Diagnosis- Mainstay for any Treatment

Dr Manisha Shree, Senior Consultant Radiologist, Paras Hospital, Gurgaon,believes that diagnosis is the mainstay for the treatment of major deadlydiseases. In an interaction with Ekta Srivastava, ENN

How does the introduction of the newer technologies change the face of Radiology?
Radiology has come in a very big way in the last 10-15 years. With the advent of computers and the sophisticated electronic mediums now the diagnosis has become the click away facility. Initially if you have brain hemorrhage then you can just presume it by watching the symptoms and signs of the patient but today you just get an MRI and thats how the patients are improving because you are treating them with exact pathology. So it has tremendously changed. We have amalgamated the imaging and the computerize version in a way that now we can sit anywhere and advice accordingly. With these PACS system, today we can give the diagnosis in depth over the phone itself.

Today Radiologist also starts working as a clinician. What is your intake on this?
Hospital is always a team work. Today radiologists have to update themselves with emerging technologies. This is the one aspect where radiologist needs to work up, radiologists are always the part of the diagnostic team but their involvement now more because of the expansion of the modalities and a number of things that you can do now, which you cannot do initially and then there is a branch called Interventional radiology where radiologists are working as the clinicians also.

Where does India stands in global standards in terms of using the recent technologies?
Well, at par with rest of the world, these facilities are limited to the bigger cities; still people from the smaller cities have to travel in the big cities to avail these facilities. While in the west they got all the facilities in the peripheries so thats the difference. Nevertheless, this is a different story but in the quality level what is happening there we have here.

Do you think that every hospital should have their own diagnostic centers?
Yes, it should be mandatory. In case of a critical patient or in an emergency patient, the diagnosis is extremely important. In extreme trauma cases, diagnosis plays a very major role and you cannot wait for the reports from the other centers to reach you. So, availability like basic radiology should be there. Now even the causality medical officers are being trained in the basic radiological modalities like ultrasound and same training is given to the emergency department also. Now, its like other field are more dependent on radiology then radiology being penetrating in the other fields.

“The number of the Radiologist that comesout every year and the requirement ratiothat we need has a big disparity”

Patients using medical devices which can be used at home, what do you think about this?
Any decision should not be taken up on the part of the patient it should be under the medical supervision of the medical person. It has both pros and cons, it cannot be like that I can check my sugar level and treat myself, it is wrong. But if the doctor advises you like ok this is the time when you have to check your sugar level, this is the time after your medicine and if there is any kind of disparity then doctors should be informed, patients are not the one to take the decision.

Websites coming up, where you have to upload your prescription and get the medicine or treatment being done, Are you in favor of such things?
Doctors, they are not in favor of this. Like you have fever, and you cannot drive down to the doctor then you take an antipyretic and lower down your fever but nothing beyond that. People are just pepping up pills like pain killers and lots of things without knowing how it is harming them or how it can harm them in the long run. So, I am not in much favor of uploading the symptoms and treating yourself. In fact what I am more in favor of how like NHS and all work in England, there are more of family clinics coming up ,that is also how the government can as well help you, so rather then everybody rushing in the bigger hospital to get the care , they can access them in the smaller areas as well.

What according to you are the pros and cons in the Healthcare sector?
I think websites that are asking to upload the symptoms and prescriptions and then helping you out with the treatment and people taking advantage of this, it should not be done to the radiology. Today as the technology being used as the prime focus, I think they are like the technologies but they have to learn the technologies. Numbers of people who are trained in those kinds of technologies are less there are not too many to work in those places and there is disparity between the number of trained people to work on such things and number of patients. The ratio is not very ideal in the country. The number of the Radiologist that comes out every year as this is a specialized branch and the requirement ratio that we need has a big disparity. But we can take advantage of the Tele-radiology, a lot of work from the periphery or the remote areas can be done or reported can be advised through the bigger centers.


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