Patient's Voice in Washington

Dear Editor,

Owing to rising costs of treatment and indifference, many aged persons will be unable to seek timely intervention. Human body undergoes deterioration with age. Therefore timely checks and corrective actions are very much required, that will have the potentials of better health outcomes. A regular medical examination each year for the geriatric population, by picking up diseases in its infancy, can serve the purpose of stubbing out the fire before the flame starts by a careful follow up remedial action. Catching a problem early shall help improve the overall outcome and would also improve patient satisfaction tremendously. A start line has to be determined, say around 45 years, and thereafter regular yearly workups can be done. A detailed workout has to be planned for the elderly as illustrated below:

• History: present illnesses, previous medical illness, hospitalization.

• Family history: chronic ailments, sudden death, medication history.

• Personal history: bowel & bladder, alcohol, smoking, including passive smoking, nutrition, diet and medications.

• Type of medical cover enlisted, medical insurance etc.

• Vital Parameters: Pulse, BP, respiratory rate, standing height, weight, hip-waist ratio, skinfold thickness.

• Mini-mental status exam and rapid psychological assessment.

• Vision and hearing.

• Dental examination.

• Dermatological assessment.

• Systemic examination: cardiovascular, respiratory, central nervous system, dermatological, abdomen including hernia, external genitalia, PR and PV examination (including Papanicolaou smear). Breast examination should be included for females.

• Laboratory investigations: Haematocrit, ESR, urine analysis, stool analysis including tests for occult blood, blood sugar, urea, creatinine, lipid profile, liver function test, thyroid profile, PSA in males.

• Plain X-ray chest.

• Resting ECG.

• Pulmonary function tests.

• Dual energy x-ray absorptiometry for early detection of osteoporosis.

By adoption of this new system, there would be a tremendous burden on the health system initially. However with time it would be realized that having detected any budding problems and having taken due care of it, the overall workload thereafter shall reduce tremendously. Depending on the prevailing health status and the burden of diseases, the above recommendations can be suitably altered. This will definitely improve upon the health status of the aged, disease limitation/arrest, improved quality of life, leading to better clientele satisfaction levels and also decreasing the overall cost to the exchequer and the insurance agencies. Moreover, by and large the world tries to follow whatever your country does, and maybe this can kick start a change globally for the aged and the helpless.

With regards.

• Dr. Rajesh Chauhan. MBBS, DFM, FCGP, ADHA, FISCD, FAIMS.

Consultant, Family Medicine & Communicable Diseases.

• Dr. Akhilesh Kumar Singh. MBBS,MD.

Sr Resident Neurology.

• Dr. Parul Kushwah. MBBS, MISMCD

Family Medicine Practitioner.

• Sandeepa Chauhan

Freelance Medical Reporter & Aid Worker.

• Shruti Chauhan

• Shivendra Pratap Singh Chauhan

Competing interests:   None declared