Role of Family Milieu in Tobacco Addiction: A Study in a Tertiary-care Institution in India.

Use of tobacco is singularly responsible for most cases of cancer and coronary artery disease (CAD). Efforts to stop tobacco-use need to be guided by social circumstances. It is believed that family milieu may play a role in tobacco addiction. We studied the prevalence and pattern of tobacco-use in families of 50 consecutive tobacco-user patients who presented to a tobacco-cessation clinic and compared with age- and gendermatched controls (non-users of tobacco). The tobacco-use rates were significantly higher in the family of patients with tobacco-use compared to the control group. We conclude that problems of tobacco-use are not related to individual phenomenon, and efforts for control of tobacco addiction must be focused on entire family.

Analysis of physicians’ strikes and their impact.

Resident doctors often resort to strikes for reasons concerning safety at the workplace, better working conditions, better remuneration, and policy issues such as caste-based reservations and appointments to institute positions . Although many articles have discussed whether or not physicians should resort to strikes, few have analysed the prevalence of strikes, their direct impact on healthcare delivery, and beneficial outcomes, if any, for physicians . We conducted a single centre retrospective study for analysing the same.

My first suture.

Internship is the final year of medical school in India. The Medical Council of India defines internship as “a phase of training wherein a graduate is expected to conduct actual practice of medical and health care and acquire skills under supervision so that he/she may become capable of functioning independently”. It is meant to serve as a bridge between the theoretical learning of a medical student and the practical skills of a trained physician. It is also meant to provide future doctors with exposure to the problems they will face at some point in their practice.

Attitudes and practices of medical graduates in Delhi towards gifts from the pharmaceutical industry.

Pharmaceutical companies use a variety of strategies, including gifts, to influence physicians. In December 2009, the Medical Council of India amended the Code of Medical Ethics to ban medical professionals from accepting gifts from pharmaceutical companies. In view of this ban, it is important to find out the magnitude and contours of the problem amongst Indian medical professionals. We aimed to study, through an e-mail based survey, the attitudes and practices of young resident doctors and interns from two medical colleges of New Delhi regarding acceptance of gifts from the pharmaceutical industry. We e-mailed the questionnaire to 150 fresh graduates. We found that the majority of graduates agreed with existing guidelines: they accepted low cost gifts but considered expensive gifts unrelated to patient welfare unethical. Despite the low response rate, this study is important because data from India on attitudes and practices of medical professionals regarding gifts from the pharmaceutical industry are virtually non-existent.

Seeking better inter-departmental cooperation in healthcare settings.

Hospital healthcare is essentially teamwork. Frequently, however, one comes across incidents where inter-departmental cooperation is compromised. It can create an awkward situation for residents and other staff members involved in the healthcare system. We can recall many such incidents during our training. Studies have indicated that failure in “tightly coupled” organisational relationships between hospital departments imposes a threat to patient safety. Clear guidelines on how to manage certain situations should be in place, leaving no ambiguity as far as issues concerning patient management are concerned. A lot more needs to be done by administrators to avoid such incidents and to promote inter-departmental co-operation. In addition, more caution and effort by administrators, residents and faculty can help avoid such incidents.

Residents' strikes on policy issues.

Strikes by residents or medical students have become fairly common and the new trend is to resort to strikes to protest matters concerning health policies. This article discusses the justification for and the ethical issues involved in these strike actions. Mechanisms to prevent such strikes are also discussed.