Table of Contents
Clinical Process
1. Patients visit a consulting physician with symptomatic complaints.
2. A Physical examination(eyes, tongue, skin, odor), is conducted, and vitals(BP, Glucose, weight, etc) are measured.
3. Detailed history of the patient is collected.
4. The history must involve detailed family history, life chronology, symptom history, assessment of past medical records, lab tests, and pharmacological history.
5. The clinician then is required to take a clinical decision of whether the current symptom is Acute and life-threatening or is chronic and long-term.
6. If the clinician finds an immediate risk, he must refer the patient to a specialist with detailed documents of his observation.
7. After correlating history, symptoms, medicines, past lab records, and vitals, he must prepare a document providing his intellectual input about possible syndromes or illnesses, and their pathogenesis.
8. Then the clinician needs to educate the patient about what he thinks is the possible health condition.
9. Once a patient has understood his/her condition, current and future risks, and precautions to be taken, the clinician must initiate the Screening process.
10. A screening is a set of lab tests to rule out or validate each suspected condition.
11. Now the test results are correlated with the primary clinical document he prepared. At this stage, a differential diagnosis is carried out and only a handful of condition remains. This is still not a diagnosis.
12. The clinician then asks the patient to change lifestyle(for a chronic condition), and report back after a specific period of time T2.
13. Again (T2-T1) changes in Symptoms and vitals are documented.
14. If there is no improvement, then the clinician advises costlier confirmatory tests, but under the supervision of a specialized clinician.
15. The test is conducted by the specialist in coordination with say a pathologist/radiologist based on the clinical document prepared. Because they have to know what they have to look for.
Estimated Time and Cost for a Clinical Process
a. History: 2-3 Hours, ₹600
b. Document: 15-18 hours, ₹12000
c. Physical Examination: 30 minutes, ₹500
d. Study and Primary Screening/Diagnosis: 8-12 hours, ₹6,000
e. Differential Diagnosis: 2 Hours, ₹2,000
f. Pharchological study and prescription: 1 Hour, ₹1,000
g. (Patient’s Average Cost for Screening Tests): ₹15,000
Total Cost: About ₹40000 just to make sense of one’s condition.
Manpower: 4-6(1 Nurse, 1 GP, 1 Clinical Writer, 1 Junior Doctor)
Time: 35-40 Hours.
Healthcare Parallels
A useless Engineering lecturer gets ₹50000 pm for 6 months, to cover two subjects of 52 hours each+1 lab(where he/she just sits). So ₹2000 per hour.
Conclusion
People perceive life to be cheaper than Pizza, and so Chefs are paid more than physicians. When a 30-day assessment becomes a 2-minute Noodle, the outcome is like ₹1500 lottery. Patients will anyways pay the price with money, and also with organs.
