This has reference to the story “Tele-psychiatry averted mental health crisis in Kashmir amidst COVID19”, GK dated September 10, 2020. The story reveals that with the efforts of the Institute of Mental Health and Neurosciences (IMHANS) at GMC Srinagar, the mental health crisis in Kashmir was avoided by virtue of online consultation to patients – 900 video calls, 2500 telephonic consultations….a very good move indeed, though the number of patients is too large and consultations expected accordingly higher, however, this effort amid multiple ‘time-blockades’ was applaudable. This news story gives birth to a number of questions about the patient-care amid an emergency, like that of today’s Pandemic, COVID 19, particularly in the times of Information Technology (IT) and advancements made in the field of Tele-Medicine and the adaptation of societies to it thereof. Unfortunately due to varied reasons swinging from conservative thinking to material interests, Tele Medicine has not been taken much advantage of by the societies like other fields of life; our society is no exception despite the fact that modern day medico relies on machine diagnostics but a smartphone owned by a poor person nowadays can’t be used to send certain findings to the physician because we don’t have that ‘culture’. Well, psychiatry and perhaps many other areas of treatment can be dealt now with by virtue of Tele-Medicine, be the circumstances normal or not. This will reduce the load in the OPDs in the already overburdened hospitals and perhaps the patients who need a physical consultation will get a closer date for their turn and so on. But this needs establishment of an all-time inbuilt telemedicine extension in the healthcare system of our hospitals and if IMHANS at GMC Srinagar has experimented it and the results as per the news story were encouraging, the experiment should be made a pilot project for other fields of the medicine.
The COVID 19 trauma and its impact is in front of all of us. The space and scope does not allow me to discuss that issue here which is more or less known to almost every person. Also blame games evoke bad taste. Instead, we applaud real warriors from all fields, world over. The Pandemic journeyed too fast to give any time to scientists and researchers. This all spread a general but severe fear-psychosis from medicos to masses, rightly so when anything is all new for the world.
Amid this emergency a patient who desperately needs treatment, cannot wait. Here comes the role of Tele Medicine for which the stakeholders must strategize a policy to incorporate it into the system of J& K’s Health Sector. Govt. too has to be flexible in keeping provisions for an online ‘state of art mechanism’ open for hospital as well as for private health sector under a definite policy so that both the sides – Doctors, Paramedics and Nurses on the one hand, and patients and their guardians on the other, can be benefitted.
A Stich In Time Saves Nine fits here. A rash on your skin shown to a doctor via whatsApp on a lockdown day can be a perfect diagnosis to start the treatment both for your physical problem, and to the psychiatric trauma it may cause. This was but only possible and practicable if our healthcare had developed such kind of a base system. But we are lagging far behind. Our medicos have profiles on “Dial portals” but either the profiles are mere intros or the Tele-system requirements are not patient friendly.
Doctors run private clinics and patients believe in them. Doctors prescribe a specific brand of preparation. Even a learned patient refuses to take a substitute name of the same preparation from the market. Why? Because he upholds his faith in the doctor. I have seen patients revealing life secrets to doctors which they don’t reveal even to their family members. Doctors are not put on additional assignments like that of election duties because they have to be always present as a cord between life and death when a patient reaches to them for a consultation. And if a doctor closes his clinic for months together and the hospitals close OPDs in the times of Pandemic, where should a patient go. Should he wait?
Thank God, this is now 7th month, the situation is not out of control, God has been very kind to us. Ahead, we don’t know, hope is the healing treatment. The fear psychosis has receded, a very good sign indeed, because in fear and fright we could not do justice even with the funerals of our dears who departed from us of the same disease. Now the times are changed believing in the protection with SOPs we are in offices, markets and so in social gatherings.
Clinics of some reputed doctors are closed and their patients are waiting them to come forward at this crucial juncture because a family doctor knows the history and the background of the patient. If you are still reluctant at least enter into the domain of Tele- Treatment, sooner the better.