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What should be in a book to make it a best seller? A girl What should be in a book to make it a best seller? A girl on the cover & no cover on the girl

Story of Doctor Q Q Q Q Q Me 12 th me tha, wo Story of Doctor Q Q Q Q Q Me 12 th me tha, wo 12 th me thi Me MBBS me aagaya, wo BSc me thi Me MBBS me tha, wo MSc me thi Me MBBS me tha, wo Ph. D me thi Me MBBS me tha, wo Dr ban gayi Uski Shaadi ho gayi, me PG entrance de raha tha Wo 2 bacho ki MAA ban gayi, me MD Gync kar raha tha Bachhe 5 sal ka hokar school jane lage, me SR kar raha tha Bache 10 th pass ho gaye, main hospi suru kiya Afsos yeh hai ki Aaj uski Tubectomy hai aur meri Engagement Story doesn’t end here journey continues …. .

Medical Profession – An Introspection Dr. P. C. Mahapatra Professor, O & G S. Medical Profession – An Introspection Dr. P. C. Mahapatra Professor, O & G S. C. B. Medical College, Cuttack PRESIDENT, FOGSI – 2011

Oldest Profession in Human Race ¯Medical. ¯Legal. ¯Prostitution. Oldest Profession in Human Race ¯Medical. ¯Legal. ¯Prostitution.

Medicine Man Priest Herbalist Magician To bring relief to the sick in complete absence Medicine Man Priest Herbalist Magician To bring relief to the sick in complete absence of medical knowledge

Primitive Medicine Magic Religion Magician Priest Anesthetist Surgeon / Physician / Gynecologist Primitive Medicine Magic Religion Magician Priest Anesthetist Surgeon / Physician / Gynecologist

 Medicine was conceived in sympathy & born out of necessity The first doctor Medicine was conceived in sympathy & born out of necessity The first doctor was the first man The first woman, the first nurse

Evolution of Medicine & Medical Profession Ø Prehistoric – Indian, Mesopotamian, Greek Ø Emergence Evolution of Medicine & Medical Profession Ø Prehistoric – Indian, Mesopotamian, Greek Ø Emergence of organised medicine AMA, 1847 Ø Emergence of Public Health Ø Generalist / Specialist / Subspecialist / Superspecialist Ø Technological innovations & Pharmaceuticals – Impact Ø Health Care Vs Medical Care Ø Doctor Patient Relationship – Change Ø Doctor & Society – Change Ø Medicolegal Scenario – A Curse Ø Health Care System Vs Health Scare System Ø Policy makers – Bureucritic & Political Hippocritic will Ø Changing Society, Changing Problems

Believe It or Not Noblest of the Noble Profession Changing System Changing Society & Believe It or Not Noblest of the Noble Profession Changing System Changing Society & Changing Philosophy Usually by choice not by chance Strong believer of destiny Mainly by labour not by luck Live for others, don’t live for yourself Balancing personal & professional life Easy to tell, difficult to practice Individually very strong & powerful, collectively very weak & timid Tunnel vision personality

Believe It or Not 3/4 th of life spent for profession & don’t understand Believe It or Not 3/4 th of life spent for profession & don’t understand the meaning of life Bound to be exploited from everybody – Professional Hazard Highest ranking in society but unsocial Don’t think of future, only lives in present Head, Heart & Hand – A Real Amalgamation Art, Science & Commerce – Unique Combination No religion – Humanism

Sickness / Diseases QEmergency medicine - 10% QMinor illness syndromes - 30% QDoctor thinks Sickness / Diseases QEmergency medicine - 10% QMinor illness syndromes - 30% QDoctor thinks you have a disease - 10% QPatient thinks he has a disease - 10% QChronic illness syndrome - 25 -30% Pathy & QDrug or doctor induced (iatrogenic) - Pathy 10 -15%

Annubhutti Vs Anubhav Introspection Experience Annubhutti Vs Anubhav Introspection Experience

My Introspections Only brother sandwitched between 6 sisters – Feminine personal development to some My Introspections Only brother sandwitched between 6 sisters – Feminine personal development to some extent From a lower middle-class family – Realising the ground reality Born & brought up in remote sub-urban area of Western Orissa Schooling in conventional Oriya Medium School Ambition to become a doctor from childhood – Role Model

 God fulfilled my ambition Shifted from Engineering to Medical – From REC, Rkl God fulfilled my ambition Shifted from Engineering to Medical – From REC, Rkl to MKCG, Bam. Mediocre medical student – involved in more extracurricular than curricular activities enjoyed every bit of studentship excepting studies Wanted to be gynaecologist Unpredictable, chance, competency Enter into PG Course in OBGYN, SCB by luck, not by labour Started study during PG Course

 Inspired & stimulated by my then teachers for excellence I love my profession Inspired & stimulated by my then teachers for excellence I love my profession most Desire to have a family of Gynaecologist & could be successful Wanted to settle in my own State & make the State at par with place of professional excellence – Struggling continuing … Wanted to be Teacher-Doctor and by God’s desire, could ultimately be – Father’s inspiration

 My teacher’s guidance & effort and goodwill of Seniors & friends – Key My teacher’s guidance & effort and goodwill of Seniors & friends – Key Enjoyed in Cuttack a lot & exploited in Cuttack a lot more Blessed by having dedicated desciples Done more mistakes in life than an average gynaecologist could do Stress has given stimulus to me to growth Believes in life’s utilisation in different phases for different purpose I am proud of my Profession & derive pleasure out of my work I don’t know where God desires to take me till my last breath

Pre-Medicos Majority do have an ambition Change over a period of time Emergence of Pre-Medicos Majority do have an ambition Change over a period of time Emergence of other alluring disciplines Personal Choice to Parental Choice to other’s influence – Family Legacy Gender Role – Change Labour & Luck Sense of Wellbeing & Satisfaction High hopes & Aspirations in life

 The pinch is felt by many in the field, and one university, the The pinch is felt by many in the field, and one university, the Brisbane University in Australia, tries to pick medical students from among the graduates in humanities – arts, literature, music, etc. Their experience has shown that this class of students would make better doctors; while the physics, chemistry & biology students make better technicians.

Ask Yourself relevant queries Can you smile at someone Naturally ? Can you touch Ask Yourself relevant queries Can you smile at someone Naturally ? Can you touch someone Naturally ? Do you have an insight into another human beings problems ? If Yes – Ideal Candidate for Medical Courses If Not – Other Profession

Medicos Forgets the toiling – Phase of amusement Changed behaviour by peer influence Residential Medicos Forgets the toiling – Phase of amusement Changed behaviour by peer influence Residential effects – Newer environment Pressure of studies & torture of teachers Love & Romance – Failures & Success Happiness & Frustration Acquiring newer habits Segregating into different groups

 Extracurricular activities Examination – Pre, intra & post Internship Phase of insecurity Indecisiveness Extracurricular activities Examination – Pre, intra & post Internship Phase of insecurity Indecisiveness Uncertainty Higher studies

 Thomas Babington Macaulay in the House of Commons on the 2 nd February Thomas Babington Macaulay in the House of Commons on the 2 nd February 1835 says it all. “I have traveled across the length & breadth of India and I have not seen one person who is a beggar, who is a thief. Such wealth I have seen in this country, such high moral values, people of such calibre, that I do not think we would ever conquer this country, unless we break the very backbone of this nations, which is her spiritual & cultural heritage, and, therefore, I propose that we replace her old & ancient education system, her culture, for if the Indians think that all that is foreign and English is good and greater than their own, they will lose their self-esteem, their native self-culture and they will become what we want them, a truly dominated nation. ”

Medical Practice G. P Specialist Superspecialist From India to Abroad From Rural to Urban Medical Practice G. P Specialist Superspecialist From India to Abroad From Rural to Urban From Private to Government From Practice to Teaching From Medical Profession to Other Profession Majority Settles & Continue Very few dissatisfied till last Pleasures & Pains Benefits & Risks

 It is preposterous that medical science does not worry about health promotion, while It is preposterous that medical science does not worry about health promotion, while it goes overboard about disease intervention, many of which make the patient worse ! Sir Willam Osler had warned us not to intervene when the patient is doing well, but that is exactly what we do today ! Medicine does not believe in the wellness concept. Everyone is ill unless proved otherwise is the present paradigm, thanks to the total body scanners. Routine check up is the biggest medical industry, while we know that predicting the future is impossible in a dynamic human system using a few data of the initial state.

 Even changing those parameters might not hold good as time evolves. Changing those Even changing those parameters might not hold good as time evolves. Changing those parameters might even harm patients in the long run, while it is mandatory to do so if the patient is symptomatic and is suffering, because doctors are here to “cure rarely, comfort mostly, but to console always”.

 To quote the most authentic scientific body of the USA: “The National Academy’s To quote the most authentic scientific body of the USA: “The National Academy’s data attributes 100, 000 deaths per year to physicians’ errors, added to well over 100, 000 deaths due to severe drug interactions and another 100, 000 fatalities from hospital-based-infections. ”

Key Issues to be Addressed Changing Society Legal issues Role of Media Practice & Key Issues to be Addressed Changing Society Legal issues Role of Media Practice & Malpractice Ethical & Moral Issues Professional & Personal Issues Management Administration Leadership Social Activist Other aptitudes

Last Phase of Life No End Stage unless incapacitated Change of Profession, but continuing Last Phase of Life No End Stage unless incapacitated Change of Profession, but continuing activities Time for enjoyment of life Sharing experiences Social activity Religious issues Physical & Psychological disabilities

What is preferable… Parkinsonism or Alzheimer? It’s Parkinsonism… It is better of spill half What is preferable… Parkinsonism or Alzheimer? It’s Parkinsonism… It is better of spill half glass of bear than forgetting where you had kept the bottle.

Health System Unfortunate deaths of nearly 3000 people in most inhuman 09/11 bombing in Health System Unfortunate deaths of nearly 3000 people in most inhuman 09/11 bombing in New York brought the whole world together to fight Terrorism, but the knowledge that there are well over 540 millions in this world suffering from malnutrition and 680 million living below poverty line does not seem to bother any of us.

Just about 40 millions of the World people suffering from the enigma called AIDS Just about 40 millions of the World people suffering from the enigma called AIDS seems to affect $8 billion annually in research grants. In some poorer country, more children die of NIDS (Nutrition Immune Deficiency Syndrome) than AIDS. Who Cares ? ? ?

Highest percentage of specialised doctors – more is the disease More Laws in the Highest percentage of specialised doctors – more is the disease More Laws in the Court – Less Justice

Health Tourism Health Economics Health Insurance Health Tourism Health Economics Health Insurance

Proper education of future generation giving them right attitude and aptitude of life could Proper education of future generation giving them right attitude and aptitude of life could keep all of us happy. In addition to external objectives, intellectual based knowledge that present educational system imparts the need of internal intuitive based, subjective knowledge of self that he/she is born to live for others, not for self.

Blessed is one who expects nothing for he will never be disappointed. Jonathan Swift Blessed is one who expects nothing for he will never be disappointed. Jonathan Swift

Twenty-first Century is the best of times, if one considers the so called scientific Twenty-first Century is the best of times, if one considers the so called scientific development and the worst of times when one critically looks of human development. Charles Dickens Modern Civilisation – bringing man close to his animal instincts and perhaps even worse

God give me deliverance from: Not letting the well alone Treating suffering humans from God give me deliverance from: Not letting the well alone Treating suffering humans from cases and Making my treatment worse than his suffering

A fool thinks himself to be wise but a wise man knows himself to A fool thinks himself to be wise but a wise man knows himself to be a fool. Shakespere

Health is a state of holistic wellbeing of man emerging him to be enthusiastic, Health is a state of holistic wellbeing of man emerging him to be enthusiastic, to be creative in society for his own good as well as good for others

Health – A State of Work and Love Richard Smith S. Freud Health – A State of Work and Love Richard Smith S. Freud

↓ Epidemic Disease ↑ Degenerative Disease Accidents, drug addiction, violence, new infections ↓ Epidemic Disease ↑ Degenerative Disease Accidents, drug addiction, violence, new infections

Power of Prayer Fear of God or Love of God Power of Prayer Fear of God or Love of God

Intellectual Intolerance is the worst kind of terrorism Poverty & Illiteracy will breed terrorist Intellectual Intolerance is the worst kind of terrorism Poverty & Illiteracy will breed terrorist

I keep six honest men Serving Me They have taught me all I know I keep six honest men Serving Me They have taught me all I know Their names are: Who, Why, Where, What, When, How R. Kipling

World of Living World of Dead Unbreakable bridge of human love Doctor as a World of Living World of Dead Unbreakable bridge of human love Doctor as a Healer

Quality of Head & Heart Imperturbability: Under no circumstances you should get perturbed while Quality of Head & Heart Imperturbability: Under no circumstances you should get perturbed while dealing with patients Aequanimities: Keep your mind cool Cool mind rationally think in emergency situations

Medicine as a Business Is academic medicine for sale Medicine as a Business Is academic medicine for sale

Trouble is an integral part of living but Care is what makes it worth Trouble is an integral part of living but Care is what makes it worth living

Art of Giving is the Art of Living Art of Giving is the Art of Living

Disease based Medical Education Vs Patient based Medical Education Disease based Medical Education Vs Patient based Medical Education

If you listen to your patient long enough He / She would tell you If you listen to your patient long enough He / She would tell you what is wrong with him / her Lord Platto

The ear says more than any tongue Tongue has no bones But it has The ear says more than any tongue Tongue has no bones But it has a capacity to break bones Don’t allow your tongue to say

Be wise like a Serpent But harmless like a Dove Jesus Christ Be wise like a Serpent But harmless like a Dove Jesus Christ

If there is no problem There is no joy Happiness is living dangerously If there is no problem There is no joy Happiness is living dangerously

Students are scheduled to mistake medical treatment for healthcare, social work for improvement in Students are scheduled to mistake medical treatment for healthcare, social work for improvement in community life, police protection for safety, military poise for National sanctity and the rat race for productive work Ivan Illtech

Wise people learn from their own mistakes Wiser people from the mistakes of others Wise people learn from their own mistakes Wiser people from the mistakes of others

Continued Professional Development Vs Continued Personal Developments Continued Professional Development Vs Continued Personal Developments

Medicine is a wonderful profession, if practised ethically It could be a curse if Medicine is a wonderful profession, if practised ethically It could be a curse if is transformed into Business

The whole world of Medicine revolves around two human beings A human being who The whole world of Medicine revolves around two human beings A human being who is ill or imagines being ill comes to seek advice of another human being in whom the first has confidence Expectation Effect Sir James Spence

Learning Medicine from books alone is like swimming on uncharted sea While books learning Learning Medicine from books alone is like swimming on uncharted sea While books learning medicine without is not going to sea at all W. Osler

Let’s not take the world for a ride with our scientific halo. While the Let’s not take the world for a ride with our scientific halo. While the world is suffering from Giga problems like hunger, poverty, ignorance & illness killing millions. We, in the scientific community are bothered about our nano problems of trying to kill germs & producing self replicating nanobots

Young Doctors There is a pill for every ill Surgical correction for any anatomical Young Doctors There is a pill for every ill Surgical correction for any anatomical deviation Scopes & Scanners – Be all & end all

Well man would be one who have not been properly investigated Well man would be one who have not been properly investigated

Euboxic Medicine & Dysboxic Deaths Euboxic Medicine & Dysboxic Deaths

Try to be A man of Value Rather than A man of Success Albert Try to be A man of Value Rather than A man of Success Albert Einstein

Love All Trust a Few Do Wrong to None W. Shakespere Love All Trust a Few Do Wrong to None W. Shakespere

Learn to be Wise If Not, you will be Otherwise Learn to be Wise If Not, you will be Otherwise

I would rather be strongly wrong than weakly right I would rather be strongly wrong than weakly right

God give me deliverance from treating suffering human beings as cases not letting the God give me deliverance from treating suffering human beings as cases not letting the well alone and making my intervensions worse than his disease

Patient doing well Don’t Interfere W. Osler Patient doing well Don’t Interfere W. Osler

Read Little See Much Think More Do Much Read Little See Much Think More Do Much

As doctors write Prescriptions Drug Company will write a Cheque As doctors write Prescriptions Drug Company will write a Cheque

Treatment Abuse It takes 5 years to learn and do surgery It takes 25 Treatment Abuse It takes 5 years to learn and do surgery It takes 25 years to decide not to do surgery.

Malignant Medical Myths Screening industry Artificial epidemics Hitech interventions Health Care Vs Health Scare Malignant Medical Myths Screening industry Artificial epidemics Hitech interventions Health Care Vs Health Scare Technology driven research Pharma driven treatment Modern Medical Delusions

3 Blunders in Life To become a Doctor. To Select Doctor as life partner. 3 Blunders in Life To become a Doctor. To Select Doctor as life partner. To create doctors as progeny. “Anonymous Doctor” By Choice or By Chance

Advances in Medicine 2000 BC 1000 AD 1850 AD 1940 AD 1985 AD 2000 Advances in Medicine 2000 BC 1000 AD 1850 AD 1940 AD 1985 AD 2000 AD - Here eat the root - That root is heathen say this prayer - That prayer is superstitious, here drink this potion - That potion is snake oil, here swallow this pill - That pill is ineffective, here take this antibiotic - That antibiotic is dangerous, Here eat this root Anonymous

Change in Medical Profession – A Close Look From healthcare to medical care From Change in Medical Profession – A Close Look From healthcare to medical care From disease to diagnosis From social identity to disease identity From generalist to specialist & superspecialist From healing to treating From clinical sense to technologic dependence From rational use to irrational abuse From faith to court From pleasure to pain From charity to business Needs Serious Introspection From We Concept to I Concept

10 reasons why I choose to be a doctor…… 1. 2. 3. 4. 5. 10 reasons why I choose to be a doctor…… 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. I hate sleeping I have enjoyed my life in childhood I can’t live without tension I want to have disturbed family life I believe in Geeta “Kam Karo, Phal Ki Kamana Na Karo” I don’t want to spend time with my family I want to take revenge on myself I wanted to break up from my friends I want social boycott I love to work on Sundays & holidays

Last Words …. Continue to be one of the best profession in all centuries. Last Words …. Continue to be one of the best profession in all centuries. Past, Present and Future Amidst Pains, Pleasure Ethical, moral and human Amalgamation of Head, Heart & Hand Amalgamation of Art, Science & Commerce We are the Winners

Coming Together is the Beginning Staying Together is the Progress Working Together is the Coming Together is the Beginning Staying Together is the Progress Working Together is the Success