I am writing this article for my fouji friends who are not from the medical side. I suggest you spare a few minutes to go through it. You may perhaps benefit from it some day.
Many of us may not be aware of the fact that India is now the “Heart disease capital” of the world – we have the highest number of coronary artery disease cases (the ones blocking the coronaries leading to heart attacks) …..and the number is rising every day. We foujis are also part of this population that is certainly not insulated from this risk. This is despite the fact that we are in general, a screened lot having undergone a rigorous medical exam on entry and subsequently every year. It is high time that we take remedial measures to prevent a catastrophe……I shall begin with a few examples to highlight my point.
Let me begin with my own case……I have been a teetotaler, non smoker, non obese, not suffering from diabetes or hypertension and a fitness freak all my life despite which I had a heart attack just after retirement. Had I undergone a routine Treadmill Test earlier, this could have been largely prevented.
The second example ….. a fairly recent case… a senior specialist doctor, a man with clean habits and a fitness freak, at a large service hospital was playing a vigorous game of squash when he suddenly collapsed with a cardiac arrest. Fortunately for him, the cardiologist happened to be his game partner. He was revived and taken up for emergency angiography when a block was detected which was subjected to stenting. He luckily made a full recovery.
No body is therefore insulated from this risk. What is the solution? Well, I strongly recommend a yearly Treadmill Test for every one over 40 years of age and once every five years between 30 and 40. This may not be available through your unit facilities because a yearly TMT may not be authorized as per “rules”. At the most, what they do is a routine ECG which is quite useless as a screening tool. But you can always get a TMT done through any cardiologist in your home town when you go on leave. Get a yearly Lipid profile and get your Blood pressure and blood Sugar monitored on a yearly basis. Lifestyle modifications as under, are important as a preventive measure.
Dietary Habits : Avoid Red meat , yellow of eggs, and saturated fats, fast foods. Take more of vegetables and fruits. Fish is good for the heart. Moderate your alcohol consumption.
Exercise: A brisk daily walk for 30 to 45 minutes at least 5 days a week is good for your heart.
Your heart is in your hands ! Look after it …..before it is too late….
Tuesday, March 9, 2010
Tuesday, March 2, 2010
ECHS needs to do more......................
The ECHS was a well conceived scheme with the objective of providing comprehensive medicare to the Veterans in the evening of their lives. The scheme has indeed benefited a lot of ex-servicemen and their families. It is stating the obvious to say that the govt spends crores of rupees to sustain the scheme as a measure of welfare towards Veterans.
However the scheme like several other newly introduced schemes has its share of shortcomings. If remedial actions are taken to rectify these, I think it will go a long way in making it much more meaningful to the clientele. I have tried to comment upon a few of these shortcomings based purely on my personal observations.
Procedural Simplifications : An ESM on reporting to an ECHS polyclinic is referred to a specialist at an empanelled hospital . The specialist at the empanelled hospital after examining him orders for additional tests like a thyroid function test or an ultrasonogram or a CT scan or a treadmill test. Now the poor old man has to go back to the referring doctor at the polyclinic merely to get a rubberstamp of approval and return back to the specialist at the empanelled hospital. Assuming that the ESM stays in a village 30 kms away from the polyclinic and the empanelled hospital is 50 kms away from the polyclinic, one can well imagine the plight of the old man !! This extra trip could have been avoided had the referring doctor written “referred to the cardiologist xyz Hospital, for appropriate investigations, opinion and treatment“ . Now if this patient is asked to undergo a coronary stenting, he goes back to the polyclinic, where a statement of case is made, forwarded to the SEMO , who is the CO of the nearest MH. After scrutiny by the SEMO, the SOC is forwarded to the Command Hospital for approval by the Cardiologist. I am sure the cardiologist merely affixes his stamp of approval after which the papers find their way back to the same polyclinic where it all began. This entire exercise would have taken full two months. If the old man is lucky to be alive, he gets to undergo the procedure.
This is the delay that is entirely avoidable. In today’s world of fast communications , secure e mail channels, telemedicine, I think such a delay is uncalled for. .I feel a telephonic/ e mail approval followed by the usual channels of “SOCs” without causing undue hardships/ delays to the patient would be more appropriate.
Attitudinal problems : Many of the staff members at the polyclinics are rather rude to the ex- servicemen. This includes some of the doctors also who appear to be disgruntled with the “post – office “ job that they are doing at the polyclinic. Careful selection of doctors and other staff members is important…….. they need to be sensitized to the elderly irritable clientele that they are required to deal with.
A word of caution……….ECHS has been discussed in several blogs wherein a few of our friends in the medical fraternity particularly the younger lot of serving doctors have expressed a view that the Organization is already “overburdened “ with the ECHS….that the Veterans are enjoying the “hospitality” extended by the ECHS and so on….Some of them also portray an impression that they and the ECHS are doing a great favour to the ex-servicemen by giving them treatment.!! Well, these are the irresponsible outbursts from immature minds and ought to be condemned. Perhaps one does not realize the plight of an ex- serviceman until he him selves becomes an ex-serviceman one day !!
Let it be clear….veterans have given their best years to the organization and now they need to be looked after. Nobody is doing a great favour to them by extending medicare…..besides no ex servicemen are interested in falling sick merely to “enjoy the hospitality” of the ECHS !! They need to lead a life of dignity in the evening of their lives !! After all each one of us has to become an ex-serviceman one day…………..
However the scheme like several other newly introduced schemes has its share of shortcomings. If remedial actions are taken to rectify these, I think it will go a long way in making it much more meaningful to the clientele. I have tried to comment upon a few of these shortcomings based purely on my personal observations.
Procedural Simplifications : An ESM on reporting to an ECHS polyclinic is referred to a specialist at an empanelled hospital . The specialist at the empanelled hospital after examining him orders for additional tests like a thyroid function test or an ultrasonogram or a CT scan or a treadmill test. Now the poor old man has to go back to the referring doctor at the polyclinic merely to get a rubberstamp of approval and return back to the specialist at the empanelled hospital. Assuming that the ESM stays in a village 30 kms away from the polyclinic and the empanelled hospital is 50 kms away from the polyclinic, one can well imagine the plight of the old man !! This extra trip could have been avoided had the referring doctor written “referred to the cardiologist xyz Hospital, for appropriate investigations, opinion and treatment“ . Now if this patient is asked to undergo a coronary stenting, he goes back to the polyclinic, where a statement of case is made, forwarded to the SEMO , who is the CO of the nearest MH. After scrutiny by the SEMO, the SOC is forwarded to the Command Hospital for approval by the Cardiologist. I am sure the cardiologist merely affixes his stamp of approval after which the papers find their way back to the same polyclinic where it all began. This entire exercise would have taken full two months. If the old man is lucky to be alive, he gets to undergo the procedure.
This is the delay that is entirely avoidable. In today’s world of fast communications , secure e mail channels, telemedicine, I think such a delay is uncalled for. .I feel a telephonic/ e mail approval followed by the usual channels of “SOCs” without causing undue hardships/ delays to the patient would be more appropriate.
Attitudinal problems : Many of the staff members at the polyclinics are rather rude to the ex- servicemen. This includes some of the doctors also who appear to be disgruntled with the “post – office “ job that they are doing at the polyclinic. Careful selection of doctors and other staff members is important…….. they need to be sensitized to the elderly irritable clientele that they are required to deal with.
A word of caution……….ECHS has been discussed in several blogs wherein a few of our friends in the medical fraternity particularly the younger lot of serving doctors have expressed a view that the Organization is already “overburdened “ with the ECHS….that the Veterans are enjoying the “hospitality” extended by the ECHS and so on….Some of them also portray an impression that they and the ECHS are doing a great favour to the ex-servicemen by giving them treatment.!! Well, these are the irresponsible outbursts from immature minds and ought to be condemned. Perhaps one does not realize the plight of an ex- serviceman until he him selves becomes an ex-serviceman one day !!
Let it be clear….veterans have given their best years to the organization and now they need to be looked after. Nobody is doing a great favour to them by extending medicare…..besides no ex servicemen are interested in falling sick merely to “enjoy the hospitality” of the ECHS !! They need to lead a life of dignity in the evening of their lives !! After all each one of us has to become an ex-serviceman one day…………..
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