1. Blog 21 Feb 2020 8 min read

   7 things I wish I knew before starting private practice

   Private practice is one of the common answer for, what after residency/ after fellowship questions !. Unfortunately, even though we become brilliant ( atleast hope to ) doctors ,we sadly lack the exposure to the business side of the healthcare. Many of us either lack guidance from the right people or more frequently take advice from the other doctors which is from the same perspective I personally think it is important to keep learning different things beyond medicine to improve productivity and efficiency while running a successful practice Its been 10 years since my residency and i have certainly learnt few things over this period some of them the hard way When I look back, I wish I knew these things when I finished my residency .!! Location of private practice We are doctors and we practice the art and the science of medicine. We also use super expensive equipment in the clinic and in our state of art operation theatres . And we also exist in a bubble imagining our business to be on

   Dr. Deepak Garg
2. Blog 21 Feb 2020 7 min read

   Generic drugs: boon or a bane

   I first heard about generic drugs 20 years ago when Cipla an Indian company came up with generic versions of antiretroviral drugs (drugs used to manage cases of HIV/AIDS). Management of HIV/AIDS, hitherto expensive and beyond the reach of many patients finally became affordable. Health organisations like WHO which were grappling with high burden of the disease especially in African and Asian countries finally found an economical way of reducing the disease morbidity. It was a matter of pride for every Indian, especially those in the medical fraternity. Despite such a spectacular impact, why are significant sections of doctors wary about prescribing generic drugs? What does it take to make a drug? A company intending to make a new drug needs to invest in a good research and development (R&D) unit. This includes good manpower (researchers, technicians etc), expensive equipment and facilities like animal laboratories. Even after investing liberally in all the above mentioned areas, there

   Dr. Tandava Krishnan
3. Blog 21 Feb 2020 13 min read

   "Powerpoint presentations can be a good resource for a refresher course but never for primary learning": Prof. Amod Gupta

   eOphtha: You have been a teacher for more than 3 decades. You have seen the transition from bed side teaching to teaching which predominantly hinges on a power point presentation. Your thoughts on it. Answer: Very interesting question at a time when ppt. presentations hold sway in the class room and the conference hall. There is no way a ppt. slide can substitute a bedside/clinical exam. For us in Ophthalmology ‘the bedside’ is ‘the slit lamp side’. When you examine a patient on the slit lamp, each step in the exam is preceded by a question in our mind, do I see flare? Do I see Iris atrophy? Or do I see new vessels in the angle? When you discover what you are seeking it forms a long lasting memory. Seeing the same sign on a power point slide is a passive phenomenon like watching a movie, in that it is an information in the first place you are not actually seeking, and this unsolicited information is likely to be lost sooner than later. Certainly, sign seen on a ppt. slide can be a quic

   Prof. Amod Gupta
4. Blog 13 Feb 2020 3 min read

   5 Tips To Achieve Ideal Rhexis

   Pioneered and popularized by Howard Gimbel, capsulorrhexis is probably the most challenging task to learn in cataract surgery. In other words once a good rhexis is done half the battle is won. All the post-graduates and beginners struggle to do a ideal rhexis. This small write-up shares small tips and tricks to do rhexis better. Ideally rhexis should be continuous and curvilinear i.e Circular, Central & of Correct size (5.5-6 mm). Circular: for proper IOL centering and stabilization in the bag Continous: to prevent rhexis extension Correct size: for IOL centering and to ensure anterior capsule overlapping IOL optic 360 degrees. It can be done with the help of double bent 26 G/27 G needle or rhexis forceps. Advantages of rhexis with 26 G/27 G needle(Cystitome): Cheap Disposable Universally available Customized Small diameter, light weight Can be done through side port so less chance of AC shallowing Cons of rhexis with 26 G/27 G needle (Cystitome): Less precise control With needle it is

   Dr. Rohit Rao · Dr. Charudutt Kalamkar
5. Blog 13 Feb 2020 5 min read

   KISS: Keep it simple silly

   One day we saw a patient who was recently given an injection inside the eye for a retinal condition. He had come for a review and examination revealed that he had developed a tear in the retina which resulted in detachment of retina, thereby causing decreased vision. Needless to say, the patient was anxious because his vision had deteriorated further after the injection. While we were struggling to explain (and failing miserably at that!) to the patient about how the two entities were different, a senior consultant reviewed his file and spoke to him thus, “Imagine you had a leaking tap in your house. The plumber has just come in to repair the problem when the power goes off in the house. Your eye condition is something similar, before the injection could rectify the problem inside your eyes; a newer more serious issue has cropped up.” Surprisingly, the patient who till then seemed to be unsure about what was happening, understood the seriousness of the situation and urged us to do what

   Dr. Tandava Krishnan
6. Blog 13 Feb 2020 7 min read

   Dear doctor, look before you leap!

   Couple of years ago, I sat through a presentation by a doctor. His topic was, “Importance of sterilisation process in an operation theatre”. He started his presentation by putting up a picture of road traffic accident and said,” We all are good at driving vehicles but it just takes one accident for people to lose their lives. Sterilisation is also similar! A small slip here, a little laxity there and we all end up with a big catastrophe of post-operative infection.” As doctors, we strive to keep our patients happy. We read newer books and journals, attend conferences and participate in hands on refresher courses to familiarise ourselves with the latest developments in the medical field so that we may do what is best for our patients. Sometimes we go beyond the call of our duty to ensure that the patient is not inconvenienced. This could be in the form of working extra hours or on holidays or working without charging the patient. These measures might sometimes be at the cost of sacrific

   Dr. Tandava Krishnan
7. Blog 13 Feb 2020 5 min read

   How l published 35 papers in the best Ophthalmology journals during Residency

   Publishing papers in scientific journals is the biggest boost you can get. It is an adrenaline rush that is understood only when experienced. Even after having achieved a few recognitions and awards, including the DNB gold medal, I still find it exhilarating to work on papers and get tremendous joy when a paper is accepted in a journal. Publishing is a great habit to develop early in your career and once you have a few papers under your belt, the habit literally turns into an addiction and you keep striving to publish more. There are many successful surgeons when you look around, but there are only a few researchers who have made it big in India. As a resident, there is plenty of scope to publish papers (especially from India) and make your mark. I also feel that getting peer recognition is much faster when you publish meaningful studies that influence practice patterns rather than by doing good surgery alone. This will eventually translate into more patients seeking your services and

   Dr. Sabyasachi Sengupta
8. Blog 13 Feb 2020 6 min read

   Doctor heal thyself!

   One day, after a check-up I declared a baby to be out of danger. The baby had recently undergone LASER treatment for a vision threatening condition known as Retinopathy of prematurity(ROP) The parents who had been stoic and composed till then suddenly broke down. It was as if a burden had been lifted of their back. I knew exactly what they were going through. For we had been through a similar experience in the past... One month before our son was due for delivery, we visited our obstetrician. An abdominal ultrasound scan was suggested by the doctor. When we were ushered into the scanning room, the first question asked by the Sonologist (London trained) was, “Are you a diabetic or a hypertensive?” A negative answer was met with a bizarre retort from the sonologist. “How can that be possible? Usually you people tend to develop something by this stage of pregnancy!” She managed to sound both incredulous and disappointed in the same tone. With that introduction, she went about the motions

   Dr. Tandava Krishnan
9. Blog 13 Feb 2020 10 min read

   What I learnt as a doctor

   “Get into the medical course and your life is made”, was the advice often given by elders during our school days. I am currently 36. I got admitted into a medical college 18 years ago on my birthday. To put it simply, half of my life has gone into training and then applying what I have learnt in this field. Throughout my life I had adjectives like hardworking, brilliant, intelligent so on and so forth thrown at me. However, a cursory look at my bank balance makes me wonder if there is any justification for such adjectives! Of course, a lot of people would surmise that bank balance is hardly the correct yardstick to judge a doctor’s life. If clinical excellence and financial success are the parameters to grade a doctor’s success, a 2x2 table can be designed to fit doctors into one of the four groups depending on the presence or absence of the two attributes.(I am not sure if my community medicine teachers in Mangaluru would approve of my application of a 2x2 table!). Dichotomy in the me

   Dr. Tandava Krishnan
10. Blog 13 Feb 2020 4 min read

    Medical Omerta: The doctors’ oath of silence and how far would you go to keep it that way?

    The Supreme Court of India on 1st July 2015 awarded a compensation of 1.8 crore rupees as damages to a girl who was rendered blind due to lack of timely referral by paediatricians for Retinopathy of prematurity(ROP) check up. It reminded me of a similar incident during my fellowship. A child with both eyes stage 5 ROP with closed funnel retinal detachment was referred to the hospital. After the consultant broke the sad news to the parents, a flurry of questions followed which was patiently answered to. Finally, the visibly shaken mother asked,” Doctor, had the paediatrician referred the child on time to an ophthalmologist, could the vision have been saved.” It was a very tricky question, considering the hospital’s policy of not passing adverse comments on the work done by other Doctors. The answer by the consultant was,” I do not know if the vision could have been saved but I am pretty sure that the child is alive only because of the good work done by the paediatrician.” As a student,

    Dr. Tandava Krishnan

More articles