How to choose your surgeon or physician?
In India, we are lucky that we can choose our own doctors and the place of treatment. The downside of this is that you have to know more about what your doctor is and what your hospital stands for, as there is no regulatory authority. In this blog, I have written a general guideline of how to know more about your doctor so that communication and mutual understanding grows. As a person who has loved to be a surgeon, I see the problems of miscommunication and crass commercialism destroying the very foundations of medical practice.
One of the foundation principles of medicine is written like this in french: "Guérir quelquefois, soulager souvent, consoler toujours". It means to cure sometimes, to relieve often, to comfort always. I found these words as a medical student and sort of memorised it. It has grown with me during these 20 years and guided the principles of practice. Medical science seems to be rapidly advancing and technological revolutions have brought many changes at the way we look at disease. But the perspective of the patient is the most important in medicine. Somehow, science seems to forget it and needs to rediscover the actual purpose of its existence.
The three primary marks of a doctor: availability, empathy and ethics decide whether you are in the right hands. Note that I have not placed any importance to knowledge and skills at this particular point of time. These are basic characteristics and do not change whether you are a transplant surgeon or a general practitioner or a psychiatrist. A problem in this aspect will lead to wrong treatment choices even in the presence of skills and knowledge. Extra ordinary skills and knowledge are a waste if your doctor is not available for you at the time of your need. Now I am not saying that a patient can walk in at any time and expect the doctor to attend on him. But if your disease condition needs the doctor's presence, he must be available to you. One of the surgical teachings to select the right surgical resident goes this way -"Don't give me a guy with straight As, Give me a guy who will get up from the bed at night". Availability is primary.
The second important attribute to your doctor is empathy. Inability to see the disease through the patients eyes results in harsh unrealistic medical decisions by physicians and surgeons. It is important to provide scientific medical care, but much more important is to actually care for the patient. It is a state of connectedness with the patient, a conversation that goes beyond the words you are saying. I am unable to find a better description to go for that word.
The third important character is ethics. Now this is a buzz word that has caught headlines in many medical and non- medical journals. Ethics in medicine is defined as guidance principles of good conduct in patient management. It speaks of the motives behind the different aspects of the patient physician encounter. We treat patients so that they get the benefits of our experience and knowledge in medicine. Motives other than this may exist, but is irrelevant in the practice of medicine and surgery.
If these are the primary requirements of good doctoring, then why do we need to study for long years to get the necessary degrees and taining. Well, that brings us to the next set of things you must assess: Knowledge and Skills. Doctors undergo five and a half years of training to obtain the primary degree MBBS. Post graduation for Masters degree is for three years, a diploma is for 2 years and the specialisation is for another three years. A total of 11 - 12 years of study is required for the doctor to obtain the specialty degree in India. The time duration of these programs vary all over the world.
But knowledge is simply more than a degree. Medical knowledge adds 3 miles of publications each year. The information is simply explosive. The eleven years of training provides the surgeon and physician with a frame work of knowledge that can be applied to the patients to solve their individual problems. Applying these knowledge pearls to clinical situations leads to a clinical process. It is in creation and execution of the clinical pathway, you can distinguish a knowledgable person from the rest.
The skills set is also important for surgeons. Just like the clinical pathway, the surgical care involves translation of a set of surgical skills into the protocol of a well executed operation aand post operative care. Also this involves a knowledge of the different surgical options in different stages of the disease. It is a tall calling indeed.
Remember, lack of knowledge and skills at least will improve with time. But a wrong attitude is really difficult to change.
Have a great day.
One of the foundation principles of medicine is written like this in french: "Guérir quelquefois, soulager souvent, consoler toujours". It means to cure sometimes, to relieve often, to comfort always. I found these words as a medical student and sort of memorised it. It has grown with me during these 20 years and guided the principles of practice. Medical science seems to be rapidly advancing and technological revolutions have brought many changes at the way we look at disease. But the perspective of the patient is the most important in medicine. Somehow, science seems to forget it and needs to rediscover the actual purpose of its existence.
 |
| Surgery in progress at a rural general hospital in North India. Doctors in small mission hospitals in North India have consistently met the needs of the local population for a long time at an extremely low cost. |
 |
| Surgery in progress at a Mission Hospital in Chennai. Surgeries can be performed with simple and caring hospitals, and provide the same outcomes as the more posh and comfortable ones. |
The second important attribute to your doctor is empathy. Inability to see the disease through the patients eyes results in harsh unrealistic medical decisions by physicians and surgeons. It is important to provide scientific medical care, but much more important is to actually care for the patient. It is a state of connectedness with the patient, a conversation that goes beyond the words you are saying. I am unable to find a better description to go for that word.
The third important character is ethics. Now this is a buzz word that has caught headlines in many medical and non- medical journals. Ethics in medicine is defined as guidance principles of good conduct in patient management. It speaks of the motives behind the different aspects of the patient physician encounter. We treat patients so that they get the benefits of our experience and knowledge in medicine. Motives other than this may exist, but is irrelevant in the practice of medicine and surgery.
If these are the primary requirements of good doctoring, then why do we need to study for long years to get the necessary degrees and taining. Well, that brings us to the next set of things you must assess: Knowledge and Skills. Doctors undergo five and a half years of training to obtain the primary degree MBBS. Post graduation for Masters degree is for three years, a diploma is for 2 years and the specialisation is for another three years. A total of 11 - 12 years of study is required for the doctor to obtain the specialty degree in India. The time duration of these programs vary all over the world.
But knowledge is simply more than a degree. Medical knowledge adds 3 miles of publications each year. The information is simply explosive. The eleven years of training provides the surgeon and physician with a frame work of knowledge that can be applied to the patients to solve their individual problems. Applying these knowledge pearls to clinical situations leads to a clinical process. It is in creation and execution of the clinical pathway, you can distinguish a knowledgable person from the rest.
The skills set is also important for surgeons. Just like the clinical pathway, the surgical care involves translation of a set of surgical skills into the protocol of a well executed operation aand post operative care. Also this involves a knowledge of the different surgical options in different stages of the disease. It is a tall calling indeed.
Remember, lack of knowledge and skills at least will improve with time. But a wrong attitude is really difficult to change.
Have a great day.
Comments
Post a Comment