How to say, What to say to your doctor

Surgery Hospital Complication Treatment

Relationship of doctor and patient is the most delicate and yet the most trustworthy. But they do have to go by the rule book. A few things need to be followed during the term of their relationship.

Informed Consent: The patient has a right to be informed of what is going to be done, why it needs to be done, anticipated complications, possible alternatives and consequences of delaying or refusing treatment. Some of the consent is implied, like raising a shirt up for an abdominal examination or holding out a hand for a needle prick. Some consents for internal examination, surgery have to be specific and clear. The ground situation is that most patients prefer to let the doctor take the decision for them.

Consent to doctor

There are a number of patients who rightly attempt to locate information (from Internet) and understand their disease. However their opinions may be tarnished by personal anecdotes and experiences of their friends, blogs or comments by untrained people. In the Indian scenario, patients are usually afraid to question their doctors.

On the other side, most doctors are over-worked and do not seem to find the time to settle all the queries raised by patients. They also deal with a different set of relatives every now and then who need information about the patient. Technically, doctors are required to discuss the medical condition only with the patient and their legal next of kin.

Patient participation in Decision Making: There are times when multiple treatment options are available or sub-optimal outcomes are expected. These are situations where patients need to make an informed choice about the treatment they are willing to undergo. This choice may become mandatory due to issues about the patients general condition, concurrent illnesses, mental incapacitation, cost considerations. This needs to be addressed jointly by the treating team and the patient.

Prognosis and end of life issues: Often, unfortunately, doctors and their patients have to deal with end of life issues. This requires sensitive handling by the treating team as the patients and their relatives go through phases of denial, anger, bargaining, depression and acceptance. Bad news is received poorly and most doctors receive little or no training in discussing end of life issues.

Further, relatives do need someone (rather than something) to blame for the death of their near and dear ones. The most likely candidate is a member of the treating team especially when associated with a perceived or actual mishap just before death. This is part of coping.

Further, in India, there is a tendency for relatives to urge the treating team to continue aggressive (rather than supportive) treatment till the very end. It is a noble thought and finally the relatives have to deal with the loss in the long term. Yet it is the patient who may be suffering despite the treating team explaining the consequences. This is not to be confused with euthanasia which deals with ending life support in hopeless situations.

Complications in medical care: Complications are unfortunate outcomes of medical intervention. These are not unknown or unexpected. All descriptions of medical or surgical treatment do list a series of complications that may occur.

The doctors are trained in reducing, recognising and managing complications. Yet the smallest medical intervention may result in death of a patient. If the entire list of possible complications is explained to every patient, probably no one will undergo surgery. And if every doctor is punished for complications, no one would ever become a doctor. Hence, the international yardstick of reasonableness.

Briefly it means that did the doctor possess reasonable skill or take reasonable decisions in the care of the patient. Hence, would another doctor with reasonable similar training and in a similar situation done the same thing? This is why complications remain a tenuous subject of doctor patient relationship.

Patients have a right to expect reasonable care hence, they should ask their doctor about possible complications. The treating team has a duty to explain possible complications beforehand and to keep the patient or next of kin informed about complications that have occurred.

What can patients do:

  1. Take a close relative (preferably the same person) for every interaction with the doctor or paramedic.
  2. Jot down questions to be asked.
  3. Ask lots of questions. There is no need to be afraid of the doctor. However, do schedule an appointment for taking the doctor’s time.
  4. Take active part in decision making.
  5. Understand that medical care is all about reasonableness. Anyone who offers a guarantee of any kind of cure is best avoided.
  6. Be open to discussing end of life issues.

How to say what to say: This is not a medical topic. It pertains to the service industry at large. Medical care is a service purchased by the patient. Patients have every right to be treated in a courteous and honourable manner by everyone in the hospital.

Problems arise when doctors and their subordinates speak to patients in a manner that is perceived by the patient as condescending, brusque or dismissive. The number one cause of complaints in a hospital is not what was said, but how it was said. Unfortunately this is where the parallel with service industry ends. In a hospital setting, the patient is the weakest link in terms of medical knowledge and is the weakest person in terms of health.

Combined, it makes for a person who needs and deserves more compassion and care than a customer ordering a meal in a restaurant. Hence medical and paramedical students are now being trained in soft skills and dealing with difficult situations.

Smartphones Are The New You


The new age has arrived. Thanks to smartphones.

Smartphones have already dominated 2014. Everyone seems to be looking for that perfect phone.

Whether you’re a mobile-tech expert, novice or somewhere in between, companies from America to China have a wide selection of smartphones.

It is another fact that Indian Government is advising public servants to choose from Made in India phones.

High alerts are also pending against some foreign brands on account of data security.

The United States is already accused of reading phone data of world leaders.

But even at our ends, somewhere along the line there is a huge lack of trust when it comes to smartphones.

Thus, the new technology is creating barriers also. Do you share your smartphone with someone?

Everyone has one’s individuality stamped on smartphones

Earlier, anyone could use anyone’s phone. Today, everyone has one’s individuality stamped on smartphones, be its use or data in any form – photos, videos, messages.

For many, smartphones have become a status symbol and also the deciding factor to determine how advanced you are.

True, smartphones connect you well and have made communication easier, but they have also impacted our lives in a manner that we are constantly on the hook.

Aren’t you available now 24×7? Aren’t you reading your mails all the time? Aren’t you hanging on the social media apps checking updates?

You’re now bombarded with all kinds of forwarded messages

And thanks to free messaging and telephony services like WhatsApp, Hike, Viber etc, you are being bombarded with all kinds of forwarded messages which travel from one smartphone to another without any purpose.

Worst. A good morning and a good night message from any Tom, Dick and Harry is annoyingly becoming mandatory that should be cause for concern in the New Year.

You may say one should not download such features or apps in smartphones that create cobwebs but then, the smartphones are addictive enough, so much so that one gets crazy in the head when the wonder phone goes for repair.

All said and done, the new age machine is a blessing in disguise for sure. No wonder there is a brand war going on to capture the market.

You better leave these companies to compete among themselves for they are working overtime to bring new features for you with new generation phones.

After all smartphones are not just mobile phones anymore. They are new phones with an operating system with a camera, global navigation unit, wi-fi, payment gateways, touch screen media players and… what more!

God speaks in Volkswagen Polo ad

Will God punish your child if the home work is not completed while you are out for dinner! A Volkswagen advertisement says so in its latest ad.

The German car maker’s TV commercial for its ‘Polo’ version shows a mother picking up her son from school. As her son sits in the car, she informs that he will have to do his home work all by himself as she will be going out with his dad.

She warns him that if he doesn’t do his homework, God will punish him. The child then asks her if God would have time to notice and punish him.

There comes the answer via the Bluetooth installed in the car as the child’s father changes his voice and says, “I am busy, but I am sure I can take some time to come punish you.”

The child is left surprised and the commercial ends after introducing the car’s features.

How many of us scare kids in the name of God? It could have sounded better if the mother said that you would make God and us happy if you were a good boy and do your work on your own. The voice heard by the child in the car scares him and the mother has been shown happy doing that.

As parents, we always give a beautiful picture of God to our kids and by making a small child hear a forceful voice is like going back to old ways like, ‘buddha baba aa jayega’ (that scary man is due anytime). Why can’t TV ads show kids a better picture of lot of things and issues?

We all believe in making our kids smart, but at the same time we don’t want to scare them.

Why do kids love Santa Claus? It’s because kids see an old man with a long beard getting them gifts, which of course parents keep. Haven’t we all done that!

A twinkle and a smile on our kids face make us happy. What is God for our kids? They see us praying and they follow the same. We tell them that He will always be there for you and they believe us.

Many kids remember God before and after exams or any other work.

It’s their innocence. In addition, even if they do not get the desired result, as parents we guide them by asking them to work hard next time.

The advertisement in question shows a child not more than 4 or 5 years, an age where they need a parent’s help for homework. We always teach our kids that God punishes those who do bad and evil things. Not doing homework is not a punishable act by God.

Let us deliver good messages to our young and smart generation, or would you be amused by the defence published by Business Line newspaper: “The look of awe on the face of the little one makes the film. And the innovative way of conveying the message about the new feature-laden Polo works rather well”!

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