A job well done

 The ninth edition of the WHO’s classification of diseases, details:

1.  more than thirteen thousand different diseases, syndromes, and types of injury,

2. six thousand drugs and

3.  four thousand medical and surgical procedures.

_ Atul Gawande

In the good old days, when I was studying medicine, a single physician could cover all cases medicine- from heart to foot, lungs to brain. He could see both children and mothers, write medicine for your eyes and ears, treat skin and joints as well.

A general surgeon those days could pretty well manage most of the surgeries from bone to stone, abscess to tumor and prescribe medicines also. Life was so simple then.

If we can go back 10 more years to that, an MBBS doctor would conduct delivery, give vaccines to children, set fractures, do surgery and give urine report as well. Today also, the old timers can do that.

….

But now, any one patient has to complete an average round of 15 doctors for his single illness. Radiologist, pathologist, biochemist, histo-pathologist oncologist, Cardiologist, anesthesist, Dietitian and so on. Each one is a specialist in his part of your body and refer you to his colleague for the adjacent part of your illness.

 The ninth edition of the WHO’s classification of diseases, details:

1.  more than thirteen thousand different diseases, syndromes, and types of injury,

2. six thousand drugs and

3.  four thousand medical and surgical procedures.

   Each one is as different from other as is physics from chemistry. It’s humanly impossible to be expert on all these things.

So what is the solution ?

….

Has this explosion of knowledge occurred in  medicine alone ?

What about construction business, energy sector, building a skyscraper or flying a jet plane. When we want to construct a house we have to use at least 60 different specialist- architect, Masons, marble Mistry, plumber, electrician, excavator and so on. 

How do we get our houses built then ? How do Railways build new lines now?

In my limited vision, I believe Railway has the best answer for this. A DRM style. DRM can belong to any speciality, but his job was to get the job done from all the super specialist under him, the bridge people, the health cadre, the electrical or the train drivers. He has one single agenda: to run the train as smoothly as possible. He sits in his chamber with his check lists and just goes on chasing. He is no longer a civil or electrical man, he is the ultimate chaser. 

Just like when you build your own house you’re no longer a medicine man or finance person. You’re there to Know small bits of everything so that no specialist cheats you. Your job is to stick to a time table, solve any obstacle, manage the conflicts and see that the house is completed.

A job well done.