Dr A K Khokhar, Professor (Hospital Management) and Dean (Training), International Institute of Health Management Research, New Delhi speaks about the needs for doctors to evolve as responsible healthcare leaders who have a patient-centric approach in providing care
Over a period, there has been a tremendous change in society’s approach and attitude towards medical professionals. There was a time when doctors were considered next to God and patients blindly followed their advice. Rapid industrialisation, technology transformation, spread of knowledge through internet, artificial intelligence, and easy availability of information/ misinformation about medical facts and varied methods of medical treatment have brought about a crisis of confidence between doctors and patients. Sociological and technological advancement in last few decades have not only changed the standard of living of people but have also brought about massive changes in healthcare. With fast-paced changes, demanding patients, regulatory bodies and media intervention, doctors are feeling the pinch of lack of trust in medical services and have lost their traditional relationship with patients.
Doctor’s Dilemma
Today, with frequent incidences of violence against medical professionals, doctors are feeling threatened and are working under stress leading to a crisis in delivery of medical/ healthcare services. Today’s generation of doctors are “the most challenged by moral choices in perhaps a century– and physician must break their silence or assist the harm that silence perpetuates because, there is no third choice”- writes Don Berwick, Former (MS Administrator in JAMA).
The ethical issues in medical practice require respect for autonomy of the patient. They need to provide required information about patient’s ailment and available treatment options. Informed consent must include all possible complication so that patient is mentally and psychologically prepared to choose and accept the offered treatment.
Continuing Education
Good medical practice require doctors to be familiar with latest development in their respective field. Continuing medical education and training are vital to their development. They need to continually update their knowledge, skills and practices to provide quality medical care expected from them by their patients and by society at large.
Enunciation of ethics does not automatically result in ethical practices. The ethical practices need to serve the society as a whole and this at times calls for sacrificing the personal and financial interests of individual doctors. There is a need to avoid all malpractices prevalent in the profession.
Patient’s Affordability
The paying capacity of a patient’s vis-a-vis the treatment/ prescription is another issue that medical professional needs to consider. The affordability of required medical care must be given priority in order to make universal healthcare available to all. Doctors themselves are a part of society and the medical community. There is a need to adopt blameless strategies towards their colleagues as well as towards the society as a whole. This requires honest transactions.
Fundamental Values
Medicine will continue to evolve around societal, technical, and demographical changes. The medical profession has to identify potential challenges and respond to shape its practice accordingly. It has to aim at developing trust amongst patients, respect for human life, continuing upgradation of skills, safety, quality and team spirit. Fundamental values like compassion, kindness and caring attitude are at the heart of good medical practice.
Today’s doctors must decide, based on their conscience, what to do in certain situations about issues which may not have been taught in their medical curriculum. Physicians must work as a team in delivering good healthcare. This requires interpersonal skills, besides the technical skills of medical treatment. Further, it requires the medical professionals to think beyond their clinics/ hospitals and see themselves as part of the total healthcare system involving health professionals and the community at large.
Holistic Approach
To be an effective doctor today, he/ she will have to look into the holistic aspects of healthcare as well as of healthcare management. This requires that some important issues related to health management/ hospital management viz human relations, leadership, legal and ethical issues are incorporated into the undergraduate medical syllabus itself. Those already in practice, need to acquire, these professional skills through short-term management development programs/ training on health and hospital management. Doctors who would be involved in management of the health institutions should take up professional course in health and hospital management. Many institutions are providing MBA/ PG Diploma in such subjects and in service training to doctors to address these issues. To conclude, today’s doctors need to have emotional quotient and humanitarian approach in addition to management skills and technical knowledge of medicine and medical procedures.
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