When I began practising Medicine at MGIMS, whenever I ran into a medical problem, which I thought I could not solve, I would seek a super specialist’s help.
This indeed made sense. After all, their years of training and rich experience would help me order the best test, choose the drug that works or pick up an intervention that would get my patient to regain her health.
For years, I naively subscribed to this belief. Until I found out that most experts have feet of clay. That they are wrong more often than we think they are.
Their opinions are often biased. Their plans are based on their individual experience (Oscar Wilde defines experience as simply the name we give our mistakes) and often driven by the powerful drug and device industry.
I also discovered their illiteracy—not being able to read medical papers, or critically appraise medical evidence. Their sources of knowledge are annual conferences- heavily coloured by industry-sponsored experts and specialty leaders. No wonder that the experts—their opinions are often money- driven— order more tests, prescribe more drugs and carry out more procedures — regardless of whether they benefit the patients.
So, I have changed my strategy.
Now I can figure out what lies beneath simply by reading UpToDate. In my OPD. Along the hospital corridor. On the patient’s bedside. Thanks to the campus-wide Wi-Fi connectivity, we can access it anytime, anywhere.
My residents and I can assess what works and what does not. We share this information with the patient. And then we mutually decide whether to seek expert opinion or not!
We have been able to cut down unnecessary tests, substantially. We have learnt the art of deprescribing. And we have been able to make our patients believe that “Less is More”.
Conflict of Interest: I am not a super-specialist.
