signs of a good doctor

1) Jo patient ko na loote

2) Jo hamesha patient ke bhalai ke bareme soche

3) Jo khudke benefit bareme km soche

4) 

PRESCRIPTION (P-DRUG)

 

Hypertension Treatment

• Country Differences:

  • In the USA: ACE inhibitors (e.g., Lisinopril) are often the first choice for hypertension due to high prevalence of comorbid conditions like diabetes.
  • In India: Calcium channel blockers (e.g., Amlodipine) are commonly preferred due to cost-effectiveness and better efficacy in salt-sensitive hypertension.

• Doctor Differences:

• A cardiologist may prefer beta-blockers (e.g., Metoprolol) for a patient with coexisting heart disease.
• A general practitioner might choose a diuretic (e.g., Hydrochlorothiazide) due to affordability and simplicity.

In contrast, countries relying on the WHO Model List of Essential Medicines may prefer Hydrochlorothiazide due to its inclusion as a cost-effective option.

Impact of Treatment Guidelines

Treatment guidelines provide evidence-based recommendations that directly influence P-drug selection.

• Example 3: Hypertension

• USA (ACC/AHA Guidelines): Recommends ACE inhibitors (Lisinopril) or ARBs (Losartan) as first-line P-drugs for hypertension, especially in patients with diabetes or chronic kidney disease.
• UK (NICE Guidelines): Suggests calcium channel blockers (Amlodipine) as the first choice for hypertension in older adults or Black patients.
• India: Diuretics (Hydrochlorothiazide) are often selected due to affordability and inclusion in national guidelines.

Understanding Clinical Guidelines

• Example 1: Hypertension Treatment

• Doctor A: Interprets the American Heart Association (AHA) guidelines and emphasizes ACE inhibitors (Lisinopril) for hypertension in diabetic patients due to their protective renal effects.
• Doctor B: Focuses on the same guidelines but prefers ARBs (Losartan) because they are equally effective and have a lower risk of cough as a side effect.

"All diseases need not to be treated with a drug."

• Example 1: Hypertension

  • Non-drug approach: Lifestyle modifications such as regular exercise, low-sodium diet, weight loss, and stress reduction can be effective in controlling mild hypertension.
  • Rationale: Drugs may not be immediately necessary, especially in borderline cases.

PDL MR COMMUNICATION

 

https://iris.who.int/bitstream/handle/10665/69177/WHO_EDM_PAR_2004.3_eng.pdf?sequence=1

Ethical criteria for medicinal drug promotion

https://iris.who.int/bitstream/handle/10665/38125/924154239X_eng.pdf?sequence=1&isAllowed=y

INDIAN MEDICAL COUNCIL (Professional Conduct, Etiquette and Ethics) Regulations, 2002

(AMENDED UPTO 8th OCTOBER 2016) 

https://www.nmc.org.in/wp-content/uploads/2017/10/Ethics-Regulations-2002.pdf

The Gazette of India

https://www.nmc.org.in/documents/e_Gazette_Amendments/Ethics%20-%2010.12.2009.pdf

Code of Medical Ethics Regulations, 2002

https://www.nmc.org.in/rules-regulations/code-of-medical-ethics-regulations-2002/

LOK SABHA UNSTARRED QUESTION NO.4422 TO BE ANSWERED ON 19TH JULY, 2019 UNETHICAL PRACTICES 4422. SHRI SYED IMTIAZ JALEEL: 

https://sansad.in/getFile/loksabhaquestions/annex/171/AU4422.pdf?source=pqals

Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 (Published in Part III, Section 4 of the Gazette of India, dated 6th April, 2002) MEDICAL COUNCIL OF INDIA NOTIFICATION New Delhi, dated 11th March, 2002

https://wbconsumers.gov.in/writereaddata/ACT%20&%20RULES/Relevant%20Act%20&%20Rules/Code%20of%20Medical%20Ethics%20Regulations.pdf

Shastri Bhawan, New Delhi March, 2024 Subject: Uniform Code for Pharmaceutical Marketing Practices (UCPMP) 2024 — reg. Sir / Madam,

*UCPMP 2024 for website_0.pdf 

नाहं कालस्य, अहमेव कालम|

 नाहं कालस्य, अहमेव कालम|

MAI AHAM NAHI HU

MAI AATMA HU

https://acharyaprashant.org/en/articles/naaham-kaalasya-ahamev-kaalam-1_593683c

Bhagavad Gita (Chapter – 4, Verse – 7)

Whenever there is rise in evil, whenever ignorance and arrogance rise, obviously the result is suffering. The Lord does not drop physically somewhere from the heavens. The metaphor must be understood. It does not mean when there will be people of certain kinds who would be behaving in evil ways then some avatar will descend from the skies. What it simply means is that whenever the ego inflates, the consequence is suffering and suffering itself calls for its cessation. You do not like to suffer. This call of cessation of suffering itself is the coming of the Lord.

The ego is caught in a quandary. It likes to be inflated but it does not like to suffer. But the natural consequence of its own inflation is suffering. It likes to be big, it likes to act powerful, but the more powerful it acts, the more it suffers and suffering is something it does not like. So the very inflation of the ego, the very rise of ego, the very increase of evil, is also a parallel increase in the urge to dissolve the evil, the suffering, the ego. The Lord doesn’t come from anywhere; the ego sees its own futility, its vanity and surrenders. 

 “Everything we hear is an opinion, not a fact. Everything we see is a perspective, not the truth.” [Marcus Aurelius]

ETHICAL

 censure

‍ˈसे᠎̮न्‌श(र्‌)

written

verb

to tell somebody, in a strong and formal way, that he/she has done something wrong

अनुचित काम करने के लिए किसी की भर्त्सना करना

घोर निंदा, भर्त्सना

written

‍ˈरिट्‌न्‌

adjective

expressed on paper; not just spoken

लिखित रूप में व्‍यक्त (न कि मौखिक रूप में)

sober

‍ˈसोब(र्‌)

adjective

adjective: sober; comparative adjective: soberer; superlative adjective: soberest

1.

(of a person) not affected by alcohol

not funny; serious

मज़ाक़िया नहीं; गंभीर

(of a colour) not bright or likely to be noticed

(रंग) चमकीला या भड़कीला नहीं; सौम्‍य

solicit

सˈलिसिट्‌

verb

1.

formal

to ask somebody for money, help, support, etc.

धन, सहायता, समर्थन आदि माँगना

ethical

‍ए᠎̮थि़क्‌ल्‌

adjective

1.

connected with beliefs of what is right or wrong

उचित-अनुचित के विचार से संबंधित; नैतिक

That is an ethical problem.

That is an ethical problem.

2.

morally correct

नैतिक दृष्टि से उचित, नैतिकतापूर्ण

adjective. pertaining to or dealing with morals or the principles of morality; pertaining to right and wrong in conduct. being in accordance with the rules or standards for right conduct or practice, especially the standards of a profession: It was not considered ethical for physicians to advertise.