Our body consists of physique, mind, intellect, memory, ego and soul. We, therefore, have our physical profile, mental profile, ego profile and a soul profile.
Our soul profile makes us calm, compassionate, caring, smiling with full of empathy. Our ego profile (controlled) on the other hand makes us behave like a well dressed and self-disciplined gentleman.
Patients want us to live up to our soul profile and be compassionate with them and practice empathy and not sympathy.
To practice conscious-based medicine, one needs to control one’s desires and detach oneself from the results of action and from attachment to the patient and the worldly atmosphere.
The job of medical associations and the councils should be to educate medical graduates to become compassionate physicians and if that is not possible, they should at least inculcate etiquettes and habits to make them learn good behavior.
The new terminology for intellectual profile or skill based profile is now called etiquette based medicine which prioritizes behavior over feeling, stresses practice and mastery over character development and puts professionalism and patient satisfaction at the centre of the clinical counter and brings back some of the elements of the rituals that have always been important part of healing profession.
It is simpler to change behavior than attitude. Training of etiquette-based medicine complements with physicians becoming more humane. However, the aim should not be to make etiquette-based medicines a priority over compassionate based medicines.
The first step in etiquette-based medicine is to learn good manners and good bedside skills. It includes patient-doctor communication and details of explanations at admission and discharge or declaring deaths.
For example, when you are meeting a patient for the first time at the time of hospitalization, you may not be compassionate but at least you can follow the following:
· Acknowledge the patient and ask permission to enter the room and wait for an answer.
· Introduce yourself – shake hands and let the patient know your name.
· Sit down near the patient and smile.
· Explain in detail your role in the team.
· Explain about the time, duration of everything of your plan.
· And lastly, always thank him for giving you an opportunity to serve the patient.
Such a checklist is clear, efficient to teach, evaluate and is easy for anyone to practice. It does not address the way a doctor feels but at least it disciplines us how to behave.
Let our patients not start writing in the suggestion cards as under:
· My doctor was not with me during consultation.
· My doctor never smiles
· I have no idea to whom I was talking to.
· My doctor did not look in my eyes even once.
· My doctor was all the time receiving phone calls on mobile
· My doctor’s concentration was on the computer screen.
(With excerpts from Dr. M.W. Khan, MD, New MEJM 2008; 358, 1988-89, May 8)