Thursday, May 07, 2009

The surrogacy racket

It's amazingly easy to fool infertile couples - especially those who are
desperate , and are clutching at straws. An excellent example is what some IVF clinics in India who offer surrogacy do.

Even though these clinics know that there is no legal method of allowing the couple to take the baby after birth with them out of India ( because Indian law only recognises the birth mother, whose name must go on the child's birth certificate, which is a legal document), they use the garb of the " ICMR guidelines" ( which have no legal validity whatsoever) to put the intended parent's ( the infertile couple's) name on the child's birth certificate. While one may justify doing this for various reasons, the fact remains that the truth is being distorted out of shape - and once you are willing to do this, it's very easy to continue the distortion even further. This is why these clinics refuse to allow the surrogate to give interviews to the media .

So how come so many couples continue to come to India for surrogacy ? The fact is that infertile couples are desperate, and because surrogacy is so much cheaper in India, they are happy to be party to this deception . The problem is that if the doctor can put a false name on the birth certificate, he can also lie to the intended parents.

A common racket is to tell the infertile couple that the surrogate got pregnant after the embryo transfer ; to collect the fees; and then to tell the infertile couple ( who is most probably in the US or UK and has no method of monitoring the surrogate's pregnancy, which means they have to rely completely on the doctor's integrity) that she miscarried at 8 weeks !

Unfortunately, there's no way to track how many of these " surrogate pregnancies" miscarry - which means that infertile couples are completely at the doctor's mercy - and some doctors will take undue advantage of this trust.

It's hard to place your trust in someone whom you know is not being completely honest. If the doctor can put a false name on the birth certificate ( and thus lie to the Government), what's to stop him from lying to the infertile couple ?

Open-Source EHR Systems for Ambulatory Care: A Market Assessment -

Open-Source EHR Systems for Ambulatory Care: A Market Assessment - " Open-source electronic health record (EHR) systems have proliferated in recent years. This executive summary presents the findings from an evaluation designed to determine whether these systems, commonly referred to as free and open-source software (FOSS), are suitable for ambulatory EHRs.

The authors investigated a number of FOSS EHR projects to assess their organizational structures, development communities, functional capabilities, and available implementation and support services. The evaluation also analyzed the potential advantages of FOSS EHR systems for physician practices, as well as the limitations and general challenges of this alternative approach to acquiring clinical information technology."

Tuesday, May 05, 2009

Better Health » Doctor Patient Relationship

Better Health » Doctor Patient Relationship: "I frequently am asked the question “Aren’t you afraid of the malpractice risk?” when I explain my medical practice model, which is based on the doctor answering the phone 24/7, resulting in the patient’s medical problem being solved by the phone more 50% of the time. The simplest counter to this question is to analyze the risk patients incur when the doctor won’t answer the phone. What happens when the doctor is the LAST person to know what’s going on with patients? The answer is obvious. But malpractice companies could have concerns beyond patient safety. Buy-in from the malpractice companies would be critical to the future viability of all telemedicine.

I prepared a summary paper, which included 12 bullet points, explaining how a doctor- patient relationship based on trust , transparency, continuous communications and high quality information systems significantly reduce risk to the person you’re trying to help."

Websites and emails are a great way of improving doctor-patient relationships because they promote transparency . When everything is in writing there is no scope for confusion.

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