by S Sharma | 09 JAN 2018
The relationship between a doctor and a patient is a person who is seeking help, and who may be vulnerable, and a person who has the skills and knowledge to help.
According to former administrator of Center for Medicare & Medicaid Services (CMS), today's generation of doctors are "the most challenged by moral choices in perhaps a century"and physicians must break their silence or "assist the harm" that silence perpetuates because "there is no third choice.”
Those choices come in three tiers: personal, organizational, and societal.
Dr KK Aggarwal, National President IMA, Padma Shri Awardee says, “We are doctors, we are demi Gods, we are next to God then we have no business to be inhuman. We not only need to be scientifically and legally correct but also morally and ethically correct. We are supposed to follow two bioethics principles: non-maleficence (first do not harm) and beneficence (welfare of all). Our main business is compassion. It should be demonstrated in practice as much as felt. A compassionate attitude in practice is more important than the science. Poor, inconsiderate and uncompassionate communication is why most patients sue.”
The choices to make during drama by the relatives should be ethical, and convincing and usually depends on the type of situation. “One need to spend sufficient time with the attendants in explaining the prognosis of the disease and any eventuality and this should be explained in very clear terms and shouldn't be giving false hope. And in the case of very sick patients we need to educate the concerned people with the in definitive nature of the disease and medicines,” says Dr Hemanth Kumar, General Physician, Yashoda Hospital.
Current physician not only needs to have clinical skills but due to complex structure of our ever evolving society. He also needs to have leadership and management skills, explains Dr I. Bharat Kumar Reddy, consultant psychiatry, Apollo Hospitals. He says, “Experience teaches you how first to have control of your emotions in any challenging situation. No matter how well you may be prepared for any problem each problem would be different. Always we have to keep our priorities clear. The reputation of organization comes first followed by self. When we deal with a patient it should be assumed that we are dealing with the entire family. Always maintain good rapport with patients family and keep them on board with any decisions you make r this reduces the chance of any drama by them.”
Limitations of a doctor in treating any illness
Doctors can not set a protocol for unannounced problems. “When they arise we need to undo the problem by explaining the cause and it's effects and what remedies were taken to correct them. And having a good relationship with the patient and attendants and the trust they have in the doctor goes a long way in sorting out these kind of situations,” says Dr Hemanth.
To be prepared to face an unannounced problem one has to learn from each problem one faces have a thorough root cause analysis of that problem to learn lessons from it and try to minimise such issues in future.
Have a robust support structure in the organisation to help in diffusing such unannounced problems. When it comes to making a choice between family and work. One has to have a balance between these two.
“It should always be remembered that our total life is not just the profession but a part of the life itself. One need to take care of himself and his family and pursue his own interests. One should be very strict about his professional timings and stick to them and forget about it once it's done. And if one doesn't have enough time to relax one may burnout because of the over work,” says Dr Hemanth. “Spend quality time with your family this will help in reducing everyday stress and prevents burnt out effect,” adds Dr Bharat.
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