Doctor-Patient Relationship - II Elective surgeries tricky Anshu Seth Tribune News Service Ludhiana, July 16

A majority of incidents of violence against doctors and hospitals are followed by the death of patients operated during elective surgeries, which has become a matter of concern according to the medical fraternity. Leading surgeons in the city feel that elective surgeries, if unsuccessful, become a bone of contention between the hospital authorities and the patient’s family due to the money involved. In case of the death of the patient, some families refuse to pay the dues that result in confrontation, which often ends on a violent note. Missing transparency on the part of doctors is another reason for the outburst of families and friends of patients who die following the surgeries. A senior physician says: “The consent form should not be a formality to safeguard the interests of the doctors or surgeons, but it should be a proper document, informing the patient’s family about the risk involved and the chances of all the post-operative complications.” The deaths following bariatric surgeries wherein the authors used summary data on bariatric surgery procedures was performed in Pennsylvania for a 10-year period from 1995 to examine mortality in relation to factors such as age, sex and time since surgery. Overall, there were 440 deaths, yielding a crude mortality rate of 2.6 per cent. The cumulative death rates in the first year and the next five years were 1 per cent and 6 per cent, respectively. Dr HS Bedi, chief cardiac surgeon at the CMCH, said surgery should be the last resort, but in cases of morbid obesity, it was therapeutic. The risk involved in the surgery of obese patients was always high, he said, adding that cardiac arrest was not unusual after surgical procedures. But amateurs doing new procedures in the absence of experts is another problem that has added to the “risk” of patients being operated. Advancements in surgeries come with complications, which the surgeons cannot ignore at any cost.