A year into the pandemic, a section of senior doctors at government hospitals is still reluctant to be at the bedside of Covid patients, a tendency that at least two members of the government’s Covid monitoring team said was affecting treatment.
The team members, who are visiting hospitals in Calcutta and districts, including government medical colleges, said the problem of senior doctors avoiding Covid patients still existed at many units, though on a much lesser scale compared with initial days of the pandemic.
The members, all of whom are doctors, said the condition of many patients would not have turned critical had experienced doctors monitored them better.
The team recently sent several reports to the state health department stating that senior doctors were reluctant to be at Covid patients’ bedside. “The issue has again recently come to our knowledge. We have asked the senior doctors of the monitoring team to visit Covid wards and see the condition of patients and whether their condition is being monitored properly,” a senior health department official said on Wednesday.
A senior doctor, who is part of the monitoring team, said he had recently visited the Calcutta Medical College and Hospital, where he had asked senior doctors, along with the medical superintendent and the principal, to accompany him to the wards.
“But senior doctors refrained from visiting the Covid general ward or the critical care unit,” said the doctor. “We could see the management of some patients was not done properly because only junior doctors were physically examining them.”
Manju Banerjee, the principal of the medical college, denied the allegation. “At our hospital, all senior doctors are examining patients at the bedside. There is no problem in patient management,” Banerjee said.
Another member of the monitoring team said he had seen a similar reluctance among senior doctors at the Burdwan Medical College and Hospital.
Suhrita Paul, the principal of the medical college, denied any negligence in Covid treatment. “I don’t know about other hospitals, but in our hospital senior doctors are examining patients,” she said.
The problem exists at other medical colleges, too, the member of the monitoring team said. “Junior doctors at several hospitals told me their seniors were not physically examining patients. They are giving advice based on the parameters juniors are recording,” he said.
A doctor, who is part of the Covid management team at a private hospital in Calcutta, said it was important for experienced doctors to physically examine a patient to detect small signs that could prevent the condition from turning critical.
“Pulmonary embolism, clotting of blood in the pulmonary artery that can lead to stroke, is common among Covid patients. An experienced doctor can pick up the early signs of stroke and that can lead to better management of the patient,” the doctor said.
Some Covid patients suffer from diabetic ketoacidosis, a serious complication of diabetes that occurs when the body produces high levels of blood acids called ketones. According to doctors, the condition develops when the body can’t produce enough insulin.
“There is a typical breathing pattern by which we can say the patient is in an early stage of diabetic ketoacidosis and management can start immediately. A not so experienced eye might miss the sign,” said the doctor.
A member of the state health department’s monitoring team said that at the Calcutta Medical College and Hospital, they had seen the condition of several patients with diabetic ketoacidosis had turned critical.
“These patients need to be given a high amount of fluids as they lose body fluid and electrolyte. But if no senior doctor is attending to the patient, the intake amount of fluid might not be accurate,” the member pointed out.
A junior doctor at a state-run Covid hospital in Calcutta described how senior doctors were refraining from seeing patients closely.
“The senior doctors, who are around 60 or above, are seeing patients in the emergency ward or the outpatient department. In the emergency ward, they are examining the parameters like oxygen saturation and then doing the paperwork for admission. For this they need not go close to the patient,” said the doctor. “At OPD, too, they are seating several feet away from the patients.”
According to the doctor, at the ward or critical care unit, senior young doctors and their juniors are intubating Covid patients and managing them.