Challenges and Opportunities in Family Medicine with Dr. Ashutosh Pandey (Part-2)
Welcome to part 2 of our conversation with Dr. Ashutosh Pandey (Medbound Handle:@Dr. Ashutosh Pandey)
How do you manage situations where a patient's relatives create stress by expressing concern when the patient doesn't feel well after receiving prescribed medication in a regular OPD visit?
Dr. Ashutosh Pandey: Yes, this happens daily.
I have just told you about migraine. Migraine is very complicated as it can cause various types of pain. For instance, imagine you have a patient, and you prescribe them medication for 15 days. They may feel some relief. However, with migraine, the relief is often limited, and most of the time, we need to closely monitor the patient's condition. The patient might inquire about the medication, saying, "Doctor, what medicine did you give? It's not effective." This is where the counseling aspect becomes challenging.
When you communicate with the patient, you can say, "Have you noticed that you used to experience pain five times a month, and now it's down to three times?" The patient might respond, "Yes, but those three times are still quite painful." In such cases, you can explain, "Our goal is to gradually reduce the frequency of your pain. While we might not eliminate it completely right away, our aim is to decrease the number of migraine episodes you experience. It's a gradual process."
What is the rewarding aspect of being a physician?
Dr. Ashutosh Pandey: In the field of general medicine, doctor often handle a substantial number of patients. This presents two significant benefits. Firstly, by attending to a larger volume of cases, practitioners gain valuable experience and expertise. Secondly, when treating non-hospitalized patients, they have an opportunity to contribute to a wider range of medical conditions.
Now, if we consider the impact of this practice, seeing 100% of the patients in a day means that even if you can successfully cure 80% of them, you've effectively helped 80% of the patients seeking medical attention. This brings immense satisfaction.
From the perspective of surgeons, they too have their unique viewpoints and practices. Generally, medical practitioners can treat a broad spectrum of conditions, often medically, without the need for surgical intervention.
We firmly believe that maximizing the number of individuals helped within a day is a fulfilling aspect of this profession. Furthermore, looking at it from a financial standpoint, seeing more patients directly correlates with higher earnings. It's as straightforward as that. Those who aspire to build a renowned reputation and increase their earnings can achieve both by attending to a larger patient base. This contributes not only to their personal success but also to their recognition and value within society.
In your opinion, what is better, MBBS or BAMS?
Dr. Ashutosh Pandey: The treatments that have been in practice for years have evolved through a cumulative process, and it's important to acknowledge that people aren't foolish to create such methods. Governments invest significant effort in healthcare systems, and these systems can vary by region. It's prudent for us not to pass judgment on them since we possess limited knowledge in this regard.
Only someone well-versed in Ayurveda can provide insights into its effectiveness, strengths, and weaknesses. Ayurvedic education often includes the study of ancient texts, although we may not fully understand the specifics of their syllabus, study methods, or the inclusion of modern medicine within their curriculum.
We should also consider the government's guidelines and requirements for individuals studying modern medicine. It's unclear whether we are qualified to comment on their education, including what they must or must not study. It would be wise for us to refrain from making judgments about which system of medicine is superior.
Furthermore, determining the difficulty or toughness of each system is a complex matter. People who are well-versed in both systems can provide insights into their respective challenges. It's important to note that modern medicine, for instance, is highly competitive, particularly regarding admission to medical programs like MBBS, BDS, and postgraduate studies. However, evaluating the difficulty of studying and practicing Ayurveda is beyond our knowledge, as we have not experienced it firsthand.
I have experience in studying modern medicine, and I can attest to its difficulty. Understanding its intricacies was indeed challenging for me. However, I cannot provide insights into the challenges of studying Ayurveda, as I have no knowledge in that area.
How did you feel when you went to the ward for the first time in your second year of college to start your medical duties?
Dr. Ashutosh Pandey: I realized that I am not a medical doctor because in the MBBS program, the entire curriculum is well-structured. We don't refer to it as "duty"; it falls under the clinical program. Clinical rotations typically begin in the third semester.
My first clinical posting was in general medicine. I had a particular affinity for general medicine, so I started my clinical experience in the general medicine. They taught me how to assess a patient's pulse and determine if it was abnormal. All these fundamental skills and clinical knowledge start getting introduced from our third semester onwards. It's important to clarify that these activities are part of our clinical classes and not referred to as "duty." The term "duty" is typically reserved for when we embark on our internship, and this terminology reflects the thorough training and professionalism ingrained in medical education.
What are the major challenges in modern medicine, and what strategies can be employed to address them?
Dr. Ashutosh Pandey: The main challenge is stress. Sometimes there are many patients in one room, and it's easy to lose your temper in such a situation but if you lose your temper, you'll be upset with yourself, also the patient won't feel good. Your colleagues may also perceive you as someone who frequently loses their temper. To maintain composure, it's crucial to find mental peace, which is particularly difficult in the medical field. These factors have adverse effects and can work against you, ultimately affecting your medical career.
So, in a hospital, stress is inevitable, but you must keep your temper in check. To achieve this, meditation and a healthy lifestyle are essential. Smoking is not a solution for reducing stress. Instead, you should focus on meditation and regular exercise. If you can find the time, that's great, but even during your breaks, you can practice meditation.
Taking care of your lifestyle is crucial too. Skipping breakfast can lead to irritability and it can affect your overall mood. Accepting this reality can help you maintain mental peace. In a hospital, teamwork is vital, and it functions as a support system with seniors, juniors, and colleagues working together.
The key is not to shoulder all the burdens yourself. When a patient is diagnosed, the treatment is a collaborative effort involving your colleagues, such as your sister, intern, junior resident doctor, senior PD, and senior resident doctor. This distribution of responsibilities also distributes the stress levels, ensuring you don't have to bear the entire load. It's not about doing everything on your own; it's about working as a team in the hospital.
Dr. Ashutosh Pandey
What changes in your status, qualities developed, and negative traits lost did you experience during your journey?
Dr. Ashutosh Pandey: The key to success is not just about having talent; it's about developing the right qualities. Earlier when I was playing cricket, and I understood the importance of quick thinking and teamwork. In sports, you might set a goal to score three runs, and when the ball comes, you make it happen. However, the medical field is different, and many challenges can be overwhelming.
During my time in Haryana, I noticed that people often rush things, wanting immediate results. They may think, "I need this and that right now." But I realized that integration and patience are essential here. Another challenge is ego. When you get selected for a prestigious program like MBBS, your photos are displayed everywhere, and it's easy to develop an ego, thinking you're the best doctor in the world.
However, this ego tends to deflate quickly, especially in the first year of MBBS when you realize how little you know about the human body. Professors share complex concepts, and it's challenging to grasp them initially. You work hard, and over time, you become humbler and gain a deeper understanding. Personally, I believe that my greatest development during my MBBS journey has been in cultivating patience and improving my work ethic.
Any final message for your upcoming juniors?
Dr. Ashutosh Pandey: Stress is a common experience, and during PG studies, it can be particularly challenging. Many times, we tell ourselves that we should enjoy life, spend 2-3 hours each day doing activities like exercise, developing our bodies, pursuing hobbies like music, or playing cricket. Allocating time for such activities can make life more manageable, and it can even ease the pressure of preparing for PG exams.
Educational stress is especially pronounced for ambitious students who procrastinate. They have to pass exams, pursue their dreams, and watch their classmates progress to other batches, eventually becoming seniors. These factors accumulate and create a significant amount of stress. For such students, it's crucial to avoid frustration by adopting a balanced approach. Study diligently for 2-3 hours, take regular breaks, and enjoy some leisure activities.
Remember, your health is like a vehicle's engine running on good-quality fuel. So, maintain a proper diet and nutrition because many individuals come from other states where they face various challenges. Do everything in your power to eat well and take care of your health. This combination of strategies, including meditation, a balanced lifestyle, and good nutrition, can provide you with a 50% sense of security in managing your stress during PG studies.
What are your future goals?
Dr. Ashutosh Pandey: I had a deep passion for cricket since my childhood. over time, my interests shifted towards medicine, and I decided to become a doctor.
During my free time, I enjoy making tea and listening to good music.
Apart from medicine, I engage in creating and sharing short videos on platforms like Instagram and YouTube. I love to travel and have explored the entire Northeast region of India as well as many other parts of the country, including its beautiful mountains. I'm also passionate about trekking.
For future, I aim to complete my studies and further my skills in a reputable hospital with a strong medical team. My goal is to develop an approach that will benefit patients and make their experience more comfortable, such as reducing wait times in healthcare settings.
I understand the challenges many aspiring medicos especially those from middle class families. The burden of coaching fees and financial stress can be overwhelming. Self-study is essential, but sometimes, guidance is necessary. Online platforms have made self-study more accessible.
In my experience, it's crucial to maintain a structured approach to studying. Consistency is key, even if it means dedicating just an hour or two daily. You can't cram all your learning into a few hours. Break your study sessions into smaller chunks and make the most of the time you have.