Wednesday, 6 February 2008

CHRISTIAN MEDICAL COLLEGE VELLORE

……WHEN AUNT IDA BEGINS TO WEEP !!

( PART-II )

On the condition that his identity would not be disclosed (as some sort of bias might be developed among those concerned) Mr. Z who was once a neuro-patient here & has come this time with some fresh complaints declares that much of corruption has spread in CMC now-a- days at its various levels including the M.R.Os. (Medical Record Officers) to name the one. Being the member of staff of the same institution they also get, as a natural course, support from the concerned doctors. For this, they (M.R.Os.) tactfully craft their story & place them before the doctors - fabricating the illiterate & childish activities of the outpatients with which the doctors already remain annoyed. True, many of the patients are illiterate & there is substance in saying that their illiteracy brings a lot of childish cleverness. So, keeping in mind that they can’t be made literate overnight it is an ethical responsibility on the literate world to make them literate at one hand and to co-operate them genuinely at the other. Unfortunately this is not happening here now-a-days. Rather some M.R.Os. have become habitual in taking benefit from such situation & for that they successfully utilize the aforesaid psychology of the doctors. Using this, they become able to manipulate the original order of patients’ file. How & why ? The reply of HOW is very simple. They act to do it above board - presuming no one is either able to understand their act ( of manipulation ) or able to gather courage to protest. If somehow challenged they cunningly shift the onus onto the deprived patients - falsely accusing them of their remaining absent at the time of their call (or announcement through the speaker). Finding answer of WHY is also not difficult. This author knows everybody knows it & as it would amount to go beyond the decency & decorum of the literate and civilized world of CMC she finds it futile to use the bitter- cum-appropriate words.

TO PUT FORTH AN EXAMPLE:

* Mr. Z got an appointment in Neurology Department on 29.01.08. App. Type was Private & TIME OF REPORTING was at some early hours.

* He arrived at the M.R.O.’s counter exactly at 8:20 AM, a bit earlier than his normal REPORTING TIME, as he knew well through earlier experiences that irrespective of the REPORTING TIME he would be called as per his order in the queue . It is a general phenomenon that the M.R.O. prepares patients’ files (before bringing them to the doctor’s room) in order of patients’ presence in the queue.

* When he got his turn to face him at his counter’s window he forwarded his appointment-slip inside his cabin. The M.R.O. copied his registration number from the slip into the relative register & stamped a seal over the same.Two columns, what appeared inter alia on the slip through that seal, were obviously to be filled by him. He, however, left the column of “Serial No.” unfilled and filled “4 ” in the column of “ Room No.” before returning the slip to him. Then he advised him to wait (inside the hall before his counter) until his name was announced. He, however, made it a point that the doctor concerned had not arrived till then.

* Mr. Z continued to wait for the doctor. At considerable intervals he however asked many a times to the M.R.O. as to whether he had arrived. Every time his answer was in negative. With a view to sit & wait in the INTERNAL- HALL (where the doctors’ rooms situate and at the gate of which a security guard prevents the undesired entry) he approached the gate. But the security guard didn’t allow him to enter inside stating that the doctor (required for Room No. 4) had not arrived. He also advised him to sit in the EXTERNAL-HALL (the one described earlier) till his name was announced on the speaker.

* At about 1:00 PM when asked again about the doctor’s arrival, the M.R.O. abruptly lost his temper & replied rudely, “ Who told you that the doctor has not come ? ” He turned stunned & could not gather courage to retort. As he had not heard any announcement being made from Room No. 4 till then he simply wanted to be confirmed whether the doctor had arrived. Useless was this to start an arguable discussion with him or anybody else in such a distant province where nobody was his own, Mr. Z states.

* Time went on passing. Mr. Z, merely by chance, noticed that the gentleman (M.R.O.) was busy in some unethical activities. Had it not been so his replies (even if in negative) would have been in a normal tone. His exposures were such as if he was about to be caught red-handed committing some crime. And, while giving a reply to almost everybody he looked unnecessarily furious & irritated. Therefore Mr. Z started to observe the things very carefully. He now declares it was not at all a normal man’s busy exposures. And he can bet with anybody that the M.R.O. was behaving abnormally only because he was loaded with his own guilty-feelings on account of doing manipulations with the patients’ files.

* Also what happened next bears the significant substance. This, too, happened by chance. While observing his activities Mr. Z suddenly saw a glimpse of his own file bearing his registration number that was thrown in a corner of his cabin over some other files. Though he wanted to burst into anger he somehow controlled himself. Avoiding the direct accusation he strongly (but very carefully choosing the appropriate words) asked him, “Would you give me a patient hearing please? I have been regularly asking you the fate of my turn & every time your advice is to wait. I have repeatedly requested you to check my position but you are not even listening to me than to say “sit ahead & wait, your name will be announced.” See, I have been waiting here since 8:20 in the morning & have not moved anywhere even for a single minute remaining hungry & thirsty that long. So many people who joined later in the queue have already gone. I can say there is definitely something wrong & you need this be examined.”

* This time it worked. It worked, Mr. Z says, because the expertise (of dealing with the variety of people) in him cautioned him to immediately correct himself. He demanded the slip from him &, retaining the same, assured - this time politely - to look into the matter. He also advised Mr. Z to sit in the Internal - Hall. Fortunately, the security guard was not at the gate this time. He entered inside & started watching what was forthcoming.

* He knew well the M.R.O. would appear in few minutes with his file & would enter the doctor’s room (Room No. 4). Mr. Z remained silent and let the same happen. He saw his file was being carried by him. When he came out of the room & reported to him that his name would soon be called, Mr. Z could not stop asking, “May I ask you why had you held up my file till now ?”

* Interestingly, he did not reply & entered the room again.When he came back he replied, “I had told you to come at 11:00 & you did not turn up.”

“You know you are telling a lie.” Mr. Z retorted. He saw the M.R.O. was entering the room again. And when he came out finally he said rather firmly, “Go inside & see the doctor himself had called your name many a times.”

“I need not. I know what really happened. Everybody knows this.” There was a sort of murmuring, whispering, applaud & moral support from almost every corner of the hall - especially from those deprived of their normal turn but were helpless to do anything. Soon there was a call from the doctor’s room & the matter apparently ended. But the entire episode definitely left certain issues to be analysed.

Like before, without malice to anybody, once again this author wants to put some questions
before the concerned authorities of CMC in order to cause their constructive considerations :

( A ) Why is there lack of uniformity in the parameters with which the respective M.R.Os. of different departments deal with the patients’ files ? For example, there is no event like stamping such kind of seal on the appointment slip (& acting in that accordance) in the departments of Medicine-3 & Opthalmology.

( B ) Why is there lack of such uniformity even within the different segments of the same department ? For example, there is a certain parameter in the PRIVATE segment of NU3 (Neurology Department) as per which the patients are called by the doctor concerned one after another. For that he (the doctor) picks up the files one after another in the arranged order & calls the patient’s name accordingly. Obviously, it is the duty of the M.R.O. to arrange the files in the order of patients’ presence in the queue & to present them before the concerned doctor. Remarkably, he doesn’t allot any serial number to any patient so as to establish his priority in the queue.

However, there is another parameter in the GENERAL segment of the same NU3 department where the patients are allotted a serial number (establishing their priority in the queue) added with the room number (of the concerned doctor) and the time (as to when he will be called by the doctor).

What the lack of such uniformity brings can be understood by the following example. Mr. Z had got an appointment, prior to the one on 29.01.08 referred above, in the same NU3 department but in its GENERAL segment on 21.01.08. For certain unavoidable reason he couldn’t present himself in time before the stipulated room. He was late hardly with half an hour. The doctor had left by that time. The M.R.O. rose his wrist-watch to him indicating that time allotted had already passed. Since a few of the working hours were still in stock of the day & a number of patients were waiting in the hall before different rooms, Mr. Z requested him (to M.R.O.) to postpone the appointment-date so as to save his money if not time. While refusing, the M.R.O. showed to him his wrist-watch once again but couldn’t satisfy him as to why different rooms were still having the doctors or why the patients in bulk were still waiting inside the hall for their turn of being attended. It was why, having gathered this unpleasant experience to his score, Mr. Z had appeared on 29.01.08 in front of M.R.O.’s office forming a part of the queue even before the reporting time. And, what he had to suffer there in spite of all his experienced anticipations has already been described in the foregoing paragraphs.

( C )
There is an excellent mechanical arrangement of entertaining the patients in the OPD building at its ground floor where the cash-counters are situated. An employee is deputed there to issue TOKEN to the patients. This TOKEN comprises a number written on it. The patients are now required to sit & wait for their turn inside the stipulated area. A commonly visible machine displays such TOKEN-NUMBER one after another indicating each time the number of the respective cash-counter. In tune with the same, there is an announcement-system as well which announces in clearly audible voice both the TOKEN-NUMBER and the number of the respective cash-counter. It makes the work easy & transparent. The patient gets completely satisfied even if he is required to wait for his turn for hours and hours long. Nevertheless, he finds it quite manageable to spend time over his other simple needs such as taking tea, breakfast or meal or to attend bathroom etc. Should the author not be surprised over why the similar transparent system is not enforced in the matter of examination of patients by the doctors ? Should she get convinced, as opposed to her belief, with a lot of views expressed by various corners that there is a powerful machinery working within the governing body of CMC who does not want such improvements for its vested interests ?


( D )
It appears that some kind of irregularity also lies in the calling or announcement system. Some rooms are eqipped with announcement-system & some perhaps not. Or, the doctors of some rooms do not like to use it rather prefer to call the patients verbally. Or maybe, their announcement-system has gone out of order or not working properly. The exact reason is required to be traced out & be corrected. The security guard is also required to be made known of this fact & be accordingly instructed not to restrict entry of the concerned patients.

(..........to be continued)

................ Savitree
( At Vellore on a study-tour )

1 Comments:

At 8:44 pm, February 18, 2008 , Blogger Unknown said...

Although author has made dere best to bring the some hidden fact about india one of d best hospital....but i would like to say way in which dis hospital is running is one of best in india in there own field...

 

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