Monday, November 25, 2013

Maligning Doctors on social networking site: A trend to be discouraged

Maligning Doctors on social networking sites: A trend to be discouraged

Hitesh Gopalan MS(Orth),

Fellowship in Joint Reconstruction(Lilavati and BreachCandy Hospital, Mumbai),
Fellowship in Sports Surgery(Chang Gung Memorial Hospital, Taiwan),
Visiting Lecturer, Centre for Evidence Based Orthopaedics, McMaster Unviersity, Canada
Editor, Orthopaedic Principles A Review
Editor, Handbook of Orthopaedics
Editorial Board Member, Journal of Orthopaedics, Indian Journal of Orthopaedics
SICOT India Core Scientific Member
Clinical Assistant Professor, Orthopaedics and Traumatology

There is no doubt that medical profession is facing grave challenges. It takes years to become a doctor and once you become a doc, you need further training to refine your skills and provide the best possible treatment.An incident that happened in Delhi recently Show how aggressively people can malign you.

The  story goes like this:

Patient A was admitted to a high profile hospital in Delhi, India. The patient complained of pain in the ankle following an injury and Xrays were ordered. Xrays showed a lateral malleolar (outside bone of ankle)fracture. The doctor after careful examination and review of Xrays suggested that it would better to operate on the ankle as there was a high risk of late displacement,  and the potential for a less than optimal function of the ankle if NOT operated. Now, this is the season of "Second opinions". Everyone wants to go for a second opinion, third opinion and probably a 'n'th opinion. It is very well understood in medical and orthopaedic literature that a single fracture can be treated in many different ways. Sometimes an early surgery can get the patient back to his job quickly. Modern day Orthopaedics is all about bringing a patient back to his normal function at the earliest.We are talking about "Restoring Motion and Resumption of work", in every conference in India and abroad.

Now patient A and his family goes to many doctors and take 'n' of opinions. And possibly many of them had a more conservative approach and recommended against surgery. Patient A and his relatives now plan to malign this doctor in the  maximum possible way. They make an image and write a few words that puts the doctor in bad light, that they wrote his name and hospital affiliation and posted in multiple facebook profile 'walls" and "groups". What is surprising is that they even created an application to make these posts go " viral". The post was shared by 22000 people.

There is no doubt that this is quite rather an unusual behaviour by a group of paranoid individuals who want to show the medical profession in bad light. All of us must rise to the occasion and see that we protect our fellows and friends in medicine,  especially if you hold the highest level of medical ethics close to your heart. The only way is to educate the public that there is a long way that one has to travel to become a doctor. There are countless nu mber of exams,  failures and hardships in this journey.  Before you put down a doctor think for 5 minutes about the sacrifices a doctor endures during his lifetime. Take one minute of your time to share this post on your  facebook and twitter profile. Tweet #SaveMedicine. Share it so that it reaches 22001 people. Share the following Image as well.
 Tweet #SaveMedicine

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  1. Hitesh, there is absolutely no doubt that our profession is getting terribly maligned by irresponsible propagation on social media. I have been following up this story on Facebook and it really hurts me to see how people are generalizing things to our profession. The lady who fractured her lateral malleolar fracture was in her 30s, and I think its completely justifiable to fix this fracture in a young person, especially if a concomitant syndesmostic injury has been identified. Many of our patients from the so called "educational class" believe that the sole purpose of recommending surgery by a doctor is to earn money. I wonder how much difference would a fibular plate with syndesmotic screw make to the "earnings" of that doctor working in the prime hospital of India. I fully respect the decision making of that surgeon and condemn the aftermath that has happened. Also, I fully support your blog on this and hope we as a medical community can behave responsibly and respect other surgeon/physician's professional opinion. I have worked overseas, and I highly appreciate the way surgical colleagues value and respect each other. We need to bring this attitude amongst ourselves as well. Everyone is bound to commit mistakes. Medicine is such a diverse field and no one can ever know everything. We are all here for our patients' welfare only. No one can be sadist enough to play with human lives. All the patients are entitled to multiple opinions. But they should have faith in their treating doctor and realize that non-surgical management is not always the right opinion.

    1. It is high time that our professional organisations take note of this and take appropriate action. It is also imperative not to make opinions on xrays in social media if the identity of the patient or the doctor is revealed.

  2. There can be various ways to treat a fracture. A doctor should give his patients all the options and then say in my belief this is going to be the best for you. In the western world that's why so much importance is being put on informed consent.If you are trained in the UK it gets ingrained in you,like us.But then In Indian context I have seen patients , tell doctors , you are the doctor you take the decision, then where do you go. I suggest knee replacements to any end stage knees, but not all my patients accept it, i can't help it, but I have to give sound advice based on evidence some other doctor just to be popular will prescribe painkillers and damage the patient's kidneys.I cannot help it.SO,at the end of the day all the doctors should stick to supporting his colleague or charge 250 pounds or it's eqivalent in indian rupees as consultation fees from patients in private ,like in the UK and that will stop the trend for multiple consultations.In UK there are no second consultations in private.But you are practising in India and you know you can't do that, because you are there to help people and they cannot afford it.I have a colleague of mine who encouraged the patients party to sue me for doing a wrong operation when in fact it was a screw cut out, due to excessive movement , the patients still came to me for the second surgery and i did the surgery free of charge. So, you cannot choose you colleagues, they will always try to pull you down.

    1. As in every society, we need to accept that a small number of doctors do not follow the oath and ethics. But the percentage is small compared to other fields. There needs to be uniformity in education while trainings docs. This does not happen in India. As rightly said everyone should respect the treatment of another surgeon and have a 'restraint' while placing your critical comments. And all conflicts should be solved by dialogue among docs. We need to practice this ourselves. With respect to this case, someone in a popular forum wrote that all fibular fractures will unite with normal function. Now this is a sign of ignorance. One need to look at talocrural angle, tibiofibular clearspace-overlap, medial clear space before deciding on nonoperative treatment for nondisplaced lateral malleolar fractures. Advocate "RESTRAINT" before commenting!!!