Consultant-Specialist Doctor

  • Once the patient is admitted a summary of his problems, Investigations required and treatment is written on the file after an admission file is made through the admission desk.
  • To ensure that the admission process is as brief as possible.
  • They will verify whether the instructions given by them for admitted patients have been carried out properly.
  • Never leave the patient until his/her agony is resolved.
  • After the patient is settled, arrange for his/her transfer to WARD/ICU/OT. During the transfer of an emergency patient, make sure that a Doctor and a nurse accompanies the patient until the patient is handed over the respective staff.
  • While the patients are transferred to OT/LR, ensure that the checklist provided to nursing staff is properly checked.
  • The consultants will obtain consent from the patient or their relatives as per the applicability explained here under
  • Admission consent
  • Consent on charges
  • Consent for Routine Surgery
  • Procedure specific Consent ( Tubectomy, MTP, Lap Choli etc )
    • In case the patient is to be transferred to other centers for diagnosis or treatment in emergency, it is to be ensured that a competent Doctor and support staff accompanies the patient in transport vehicle along with necessary equipment and drugs.( Patient shifting procedure ) ( List of essential drugs and equipments in Ambulance )
    • Minimum of two rounds, one before the OPD hours in morning and one in the evening is taken along with the Resident Doctor and Nurse. You must visit the patient other then these rounds as and when required.
    • At the time of round, all aspects of the patient’s welfare and attendant’s problems are to be looked into by the consultants including proper Medication, Nursing Care, Sanitation and hygiene. If any lapse is found, it is to be reported at the earliest to the concerned authority.
    • Progress report of the patients is to be written on the file at time of each visit to the patient in patient file.
    • Consultant should check each aspect of the file i.e. I/O chart, TPR BP chart, Treatment chart, Investigation chart, Nursing care chart, specific charts like RMO Notes etc. Again, any lapse found is to be reported to administration immediately.
    • To ensure that patient is getting the brands of medicines as prescribed.
    • To discuss the progress of the patient with the key relative after each round. It is advisable to inform the key relative regarding schedule of your next visit so that he/she can be present at that time for briefing.
    • To ensure that the Blood requisition form is properly filled for patient who require Blood transfusion.
    • To find out from patient / relatives regarding history of Drugs allergy. If any patient is allergic to the drugs, the names of these drugs are to be boldly written on cover page of the file of patient.
    • All drugs requiring sensitivity test should he tested in your own presence before clearing these drugs for administration.
    • Write down the prescription in bold letters to avoid any error. Clearly, write in your prescription

 

 

  • All consultants are required to report to M.S. regarding followings.
  1. Undiagnosed patients
  2. Serious patients.
  3. Unusual Diagnosis.
  4. Complaining patients.
  5. Trouble making patients.
    • If a patient is to be shown to any other consultants a referral form is to be filled up along with urgency. In very urgent situations, consultants should discuss the same on telephone in addition to writing on the form. Similarly, if you are called for a referral you have to respond according to urgency. If some urgent intervention is required talk to the treating consultant and then proceed after explaining to the patient and relatives.
    • Once a new consultant is involved in the treatment a meeting should be arranged between the relatives of patient and both the consultants to explain the new arrangement. Patient and relatives should know clearly that who will brief the patient from that point onwards.
    • Following chart should be followed at the time of admission regarding the specialty in which the patient is to be admitted.
  1. a) LIMBS – ORTHOPAEDICS.
  2. b) ABDOMEN – GENERAL SURGERY.
  3. c) CHEST (Excluding trauma) – MEDICINE.
  4. d) PREGNANCY    –         GYNAE
  5. PID GYNAE
  6. BLEEDING PV GYNAE
  7. PREGNANCY with MEDICAL problems       GYNAE
  8. e) DISEASES OF CHILDREN (Below 14 years) – PAEDIATRICS.
  9. f) MULTI TRAUMA – GENERAL SURGERY.

(Including trunk)

  • HEAD –NEURO  SURGERY
  • FACE – NEURO  SURGERY
  • SPINE -NEURO   SURGERY
  • CVA/INFARACT –NEURO SURGERY

 

  1. h) SKIN Emergencies – MEDICINE
  2. i) PSYCHIATRY Emergency – MEDICINE
  3. j) EYE Patient of routine nature will go to respective OPD”S.
  • All consultants are supposed to wear white aprons during OPD hours and ward rounds along with their Identity card.
  • All consultants are required to take active participation in Administration. They will be delegated the responsibility by the M.S.
  • All consultants will be on call 24 hours and will attend to new emergency / serious case and / or any serious admitted patient round the clock.
  • All consultants are required to take part in paramedical education as per the instructions of M.S.
  • All consultants will participate in the clinical meetings / conferences etc. organized by the hospital.

 

 

  • All consultants are required to participate in various charitable or social activities organized by the hospital from time to time like free checkup or treatment camps, Health Melas, Health awareness, Public lectures.

 

  • No Doctor will refuse treatment to any patient who gets discounts or free treatment on recommendation of trust.
  • Any patient who wants discount / free treatment should be referred to the M.S. for further processing.
  • All Doctors will charge the patients as per the rate list of the hospital. Any extra money charged will be refunded but in any case, Doctor will not have the right to take extra money charged.
  • In all panel patients, some percentage of money will be deducted as administrative charges as per the guidelines issued from time to time
  • Following protocol of investigations must be followed for patients who are to be administered GA/SA.
  • HB, TLC,DLC
  • BLOOD GROUP, RH TYPING
  • PLATELET
  • PROTHROMBIN TIME,APTT
  • BLOOD GLUCOSE,BLOOD UREA
  • SERUM CREATNINE,TOTAL BILIRUBIN,CONJ./UNCONJ. BILIRUBIN
  • SODIUM,POTASSIUM
  • HBSAG
  • HIV
  • URINE –R/M
  • ECG
  • X-RAY CHEST.
  • However, this is the list of minimum investigations to be done. More investigations are required for patients suffering from medical disease.
  • Never compromise on investigations or treatment for economizing the treatment.
  • All patients requiring elective surgery should be admitted at least a day before surgery. They should be subjected to PAC fitness till 6 pm.
  • Consultants to fill OT Booking register placed in OT before 2 PM a day before the surgery mentioning the details of procedure, diagnosis, specific requirements if any, time and bed no / advance receipt no. and other information desired in the OT booking register
  • A provisional OT list should be ready before 3 pm and final OT list after PAC fitness should be ready till 7 pm same should be communicated to OT, Anesthetist, Surgeons and the patient on evening round.
  • Strict antiseptic precaution must be taken in OT as per the operation theater guidelines issued from time to time.( Records of culture swabs to be checked and corrective action taken )
  • All procedures / operations which require intravenous sedations, Spinal/general anesthesia, intravenous contrast injections, and cataract surgery must be performed by or in presence of anesthetist. These procedures include MTP, IVP, CT with contrast injection AV fistula, Biopsies, Endoscopies etc.( Anaesthetist notes to be taken in all such surgeries )
  • He will try to be in touch with the patient after discharge for follow up visits and to know about his well being and health progress.( Letter formats sent to patients )

 

 

 

 

  • In the event of a death( NMLC ) of patient under a consultant the concerned doctor is supposed to call the relatives and explain in person the circumstances leading to the death assuring them that all possible efforts have been done to save the patient life . After the nearest relative have seen the dead body, the arrangement should be made by asking the staff nurse to pack the body taking due precaution of removing all tubing and attachments and making sure that the body is cleaned of all blood and secretions. Death form is to be filled as per the guidelines provided separately under the heading of birth and death registration. Death slip is to be given to the attendants for transporting the body. Never hold the body for non clearance of dues. Procedure for handling death patient

 

  • Consultants are supposed to supervise in person the process of packing, and sending various tissues and fluids of operated / precedured patients for histopathology and other lab tests. Due precaution should be take to fill in the requisition form providing sufficient clinical details of the patient ( Histopathology requisition form )
  • Consultants will ensure that all medical records of patients treated under them in the current month are updated in all respect before submitting to MRD. This will form the basis of deciding the date of their monthly cheque disbursements
  • Consultants will follow all rules and regulation governing consultants as specified under separate section of this manual
  • Consultants will follow all legal and ethical issues as specified in separate sections of this manual
  • All consultants will sign the attendance register available at MS office first thing before start of their daily activity.

 

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