Consulted Dr. Agilan M Doraiswamy (Cardiologist) for Chest Pain
I do not recommend the doctor
Hoped for better: Explanation of the health issueTreatment satisfactionValue for moneyWait time
After cheking my pulse and few questions like my eating habits. He suggested i might have ACS, GERD or Musculoskeletal pain and suggested me 15-16 tests for confirmation.
As pescribed I had my TMT, echo and ECG test done. Others i skipped as felt unnecessary.
Strange thing for me that, doctor prescribed medicine for GERD, before even waiting for all test results
Even for GERD he should have suggested diet and not just say bland diet. Further, nothing was shared on the outcome of Ecg test.
Even for GERD he prescribed 4 medicines, not sure if that’s necessary.
Then I went to another doctor for second opinion, he looked at my report, checked my pulses, asked other few questions and asked my family history on heart issues and ruled out that I have heart problem and told that my eating time and bowl movement was not good and its gastric issue and just gave one tablet and asked me to take fiber rich food and further if it doesn’t give relief asked me to go to gastroenterologist and told no more test is needed.
Dr. Agilan M Doraiswamy replied
Interesting documentary of the patients dissatisfaction.. Your feedback is invaluable abd very impirtant to us. I jusr wanted to clarify that we follow the guidelines in getting to the diagnosis, evidence based medicine. Even after painstakingly counselling the patient about differential diagnosis, the various possibilities and started the empirical APD/GERD medicines. The drugs given are a PPI to reduce acidity, a prokinetic to mobile food downwards, an analgesic antacid liquid for pain and an enzyme for dyspepsia for supportive symptomatic treatment. If the cause is suspected to be stress induced gastritis with erosive esophagitis a sedative and ulcer healing medication can also be used. Whatever is the native diet of the patient it has to be made bland. And frequent small meals was advised. If something is abnormal in the resting ECG then it needs to be explained to patient. If resting ECG is normal and patient is suspected to have any hidden subclinical vessel block, a strees TMT is done to check and rule out inducible ischemia after an echocardiographic screening of the heart's structural and hemodynamic well being. As a cardiologist i need to do justice to my patients evidence based ethical approach. I could have just referred to a consultant gastroenterologist and avoided the blame. Here in India we dont have the GP referral system. Pts directly come to considerate,and to do justice to them we consultant who also double up as GPs and primary point of contact doing beyond their scope but with good intention of helping the patient to alleviate his or her suffering. Just one question to this patient. What if this was much more sinister and grevious cardiac thing and we did not evaluate it. It amoubts to grave medical negligence and a henious crime. The tests suggested and medicines prescribed were given in the best interest of the patient. If you are a technical person would you not do your root cause analysis to trouble shoot your systems. Why such double standards of just stop gap symtomatic supportive treatment alone without opting for the evaluation of the root cause when it pertaining to our own bodies. Our bodies deserve more respect. Your negligence of your own bodies and disrespecting its sanctum, you bring disease and disorder to it by your erratic life styles. And feel the pinch spending for its care but spend in other materislistic things.. We can satisfy every body some times, somebody all times buy not everybody at all the times. It does hurt ones sentiments. But the treatment is given with the good intention and to the best of my knowledge adhering to the best of ethics known to my conscience. If communication gaps are there then there is an imminent need to work harder in those gray areas. Thanks for the critical feedback. It definitely helped me retrospect and introsoect and opened the avenues to refine my approach for better services to all those who seek my treatment henceforth.