Thursday, September 30, 2010

'Open request to the QCI, MCI and others - Quality in Healthcare-should be a subject in medical colleges'

Hi all,
I have been troubled with this thought lately to the fact that there are so many incidents where doctors are beaten up, hospitals broken down when a patient is lost or harm done.
The move now by government to take severe action against the miscreants and angry mobs who do such things is welcome, but the moot root cause is still unaddressed.
I feel there is a severe lack of communication, facts hidden and mostly may not be of malafide intention, but the doctors and health care authorities were never 'trained to handle such sensitive situations of handling end of care, or how to speak to a patient, and skeptic nature of not being transparent in sharing care plan completely, treatment, and progress in even critical most situations.
The patients are taken for granted by medical fraternity that they better adhere to the treatment advised and the patients entrust everything on doctors and sign consent forms even without reading the pros and cons. Doctors too many times do not explain the consent forms with the fear that the patient would get scared and would refuse the surgery, and loss of business thereof.
Typically a ambiance of assurance is provided and situations get out of hand when the outcomes do not meet expectations. The attributes are worsened in communication as doctors are trained mostly in public institutions where mostly poor are treated and there is no scope for good communication skills and no attempt is even made to be 'humble'. More so lack of quality in infrastructure & processes also play a major role as a gap here will lead to less than satisfactory treatment outcome and dissatisfied patients and relatives thereof. Such lack of processes and quality parameters also make the system more 'adhoc' and and then unavailability of desired quality and processes brings in irritability and ultimately carries forward negatively on the patient.
I feel a chapter or even a subject in quality/ NABH accreditation and communications should be introduced in medical schools and nursing colleges just like preventive and social medicine, and the budding doctors and nursing students should be trained on the health care accreditation standards, communication skills and even laws and policies and then should be evaluated like any other subject on the same. If this aspect comes to light, I am very confident that the future of Indian health care will be invincible and at international standards. Such teachings will create and ingrain concepts of 'quality' and 'processes' in the minds of these future medical practitioners and a sea change will be seen over a period of time in the working pattern of any health care institution be it public or private. the way we learn technicalities of medicine, diagnosis and treatment in medical schools, we would then learn the essential aspects of it very important and undeniable aspect of Quality.
We have excellent 'individuals' but do not have excellent 'quality driven mindsets' which need to change.
I openly request Quality Council of India (QCI) and MCI (Medical Council of India) and NBE and CPS and others including the National Health and family Welfare Ministry to sincerely give this a thought and implement the same ASAP.
Dr Akash Rajpal

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