Just occasionally, when the media run a “bad doctor” story, the doctor is actually bad. Such is the story of Sajan Bhatia, the disgraced Southland urologist, who has apparently continued to practice as a doctor long after the medical council refused to renew his practicing certificate. This is the medical equivalent of a hanging offense.
Bhatia is a colourful and often highly annoying character. Not in the “cheerfully inane” category of Tim Shadbolt, but in the “spectacularly arrogant” category – the kind of person that assumes Galileo was wrong and that the earth actually revolves around them.
Every doctor who has worked in Southland, including the MacDoctor, has a Bhatia story. My personal favorite is the time one of our ED doctors attempted to call Dr. Bhatia, who was the on-call urologist, only to find he was deep sea fishing off the coast of Otago somewhere! My relationship with the man was irretrievably damaged when he refused to come in and see a patient who was seriously ill with sepsis, only later to make out that his registrar had not made the seriousness of the patient’s condition clear to him. Unfortunately for him, I was standing next to the registrar when he made the call and could vouch for the registrar’s version of events. I don’t think he spoke more than three words to me in the 18 months I remained working in the ED in Invercargill. He even went as far as to put the phone down as soon as he heard my voice.
So why am I telling you my Bhatia stories?
Because it illustrates (in the worst possible way) the problem of rural doctors practicing in isolation. Bhatia could probably have practiced safely in a large hospital (though his registrars may have hated him!) But the effect of a supremely arrogant and independent maverick practicing in complete isolation was that a feeling of invulnerability and infallibility slowly came over him. After many years of being the only urologist in Southland; having no-one to correct him, he became increasingly careless, taking more and more shortcuts until one caught up with him, leading to his disciplinary hearing with the medical council.
The sad thing is that originally he was a good urologist. He probably still is capable of being a good urologist again, but the isolation process has been allowed to go on too long. You can see this from his attitude to the conditions that the council set to allow him to continue to practice. They were not onerous:
He was also ordered to practise under conditions that he join a peer review group, undergo a clinical audit and practise under the supervision of a urologist.
These are very similar to the conditions under which I practice as a foreign doctor on the general register (my audit conditions are much easier but I have to be in a peer group and have a vocationally trained doctor oversee my practice). I have not found these conditions particularly troublesome in the 14 years I have lived here, yet Sajan Bhatia could not even do them for a single year. It is doubtful whether he even attempted to fulfill any of the conditions. Apparently, he just continued to practice as if nothing had happened. In his world, probably nothing had.
Even the question of when he knew his practicing certificate would not be renewed has been obfuscated by him. He claims he only knew in May when the letter from Medical Council arrived telling him to stop practicing. This is codswallop. Every doctor knows that you can’t practice without a current APC. It is simply unbelievable that he would not have realised that the renewed certificate had not arrived. It is even more unbelievable that he would not have realised that his non-compliance with his disciplinary conditions would render him ineligible for a new APC.
This sad story underlines once more the reason why specialist services are gradually concentrating into a few large tertiary hospitals. Isolated practitioners eventually burn out and become a danger to themselves and patients. Some manage extraordinarily well in rural situations, but the qualities that make a good surgeon count against the survival of rural surgery.
The days of Lone Ranger medicine are numbered.
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