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)
very good suggestions which are the basic rules in practice
ReplyDeletevery important basics for a good doctor patient relationship
ReplyDeleteThis is all possible by appropriate behaviour on the part of the faculty during UG and PG training in medical schools. The students learn what they see. Unfortunately in busy Govt Medical Colleges with patients far in excess of medical personnel and their time it is often not possible. Ofcourse these etiquettes are learnt quickly by physicians in private practice as it is a necessity for their survival.
ReplyDeleteThis is all possible by appropriate behaviour on the part of the faculty during UG and PG training in medical schools. The students learn what they see. Unfortunately in busy Govt Medical Colleges with patients far in excess of medical personnel and their time it is often not possible. Ofcourse these etiquettes are learnt quickly by physicians in private practice as it is a necessity for their survival.
ReplyDelete