Helping Turn the Clock Back-Thoughts on Cosmetic Surgery

Plastic Surgeons are a rare breed. With in the medical circles they are known as the artists ( in comparison, Cardiac Surgeons are the plumbers and the orthopaedicians the carpenters), those who sculpt the human body, try and turn back the clock by the magic of their scalpel. While plastic surgery can be cosmetic as well as reconstructive, the plastic surgeons are mostly identified with cosmetic surgery.

They are also the ones who routinely get celebrities under their knives. Filmstars often owe their longevity to these very skilled surgeons, whose deftness ensures a flawless visage. In India, cosmetic surgery is still considered something of a luxury, meant for the super rich, with tonnes of money to burn. The association of this art and science with womenfolk also continues. It is commonly believed that women like to go for cosmetic surgery be it liposuction or a tummy tuck or a nose job, they just love to get under the knives of a plastic surgeon.  

The Death of Amann Kachroo

More than 200 people gathered at Jantar Mantar in New Delhi a few days ago for a candle light vigil in the memory of Amann Kachroo, a 19 year old student of medicine, who was brutally murdered on the medical college campus in Tanda, Himachal Pradesh a couple of weeks ago.

Amann would have been alive today, had his parents taken his previous accounts of ragging on the campus a lot more seriously. Alas, like most parents they thought of ‘ragging’ as innocuous initiation in college life, a rite of passage, which everyone undergoes. They did not realise that what passes for ragging in our institutions of higher learning is often criminal assault, physical and mental torture and now I guess murder. I hate to add this but the college authorities by remaining silent and often trying to push everything under the carpet  are equally complicit in these crimes.  

Doctor Doctor!

Sushil Jain and I grew up together in Indore, a provincial city in Central India. We were classmates for about a decade and I have known him from the time when both of us were about 8 years old. Sushil is now a cardiothoracic surgeon. I remember him today because unlike anybody else in our school class, he was from very early on sure about the career that he wanted to pursue. From as long as I can remember he wanted to be a doctor, just like his father. 

Sushil chased his dream with a single minded focus, prepared hard, appeared for the Pre Medical Tests, failed once, tried again and eventually succeeded in joining the medical college in Indore. He worked hard and graduated, tried a couple of times for admission in a post graduate course, failed and tried again. Finally, he trained to become a surgeon and is now well into surgical practice in a hospital in Indore.  

On Nursing

Nursing is perhaps the most important function in a hospital. The nurses spend the maximum time with patients, are physically involved in taking care of them, are the first port of call if the patients need anything. Nursing professionals are also drivers of the hospital imagery. They epitomise care and efficiency and the patient experience that they deliver is what the patients carry with them. Well trained, well groomed and efficient nurses are a huge asset to a hospital. They are really the backbone of hospital operations.

And yet they are often treated in hospitals in India as mere skilled workers. They are made to work long hours (double shifts are common), live in hostels with bunk beds and have little by way of personal lives.    

Why we do not need ‘Claim Ref’?

A few days ago The Hindustan Times in New Delhi reported that the global acturial company Milliman has ‘launched ‘claims processing guidelines’ that enables a third party administrator (TPA) or insurer to determine the severity of a patient’s condition and identify if the length of hospital stay investigations, consumables and treatment procedures are more than what is typically required’. 

The product reportedly called ‘Claim Ref’ can apparently be linked to a software, which allows it to compare a claim made by a hospital, with a ‘typically’ similar case taken out from a database containing information about 125 procedures gathered from Indian hospitals. This simply means that the insurance companies can hold back payments to the hospitals if the claim amount is in excess of what ‘Claim Ref’ indicates.

I am hugely skeptical of such arithmetic modelling for the following reasons.  

Hepatitis Outbreak in Gujarat

Gujarat is widely considered to be one of the most developed and industrialised state in the country. The Gujaratis are known for their astute business acumen and they symbolise success. The chief minister of Gujarat, Narendra Modi, is a man of strong convictions and sports a business like no nonsense attitude. The chief minister is widely known to harbour Prime Ministerial ambitions, has the big guns of the Indian industry eating out of his hands and is clearly aiming for higher office mostly on the back of his success in Gujarat.

Thus it came as a shock that in Modi’s shining Gujarat, scores of people have died of a hepatitis outbreak. Hepatitis B and D are stalking the town of Modasa in the Sabarkantha district, about 50 kms from Ahemdabad. The government machinery is struggling to cope with the situation and the toll is likely to go up.