Treatment-induced complications: Need to spread awareness.
Treatments of all kinds are invariably fraught with potential complications which are generally minor and ignorable, occasionally severe and may rarely be fatal. While most of the drugs have their distinct side-effects or toxicities, the surgical interventions are associated with post-operative problems. Some of these problems may be attributed to the surgical procedure while others may occur as a consequence of the desired surgery. The spectrum of complications is huge and wide, but one must admit that no treatment can be guaranteed as 100 per cent safe.
Patients are generally aware of common problems and accept minor complications as “fait accompli”. The physician often considers them granted and may not even bother to educate the patient about them. The problem lies with the complications which are rare to occur and, therefore, left untouched. For example, a sudden and severe drug-reaction, which can also be deadly, can happen as a bolt from the blue in one out of hundreds of individuals. Similarly, there can be failure of an organ (heart, kidneys, liver, blood and lungs) following a drug administration. Most such situations are not only unexpected but also unavoidable. The doctor inadvertently becomes a culprit for a crime he has not committed. Can he/she be blamed for such an adversity?
There are innumerable examples of similar kinds. Even the worst complication of a cardiac arrest can happen, albeit rarely, following routine procedures such as an intubation and any other intervention, including simple catheterisation or a parenteral injection. This is generally explained on the basis of a reflex action. Such patients are often resuscitated with immediate cardiac massage and other emergency measures. If that does not happen, the doctor starts seeing a noose hanging around his neck.
Unexpected bleeding following a surgery, a caesarean section or a simple delivery is another cause for worry. Serious consequences can result if the bleeding is uncontrolled and leads to further complications. The cause is attributed to the surgeon concerned in spite of the best of his/her expertise, intention and efforts. The doctor is made to pay the price for the treatment and defend the actions. Not uncommonly in this country, he also becomes a victim of violence.
It is not my intention to defend the indefensible and the criminal offences as per the law of the land. But it certainly hurts when one hears of violent and aggressive episodes. The basic issue, however, remains — can the treatment complications be avoided?
Unfortunately, the treatment complications happen even when administered by an appropriately qualified doctor. Some of the complications are, in fact, related to the underlying diseases or other factors. Treatment in the hands of the quacks or fake and unscrupulous doctors is not the issue of my subject. Most of them themselves are not aware of the treatment they provide or the complications which can occur.
Obviously, the complications threaten both the patient and the doctor. How to avoid and get rid of them is a moot question. As stated earlier, they are not altogether avoidable in spite of the continued improvements in the safety profiles of medicines and other medical procedures. Unfortunately, the new and the more safe treatments also come at tremendous costs which are often not affordable even by the well-to-do patients and the governments. Insurance companies also keep on increasing the premium costs in lieu of the increased amounts of claims by the patients.
There are a few simple precautions which one needs to take with any treatment protocol: Do not prescribe or use unnecessary or supernumerary drugs; follow standard national guidelines of government/professional societies; do not prescribe medicines or procedures about which you are not fully knowledgeable; half-baked information from the Internet is frequently misleading; be vigilant about the occurrence of a problem but be not afraid of the same; consult your doctor in case of confusion or occurrence of a problem. Importantly, the doctor needs to inform the patient about such possible problems, seek their consent and also enable himself/herself to deal with the same in case of a mishap.
The possibility of a treatment complication, however, is not a prelude to avoid a treatment. They are uncommon and generally manageable. Panic and blame game must be avoided at all costs. One must understand that any treatment is a kind of “package” that comes with its benefits and problems.