Archive for the ‘Health Care’ Category

Who makes a successful Doctor? Afia Mansoor

Monday, December 14th, 2009

There is no escaping a doctor. One encounters all sorts of them. The pediatrician, the dentist, the vet and so on. But there are reasons we keep running into the same doctor frequently apart from the reason that we or our loved ones get ill.

 

What is it that makes us go to a particular doctor for our treatment, despite so many others out there with the same specialization? What is it that makes a doctor really successful?

 

Measuring Success:

Is success a measure of wealth?

 

Does that mean a successful doctor is wealthy and vice versa?

 

The reason why a doctor becomes one is to treat patients for illnesses, not to become rich. It is a given though, that the one who does his job well has profoundly more chances of getting rich. So a successful doctor is not one who earns pots full of money each day; it is one who treats his patients well.

 

I avoid the words, ‘cures the patients well’ as a successful doctor will not try to define outcomes, but he will try to do the job as best as he can given his knowledge and skill. He knows that his knowledge is limited in case it is a disease the cure for which has not been found. But that does not deter him from trying his best to cure the illness with the minimum side effects on the patient’s health.

 

Given that one is qualified and skilled in his profession, some additional attributes that make a doctor truly successful are:

 

Being human

Fore mostly, a successful doctor must first be a good human being working with the benevolent intent to serve the patient. Whether it is about breaking bad news to the patient or convincing him of a treatment procedure, the key is to do to the other as you would have it done to you.      

 

The Element of Care:

The doctor who takes genuine interest in the welfare of his patient will be more likely successful than the one who is merely concerned with attempting to remove his patient’s illness.

 

My son’s pediatrician’s is a very successful doctor if you measure it by the number of people coming to his private clinic for a consult. The reason why I take my 3 year old to him is that he avoids giving medicine to him unless it is absolutely essential.

 

Many a times, he sends me off with only a suggestion of patience and a list of natural remedies that eventually cure my child’s viral illnesses. He reads up on latest medical research and backs it with the most natural substitutes he can come up with. When he has to administer stronger medicine, he explains its need to me carefully and is always very friendly to my son. I trust him for my son’s health because of his genuine concern.

 

Over a period of time, I have also noticed that hospitals and doctors who maintain a database of their patients themselves, with a view to ease their next appointment or maintain a comprehensive history, also have a loyal clientele. Procedures like these tell the patients that they are cared for. 

 

Unconditional Service

Another immensely successful doctor in Lahore is a young homeopath. The striking feature of his clientele is that it comprises of rich celebrities and impoverished nobodies simultaneously!

 

This doctor does not discriminate on the basis of the client’s financial status while treating. He maintains a detailed database of each patient, does not charge those who cannot afford to pay, is extremely docile to all and insists all patients gives him a phone call after the first few doses to tell him how they are.     

 

Now that is Care and Unconditional Service to me.

 

Humility

The word doctor is derived from docere in Latin. It means to teach and also means to be docile!

 

There is no end to knowledge really. You cannot stop learning and you cannot stop giving it back as service. The doctor who is arrogant and rude is the antithesis of the giving messiah!

 

I have noticed at OPD clinics, that the most crowded waiting areas are for those doctors who are the most humble and kind to the patients. People are willing to wait for hours to get to talk to these angels who are really good at listening. They grant significance to the patients.

 

This humility also goes a long way in making a doctor successful if each case is treated uniquely. Many a times, patients have to go through the torture of a misdiagnosis because the doctor impatiently attributes the symptoms to earlier observations of similar cases or has not been thorough enough in investigating the symptoms in further detail.

 

Once, I landed up at a doctor’s clinic for an internal infection. On examining, she gave a colorful verbal description of the scale of damage. She failed to explain how various symptoms were linked and brushed it aside with the sweeping suggestion that a surgery would cure it all and that I should be admitted next week because that’s when she had time to accommodate a surgery. When I asked her if the surgery would hurt, she replied, “Obviously! That’s why I’ll sedate you.” I was scared. 

 

I went for a second opinion to another doctor. She recommended surgery without colorful comments. When I put the same question to her, she replied very sweetly, “You will not feel a thing because you will be sedated.” She suggested some more tests and when they showed it was nothing serious, she asked me to come in for surgery when I was stronger from the medicines I was already taking.

 

It doesn’t take a genius to figure out which of the two ladies has a bigger following.

 

Involving the Patient

 

It is exceedingly important to involve the patient in the process of treatment. Somehow your anxiety dissolves (if only temporarily) on the dentist’s chair if the dentist kindly explains what’s going to be done next and whether it will hurt or not.

 

A successful doctor also does not force the patient to his opinion. It is always up to the patient and/or the family to choose the course of treatment. The more complicated the illness, the more a patient and the family needs to be involved in discussions and even decision making. For patients who are illiterate and unaware of medical procedures, the doctors should be doubly humble and considerate. 

 

Each case comes with an opportunity to show care and to grow in return.

 

 

Photo courtesy:

 

 

 

Transforming Pakistan’s Healthcare. Afia Mansoor

Saturday, December 12th, 2009

 

Huma Wasim

Huma Wasim

In October this year, the death of legendary cricketer Wasim Akram’s young wife, Huma shocked many around the world. What started as a minor ailment of tooth fungus, took Huma eventually to a ventilator and she lost her battle with death to convoluted bureaucracy and even intentional malevolence. A traumatized Wasim revealed to the press later that two of the best hospitals of Lahore had failed to diagnose her wife’s disease and in a bid to prolong her treatment, ended up extorting a total of $200,000 from Wasim.

   

 

Only a few weeks later, another tragedy took place. The news of three year girl Imanae Malik dying at one of the best hospitals in Lahore due to negligence has initiated a serious debate into what needs to be sorted out in Pakistan’s healthcare. Imanae Malik was brought to Doctor’s Hospital during the Eid holidays with minor burns. She was injected with anaesthesia in doses unsuitable to her age and died within minutes. According to Imanae’s father Aqeel Malik, precious time was wasted by the hospital staff which kept saying that Imanae was asleep even after he failed to detect the child’s heartbeat. Children and adults like Imanae and Huma die everyday at the hands of medical practitioners and many don’t even make it to the news as they are illiterate, poor and accept it as their fate.

 

 

Imanae Malik

Imanae Malik

On one hand, Pakistani doctors are considered to be one of the most capable ones in the world. Hospitals like Shaukat Khanum Memorial Hospital, Sindh Institute of Urology, Pakistan Institute of Medical Sciences, Jinnah Post Medical Centre, Aga Khan Hospital and the Civil Hospital Karachi to name a few, are being run by some of the finest doctors. The Consultant doctors in Public Hospitals are specially skillful because firstly they handle the most difficult cases coming from the most backward areas on a daily basis, and secondly, they usually have a very successful private practice which allows them to earn a very handsome amount of money and therefore they approach their profession unburdened by the need to make money.

 

On the other hand, sickening cases of neglect make it to news every now and then. A cat eating a newborn baby in a gynae ward of a public hospital in Karachi several years ago, a private hospital in Lahore sealed for running a kidney smuggling racket and an unqualified neurosurgeon at a hospital are some examples that send shivers down one’s spine. In a country where a population of 10,000 has access to only 8 qualified physicians and 0.9 pharmacists, there is an immense burden on the available staff and a tremendous potential for quacks to flourish. In a situation like this, when established hospitals for the affluent start showing signs of criminal neglect, it shows that conditions are appalling at large for the majority of common people.

 

The uproar in the Imanae and Huma Wasim cases has led to suspension of the concerned doctors and staff. It has also led to calls for strict accountability of health practitioners. However a deeper probe may reveal that the issue at hand has less to do with accountability, and more to do with a radical change in the way health services are provided in Pakistan.

 

It is naivety to assume that the government will be able to reform the health sector of evils completely. There is only a limit to which legislation can bring in change. Law can ensure a hospital verifies the qualifications of doctors before hiring them, it can ensure that adequate training has been given to paramedical health staff for treating patients. It can ensure that all patients, irrespective of their financial status, are entitled to finest treatment. It can specify the maximum working hours and minimum salaries for the overworked and underpaid health sector. But that is about it.  

 

Laws do not bring a caring smile on the face of a medical practitioner, neither will they bring humility and patience. They will certainly not guarantee a genuine interest by the health professional in the patient’s condition. The essence to reform lies in the intent with which medical practitioners approach work.  

 

To the Health Practitioner

Medicine is the quintessential example of a profession that is there to serve the other. Examples of the healthy becoming terminally ill or dying due to negligence at a health facility are a stark manifestation that the profession is being used as a tool to TAKE rather than GIVE.

 

Unless medical practitioners realise that their task has phenomenal consequences, things will not change. The intent to serve the patient, the intent to save lives is the core of a health professional’s work. The patient is the customer. He is the reason why a medical practitioner gets his bread and butter.

 

The base of transformation lies at the level of intent.

 

A benevolent intent to serve sees each patient, each case as an opportunity to learn and grow professionally. Each case is new. Each case is phenomenally significant. Each case besets you with a chance to do what is correct rather than what seems easy. Each case that makes you do the correct, steps you up on the level of success and excellence. Each of these appropriate steps secures you trust, equips you with courage and gives you Power.

 

Each case is a chance to save the entire mankind.

 

 

References:

 

  1. http://www.emro.who.int/emrinfo/index.asp?Ctry=pak#HealthStatus
  2. http://www.dawn.com/wps/wcm/connect/dawn-content-library/dawn/news/cricket/health+ministry+suspends+doctors+in+huma+akram+case
  3. www.imanae.co.uk