Kashinath Padhiary MD FICP
Associate Professor of Medicine MKCG Medical College and Hospital Berhampur Orissa
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Common Mistakes in Clinical Medicine
© 2006, Kashinath Padhiary
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
First Edition: 2006
9788180617836
Typeset at JPBMP typesetting unit
Printed at Gopsons Paper Ltd, Noida
5Preface
To err is human. He who learns from his own mistakes as well as from other's mistakes, is wise and he who repeats the mistakes is considered as a fool. In every field of knowledge mistakes have been committed and people have tried to learn from the mistakes, so that better and better things have come up. Mistakes are more likely to be done by students in the learning stage, but no one is immune to commit mistakes. Mistakes in medicine has to be specially dealt with because they can lead to increased sufferings, at times they can cause death and at other times it can cause irreversible damage to the patient and most of the time it increases the cost of therapy. So everybody should try not to do mistakes or at least minimize mistakes. Though it is the duty of the teachers to point out the mistakes of the students and rectify them in right time, but this facility exists till the completion of the course only. After the completion of the course there will be none to rectify them. Most of the medical books do not speak of the mistakes though they have written how things are to be done correctly. In spite of that mistakes are committed for several reasons. At times it is due to ignorance, at times due to carelessness, sometimes due to over-confidence and yet at other times it is due to hurry.6
I have worked in medical colleges over a period of several years and I have been closely associated with the medical students, the interns and the postgraduates. In these years I have noticed several mistakes being done by them, at times by my colleagues too. These mistakes are either at the level of learning, in the process of diagnosis, in investigations, in the management or during bedside interventions. I have tried to devote one section for each of them to discuss all these errors. Mistakes in medical practice have become more important for the doctors in these days as they come under consumer protection act. A single mistake can put a doctor behind the bar or may cost him his lifetime earning in the form of compensation. So I felt that every doctor should be aware of the mistakes being commonly done by their colleagues, so that they will not do them again.
The number of drugs has increased remarkably. It is not possible to know details of these drugs. However improper use of these drugs may be harmful under certain situations like renal failure and pregnancy. I have tried to give the list of drugs, which are safe/unsafe in these situations. Of course these are available in big books, but it may not be possible on the part of many clinicians to refer to these books immediately. However this book will help in quickly finding the drug that can be prescribed safely in the given condition. Details they can search for monograms. The other important list given in this book is a list of dialyzable and non-dialyzable drugs. In view of the increased cases of poisoning due to drugs this list will 7help whether to send the patient for dialysis or not, as facility for dialysis is available in limited centers only.
This book will help the medical students how they can plan and learn effectively. It will also help the medical graduates/postgraduates who have freshly passed out, as they are still likely to commit mistakes. They can feel the presence of their teacher by their side and at the time of need they can refer to this book. I shall be extremely happy to know the opinion and suggestions of any persons involved in patient care to modify or improve on this book.
I thank all those who have encouraged me to write such an unconventional book. They are mostly my undergraduate and postgraduate students. I personally thank Prof. Srikrushna Mahapatra for providing valuable information, Dr Niranjan Padhy and Dr Sanjeeb K. Bhoi for helping me to prepare and verify the script
I finally wish let there be no mistakes, let the right thing come to our mind in right time on the blessings of all those who have taught us the ABC of medicine.
Kashinath Padhiary