Role of training in saving the ‘tarnished’ doctor-patient relationship

image courtesy : hindustan times
Dr Kritika Nanda
     Dr. Kritika Nanda            IL&FS Skills and Healthcare Academy/Secretary-Society of Emergency Medicine India-Delhi Chapter

Views of a doctor, who gave up medical practice to pursue training in healthcare, as a full time career option.

As I sit in my almost swanky public-private partnership office of a giant infrastructure and financial services company, sipping my cup of tea, I think of the lives that are lost due to lack of awareness. That is right, at the back of my mind, I am constantly thinking about the vulnerability of the lives we live: how we believe in anything and everything is thrown at us by social media, and what ‘great losses’ we may incur because of the same.

As the sipping goes on, I see more and more ‘commoners’ entering office; I am still not sure, after one year of giving-up practice, if ‘I have acquired a sense of belonging to the commoners’ group’, but having studied for ten long years, I have, but naturally, given myself the credit of still having a sense of belonging to the ‘medical league’ – something I have not gotten out of, yet;  while I am still thinking of whereto I exactly belong, I overhear a group discussing; one of them goes: “Did I tell you what happened to my sister’s best friend’s husband? Well, he went to this rather swanky 7-star hospital; he was absolutely fine before he went to the hospital, but his condition worsened the moment the doctors took charge of him, and now he has been admitted for a disease he never had!”

Like, there you go, I thought to myself…as if there is a chamber of gas that surrounds hospitals or some evil eye cast upon them that makes an absolutely fit person unfit, the moment they step onto the polished marble.

By now my F.O.C tea is half-way through (I have learned a few short forms in the last one year), like for example, the first time my boss asked me to prepare a BD plan; fresh from the medical line, I very seriously wondered, why should I prepare a ‘brought dead summary’! Only later did I realize that not in all parts of the world did BD mean ‘brought dead’.

Humour apart, we, as a society, are seriously losing out, losing out on trust, correct medical diagnosis, and treatment. It is anyone’s guess as to who the worst sufferers are? It is that ‘common’ man; who gets unwell; it is that ailing relative, who needs serious help, but because his son/daughter read some forwarded message on a WhatsApp group, he/she did not take him/her to the hospital till things really went out of hand; it could be that child, who could probably be on the brink of a serious, permanent hearing loss, but by now his ‘knowledgeable’ parents have taken a download from Google Doctor and are now capable of taking the best possible medical decisions. Not only this, the loss is also of that very sick and aged patient, who cannot be seen by a doctor because some other patient’s attendants have crowded the hospital, and are taking pictures from phone X to be posted on social media, because they feel their patient needs urgent help compared to the rest. And last, but not the least , it is that trauma patient, who needs to be put on a ventilator as the GCS is low, but his/her relatives will not sign the consent form as after watching ‘Gabbar is back’, wherein it has been universally researched and declared that a patient out on ventilator never comes back. Of the lives I have lost as an emergency medicine physician: these are the ones that haunt me the most- lives lost due to lack of awareness. I clearly remember one such CKD patient, whose attendants used to bring her to the ER for an ascetic tap every week; one day I happened to watch over this patient, as, instead of weekly visits, they would get her to the ER twice or thrice a week. Their only concern was that she was complaining of ‘stomach ache’, and they wanted the water to be drained more often, hence the increased frequency of visits. Later we found out that she was suffering from a dangerous condition called peritonitis, and she ultimately succumbed to it. You know the irony of it? Her relatives felt she died because we had admitted her and not sent her back by simply removing more fluid. Any doctor reading this would know what I mean.

And on a lighter note, we have also had patients, who wrote complaints to hospital authorities after being asked to wash a dog-bite with soap and water because they felt this could have been done even at home.

Today, I head the healthcare academy of a major skills company; the first programme we designed was our first-aid training programme; as clichéd as it sounds, first-aid training is the need of the hour; it has gone far beyond the usual modules on nose-bleeds and abrasion-dressing; it is getting more and more detailed in order to meet the growing ‘distrust’between medical professionals and lay-persons. Training is the only solution to bridge this gap, and we are doing this by collaborating with a world-famous author of EMT textbooks, and a police officer himself, Mr. DanielLimmer. As on date, we have trained 700 plus individuals in first-aid, and every session enlightens to do better and reach out to more and more people. Our training programmes are updated, precise and logical; they give insights on the exact time frame within which a suspected patient of stroke should be shifted to a hospital to avoid permanent damage; we not only define window periods, but we lay emphasis on how to identify silent markers of deadly conditions like heart attacks and strokes.

One can have 1000 articles for reference on Google Doctor, but only a real doctor can ‘customize the solutions’ for you. The truth remains that doctors are the only option we have when we fall ill; no other professional can take over the role. Trust is the keyword; here, of course, there are exceptions and there would always be, but there is no blanket rule applicable to all, and one must understand this.

As far as I am concerned, my tea is over (I have been asked to limit my caffeine intake these days). I still get patients at work: like the pantry boy with a cut or a fellow colleague, who met with a mild accident and had bruises all over; luckily all come under the wings of emergency medicine, and touch wood, all my office patients are doing fine, as of now. Indeed I consider myself lucky to at least have access to thousands of lives through skilling network who we can reach, teach, and upskill for a better tomorrow. An extensive network to support the training programs and more than 15000 people employed towards dedicatedly trying to make this a success makes us one of the most privileged skilling company.

Until we create a better tomorrow, we must not stop skilling and learning.