Negligence in ‘General Examination’ of a patient and its consequences.

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One of my relatives had been suffering from dyspnoea with swelling of both feet and legs. As the case might be involving the heart, he consulted with a reputed as well as senior cardiologist of the city of Kolkata. The cardiologist advised investigations like E.C.G, Echocardiography. He also suggested blood tests for Post Prandial sugar, lipid profile and so many investigations excepting a routine blood test for TC, DC, ESR and Hb percentage. All the blood tests done were within normal limits and he prescribed some arbitrary symptomatic medications with full assurance of no damage of his heart. But having no improvement in his symptoms, he consulted with another senior cardiologist of the city. But unfortunately, he also did the same mistake by not advising a routine blood test for TC, DC, ESR and Hb percentage. And the result was that he had to be admitted to a private hospital in a critical condition. In the said hospital, all necessary investigations were done including a routine blood test for TC, DC, ESR and Hb percentage and it was then discovered that he was a victim of severe anaemia. His haemoglobin level was as low as 4.3gm/ dl compared to the normal range of 14.4gm/ dl in males and he needed 4 pints of blood transfusion. What could be detected at an earlier stage by a mere blood test or by inspection after pulling down the lower lids of the eyes was diagnosed after a suffering for so many days and that too after being admitted to a reputed hospital in a critical condition. What is a matter of great concern is that in this era of super specialization, the very basic principle of clinical medicine is grossly neglected. The preliminary ‘General Examination’ of a patient which is taught at the beginning of clinical medicine class to a medical student is usually not applied by specialists who are concerned about their own subjects only and nothing else. So mentality of the specialists should be changed for the benefit of the patients. Otherwise, victims of such gross negligence in ‘General Examination’ will increase day by day and people will have no faith in this noble profession. Do you agree with me?