Dr. Ranjana Srivastava, a renowned
cancer specialist from Australia, has pursued her education in India, the
United Kingdom, the United States, and Australia. She earned her medical degree
with first-class honors from Monash University. In 2004, she received a
Fulbright Scholarship to study at the University of Chicago. Upon her return,
she joined Melbourne's public hospital system. She is a cancer specialist.
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| Dr Ranjana Srivastava |
Ranjana Srivastava's book Dying
for a Chat: The Communication Breakdown Between Doctors and Patients
reveals many unknown and insightful aspects of the healthcare system.
When a person grows old, the efforts to keep them alive often create a false sense of assurance in the beginning. Eventually, this leads to a sense of despair. By 2050, the average life expectancy in Australia is projected to increase to 92 years for men and 95 years for women. In this way, a significant portion of Australia's population will become elderly and unwell. The prevalence of diabetes will increase by 200%, and the number of dementia patients will rise at a similar rate. Stomach-related illnesses will grow by 50%, and cancer cases will surge by 75%. The mortality rate from bowel cancer will double. Over a longer lifespan, individuals will suffer from a significantly greater number of illnesses.
Since family bonds in this country
are very loose, and people are increasingly isolated, the elderly will hardly
have anyone by their side—apart from doctors and nurses.
Even now, there are numerous
complaints about Australia's healthcare system. Patients' families are raising
concerns about nursing waitlists, food quality, and medical care—especially
when the patient does not recover. Yet, Australia's healthcare system remains
one of the most advanced in the world.
Here, there are excellent
arrangements to take care of everything from birth to death. The rates of
infant and maternal mortality are among the lowest in the world. There is a
robust vaccination system for children, and medicines are readily available when
needed.
However, the problem arises when the
elderly require integrated healthcare, as it is often difficult to access
everything in one place.
What does it mean to follow best
practices?
Many doctors are compelled to prescribe antibiotics unnecessarily due to pressure from patients. Many patients set their own ideal blood pressure levels based on their preferences. "I'm not experiencing any discomfort, so 120/180 is normal for me."
There needs to be a common ground
where both the doctor and the patient can reach a mutual understanding. The
doctor should have a thorough knowledge of the disease and treatment, but the
patient knows how they feel and what they can tolerate.
Australia produces around 3,000 doctors each year. Most of them prefer to live in cities, and there is intense competition among them. As a result, everyone wants to become a specialist because it offers higher pay. What happens then is that specialists make a lot, but the patients gain very little. As a result, a single patient often needs 10-12 different specialists for treatment.
In large hospitals, when admitted,
separate specialists are consulted for each issue. A cardiologist for heart
problems, an endocrinologist for diabetes, a nephrologist for kidney issues, a
neurologist for neuropathy, a geriatrician for dementia, a psychiatrist, and
many more. However, none of them communicate with each other. Each one gives
their consultation independently, at their own time.
Dr. Ranjana Srivastava believes that, instead of having so many specialists, most people would benefit more from a general practitioner (GP) who listens to the patient and offers comprehensive treatment advice.
This is a very important book, easy to read and very well written.
