Where’s the real doctor?

Although there have been phenomenal advancements in disease diagnostics and managements, most patients are dissatisfied with doctors’ way of communication.
Where’s the real doctor?

An inside perspective 

"A good doctor remembers the patients and treats them with a tender heart and caring hands beyond pens, prescriptions and practice interests. He treats them as if they were his family

What Makes a Good Doctor

I like the theme in this very popular question. Most people think they have a general idea of  a "good" doctor. I'm sure the word represents different things   to different people, can have many different answers in many different contexts. Using grounded theory and thematic analysis, when I asked people from culturally and socially diverse backgrounds to share their stories and perspective what they want more than anything else is a doctor. To some it might imply being a highly qualified and competent person in the profession, unarguably such bio helps in getting positions, promotions, prominence or, gain market share in private practice. To others  especially, patients and families,  it's not all about the faculty positions, certifications, medals, operative skills on the wall but more about winning the real heart /trust through preferences for patient-centered communication, enhancing compassion and empathy in Medical practice given to the patients and their families.'

Patient-Centered Health Care

Years ago, patient care was centered on what the doctor thought was appropriate. Patients may not have been viewed as unique individuals with different needs. But times have changed—today patient-centered care is more than a norm. People don't care how much you know until they know how much you care. Although there have been phenomenal advancements in disease diagnostics and managements, most patients are dissatisfied with doctors' way of communication. The most common complaint about physicians on the internet is, "They didn't listen to me, don't talk well ". The relationship between patient and doctor is as old as medicine itself. Most of us take for granted that we are the center of the doctors attention when we are face to face in the clinic. When you talk to your doctor, you assume they listen carefully, patiently and empathize with our situation. That's why we seek advice, or what we pay them for? They are our medical expert and a powerful shoulder to lean on when we are in healthcare  needs. However, many doctors tend to overestimate their ability in communication work marked  with pride and prejudice ,"I am the best or I am the first to perform"don't communicate well.

Should we train doctors for communication skills (Empathy)?

The goal of Patient-centered health care is treating people with dignity, respect and autonomy   to empower patients to become active participants in their care. This requires that health care providers develop good communication skills and address patient needs effectively. Sadly,the art of healing is lost in a system either due to poor training, staff burnout ,overburdened patient load or commercial interests  where doctors don't want or don't have time or patience to listen. Despite advances in diagnostics and therapeutics, much patient dissatisfaction and many malpractice complaints are due to breakdown in the doctor-patient relationship. (staff behavior) as most of us don't get any doctor patient communication training on how to deal with emotionally upset or angry, critical or terminally ill patients — so we do what comes naturally from our instinct. When doctors don't communicate well, patients are left confused and feeling their fears haven't been listened to leading to  dissatisfaction and mistrust and every advice or recommendation is re re -confirmed by patients and their families from other Physicians or internet.

Good Communication 'an essential skill' for doctors;From the times Memorial   Medical profession identified itself as Noble and its care providers attained respect in civil society as people's  Messiah's,and  effective doctor-patient communication is a central clinical function in building a therapeutic doctor-patient relationship, which is the heart and art of medicine for delivering  high-quality health care. While, many  patients and their families expressed their concerns on effective communication many of  my colleagues do acknowledge,  "The public is losing their trust in us. They see us as driven for profit. They feel we don't listen to their concerns anymore and don't care what they want or need". The process of getting better always starts with an effective conversation. Yet, this fundamental aspect of the doctor's craft is often neglected in their training. Amid the pressure and fast pace of medicine, crowded clinics, tight budgets, endless record-keeping and paperwork for a start  ( which needs to be standardized as per status of Hospital and allotted time slots) even so, doctors can't afford to compromise their greatest tool— connecting with the ill, and engaging patients in a meaningful way- doctors and other health care providers can still learn to slow down and cultivate better listening and understanding clear communication from doctors may have a healing effect . Of course, there's no shortage of barriers to doctors/staff  focusing on high-quality communication it signifies  a combination of both  professional and humanistic personality traits or mannerisms someone who behaves with empathy that we can engage and empower our patients. Currently, communication skills training don't form a part of the medical curriculum in our land, there exists no cohesive approach from Medical council's /schools to build communication skills with the result  care providers  are losing that healing touch– a psychosocial  empathetic  bond between them and their care receiver that many feel is essential to the art of healing in today's  much commercialized world. Health care delivery needs to be focused on individual patient preferences and values, and desired health outcomes based on his or her unique background, experiences, and lifestyle  involves transforming the relationship between providers and patients from the traditional model, in which a care provider prescribes the same treatment for most patients with similar diagnoses or conditions to a patient-provider partnership that considers treatment options based on a patient's unique concerns, providing care that is respectful of, and responsive to, includes listening patiently to, informing and involving patients in their plan of care that guide all clinical decisions.

Why Nice Doctors are Better Doctors?

Over the years, much has been published in the literature on this important topic- Who makes a good Doctor ? I attended lots of medical meetings, workshops, delivered lectures in Healthcare Quality improvement conferences on Patient-centered care and  the lost art of good communication in medicine, interacted with healthcare administrators ,care providers ,patients and families  trying to figure out why patients are not satisfied from their care providers? This innovative approach of the "street observation" aimed to understand exactly what people want from their treating Doctor to bridge a gap on a  broken "trust" which has fallen to an all-time low.To me and my patients i have always found besides knowledge and professional competence the care providers personality traits  on communication skill' ("khulq- urdu word )are essential for doctors(more empathetic, compassionate, and responsive) possessing strong credentials on  good morals and ethics  give unbiased advice, let people participate actively in all decisions related to their health care, dealing with  people pitched at the appropriate level irrespective of their social status or whilst putting everyone at ease being able to absorb all sorts of people's concern's  on pain and anxieties without losing focus on main  objective of patient management. Too often we underestimate the power of healing touch, reassuring kind words, a listening ear,  a smile, an honest advice these small  acts of caring all of which have the potential to turn a life around- so please lend it to ..needy .

(Dr.Fiaz Fazili is a  Surgeon, Quality improvement planner, works as Healthcare adviser on Quality improvement solutions for hospitals)

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