading COVID-19 has now ripped apart, bankrupting families, and torn apart nations because they were not prepared.
ABOUT THE AUTHOR
When Neil Armstrong landed on the moon back on July 20, 1969, my parents left me at home alone while having a party. I was suffering from high fever (serious shivering), with scary thoughts (delirious) once in every three days. The symptoms were similar to the one I experienced when I was six years old and was cured after drinking quinine (an anti-malarial drug). The doctors I saw in 1969 had diagnosed my illness as Typhoid, treated me with the wrong antibiotics, and left me isolated in a room. I remembered begging my mother to give me quinine.
My parents and the doctor failed to listen to the story of the illness, as I had lived and experienced. When I was on my own, I searched for left over quinine and drank and cured myself. On this day, I promised myself to always find a method to help educate people about the combination of symptoms that help self-diagnosis and remove the veil of illusion that doctors save lives.
I came to UK, passed PLAB, to prove I was safe to work under supervision and started my journey working in acute and intensive care in Paediatrics. In 1989, I first encountered bacteria that cannot be killed using conventional drugs or chemicals. Now, these bacteria are well known as MRSA (Methicillin-Resistant Staphylococcus Aureus). I spent months and years, reading all about Staphylococcus, searching for a solution to avert this crisis. I tried hard to slow down these bacteria spread that is infecting more people and create an army of bacteria that threaten our very existence.
Initially, I associated MRSA infection in intensive care with incubation, catheterisation, and cannulation. The infection in the hospitals occurred because the doctors and nurses were not following strict aseptic technique nor isolating infected children or babies in intensive care. Strong chemicals were used to clean hospitals, and sanitisers to wash hands that resulted in killing friendly bacteria allowing resistant ones to thrive.
I invented devices and methods to help reduce MRSA infections in hospitals. Device manufacturers protected their devices, and healthcare professionals ignored his warning. MRSA started spreading all over the world, killing in thousands and soon began spreading in the community, schools, massage parlour and gyms. They started sharing the knowledge, technical know-how and helped other bacteria, fungus, and viruses develop resistance.
When I worked as a doctor in the intensive and critical care in paediatrics, I diagnosed numerous illness based only on history and managed them. I requested tests and investigations to confirm my diagnosis. I used the same strategy for almost forty years and have never made an error in the diagnosis or management of illness. In my letter, criticising the Preprinted assessment sheet,
published in 1996, I explained the importance of history taking and proper clinical examination.
When patients describe the symptoms for which they are seeking professional attention, they are also reporting the story of an illness as they have lived and remembered it, and so it can vary. Doctors must listen to the story and offer a solution and not a prescription
.
Srivatsa KM. Preprinted assessment sheet. QCJ(BMJ) June 1996, Vol 5;6
In 1994, a junior doctor who was not confident enough called me to review every child brought into the hospital. My job was to teach junior doctors how to differentiate common from serious illness so that he, as a family physician will refer patients with the condition that he/she can manage in the community. I compiled a list of serious symptoms that he must contact me and common symptoms that he must learn to manage at home.
The list I created helped junior doctors acquire the skill. I then bought a handheld Psion PDA and wrote a programme PAT
(Paediatric Assessment tool). This programme helped doctors learn to differentiate well from unwell children, to help reduce hospital admissions. I also created a database of protocols, tests, illness, disease, syndromes, drugs, symptoms, and signs because it was easy for me to access and share them with junior doctors and students.
I stopped working in hospitals because I could not stand and watch children develop Superbug Infection
in hospital and die. After all, iatrogenic infections will kill patients needlessly. Knowing one-day, the hospital resistant strain of bacteria will create an army that will not only bring an end to modern medicine but also kill millions, I retrained and qualified to work as a GP (family physician).
I started collecting data to find out why patients access healthcare and find a solution to offer help using advances in information technology. Working as a locum G.P. in the), in GP surgeries across UK, I identified how doctors are labelling illness as URTI, LRTI, UTI, allergy, stress, viral flu, wheezy tendency…and abusing antibiotics.
The Surgery, emergency care centers, and hospital A&E are like the mecca of infection, colonised with twelve strains of treatment-resistant bacteria, viruses, and fungus.
When I started working as a family physician, patients were finding it difficult to understand how I can diagnose illness fast and advise treatment. They were used to doctors who published a website named GoToSurgery.COM in 1994 on the internet, years before Google was born. I uploaded the database from my Psion, linked signs with the first atlas of skin rashes, DermNet NZ. I thought it was great because it was easy for me to share information about the illness with students and junior doctors.
Gotosurgery.com must have been the first website with medical information that helped not only people but also educated me. AOL soon published a similar site a few years later. I stopped updating the site because I was indented with emails, asking my opinion and advice about the illness. I believe information about common disease must not be commercialised or sold because as a doctor, I acquired the knowledge I share from people like you.
I received a call from the director of PdxMD, asking me to compile a list of symptoms and signs that are common to a rare illness. I searched for data, inventory, studies, or methods to help validate the reason, but found none. Doctors were differentiating common from a rare disease, using their clinical examination skills, knowledge, experience, and intuition, and so it varied.
In 1997, using the information I had collected in my Psion PDA, I tried to create a flow chart (algorithm) and started writing programmes in Psion 5. When writing this programme, I realised disease or illness in humans does not follow an algorithmic pattern. Dr Jerome Groopman confirmed my finding in his book How doctor thinks,
published in 2007. Disease and illness cannot be diagnosed based on statistical significance. So, the doctors must often step out from the box to make the right diagnosis before offering the correct treatment.
In 2005, Evidence-based medicine
was set as the principles and methods intended to ensure that to the greatest extent possible, medical decisions, guidelines, and other types of policies are based on and consistent with reasonable evidence of effectiveness and benefit. Soon, the National Institute of Clinical Excellence
was established.
I knew then that it was not only Superbugs
that will destroy our profession, but also institutions we trust and respect. I disagree and feel sad because diseases and illnesses do not have a starting and endpoint (like A to Z), and so we cannot create algorithms to derive at diagnosis and offer the correct treatment. The evidence used was based on the result of audits we organised and prepared guidelines for junior doctors and us to follow. I will explain why:
The doctor diagnoses illness or name disease based on the combination of symptoms. E.g., (1) burning sensation when passing urine, (2) feeling chills and rigors, (3) increased frequency of urine. The first illness I think of is Urinary tract infection (UTI).
The doctors will first collect a urine sample and send it to a microbiologist to culture the bugs and find out which antibiotic works. He will use his knowledge and experience to start treatment. No doctor must decide what to do based on the dipstick test knowing two out of ten dip tests are false-negative (you have an infection, but the test is negative) or false-positive (you don’t have an infection, but the test is positive).
Based on the guidelines, the doctors will prescribe Trimethoprim (antibiotic), because eight of ten patients (80%) with UTI had E-coli that is sensitive to this drug. Suppose the symptoms are not resolved (burning sensation, unsettled fever) in 24 hours, the doctor must discuss with a microbiologist, identify the cause of infection, and the choose the right antibiotic. If the doctor fails to find out what happens after 24 hours and does not rectify the error, you will develop an abscess or septicemia and die.
I saw a twelve years old boy during COVID Pandemic. He complained of pain on the right side of his abdomen and back. This boy was seen by a doctor, who performed a negative dipstick, so he was not treated with antibiotics as advised by the NICE Guidelines. When I saw him, I felt he had a mass in the kidney area and referred him to get a scan. This boy had developed Pyelonephritis
(puss in his kidney) that was drained and treated with IV antibiotics. I felt sad because the boy was made to suffer, and would have died if I had followed the protocol, and sent urine for tests and not done what I did. My contract was terminated because I do not follow the protocol (testing urine using dipstick).
I hope you can understand how members of my profession who act in the interest of patient are forced meticulously to follow guidelines. As doctors, we have lost our FREE WILL
to step out of the box, use our knowledge, experience, and intuition to diagnose and offer treatment. This is unethical medical care and must be stopped. The doctors who recorded temperature, performed urine dipstick, and did not prescribe an antibiotic or refer early will not be penalised in court or by the GMC. This often happens because the doctor will defend his/her action saying he/she followed the guidelines created based on the Evidence Medicine
recommended by The National Institute of Clinical Excellence
.
I hope this explains how and why someone you love or suffered in the past and could not believe someone with a common urine infection will develop an abscess, renal failure, or sepsis and die.
CHAPTER I: HEALTHCARE
FAMILY PHYSICIAN
Family physicians in the U.K. are called G.P. Patients registered in the NHS can access the service free of cost, and so any person with medical symptoms can get advice and treatment. The NHS is hailed as a National Treasure
, and people are made to believe this is the best healthcare service in the world. One in five people living in the U.K. is directly or indirectly linked to this institution.
Family physicians are like gatekeepers. They must listen to the story of your illness, investigate if necessary, or offer advice and treatment. If they make a simple error of not identifying early signs or symptoms of a serious illness, you may end up in the hospital with complications. To work as a family physician, you must have the knowledge and experience to differentiate common from serious illness and know how to refer patients to the correct specialist.
In the decade, family physicians have been directly or indirectly motivated to follow guidelines and protocols. This has resulted in serious problems, for patients and doctors were forced to surrender their FREE WILL.
In the UK, the primary care is managed by nurses, trained to follow protocol, guidelines to diagnose illness, request tests or investigations, and offer prescription or advice. This has resulted in serious scandals, increased death rate, hospital admissions, and brought shame to our profession. Still, we are unable to stop this trend and so published this book to share knowledge and experience to protect you.
When I started working as a junior doctor in 1983, the doctors and nurses were caring, worked together in harmony, and patients were getting the right treatment and care. The majority of the departments in district hospitals were managed by nine to twelve doctors (3 consultants, 3 registrars, and 3 Senior House Officers). We all knew one another, and we’re always keen on research and publish papers in medical journals. We criticised and praised one another and life was great. As a doctor, I believe primary healthcare should be offered free to every human on earth. Health is Wealth
of a poor person, and so the leaders must protect health.
I started my research about antibiotics and published my work in 1989 and continue to do so. The politicians began getting involved and started talking about Return on investment,
to which I was not pleased. How can we put a value on life? The service we offer as doctors are humanitarian and must never be driven by money. I did not qualify to work as a doctor to earn money but gratitude.
If I had focused my attention on earning money, I would have been a billionaire like my friends in Bangalore. My mission was to create a system that can offer free healthcare advice and reduce social inequality in health.
KNOWLEDGE OF HEALTH IS KNOWLEDGE OF LIFE
Good history taking in medicine has for generations been the primary method of educating medical students and junior doctors. A full evaluation of the history of a patient’s complaints is crucial to making a correct diagnosis and helps in planning the management. Every doctor spends the rest of his or her professional life relearning the lesson. The doctor’s first task is to listen and observe, not only to obtain information about the current problem but also to understand the patient as a person and to learn about their life situation.’
Symptoms identified by taking a history provide some of the essential items of information used in the process of diagnosing a disease. When patients describe the symptoms for which they are seeking professional attention, they are also reporting the story of an illness as they have lived and remembered it, and so it can vary. To some extent, symptoms are the universal human experience. Virtually, every person experiences some discomfort for which he or she is seeking some help.
Talking with a patient has a third function: it helps that person to feel that he or she is understood, and it thereby helps to establish a therapeutic relationship. A style of questioning narrowly shaped for the sole purpose of diagnosing a disease ignores much of what patients have experienced and many of their concerns and questions. It, therefore, often prevents the development of a trusting relationship and diminishes the chances of helping the patient. Talking with a patient about the experience of being ill, on the other hand, can have great value even when nothing can be done about the disease.’
Collecting information using an app or computer claiming it is based on Evidence-Based Medicine
using Artificial Intelligence (A.I.) is not advisable and often misleading. A.I. uses the same Algorithms
and so you go through questions, and the sequence of questioning to arrive at a diagnosis is based on our response, YES
or NO
. We often lose concentration, and if you are in pain and suffering, you will make mistakes, and so you arrive at a wrong diagnosis.
I have come across some junior doctors, nurses, and healthcare assistants meticulously trying to take a history using a computer when they should have concentrated on identifying the problem. The patient is uncomfortable, and at times very ill, but the doctor starts asking questions and fails to recognise the patient’s concern, nor give importance to what the patient wants to say. The delay in arriving at the correct diagnosis or identifying the problem as an emergency can lead to complications and death.
This has made the patient feel that the doctor is not keen on understanding their current problem and lost confidence in our profession. The other problem is when the doctor is taking a history and busy entering the details in the computer, and there is no eye contact. You may feel uncomfortable, and at times very ill. The doctor continues to ask irrelevant questions, claiming this is based on guidelines created using evidence-based medicine, and so in your interest. I do not blame the doctors, but blame the system for implementing the GMC for harassing doctors, and the Judges for awarding huge compensations.
If you come across doctors who are meticulously typing, please do not blame them because they are doing what they are expected to do. It is called Safety Netting
to protect doctors and the hospital’s interest.
LOSS OF HUMAN FACE OF MEDICINE
After reading various books written by doctors, patients, and following news about diseases, illness, and advances in healthcare published in medical journals and media, doctors like me start feeling very uncomfortable. Over-enthusiastic urge to encourage consultations, perform investigations, hospitalisation, operations, and prescribing drugs that may or may not be necessary has tarnished the image of our profession.
Knowing and understanding how doctors think, act, and behave is complex because the information they have is very confidential. A doctor will find it hard to raise concerns about wrongdoings knowing that the General Medical Council will prosecute him for breaching confidentiality, and he will be ostracised. After mastering the art of clinical diagnosis and the management of complex illnesses in adults and children, we developed a simple tool.
In 2003, we created MAYA (Medical Advice You Access) to protect fellow human, because it we promised to protect humanity from pain and suffering. It is our duty to DO NO HARM
.