Time for a medically based blog to prove that I'm not simply sat around eating curry and watching cricket.
I'm coming to the end of my rotations around the different departments of the outpatient section of the hospital, so feel that I can justifiably write about how impressed I've been with the way they all interact.
I've spent time with:-
1. Charting paramedics
2. Physiotherapists
3. Laboratory staff
4. Pharmacy
5. Opthalmologists
6. Receptionists
7. Occupational therapists
8. Counsellors
9. Workshop staff
Still to come - 2 days with the nursing staff before I spend the remaining 6 weeks with the medical team.
I'm still resisting taking photos of the hospital and patients but found this on the hospital website, which I'm sure I'd be permitted to borrow! It's of the occupational therapy room:-
All of these teams work closely together physically, with their rooms coming off a large waiting area, signposted in English and Hindi. What I've been most impressed with is the fluency by which they communicate with one another. Firstly, the entire system is computerised (something that the NHS needs to work on) so each department's patient list is displayed in front of them. Patients are then called using an intercom system or many just turn up at the doors (always open - patient confidentiality doesn't seem to have a place in India) and try and argue their way to the front. Secondly, a patient can see every single one of the above listed departments in one day. Some have traveled over 12 hours to get here and so there's no option of waiting a few days or weeks to see the therapists, it all needs to be done now. Incredibly, the system works.
An example case of a new patient presenting with a claw hand:-
Mr X will be given a slip of paper at reception which will have his name, number, and first room number on it. For this patient he'll first be seen by charting, who will take one look at his hand and note him as a leprosy patient. He'll go to the lab to have skin smears taken. The results of these will be ready in 2 hours, leaving him plenty of time to make his away around the other rooms. Firstly he'll go to the counsellor who will be the one to give him his diagnosis. The counsellor will answer any questions he may have, explain about the disease, reassure him, and explain about the importance of self-care and drug taking. Next stop - physio. They'll use a microfilament to test sensation of both hands and feet, similar to what a GP in the UK will use to test sensation in diabetic feet. They'll also test the patient's strength, looking for damage to the motor parts of the nerve. Our patient with the claw hand will have damage to his ulnar and median nerves. The physiotherapist will quickly test the patient's vision and if it's noted to be poor they'll visit the ophthalmologist who will write them a prescription for glasses and assess them for any eye complications of leprosy. Claw hand will make it difficult for the patient to eat his dinner, so the occupational therapist will see him and provide an assisted spoon. At some point in this process, usually near the end, the patient will see the doctor who will write him a prescription for his MDT (multi drug therapy) that he'll collect from the pharmacy. For the sake of completion, our patient has lost sensation in his feet so the physio will refer him to the workshop where within two hours he'll receive a personalised, measured to fit, handmade pair of sandals!
It's very impressive.
As an aside, I can't find a way to reply to comments, so this is to say that I am reading them. And for Pamela - I'll pass on your regards; Neelmani remembers you well!
I'm coming to the end of my rotations around the different departments of the outpatient section of the hospital, so feel that I can justifiably write about how impressed I've been with the way they all interact.
I've spent time with:-
1. Charting paramedics
2. Physiotherapists
3. Laboratory staff
4. Pharmacy
5. Opthalmologists
6. Receptionists
7. Occupational therapists
8. Counsellors
9. Workshop staff
Still to come - 2 days with the nursing staff before I spend the remaining 6 weeks with the medical team.
I'm still resisting taking photos of the hospital and patients but found this on the hospital website, which I'm sure I'd be permitted to borrow! It's of the occupational therapy room:-
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| Occupational therapy, copyright tlmnaini.org |
An example case of a new patient presenting with a claw hand:-
Mr X will be given a slip of paper at reception which will have his name, number, and first room number on it. For this patient he'll first be seen by charting, who will take one look at his hand and note him as a leprosy patient. He'll go to the lab to have skin smears taken. The results of these will be ready in 2 hours, leaving him plenty of time to make his away around the other rooms. Firstly he'll go to the counsellor who will be the one to give him his diagnosis. The counsellor will answer any questions he may have, explain about the disease, reassure him, and explain about the importance of self-care and drug taking. Next stop - physio. They'll use a microfilament to test sensation of both hands and feet, similar to what a GP in the UK will use to test sensation in diabetic feet. They'll also test the patient's strength, looking for damage to the motor parts of the nerve. Our patient with the claw hand will have damage to his ulnar and median nerves. The physiotherapist will quickly test the patient's vision and if it's noted to be poor they'll visit the ophthalmologist who will write them a prescription for glasses and assess them for any eye complications of leprosy. Claw hand will make it difficult for the patient to eat his dinner, so the occupational therapist will see him and provide an assisted spoon. At some point in this process, usually near the end, the patient will see the doctor who will write him a prescription for his MDT (multi drug therapy) that he'll collect from the pharmacy. For the sake of completion, our patient has lost sensation in his feet so the physio will refer him to the workshop where within two hours he'll receive a personalised, measured to fit, handmade pair of sandals!
It's very impressive.
As an aside, I can't find a way to reply to comments, so this is to say that I am reading them. And for Pamela - I'll pass on your regards; Neelmani remembers you well!
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