"KNOWN TO"

Doctors fight fiercely with one another. It’s true. We are all concerned about our patients, but when it comes to responsibility, we fight. The only time we don’t fight about responsibility, is when we have to treat a fellow doctor. We help each other in every way possible. Call it professional courtesy. Call it a ‘you scratch my back, I scratch yours’ kind of attitude, or just call it a community feeling. It was during this sort of help that I got introduced to a very useful term- the ‘known to’.

 

As doctors in government hospitals, where treatment is cheap, but waiting periods are long, we often get requests to speed up the process by personal recommendation, often by those with less means. Friends, relatives, maids, car washers, laundry men, drivers, almost anyone we know ask for advice, tests or referrals. So instead of enquiring about what the person being sent to me for ‘special’ referral means to the doctor who sent him or her to me, we just call them a ‘known to’. If a doctor is famous for showing a lot of people to other doctors in the hospital, we just say that he has a lot of ‘known to’ s. We don’t really care about the relationship. The person being sent to us might be a friend’s friend’s maid’s son. All we know is that the patient is a ‘known to’ of the doctor who sent him to us. It was only recently though that I had a ‘known to’ come to me for treatment.

I help people out, to show them to doctors in the best way I can. But usually I take them to see specialists. For the first time, a friend of mine recommended to his driver who had been carrying around a hydrocoele of the scrotum for a good number of years to see me for the surgery. A physical examination and a blood report later, I requested my seniors to place him on the next free minor operation slot in our unit. His name went down in the list as a ‘known to’ of Dr Nishant- no questions asked.

On the Operation day, while we had two other cases for the minor OT, I was allowed to operate on my ‘known to’ first, and to take all the time I wanted. It was when I was scrubbing for the surgery that the wisdom of my seniors hit me. My reputation was sort of on the line

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I know it’s odd for a first year post graduate to talk about a reputation. But it was true. The friend who had recommended my name and approached me to treat his driver, would definitely doubt me if the smallest complication arose due to the surgery. I knew he wouldn’t say anything, but he wouldn’t be happy either.

In medical practice we like to say that we should treat every patient like he or she is a member of our family. I don’t believe in this. Not in surgery anyway. I wouldn’t be able to operate on a member of my family. I believe that the best approach is to treat a patient like a human being. Someone who has, a family. I think that’s professional. And I reminded myself of this before I started the procedure. Complication’s happen. What’s important is to do the best you can

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Half an hour later the procedure was complete, stamped by the approval of my second year post graduate, and packed to go home. Now there was nothing to do but wait. Any real complication would present itself in a day or two. So when I didn’t get a call from my friend about his driver for four days straight, I was relieved.

A week after his surgery, the man came to me for having his stitches removed. His wound was healthy. And he was very thankful. He had a procedure done for free, when he was told that it would cost 20000 rupees by a private clinic. He went home with a smile, and I, with a peaceful mind. I guess that’s how you build a practice. With ‘known to’ s and by placing your reputation on the line when you see them.