Tuesday 23 June 2015

A Promise by a Future Doctor.


Think for a minute honestly.
Is it you who chose which bank account to open and what to do with it?
Is it you who decide/d what you want to be taught (atleast in college if not school)?
What you want to eat when you're sitting at your favourite restaurant?
Where and how your house should be built?
What mobile offers you want? Or what internet plan you want?
I bet your answer would be a "yes" to most of these questions.

But is it you who decide what treatment is appropriate, what tablets to take, for how many days, what alarming signs you should look for and when should the treatment be changed for your particular illness? (unless you are a doctor yourself, it would be a "no")
Do you now see the problem I do? 

For the efficient delivery of any tertiary sector service, the participation of both the parties, the service provider and the receiver would be important. Then why should health sector be an exception to this? Why should we dump the complete responsibility of treating an illness on a doctor and make it inefficient? (unless the doctor is a superman :P).
I believe it's easy for health sector to become a one sided participation because of the low health literacy among the common people.
The importance of letting the patient know what your treatment plan/regimen can not be overstressed especially when it comes to management of chronic illnesses and while dealing with many co-morbid conditions .
This example might explain it better.  
Suppose I started treating a patient Y for a particular condition and I have the protocol of management clear in my mind."5 days of injection and then I'll switch to oral therapy for a month", I think and prescribe the injections for 5 days forgetting to tell him my complete plan or to document it anywhere. Y comes to me after 5 days with a new symptom of his illness. Now I get involved in the management of the new symptom completely forgetting to put him on oral therapy for the previous problem as thought earlier.
Let me rewind and change the story a bit.
Lets say I prescribe him the injections for 5 days and take an extra minute to tell him my plan of switching to oral therapy after 5 days and document it.
And the story follows: X comes to me after 5 days with a new symptom which I'm concentrating on. But then he also tells me, "doctor what about the oral medication you had told that you'll be starting?" Or I notice his previous record in which I've documented my plan.
Didn't that help me and the patient in turn in the efficient management of his condition?
I've heard people gobbling pills for unnecessarily longer duration. For instance my mother herself was taking tablets for carpel tunnel syndrome for longer than the requirement which we realised only after our visit to the doctor after a long time.

So before I become a doctor, and forget what I'd once decided to do, I wanted to make this promise. To deliver 100% quality service, I'll make sure I spend that extra minute in documenting and explaining to the patients what they need to know so it makes their life and our job easier!
I promise.
       

2 comments:

  1. The value one creates by documenting (writing down) and communicating one's ideas/plans/motivations are sometimes much more than the ideas themselves. And not just doctors, most people fail to see this incredible hidden value.

    This is information age. And what was just documentation in the past can now be called data. Data is the raw material for creation of knowledge. Doctors are among the last people to realize what information science can do in curing diseases.

    It should be a crime to leave things unsaid.

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    Replies
    1. True Akshay :)
      Imagine an app where the doctor writes the regimen and treatment history, course in the hospital etc. and the patient can access his information from his device :D (that would just be a replacement of the file system we have) Probably that's how it works in the US?

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