Angry Doctor

Wednesday, November 28, 2007

TCM finally catches up with western medicine

angry doc and Dr Oz bloke have often wondered aloud on this blog why it is that patients never seem to complain about adverse outcomes when they are under the care of TCM physicians, the way they do when under the care of western medicine. In the comments section of an earlier post, angry doc speculated that "with 'mainstream' hospitals now housing TCM practices on the premises, expectations will change and I think it will be a matter of time before it happens".

It seems like angry doc's prediction is coming true:

Physician's needle joke ends in pain for patient

ON SATURDAY, I visited the new Bao Zhong Tang TCM Centre at Singapore General Hospital for the second time. For pain in my lower back and hip, a senior physician administered about 15 acupuncture needles to my back, waist, hip and thighs.

As soon as the last needle was inserted, the physician left the room to attend to other patients. About 20 minutes later, another physician came to remove the needles.

As he was not the one who administered the needles, I asked whether he had removed all of them. He said jokingly that if there was any he missed removing, I could keep it as a souvenir.

When I turned around and sat up on the bed, I felt a sharp pain in my right thigh. The physician simply pulled out the needle, as if nothing serious had happened.

Should a physician who administered acupuncture needles on a patient let another remove them?

What if a missed needle gets thrust deeper into a patient's acupressure point when he rolls over to get up?

Would it cause great injury?

I hope what I had experienced was just a sharp pain. I did not take the souvenir.

Lim Chye Hin

Such, perhaps, is the price of being 'mainstream'.

TCM has finally 'arrived'.

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  • :)

    By Anonymous Med Stu, At December 01, 2007 12:09 am  

  • I guess before I studied acupuncture I would have laughed my guts out and probably said the TCM physician deserved it etc etc.

    But as a practising acupuncturist, my perspective of this complain is slightly different.

    By Blogger Dr Oz bloke, At December 01, 2007 12:32 pm  

  • Do you mean that as a practising acupuncturist, you think that it is acceptable to not notice that a needle has not been removed?

    By Blogger angry doc, At December 01, 2007 5:11 pm  

  • Nope I don't think that's acceptable.

    However it is quite common that the person who removes the needles is different from the one who inserts them. (as far as my clinical attachments showed)

    Missed needles are also quite common and apparently most patients are quite ok with it! (I said I don't think it is acceptable but have seen that quite a number of patients think is it ok!)

    In this case I am not sure what the complaint was about.

    Was it about missed needles?

    Or was it about having different people removing and inserting the needles?

    Or was it about the worry that when he sat up the needles might have gone deeper?

    As with most complaints regarding the health care sector, miscommunication is often the main problem.

    By Blogger Dr Oz bloke, At December 01, 2007 10:39 pm  

  • "Missed needles are also quite common and apparently most patients are quite ok with it!"

    Like I said, expectations seem to be changing...

    By Blogger angry doc, At December 01, 2007 11:24 pm  

  • I think the problem is with modern western administration. Nowadays the administration at clinics and hospitals are just concerned with administrative convenience rather than the welfare of patients. The practicing doctor or physician should complete the treatment with the patient and even better still, be the one to attend to the patient the next time round.

    By Anonymous Layman Doc, At December 26, 2007 1:05 am  

  • Oh dear, nobody's seeing the real problem.

    dr oz bloke is more concerned over trying to identify what the original complainant, Lim Chye Hin, was really concerned about. That, to me, is the least of problems when we discuss his case in blogsphere.

    Others suggest that the same doctor should follow up on removal of needles that he had inserted. Nothing wrong with such a sentiment, except that it's icing on a cake.

    Let's get the basics right first - needles that are inserted into a patient must be removed professionally without the need for a patient to find the needle when he or she experiences pain from it. Let's get this right first, yah? before we debate what Lim wanted, or if the same doctor should follow up...

    After one month and six comments, nobody has pointed out that whoever inserted the needles should write out the total number of needles on a chart bedside? Sheeh!

    And the person who removes the needles should write out the numbers and tick on the same chart?

    By Anonymous Robert L, At December 27, 2007 12:33 pm  

  • robert,

    You don't give Dr Oz Bloke enough credit.

    Medical errors occur daily.

    Patients file complaints daily.

    However, not all medical errors result in complaints, and not all complaints stem from medical errors.

    Your suggestion is a practical and easily implemented system to reduce the incidence of missed needles in the future, but even then it is not foolproof as any miscount by the first or second acupuncturist will still result in a missed needle.

    And if missed needles are as common as Oz Bloke said they are, why is this the first time we read of a complaint on the ST Forum?

    The fact is (and Oz Bloke understands that) most people don't complain about medical errors - they complain about people. That is why Mr Lim felt it necessary to retell how the second physician joked about a 'souvenir', and how he 'simply pulled out the needle, as if nothing serious had happened' afterwards.

    I will even venture to say that in this case, Mr Lim's unhappiness is at the second physician's bedside manners, and that the missed needle merely gave him what he saw as a legitimate fact to base his complaint on. Had he been happy with the second physician, or the way he handled the situation after the needle was noted to be missed, he may not have filed a complaint.

    By Blogger angry doc, At December 27, 2007 5:48 pm  

  • Dear angry doc

    You are right, in more ways than you would ever expect.
    You said that I didn't give Dr Oz enough credit. That is so very true, in fact I didn't give any of the six comments enough credit at all.

    And now, you did not give enough credit to what I had said. I said that accupunturists should write down the number of needles in a chart. If they still make mistakes after that, then you have to agree with me that they are not able to count correctly. From there, it's a perfectly simple conclusion that those who cannot count properly must not be allowed to practice accupuncture any more. Indeed, they must not be allowed to practice in any industry where correct counting is a basic requirement, such as the finance industry or teaching/childcare etc. Heck, even taxi drivers or those at the NTUC Fairprice payment counters.

    By Anonymous Robert L, At December 28, 2007 1:27 am  

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