From the experts: is your doctor healthy enough?
'So, Doc, before you use that scalpel on me, how's your health?' It's a valid question for patients to ask, writes Dr Krishnan Ganapathy
A patient who is about to be wheeled into the operating theatre looks up at the doctor and says: "Hi, Doc, as per National Accreditation Directives and the Joint Commission International, may I review your current medical records, any medications you are taking, and the pre-op assessment for your fitness to operate on me? Also, I hope there were no tiffs at home or at work. All the best."
This could happen in the future. Several years ago, in a study carried out in the All India Institute of Medical Sciences' neurosurgery department in New Delhi, scientists monitored each neurosurgeon's pulse rate, electrocardiogram activity (ECG) and blood pressure while they were operating, and correlated the data with the actual surgical steps in different procedures.
It was observed that the pulse rate and blood pressure of the primary surgeon sometimes reached more than 200 beats per minute. Transient changes in the surgeon's ECG were occasionally recorded. These changes occurred in healthy neurosurgeons of varying levels of experience.
Doctors do not want patients or colleagues to know that they are not healthy
The implications of this are twofold. One is a concern for the surgeon's health, especially if she or he is on medication. The second concern is this physical and emotional stress will have a bearing on the decision-making process, and may ultimately influence the surgical outcome.
When the risk in a procedure is computed, the location and nature of the tumour, patient's age, the presence or absence of diabetes, hypertension, renal status, previous myocardial infarction and medication are all taken into account.
But what about the surgeon's weight? Should it be considered among "comorbid medical conditions"? What about their emotional status?
People forget that doctors are often under stress. It is assumed that they are superhuman, always on call, and familiar with all science and technology. They are expected to be a repository of information and mental athletes who will always take the best, cost-effective decision in the patient's interests.
