It is a goal of good medicine to alleviate suffering and not simply cure disease. Listening and understanding are necessary clinical skills. By becoming too emotionally involved with the patient, doctor may lose objectivity; by not becoming involved enough, he may be unable to relate as a human being. Each patient wants to be treated as a person and not as a disease. They want reassurance that the doctor understands all aspects of his or her life and situation. A good doctor needs to have an effective understanding of people and not merely the knowledge of clinical symptoms. The doctor should have ability to stand in a patient’s shoes and convey an understanding of the patient’s situation as well as the desire to help. Increasingly, it is now considered essential to establish trust, the foundation of a good doctor–patient relationship. This will lead to:1) Greater Patient Satisfaction 2) Better Outcomes 3) Decreased Physician Burnout 4) Lower Risk of Malpractice Suits and Errors 5) Saves the Doctor’s Time and Hence Increases Productivity. Unfortunately doctors are too busy with large number of patients and are less inclined to take detailed history or give a thorough physical examination. They try to eliminate the human aspects in the equation and treat the patient as an object. This results in a generally negative state of affairs. Patients resent it, and on the contrary, desire to be listened and understood by the caregivers.

Some of the other reasons doctors aren’t sufficiently attentive are :

  • Medical students experience more humiliation and neglect than care and support from those that teach them.
  • The focus of medical education is learning facts about diseases rather than learning how to understand people with diseases.
  • Medical institutions pay little attention to the social and political determinants of health and ethical and affordable issues.
  • There is a severe lack of role models for doctors. One study found that 34% medical students identified a lack of good role models.
  • The undergraduate curriculum is very vast, and the working conditions of medical staff put extreme pressure on them.
  • Medicine has an increasingly competitive environment.
  • The current environment is an increasingly threatening one. Threats cannot make healthcare workers more compassionate.
  • There is a loss of continuity of care, which is essential for relationships to develop between patients and professionals.

The essence of practicing medicine is to make sure that the patient comes first, i.e, their problems, issues and feelings must be the foremost priority. Commercial aspects will be taken care of in due course. Some of the skills to practice medicine are given below:

  • Listen to the patient attentively. Make eye contact with the patient, not your computer or mobile phone.
  • Don’t stand over a hospitalized patient; pull up a chair.
  • Don’t conduct a monologue in off-putting medical jargon.
  • Pay attention to your tone of voice, which can be more important than what is being said.
  • When delivering bad news, do so when you have ample time and do not allow interruptions.
  • Find out what the patient is most concerned about and figure out how best to address that.
  • Use the right words while communicating, e.g.: “This must be very difficult for you” or “I wish I had better news for you” after delivery of bad news.

Good communication and adequate information is the key

 

Some would argue that to give so much attention to each patient would be emotionally draining and difficult under time constraints that most doctors currently face. That argument is not untrue, but a balance has to be struck. Though it is desirable that a doctor is a good listener and communicator with patients and his families, colleagues, and social community, but in reality this is hardly true.  Some manuals emphasize on a doctor’s ability to communicate with patients and showing respect and attention to patient’s preferences, values, prior experiences, ethical beliefs, confidentiality and privacy in a manner that encourages patient’s participation in the treatment and helps in decision making. According to World Health Organization (WHO), a physician must possess the following five characters; a caregiver who assesses and improves the quality of care, who makes optimal use of new technologies, who promotes healthy lifestyles, who reconciles individual and community health requirements and who is able to work efficiently in a team. Clinical community has finally understood that to inculcate these qualities in a physician, there is an ardent need of extensive training on communication and attitudinal skill among clinical learners.  Keeping in mind this need of the hour, many countries including India, are encouraging course modules on communication skill in parallel with their clinical curriculum. Use of electronic mode of collection and analysis of clinical data is an emerging and very useful technique that saves time and improves the accuracy of the analysis.  There are healthcare support systems available that give out educational resources customized for specific patients on just a click of the mouse.  There are apps and software that helps in self-management of many diseases that needs continuous self-monitoring by patients.  One example of such an internet-based System is ‘Diabetes Management System’; patients have an account with their healthcare provider and are encouraged to log into the system from home to upload their blood glucose meter readings.  Patients are taught to access their own data, consult the physician, schedule their checkup dates, and thus remain actively involved with their own care. But one has to keep it in mind that a clinician’s responsibility does not end just by sharing information, but he must ensure that the patient has understood and imbibed the fact within him.

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