Wednesday, September 26, 2012

MEDICAL IMAGE- MAGAZINE OF IMA


From,

Dr Vani Kulhalli,

Psychiatrist,

Life Member,

IMA BWS Branch,

Mumbai.

To,

President and Editor,

Medical Image,

IMA,

Mumbai.

Subject- Consider converting Medical Image to e-magazine

Date-27-9-2012

Dear Sir,

I am a member of the Editorial committee and have noticed that we spend a lot of money in printing and distributing the MEDICAL IMAGE every month. This puts us at a disadvantage as we have to solicit advertisements and have to restrict the number of articles published. We may lose out on good quality articles. I also feel that we have developed a bias towards publishing articles from persons who are able to arrange for sponsorships. In other words, persons who have the resources to fund our magazine have developed the power to control editorial decisions. This is unacceptable standard of conduct for an august association as ours.

 Besides, we must consider the environmental impact of using so much paper, ink, plastic packaging and fuel for transport of copies. Therefore, I suggest that we must do away with the paper version of ‘Medical Image’ and send our members the electronic version only.

The argument of ‘not having time to access internet’ or ‘not being able to deal with new technology’ is no longer tenable. All our members use the latest mobile phones and learn to drive the  latest models of cars. Most habitually use Facebook and web albums as well as Skype to keep in touch with their children and friends. Then why the bias against learning the technology required for reading an e-magazine?

I think that we must waste no further time in converting our magazine into its electronic version only.  Kindly, consider this decision.

Note that I am sending a copy to some members, who are not in our Editorial committee but who are significant opinion-makers of our organisation.

Sincerely,

Dr Vani Kulhalli

Tuesday, September 11, 2012

CAREER PLANNING FOR YOUNG PSYCHIATRISTS- CONTACT IPS



After several years of complaining to all the high and mighty about the dearth of mentoring opportunities for young Psychiatrist, I was completely thrilled that Dr Vishal Reddy took up this task and formulated a CME based on it. I heartily congratulate Vishal and the other Editors on bringing out this book.

This book is a collection of the material presented in the CME. I think the cover is quite apt, and the 'wings' look really nice. Does the orange-yellow colour scheme suggest 'burning ambition to succeed'? Also the the teasing statement 'what you dont learn at college' is very apppropriate. The book is 170 pages and enables reading in one day.  The initial write-ups provide with an adequate and appropriate introduction.  

Most of the chapters are on careers in specialty psychiatry. The Chapters titled ‘Mastering the Art of Private Practice’, ‘Balancing academics with practice of psychiatry’, ‘Beyond Money!’ are very good and practically helpful. The chapter ‘Gender issues’ seems to have missed the point.  Overall, the book succeeds in providing guidance to young psychiatrists on important matters. 

I hope this will only be the first edition, and the beginning of an initiative which grows larger. Psychiatry is among the best professions and provides a most needed service to the community. By providing directions to the new crop of Psychiatrists and helping them survive, Psychiatry will survive.

In the next edition, I would expect a survey/ study of the common difficulties faced by young Psychiatrists and the means used to deal with them. I want someone to write honestly and practically about the career prospects and concerns of women Psychiatrists. (For now, I recommend Dr Syyeda Ruksheda’s article, on this topic). I wish we could set up a careers  cell in IPS, which helps psychiatrists find jobs and assignments. I also wish we could have some mentor-groups, who help youngsters settle into their profession.

 I would say, this initiative is not only innovative but also a very noble one. The contributors seem to have honestly shared all things they know, and this is a remarkable feature in the context of competitiveness and somewhat selfish nature of most doctors (I am sorry, but it is true).

I would recommend this book as a useful (not necessary) reading for any young Indian Psychiatrist. I cannot comment on how you can get your hands on a copy; though I have planned to give mine for display in the library of KEM Hospital, Mumbai. I don’t know if the IPS will be making this compilation widely available. At least they could put it on their website.

 


 

Friday, August 31, 2012

BOVINE SPONGIFORM ENCEPHALOPATHY



PUBLISHED IN GOLDEN JUBILEE SOUVENIR OF BYJEMEC, B J MEDICAL COLLEGE, PUNE IN 1996.

Sunday, August 26, 2012

THE WORLD AROUND YOU

I have worked in private practice as well as in an institute. My impression is that the amount of work a psychiatrist gets does depend on the setting of work.

In an institute, I have observed that the threshold for asking a Psychiatrist to get involved is rather low. We get referred any case and every case. Hence the workload is considerably high. Whereas, in private practice the referrals are slow to come. Even serious and purely 'Psyhciatric case' like suicide attempts and psychoses are retained by doctors from other specialties. Thus cases are fewer.

One explanation for this is due to the desire to work less and also to make more money; both being at the cost of the patient's welfare.

 In the first instance, the patient would benefit from continuing care of the Physician/ orthopedician, etc. But the salary remaining constant, this doctor has nothing to gain from keeping the patient in the wards and increasing his/ her workload. This doctor also has a culture of concrete thinking, where seeing ONLY is beleiving and quality of life has no meaning. But if patient is not accepting his explanation that everything is ok, and the relatives refuse to take the patient as he/ she is still distressed or troublesome, the doctor bounces off the patient to the Psychiatrist. No Psychiatrist can refuse to take care of a patient who is obviously uncomfortable. So the patient with many medical problems, and just mental symptoms (not mental illness) gets shifted to the Psychiatry ward. Now the Psychiatrist and the patient have to keep begging the referring doctor to come  regularly and have a look to maintian the physical status. This gives the additional incentive of 'ego massage' to the referring doctor, who believes that Psychiatrists are lesser mortals and anyway dont have any work to do.

The scenario is much different in private practice. Every doctor believes that Psychiatric disorders are not disorders at all and counseling will set everything alright. They are scared to use psychiatric drugs in proper doses, but since they are so intelligent they will open some book, find a few names of psychotropics and discharge the patient with a scolding and 'good advice' (which is their version of counseling). After all by treating the patients themselves, and keeping them ill as long as possible, there is money to be made. When the patient becomes fed-up or very ill, they will, very reluctantly refer to the Psychiatrist. By this time the disease has progressed to such an extent that it is a tuff situation even for a Psychiatrist and the improvement proceeds slowly, partially or not at all. Then they confirm their delusion that 'Psychiatrist know nothing and do nothing' and malign them.

I feel every professional should spend some time educating themselves about the thresholds for referral to Psychiatrists. They can just make it a habit to talk to the Psychiatrists about the cases they have referred; over the years they will learn. Of course, one can do nothing aboout unscrupulous persons who dont want to refer patients.

I am sure this discussion applies to referrals between other specialties also.

Friday, August 3, 2012

WHAT THIS BLOG IS ABOUT?

This blog is for doctors and about doctors. It will contain topics about the medical profession, and about psychiatry.