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MUMBAI: If infertility treatment sounds like jargon, dial the newest helpline in town and let the recorded voice educate you. Information about health is as accessible and easy as phone-banking nowadays. If the interactive voice recording system on the phone is too distant for your liking, try a comic book for an update on infertility management. Colourful boxes and narration make the most complex medical topics come alive. In fact, comics on HIV\AIDS, infertility and malaria are already available at some doctors' clinics and hospitals in the city.
Welcome to the desi world of patient education; it is no longer an alien concept found only in the West. In the city's clinics and hospitals, doctors and patients themselves are working out innovative ways to disburse health-related information. Dr Aniruddha Malpani launched an infertility helpline two weeks ago because he wanted to offer his patients a bouquet of information hubs. "Our clinic in Colaba has comic books that we specially developed for our patients. But a helpline helps the patient prepare for a session with an infertility specialist," he said.
Health information for patients can now be more than just about Googling on the net. Nutritionist Rujuta Diwekar wrote books on weight-loss and her celebrity size-zero client Kareena Kapoor and made it to the national best-sellers' list. Ghatkopar youngster Parag Vora has created a niche market by making CDs and DVDs on 83 health topics such as angioplasty, Caesarean section or stroke. "Five years ago, I started with eight topics and a handful of doctors in the central suburbs. My CDs are now bought by over 1,700 doctors across the country," said Parag.
Eye surgeon Dr S Natarajan begins his interaction with most patients with a virtual tour of the 3D Eye programme on his iMac. "Patients should understand their problems so that they have realistic expectations from their doctor," he said.
And herein lays the importance of patient education. Research done in leading hospitals in the US has shown that patient education improves communication between health care providers and patients. Studies done for management of chronic diseases such as cancer, diabetes and hypertension have shown that patients who were counseled and given educational material brought their disease in control faster than others who were not.
The evolution of patient education in India has been slow mainly because it doesn't have a sponsor. It is left to the doctors and patient support groups to educate patients. Said Dr Ankit Khambati of Cheeny Kum, a website that provides diabetes management for patients, "Most doctors in India don't spend time educating patients. They are hard-pressed for time. We have tried to plug this gap with our website that provides information and support on management of diabetes."
The Web as a large role to play here. "Technology in India is available at less than one-fifth the cost in the US. We can thus use technology to educate patients," said Dr Malpani, who also offers a web-based SMS service to patients who want to track their fertile days of the month.
Most important, this kind of education provides a reality check for patients, said doctors. "The patient-doctor relationship has suffered in the past because of a breakdown in communication lines. By educating the patients about what to expect from a treatment bridges this gap," said Malpani. Natrajan feels patients don't expect miracles after they are explained the facts of a surgery in a manner that they understand.
Dr Shalini Ratan
Healthcare today is unlike that of yesterday. Today, a medical professional has to face
various challenges like coping with the demands of evolving healthcare services, difficulty in achieving patient satisfaction who are evolving as consumers and overcoming hurdles in practice. Professionals now need to re-think the effectiveness of doctor-patient relationship, be able to understand basic principles of medical practice management, familiarize themselves with healthcare marketing techniques and also acquire soft skills to effectively manage the current situation. All of these therefore require a shift in the mindset of the healthcare providers.
Healthcare professionals face a number of challenges in today’s evolving healthcare environment. This can be attributed to the introduction of new techniques, corporate hospitals, changing mindset of patients and current medical practices. The healthcare market is growing at a rapid pace. Moreover, various hospital projects are slated to begin this year. These changes bring in the need for increasing enrollment of doctors & nurses in medical colleges and nursing schools in the coming years. In this scenario of emerging healthcare, doctorpatient relationship is becoming a transaction oriented practice. Media awareness has increased among patients with regard to medical malpractices, along with the rise in the number of internet-savvy patients who have started questioning the healthcare providers. Further, the corporate hospitals are now presenting a challenge to individual practitioners. At the same time, the potential recipient of healthcare, ie the patient, is evolving as a healthcare consumer and is not just an individual in a disease state. They have demands similar to those of any other service industry consumer. Therefore, the management of the current healthcare environment requires a
‘mindset shift’. Healthcare professionals invest almost a decade to become professionals through rigorous studies & trainings in technical education & internship. However, during the course of this training, the formal medical education system fails to train the doctors in some key skill areas. In order to be highly effective, a doctor needs to learn the art of communication with patients, build a compassionate doctor–patient relationship and be highly efficient in operational skills. Again, since doctors are not groomed in a corporate environment, they need to refine their skills to become Medical Entrepreneurs.
Role of doctors as clinicians Enhancing a doctor-patient relationship is an area of importance today, as it needs to move on from a ‘disease-centric approach’ to a
‘patient-centric approach’. The World Health Organization (WHO) defines health as “A state of complete physical, mental and social well-being, and does not consist only of the absence of disease or infirmity.” According to this definition, for a doctor to be referred to as a ‘Healthcare Provider’, he should provide care for the overall health of the patient rather than addressing only the disease. It is more about managing the patient as a ‘whole’.
As an adage goes, ‘Curing disease needs knowledge and treating a patient needs wisdom’. Therefore, there is a need for a transformation from knowledge to wisdom.
Good communication with patients, family members, caregivers, consultants and referring physicians is absolutely crucial for a sound patient care. According to various studies, byproducts of enhanced communication include improved health outcomes, better patient compliance, reduction in medico-legal risk and improved satisfaction for both clinicians and patients. Failure in providing excellent healthcare communication can lead to an undesirable effect on patient outcome, patient loyalty and reputation of the treating physician. Effective empathetic communication enhances the therapeutic effectiveness of the doctor-patient relationship. It is a learnable skill that has tangible
benefits for both the clinician patient.
Obtaining the knowledge and skills required to perform psychosocial counselling and diseaseprevention, patient interventions is another important area for consideration. Doctors are in an ideal position to offer education and counselling to patients, with
the purpose of preventing and/or controlling disease, better compliance and understanding of the mindbody connection of patients. Patient evolving as a healthcare consumer. Knowledge & understanding of the needs of patients and their families is now more crucial than ever for providing exceptional patient service. Today, medical practice is driven by the combination of patient experience and perception of services provided
to them. This would ultimately help in winning patient loyalty, which indicates commitment to consult a particular medical service provider. Today, a patient demands basic & value-added services from a medical practitioner. Basic attributes like medical expertise of the doctor, modern equipment and procedures are required to retain a patient. Valueadded services providing personal care for a patient’s physical and emotional needs, comfortable stay, communication with the patient, etc, are highly valuable
to create a bond between the doctor and patient. For a patient to become loyal, the ability of the doctor to treat the ailment becomes a basic requirement, while physical & psychological comfort becomes value issues. Therefore, the role of a medical
practitioner today is not only of a clinician and an academician but also of a manager and
executer of excellent medical services.
Role of doctors as practice managers
Now is the time to create clinical leaders who besides having an ethical and moral duty to
the patient also have essential management skills. Doctors should adopt medical practice
management systems to excel in today’s competitive world. It has now become a
matter of being able to integrate managerial and clinical responsibilities in the most
effective manner.
Providing quality care: The leaders must focus on providing quality service.
Quality involves building core competencies of healthcare professionals, patient-centric care, working in team to ensure that care is continuous & reliable, managing processes and systems of healthcare delivery.
Managing the healthcare team
Healthcare is driven not only by the clinicians but the entire healthcare team. In order to
provide complete quality care, the healthcare team comprises a number of other skilled
personnel, eg nurses, secretaries, staff, therapists, pharmacists, dietitians, social workers, various technicians and sometimes even family members.
The doctor is the main decision-maker with required leadership qualities.
For becoming efficient, the medical staff would require training to develop good interpersonal skills, self-initiative, sensitivity and the ability to work with very ill patients. There is a need to equip the staff with an understanding of hospital protocols and processes, infection prevention techniques and managing highrisk patients. Empowering the staff would give them an opportunity to realise their full potential.
Information-based marketing
Doctors and other healthcare providers generally misunderstand the concept of marketing in medicine, often mistaking it with advertising. Information-based marketing describes the capabilities, policies and procedures of medical practice. It gives a perception of professionalism, recognition for the practice and increased visibility, leading to increased customer satisfaction and referrals.
Marketing implies creating a place in the minds of patients with regard to the uniqueness
offered by the medical practice.
Understanding technological change
The Internet age is bringing a transformation in the doctor-patient relationship. There is a
need for empowering and engaging patients in this technology-driven era. This is for
assisting patients in the information gathering process to obtain accurate and valid medical information. Doctors need to become counselors to help patients take care
of themselves.
The role of technology in healthcare is increasing not only in the area of medical diagnosis and treatment, but it has also been documented that information technology
effectively contributes to cost saving by ways of administrative & clinical data processing and health information systems.
Clinic management
Today, a doctor needs to have the knowledge and expertise of medicine as well as equip himself with information and tools that help him in managing his clinic. This would give an overall healthcare experience to patients and enhance the professional image of the clinic.
The bottomline is that, today, a doctor requires the mastery of a complex body of knowledge, patient service skills as well as the art and humanism of medicine. This can be achieved by revamping the doctor–patient relationship, from being a healthcare advisor to the patient and not just a provider, to developing corporate thinking by opening to new learnings and branding medical practice by using avenues to promote themselves in an ethical manner.
(mmedit@infomedia18.in)
Doctors Please Click on image to subscribe to MD Consult:Good dental hygiene habits should begin before your child's first tooth comes in. Wiping your baby's gums with a soft damp cloth after feedings helps to prevent the buildup of bacteria. When teeth appear, start using a soft children's toothbrush twice a day.
Once your child is preschool-age, start using fluoride toothpaste. Don't cover the brush with toothpaste; a pea-sized amount is just right (see picture above). Young children tend to swallow most of the toothpaste, and swallowing too much fluoride toothpaste can cause permanent stains on their teeth.
Fluoride helps make teeth strong by hardening the tooth enamel. Many cities are required to add fluoride to tap water. If you live in an area where the tap water doesn't contain fluoride, your doctor may prescribe daily fluoride tablets when your child is about 6 months old. Fluoride is an important part of your child's dental health, but don't give him or her more than the directions call for. If you miss a dose, don't give your child extra fluoride to make up. Just as with swallowed toothpaste, too much oral fluoride can cause stains on your child's teeth.
Cavities are holes that are formed when bacteria (germs) in your mouth use the sugar in food to make acid. This acid eats away at the teeth. Cavities are the most common disease in children. Good tooth care can keep cavities from happening in your child
Your child might be at risk for cavities if he or she eats a lot of sugary foods (such as raisins, cookies and candy) and drinks a lot of sweet liquids (such as fruit juice and punch, soda and sweetened drinks). Your child also might be at risk if he or she has any of the following risk factors:
Was born early (prematurely) or weighed very little at birth (low birth weight)
Has ongoing special health care needs
Has white spots or brown areas on any teeth
Does not go to the dentist very often
Everyone in your family should take good care of their teeth. Family members with lots of cavities can pass the cavity-causing bacteria to babies and children.
Teeth should be brushed at least twice a day and adults should floss once a day. Everyone should see the dentist twice a year. Have your doctor or dentist show you the right way to brush your child's teeth.
Yes. Avoiding sweets, sticky foods and between-meal snacks is good advice. To avoid cavities, limit sweet snacks and drinks between meals. Have meals and snacks at regular times. Teeth-friendly snacks include fresh fruits and vegetables, and cheese and crackers.
Baby bottles can create additional problems with your child's dental health. When liquid from a bottle--like milk and juice--stays in contact with the teeth for a long time, the sugars cause tooth decay. This can create a condition called bottle mouth. Your baby's teeth can develop cavities and become pitted or discolored. Never put a baby to bed with a bottle, unless it contains plain water. Don't let your child walk around during the day with a bottle, and teach your child to use a drinking cup around his or her first birthday.
It's normal for children to suck their thumbs, their fingers or a pacifier. Most children give up this habit on their own by age 4, with no harm done to their teeth. If your child still has a sucking habit after age 4, tell your dentist. Your dentist can watch carefully for any problems as the teeth develop. In most children there is no reason to worry about a sucking habit until around age 6, when the permanent front teeth come in.
The American Dental Association recommends that parents take their child to a dentist around his or her first birthday. This gives the dentist a chance to look for early problems with your child's teeth. Pediatric dentists specialize in treating children's dental health. You and your child's dentist should review important information about diet, bottles, tooth brushing and fluoride use. Visiting the dentist from a young age will help your child become comfortable with his or her dentist. It also establishes the good habit of regular dental check-ups.
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