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29 Mar 2024, Edition - 3181, Friday

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Columns

Becoming a doctor of excellence

Covai Post Network

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This is a simple consolidation of a few qualities I have admired in many doyens in the field of medicine and what I expect as a patient while visiting other doctors for treatment for my ailments or for those of my near and dear ones.

I don’t intent to dissect anyone’s attitudes or attributes, or suggest changes for each other’s betterment. I also do not intend to hurt the sentiments of anyone. This column is a reflection of my my personal perspective, and I welcome different perspectives through your comments and suggestions.

In the last column—a brief one—I put forth my views on how certain changes in patient behaviour could make a great impact in the doctor-patient relationship. And for any relationship to be successful, changes are needed on both ends and the same definitely applies to the doctors’ side as well.

As I mentioned the importance of clear communication of symptoms to a doctor in my previous column, having a good ear to the complaints of patient is of utmost importance. Yes! While we probably have a pile of patient files waiting to be seen and cleared, I believe the one sitting in front of us is probably the most important, as he may have waited for hours for this opportunity to express his problems and listen for a possible solution.

Of course, many symptoms may not make much sense in the evaluation and the management pathways, but what one expects is a simple consideration of his/her problems.

Why do we need to do this? After all, the first impression is the best impression, and this good first impression ignites confidence. I strongly believe that it is this confidence that will eventually help us when we are unable to reach a diagnosis or even protect us when our treatment fails, especially in the background of serious complications.

Clarity of explanation is not important just from the patient. Is it not important for us doctors to clearly explain the tests needed and the reasons behind doing these tests? I remember my undergraduate days, when I took my rounds with a senior paediatrician with great academic knowledge. He would consider the many different possibilities of treatment and order complex investigations in trying to crack some of the rarest diagnosis. Most often, he succeeds.

But the person listening would be an anxious mother who would be unsure of what was happening with her child. The doctor would just say, “Let the reports come, we will see.” Doesn’t the patient who spends his/her hard-earned money on treatment have the right to know what treatment they are for, even if it subsidised government care?
Medicine is an art and a science. Art is the human element, where anything could go wrong, and science is still incompletely understood (I really don’t think we will be able to know the human body completely ever).

At the same time, when we expect our patients to accept complications as part of any intervention, we also need to be communicative of the possible complications that could happen with any intervention. We may argue that if we list all the complications, the patients will run away. The logical way will be a clear communication in a way that it doesn’t scare them, which becomes easier after initial confidence has been gained. This could also potentially save us from being seen as a criminal after a possible complication has occurred.

Although there could be many areas that we can keep discussing, I feel this last issue is probably the most important. I refer to the constant update of knowledge. Today, we are in the era of evidence-based medicine and evidence keeps throwing new ideas and concepts, sometimes even dispels certain things we might have believed for decades.

For example, nil by mouth was the basic principle for pancreatitis for years, now with accumulating evidence we now know that except for severe acute pancreatitis, patients shall be fed my mouth to preserve the gut immunity.

We can find many such examples in medicine .We also need to understand and accept that evidence doesn’t mean a single piece of publication from some random white guy. Evidence is consolidated evidence with detailed analysis on regional applicability for the betterment of patients. Many concepts what we have read in our graduate, post graduate or even in super-specialty may have dusted and gone, hence keeping pace with the growth of science is of utmost importance to make a doctor of excellence, I believe.

The patients have already given us a great place, we may just need to hold on to it strongly.

Disclaimer: The views expressed above are the author’s own

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