Monday, 24 September 2012

Primum non nocere

Sometimes, rarely, you read something that resonates  so much that you nod your head right through and maybe even develop a crick in the neck.

Such was the piece I read today under the somewhat hyperbolic title " How to stop hospitals from killing us".  I opt to offer it to you without comment,  with only a strong recommendation. I just chose a less fanciful title that simply means - First do no harm.

Perhaps an appropriate title, for, this is a mini landmark post - my 500th.  Even for writers, this is a useful tenet to follow. Never thought I would reach this figure when I started blogging one winter's day in Guangzhou 3 years ago . How much life has changed in this short while. Thank you, dear readers, for the support, the encouragement, your comments and points of view. My life has been immeasurably enriched by you and, for that, a big, big, big, heartfelt thank you.


Sandhya Sriram said...

Me First - on your 500th Blog

Sandhya Sriram said...

On this day that marks
500 Once in a lifetime inspirations
500 Life Changing Reflections
500 Never Before Insights
500 Always surpassed benchmarks
500 expressions impeccable
500 impressions un erasable
500 diamonds of knowledge
500 pearls of wisdom

I Wish you many multiples of hundreds and thousands of Business and Not So Business Musing

And I Wish your readers tons and tons of the Power of of "Rameshochondria"

Appu said...

500! Wishing and praying it will touch 5000 very soon :)

all your blog posts do lot of good.
To me it has been a life changer.

I am thanking my lucky stars that you started blogging :)
Me being at AIM would have never happened with out you and I would have never known you without blogging!

gils said...

:d cine thala reached 50 thala reaches 500 :D:D kalakkitel pongo :D ungal sevai engal anaivarukkum thevai :D ungal pani sevvanay thodrumaaga

Shachi said...

Excellent article - I nodded all the way too....

Last week in hospital, the kiddo needed photo-therapy started ASAP for jaundice treatment. Guess what? the hospital did not have a simple fabric liner to cover the took them 4+ hours to get one cover from the other hospital in their network which is 5 miles away....and his treatment got delayed by 5-6 hours...this is a 2-day old baby, and imagine my terrible frustration!!!!!

It gets even worse - I had a couple of those spare covers at home (we had rented the equipment when Ruhi was born) and offered to get it from home and start using the light, but they refused to allow me to do that :(.

One thing I have learnt and always pass on regarding doctor/hospital visits here is - always be your own advocate. Ask lots of questions. Double-check every drug going into the body. And never leave the patient alone even for a minute in the hospital. They would have killed my dad by giving him the wrong medication when he was rushed to emergency last year....I had to fight tooth and nail with the nurses to make them understand what medication he can take and what he can't.

And 500 posts - WOW! This place is a learning sanctuary, and I'm so glad I found it!!!!

sriram khe said...

Hey 500! Cool :)

Looks like the medical community is getting serious about this checklist aspect; was reminded of Atul Gawande's essay in the New Yorker (later his book) ...

But, hey, for 500, you should have had something a lot more cheerful for us ... it is not even Halloween yet for you to scare the bejesus out of us :)

Asha said...


500 posts in 3 years -- that's a fantabulous achievement.

Your insightful posts not just in the field of business but in other arenas inspires awe in most of us.

Hope you continue and enlighten people like me with many more such posts and hope your writing has a broader reach through newspapers and other media.

Read your highlighted article and i wanted to rant but this being a special post will reserve and share it later.

But, now 500 posts in 3 years. A fantabulous achievment calls for a party celebration.

When and where?

Please notify us through your next post.

Venkat said...

Just bring all the hospital goers to this blog, 500 therapy are available to save their life.

Anonymous said...

wow 500, great stuff,,,,, can't say I have read each and every one but I do glance at all and read selected.

keep on bloggin'

regards from down under !

Ramesh said...

@Sandhya - Awwwwwwww. You are far too kind.

@Filipino - Thanks very much. You were always destined to learn Tagalog and be bewitched by a Ms Marcos :)

@Gilsu - Love the pun of "els" and "ongos" !!

@Shachi - Phew; that's some experience. As the article pointed out, we'd never tolerate this in other products or services, but when it comes to medicine we seem to tolerate it. Thanks for the kind words.

@sriram - Ha Ha. The trick is never to fall sick :)

@Asha - Thanks so much for such nice words. I have exactly the same sentiments following your blog.

@Venkat - ha ha. Nicely put !

@Trevor - Thanks very much Trevor. Much appreciate your kind words.

TMM said...

Congrats on your 500th Blog. May the numbers increase exponentially. With my life being very closely connected to the hospitals and healthcare systems (thankfully as a Health Industry professional and not as a patient as yet) this was a timely article. Much appreciated. One of the life and death (pun intended) problems of what constitues good clinical care is the cause of much agony and sleeplessness for me now-a-days. Here in NZ there is the perpetual struggle in reaching the right balance between clincians controlling health care (and hence costs/affordability are aspects that are completely irrelevant) and administrators controlling health care (Read bean counters and people who put a 'cost' rather than value to life). Over the last 25 years we have seen this yo-yo from one end of the spectrum to the other and am not sure where the balance is. Perhaps this is a separate topic for me to blog about some day- evolution of govt funded health care in an OECD nation like NZ. (I can hear Shriram Khe saying what's govt funded health care). And for some of my accountant friends, here is an interesting titbit: NZ is possibly the only govt that does Accrual Accounting (The approach paper written in 1989 and implemented in all govt depts in 1993 and I have copies of both!)

Deepa said...

Last year we took our friend to the emergency. The first day the doctor said she had ulcers and gave her pain killers, the next day when it got worse he realized she had stones in her gall bladder, and finally after her surgery, some stone particles were left behind and she was operated again! The tricky thing about all these cases is that we know so little and we are at the mercy of these people, no matter how skilled or unskilled they are.

And for your 500th post! :) :) Many many congratulations, the stats are as splendid as Sachin's 100 'test' centuries! Wish you (and us), many more to come!

Vincy said...

WOW WOW WOW.. 500 posts. in 3 years. thats something. Heartiest Congratulations and a big thank you for all the perspectives, insights, your thoughts on various issues, introductions to many topics that i never knew existed, which in turn enlightened me ( and my you son). Infact, my sonny and I discuss about certain nuances in your posts much later, your blog has become a means to connect with him at an intellectual level. ( its not easy to connect with a teenager)

And the 500th post - is an amazing article. as you said nodded right through. stunned by the statistics. Dont even want to guess the stats in India :-(

Ramesh said...

@Kiwi - Yeah ; you are an expert in this space.I suspect Kiwiland is one of the better places on earth on this issue. It is an interesting thought that the "professions" are often the loudest complainers when it comes to imposing traditional business discipline - Teachers, Doctors, Lawyers .....

@Deepa - OMG , everybody seems to have a horror story to tell. I think there's no substitute for all of use being somewhat knowledgeable on medicine and therefore being able to make a judgement rather than be completely led by a doctor.

@Vincy - Awww. You are much too kind. I am totally humbled.

Anonymous said...

Many Congratulations on your 500th post Ramesh sir! There are so many new things one gets to learn from your writing.

And regarding the article...if it is so in the US, one can imagine the horrors in India...or may be not? Recommend a slim book titled 'Complications' by Dr. Atul Gawande.

Vishal said...

Safety culture scores - this reform applies for most of the professions. even more so in medical field.

But are not these basic reforms necessarily followed? Very strange and shocking!

I thank my stars to have found this space 3 years back. Many many congratulations and wish you to pen down thousands and thousands of posts. :)

Ramesh said...

@myfloatingthoughts - Hey welcome back. Nice to see you here. Thanks for the book recommendation. I am sure the situation 9in India is no better, although I would not necessarily agree that it is far worse.

Btw - get back to blogging ...... :)

@Vishal - Somehow the egoistic professions - doctors, lawyers, teachers are the ones most resistant to systems and processes. Thanks for the kind words

sriram khe said...

Hmmm ... I like the imagery of my-floating-thoughts :)
Yes, Atul Gawande is one of my favorite writers on this topic. Of course, the added attraction of being a fellow Indian-American ... though, I thought his latest one on comparing healthcare with the Cheesecake factory was, well, a tad cheesy!

So, is TMM a medic? A medic-turned manager? Or a non-medic?

Ramesh said...

@Sriram -The kiwi is an engineer like you who abandoned his profession and became a commercial man. But he has worked a fair bit in the health care industry - although on the commercial side and is fairly knowledgeable about it.

Hema said...

WOW! 500 posts in 3 years ! That is simply great!

You have touched the 500th milestone,
Your posts do stir the mind and every bone;
Do keep up the pace just so,
All your readers are kept on the go!

You rock!

Hope to catch up with all your posts that I missed reading this month soon...:)

Ramesh said...

@Hema - Awww Hema. Lovely to see you here again and thanks for that very kind verse.

Reflections said...

Congrats on the 500th Ramesh!!!

If somebody asked me to say the 1st word which springs to mind when Business Musings is mentioned I'll be quick to say 'aware'.
Every post on this blog has been food for my brain....I absolutely enjoy ur style of writing; may ur blog see many many more:-))!!!

Going to read the link now.

Ramesh said...

@Reflections - Thanks very much. I am much honoured and touched.

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