March 14, 2011

INDIA: WHO WANTS TO BE A 'MEDICAL SUPER MILLIONAIRE' ?

[Amitabh started clapping and said, "Very good, now let us start this new game of Kaun Banega Medical Crorepati. The rules are the same as the regular KBC. The only difference is that Docfriend Pharma has sponsored the first five questions. So whatever happens, you have an assured prize of Rs. 20,000. Docfriend Pharma produces Acid killer, the fastest acting Antacid. So now let's directly go to question number 6 for Rs. 40,000!"]

By Dr. Kishore Shah MD 

The psychedelic blue whirling lights moved around as the winner of 'Fastest finger first' was announced in the deep baritone of Amitabh Bachchan. Amidst the ascending music, he said, "The doctor who answered the last question the fastest is Dr. Kishore Shah."

I quickly waved to the audience my two fingers and took the hot seat. Amitabh rumbled again, "Congratulations Dr. Shah for getting into the hot seat. Tell me, to what do you attribute your success in reaching here?"





I smiled and said, "Sir, for this "Kaun Banega Medical Crorepati ?" ( Who wants to be a medical millionaire?), the  only doctors who can win are those who use their fingers fast. Proctologists and Gynaecologists are the only two doctors who keep using their fingers. But we Gynaecologists have an edge, as we use two fingers, so we are twice as fast."

Amitabh started clapping and said, "Very good, now let us start this new game of Kaun Banega Medical Crorepati. The rules are the same as the regular KBC. The only difference is that Docfriend Pharma has sponsored the first five questions. So whatever happens, you have an assured prize of Rs. 20,000. Docfriend Pharma produces Acidkiller, the fastest acting Antacid. So now let's directly go to question number 6 for Rs. 40,000!"

What is the most important thing that you do in Medical College?

A. Take part in dramas and debates,
B. Flirt with a girl,
C. Sit in canteens and time-pass with friends,
D. Study hard.

I thought for a moment and then smiled. "Sir, this one is easy. The correct option is A."

"Very good. Your choice is correct. Now could you tell us why taking part in drama and debates is important for a doctor."

I smiled again and said, "Sir, in my decades of practice, not even one patient has ever asked me how many marks I got in my exams or about the Gold medals that I got. So obviously studying hard is unimportant.  Flirting with a girl becomes important only if she becomes your wife. The other two options are very close in importance. By bonding with your friends, you can form a cross referral network, which will help your practice. But this can be developed later on also. So the most important thing to learn in Medical College is how to dramatize things, so that a common cold seems like Pneumonia. A normal delivery seems like a life and death situation. This helps you extract more fees from your patient. Talking also helps you get out of sticky consumer litigation situations."

"Congratulations! You have won 40,000. Now let us move to question number 7, which is:"

While taking the history of a patient, what is the most important question?

A. How long has he had the illness?
B. What is his occupation?
C. What past medications has he taken?
D. What are the exact signs and symptoms he suffers from?

Again, I gave a small knowing smile. They were asking such simple questions. I said, "The correct option is B."

"And why do you think so?"

"Well, it is obvious. In this age of Consumer complaints, it is more important to make sure that the patient you are treating is not a lawyer, a police official or a retired judge. Treating and curing the disease is naturally less important."

Amitabh started clapping. "Very good. You have won yourself Rs. 80,000. Let us go on to question number 8."

Which is the least important thing to have for a doctor?

A. A stethoscope,
B. An Apron,
C. A pen,
D. A prescription pad.

I was stunned. Such simple questions! I asked Amitabh, "Sir, are all these questions also sponsored by a Pharma company? They are so simple that they seem to be on the level of those asked at the stalls at conferences where you get free bags for correct answers."

Amitabh looked a bit miffed. He asked, "You think this question is easy?
What is the answer then?"

I folded my arms and sneeringly answered, "A stethoscope is the most useless thing that a doctor can have. Pen and prescription pads are essential because you need to send the patient to labs or consultants with your chits, so that you can get cuts. An Apron protects you from the patient's germs. But which sensible doctor uses the stethoscope nowadays? You suspect heart or lung disease, ask for an X ray or ECG. You want to hear the fetal heart, do a Sonography. A Stethoscope is like a floppy drive for the computer. You have one because the older versions had it. However, there is no modern use for it."

Amitabh started clapping. "Very nice, Dr. Shah. You have won 1 lakh 60
thousands. Let us go to question number 9."

When a new specialist visits you, what is most important factor?

A. How does he talk and present himself?
B. From where has he passed?
C. How much experience he has?
D. How is he dressed?

At this rate, I was confident that 2 crores would soon be in my pocket. I said, "Obviously, how much experience he has is very important."

"That is the correct option. Now can you tell me why you think so?"

"Its very easy sir. If he is experienced, he will convince the patient to pay more for some more unnecessary procedures. Due to his experience, he will naturally send you a nice big fat cheque of the commission without grumbling. Thus his experience is the most important thing."

Even Amitabh was impressed. "Hats off to you, Dr. Shah. You seem to have a lot of experience in this. That's 3 lakhs and twenty thousands in your
kitty. The next question is a 'Padav' question."

If your close friend asks you to attend a free medical camp, should you:

A. Make excuses and run away,
B. See if there are chances of getting referrals from this camp,
C. Tell him bluntly that you need to be paid,
D. Cheerfully agree to do the free camp.

Ah! Now things were getting a bit difficult. I mused over the options then said, "I would like to use the Audience poll, sir."

After a tense 5 minutes, the results were in. 75% wanted to bluntly tell him to pay. 12% wanted to run away and 12% were worried about referrals. Only 1% agreed to do the camp. I pondered over the results and then declared, "Sir, I would like to go against the audience. I will cheerfully agree to do the camp."

Amitabh looked quizzically at me. "Are you sure you want to go against the audience?"

"Yes Sir. If I agree to go to his camp, he will be obliged to come to my
camp, where I get publicity and patients. If I do not go, who will come to my camps? So for a few hours on a Sunday I get a free doctor when I want him for a camp. I will also get to know some other doctors who do free camps and will come to my camp."

"You are absolutely right. Thank God you did not go with the audience. Now, no matter what happens, you have at least 6 lakhs and 25 thousands in your pocket. You are playing very well. I hope you win the 2 crores. Okay! On to the 11th question."

When a conference is announced, what is the first thing that you do?

A. Read if there are any important topics covered,
B. See what fees are applicable,
C. Search for some Pharma company to sponsor your visit,
D. Look at the place where the conference is taking place.

I could see that things were getting tougher. This time I decided that a
Fifty-Fifty option would be better. Amitabh smiled at my discomfiture and said, "Okay, Computerji, lets do the Fifty-Fifty."

The only two options remaining were A- Important topics and D- Place of the conference. I scratched my chin and said, "Alright. I'll go with the place where the conference is taking place."

"And why do you think that is correct?"

"Well, Sir, Fees for the conference can be got from some Pharma company. And we do not need to search for a sponsor. There are companies rushing to sponsor you for conferences. The topics are hardly important because if you really want to know about them, you had better read a textbook or journal. You go to a conference to enjoy the ambience. You go to have good dinners and cocktails. You go to meet old friends. Thus the place of the conference is the most important thing."

Even Amitabh was impressed. "12 lakhs and fifty thousands! Wow! Dr. Shah, you are on your way. Let's see the next, that is the 12th question."

If a serious accident victim is brought to you in an emergency and death is inevitable, what will you do?

A. Send the patient immediately to a larger medical center,
B. Try your level best to save the patient and treat him,
C. Give first aid and convince the relatives to take the patient away,
D. Disappear from the clinic and tell the nurse to send him away.

The questions were getting more and more tricky. I thought this over for a minute. Then a bit hesitatingly I replied, "Sir, I think I shall go for option B i.e. try my level best to save and treat the patient."

"That's very noble of you. And why should you try to save the patient?"

"Well Sir, if death is inevitable, we should at least try to extract whatever fees possible from the patient. So we should put the patient on
ventilators, start costly drugs and maintenance regimes. Only then will patients, or in this case, the relatives, pay us."

"Wonderful. Now you have won an astounding twenty-five lakhs! Lets go to
question 13 and see what is in store for you."

If a patient with HIV infection comes to you, you should:

A. Make excuses and say his disease is not treatable by you,
B. Tell him that you are sorry, and he can go anywhere else he likes,
C. Refer him directly to a government referral center,
D. Admit the patient for treatment at your hospital.

Now the hot seat was really heating up. I deliberated over this one for a while. Then I took the plunge. "Sir, I think I will admit the patient. That way, even if I do not want to personally treat the patient, I can always get some 'bakras' who are willing to treat him. Why should I miss out on my fees?"

"FIFTY LAKHS!" Amitabh clapped loudly. "Just two more questions."

If a patient comes to you asking for an illegal, secret Sex determination test what will you do?

A. Quietly but firmly show her the door,
B. Quietly but firmly give her the address of your friend who does that test, 
C. Shout at her and give her a big lecture on ethics and morality,
D. Inform the police about this patient.

This seemed to be a tough nut to crack. I decided to use my Flip option. I asked Amitabh to flip the question. He said, "Okay, Computerji, lets flip the question."

However, after flipping, the same question came up. Amitabh was stunned.
"The computer was supposed to change the question. How come?"

I suddenly had a brain wave. I said, "Let it be, Sir. Maybe the computer
wants me to answer that question. Okay, I shall go with option A that is I
shall quietly and firmly show her the door."

Amitabh nearly shouted with joy. "This is astonishing, Dr. Shah. You have won a Crore of Rupees. However, I would like to ask you how you knew the right answer."

"It is simple sir. In all the other options I do not gain any money. But by quietly showing her the door, where my assistant is waiting to take her to a discreet place, I shall retain the moolah!"

There was a loud applause. The tension now was palpable. I asked for and got a glass of water. Amitabh cleared his throat and said, "Okay, now only one question separates you from the grand prize of two crores. Ready? Here is your question now."

If your son or daughter cannot make it to the MBBS seat in the Government Medical college, which is the next best option?

A. A local medical college with 25 lakhs donation,
B. A medical college in China or Russia costing 2 lakhs per year,
C. Opt for parallel streams like Ayurved, Homeopathy or Unani at 1 lakh,
D. Opt for Dentistry with 15 lakhs donation.

This final question was a true crackerjack. I had absolutely no idea of the correct answer.

Amitabh prodded me, "In case you are unsure, you have one more lifeline,
that is phone a friend. You can use it."

I agreed with him. The phone connected and soon I was speaking with my
friend Rahul. I asked, "Rahul, If your son does not make it to a government medical college MBBS seat, what will you do? Will you pay 25 lakhs for a private seat, or 15 lakhs for Dentistry or 2 lakhs per year for China or will you choose Ayurved, etc. at 1 lakh?"

Rahul answered immediately, "Am I mad? I sent my son to do software
engineering."

This put me back to square one. I thought and thought, but could not come up with any logical answer. Should I take the one Crore of Rupees and quit?

I turned to Amitabh and said, "Only an idiot would want to pay such astronomical sums for a medical seat. None of your options are correct. I would prefer to invest the money lucratively and tell my son to opt for some less expensive alternative."

Suddenly the balloon on the ceiling burst open and confetti and silver foil descended on me. Amitabh stood up with a broad smile and said, "Exactly. That was a trick question. But you have answered even that correctly. Bravo and congrats for winning the huge sum of TWO CRORES!"

He crossed over to my side and started patting my back. But in his enthusiasm, he was patting it very hard. It was almost painful. I winced and said, "Not so hard, its hurting me. Pat me slowly."

"What do you mean pat you slowly? I have been trying to wake you up for half an hour now. Get up right now or you will be late for your clinic."

I said, "Okay! Okay!" to my wife and reluctantly lumbered out of bed to the bathroom to wash my expensive dreams away.