I think OPD stands for Out Patient Department. It is ward number 7 on the ground floor just steps away from the main entrance to the hospital. (Aside one thing I like about this hospital is that the numbering actually makes sense including the floors as ground 1, 2, 3, 4). Back on track, the outpatient clinic teams for Internal Medicine are rotated on a daily basis. There are 6 Internal Medicine Teams so therefore each team spends one day a week in the outpatient clinic and causality (the ER). That is the day they admit patients to their ward service then the rest of the week they take care and discharge until their admitting day rolls around again. The Professor explained to me how the patients who come to this clinic or hospital are the rural, poor, and very sick. Those with means or in cities go to the private hospital where they can make appointments and don't have to wait to be seen. Here, however, that is not the case. Many of the patients we saw this morning and afternoon were text book illness such as tonsillitis, chronic liver disease, sciatic nerve pain, Rheumatoid arthritis, and low platelets. Yet the diagnosis and treatment were more like a puzzle and negotiation. You see part of the diagnosis and treatment is trying to figure out one the means of the patient, two what investigations fit within those means, and three how serious is the illness that you need to push the patient's outside their financial comfort zone. Evidence-based medicine is still the foundation of knowledge and desired practice but in reality if you don't have the gold to pay for the "gold standard" what value does it have?
I admire the Professor in her drive, negotiation skills, and perseverance when practicing medicine. To me I feel she has the patient's best interest in the forefront, even if is not something they want to hear. She tells them this is what would be needed and then tells them what is a must. They trust her and in return, she does what she can to do right by them. There was a time sitting in clinic today where it was as if I was in one of the resident clinics back in the US, just the surroundings and dress was different. There have been several times during my residency where a treatment or study has been prescribed but later find out it was not completed due to cost. I face this problem more and more while practicing medicine in the United States. We often must manage finances, not medicine. I think the main difference is that here in India there is transparency of the costs for labs and medications. In the US it isn't until your insurance is submitted that the cost is determined. At least in India you know up front what your costs are and if treatment will be financially feasible. Of course that being said, I am impressed with the resources available to patients in the US, if cost IS an issue. There are community pharmacies and crisis centers that will provide medications without charge.
Stepping away from medicine, Professor and I spent the downtime between patients talking about the cultures and traditions of our respective countries. One topic that came up was marriage and weddings. She was surprised that there are not really arranged marriages in the US. This to her was the way it should be, marriage revolving around love between two people instead of being told who you are suppose to spend the rest of your life with. She was also surprised that there is no dowery in the American wedding culture. We talked about the traditionally the bride's family pays for the wedding and the groom's family pays for the reception, that is as close to dowery and gifts I could come up with. We also talked about Ruby, the new puppy my sister and I gave to my Mom as a surprise early birthday present. Professor talked about how she never understood American's attachment to domestic animals until she read the book Marley and Me. She states she was weeping by the end and it made more sense to her how important pets can be. Still though, she won't go to her brother's house if his dog is there.
I truly enjoy these chats with the Professor on more of a person level. I came to India as a representative of Project HOPE in the field of Medicine. However, this journey is more than medicine, it is fundamentally about the people and culture. The rest is built on those two things. How blessed I am to learn about the culture and people by being immersed in it with such willing teachers.
Below is the Medical College and Dorms. The view is from a balcony at the hospital near my room.
I admire the Professor in her drive, negotiation skills, and perseverance when practicing medicine. To me I feel she has the patient's best interest in the forefront, even if is not something they want to hear. She tells them this is what would be needed and then tells them what is a must. They trust her and in return, she does what she can to do right by them. There was a time sitting in clinic today where it was as if I was in one of the resident clinics back in the US, just the surroundings and dress was different. There have been several times during my residency where a treatment or study has been prescribed but later find out it was not completed due to cost. I face this problem more and more while practicing medicine in the United States. We often must manage finances, not medicine. I think the main difference is that here in India there is transparency of the costs for labs and medications. In the US it isn't until your insurance is submitted that the cost is determined. At least in India you know up front what your costs are and if treatment will be financially feasible. Of course that being said, I am impressed with the resources available to patients in the US, if cost IS an issue. There are community pharmacies and crisis centers that will provide medications without charge.
Stepping away from medicine, Professor and I spent the downtime between patients talking about the cultures and traditions of our respective countries. One topic that came up was marriage and weddings. She was surprised that there are not really arranged marriages in the US. This to her was the way it should be, marriage revolving around love between two people instead of being told who you are suppose to spend the rest of your life with. She was also surprised that there is no dowery in the American wedding culture. We talked about the traditionally the bride's family pays for the wedding and the groom's family pays for the reception, that is as close to dowery and gifts I could come up with. We also talked about Ruby, the new puppy my sister and I gave to my Mom as a surprise early birthday present. Professor talked about how she never understood American's attachment to domestic animals until she read the book Marley and Me. She states she was weeping by the end and it made more sense to her how important pets can be. Still though, she won't go to her brother's house if his dog is there.
I truly enjoy these chats with the Professor on more of a person level. I came to India as a representative of Project HOPE in the field of Medicine. However, this journey is more than medicine, it is fundamentally about the people and culture. The rest is built on those two things. How blessed I am to learn about the culture and people by being immersed in it with such willing teachers.
Below is the Medical College and Dorms. The view is from a balcony at the hospital near my room.
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