What will this workshop help you to do ? Manage your life better ! A doctor’s life is very different from a businessman’s or executives We have our.

What will this workshop help What will this workshop help you to do ?you to do ?

Manage your life better !Manage your life better !

A doctor’s life is very different from a A doctor’s life is very different from a businessman’s or executivesbusinessman’s or executives

We have our own unique set of We have our own unique set of problemsproblems

A doctor needs to wear many hats !A doctor needs to wear many hats !

Clinician , who has polished Clinician , who has polished medical skillsmedical skillsAcademician, who is a Academician, who is a constant learner constant learner Manager , who understands Manager , who understands the business aspects of the business aspects of running a profitable clinicrunning a profitable clinic

A doctor needs to wear many hats !A doctor needs to wear many hats !

CEO, who understands how to CEO, who understands how to motivate staff and lead people;motivate staff and lead people;Financial expert, who can Financial expert, who can manage his money manage his money Family providerFamily providerSelf caretaker, who know how Self caretaker, who know how to look after himself and fulfill to look after himself and fulfill his personal needs .his personal needs .

The problemThe problemUnfortunately, while doctors are Unfortunately, while doctors are quite eager to discuss medicine, quite eager to discuss medicine, most are unwilling to talk about the most are unwilling to talk about the nuts and bolts of practise nuts and bolts of practise managementmanagementDon’t want to enrich the competition Don’t want to enrich the competition by giving away their “trade secrets” !by giving away their “trade secrets” !We can learn together and help each We can learn together and help each otherother

The solutionThe solutionThere is no need to reinvent the There is no need to reinvent the wheel . The challenges are similar all wheel . The challenges are similar all over the worldover the worldWe can learn from our colleagues We can learn from our colleagues and from peers in other parts of the and from peers in other parts of the worldworldApply knowledge from other fields to Apply knowledge from other fields to ours !ours !

Being a doctor today is not easyBeing a doctor today is not easyDo you find that there is:Do you find that there is:

too much worktoo much work

too much hassletoo much hassle

too much competitiontoo much competition

too much despair; andtoo much despair; and

too little reimbursement ?too little reimbursement ?

Common response – work even Common response – work even harder !harder !

Run around from clinic to clinic, Run around from clinic to clinic, hospital to hospitalhospital to hospitalTry to “expand” your practise to get Try to “expand” your practise to get more patientsmore patients

Common response – work even Common response – work even harder !harder !

Only 24 hours in a day !Only 24 hours in a day !Fed up and unhappyFed up and unhappyNo time for yourself or your familyNo time for yourself or your family

Are you fed up of…Are you fed up of…

Long energy-exhausting hours and Long energy-exhausting hours and crushing workloads leaving little or crushing workloads leaving little or no free time for yourself or your no free time for yourself or your family ?family ?

Demanding dissatisfied patients ?Demanding dissatisfied patients ?

Inadequate payment Inadequate payment

for all your hard work ?for all your hard work ?

Need to work smarter – not harder !Need to work smarter – not harder !Need to learn tools which will:Need to learn tools which will:

Give you control of your time; Give you control of your time;

Allow you to do work which you felt Allow you to do work which you felt was worthwhile, for patients that you was worthwhile, for patients that you enjoy seeing; andenjoy seeing; and

Pay you well for your effort, so that Pay you well for your effort, so that you enjoy going to work every day. you enjoy going to work every day.

Practise management skillsPractise management skills

Every doctor is an entrepreneurEvery doctor is an entrepreneur

Needs to run a businessNeeds to run a business

These skills are never taught in These skills are never taught in medical collegemedical college

Some doctors never learn them, and Some doctors never learn them, and struggle to manage their practisestruggle to manage their practise

5 stages of a doctor’s career5 stages of a doctor’s careerEntry, when you are starting out; Entry, when you are starting out;

Establishment, when you have created a Establishment, when you have created a name for yourself; name for yourself;

Exploration, when you look for new fields Exploration, when you look for new fields to conquer; to conquer;

Specialization , when you settle down in Specialization , when you settle down in your niche; andyour niche; and

Mastery, when you establish yourself as Mastery, when you establish yourself as the Expert in your area of interest.the Expert in your area of interest.

Specialise !Specialise !

Need to carve out a niche for Need to carve out a niche for yourselfyourself

Have a clear professional goalHave a clear professional goal

Shape your practise around your Shape your practise around your abilities – you will become extremely abilities – you will become extremely good at doing what you enjoy !good at doing what you enjoy !

Please PrescribePlease Prescribe InformationInformation ! !

Dr Aniruddha Malpani, MDDr Aniruddha Malpani, MD

HELP, Health Education HELP, Health Education Library for PeopleLibrary for People

www.healthlibrary.comwww.healthlibrary.com

Carrot and stickCarrot and stick

1. Promote your practise1. Promote your practise– Well informed patients are more faithfulWell informed patients are more faithful– Differentiate yourself from other doctorsDifferentiate yourself from other doctors– Good investment !Good investment !– Can vouch for this from personal Can vouch for this from personal

experience !experience !

2. Protect you from lawsuits2. Protect you from lawsuits– Document that you have educated your Document that you have educated your

patientpatient

Patient autonomyPatient autonomy

Autonomy = freedom to decideAutonomy = freedom to decide

Doctors need to Doctors need to

1. present the options to the patients 1. present the options to the patients and and

2. allow patients to choose for 2. allow patients to choose for themselvesthemselves

Informed Informed choice means patients need choice means patients need informationinformation

Allowing patients to choose Allowing patients to choose With advances in medical therapy, With advances in medical therapy, there are often many treatment there are often many treatment options available for any medical options available for any medical problemproblemDo not choose for the patient – how Do not choose for the patient – how can you read the patient’s mind or can you read the patient’s mind or foretell the outcome ?foretell the outcome ?Present the information and let the Present the information and let the patient decidepatient decide

Educating patients Educating patients

Most doctors do not spend much Most doctors do not spend much time educating their patients. time educating their patients.

This is a shame. The primary role of This is a shame. The primary role of a doctor should not be merely a doctor should not be merely treating an illness, but rather helping treating an illness, but rather helping people remain healthy, and people remain healthy, and educating patients is vitally educating patients is vitally important for this.important for this.

Doctor ( docere) = TeacherDoctor ( docere) = Teacher

In ancient India, doctors were paid In ancient India, doctors were paid only if their patients were in good only if their patients were in good health. If someone fell ill, the health. If someone fell ill, the doctor’s payments were stopped doctor’s payments were stopped until he treated the illness until he treated the illness successfully.successfully. This was a very useful This was a very useful model, which should be more widely model, which should be more widely practised! practised!

Barriers - 1Barriers - 1

Most of us do not have the time to Most of us do not have the time to encourage questions from patients. encourage questions from patients.

Most doctors are just not very good Most doctors are just not very good at communicating with their patients. at communicating with their patients.

  Doctors are used to talking Doctors are used to talking medicalesemedicalese

Barriers - 2Barriers - 2

Educating the patient is simply not Educating the patient is simply not valued enoughvalued enough

It is not seen to be glamorousIt is not seen to be glamorous

It is not financially rewarding. It is not financially rewarding.

It can be quite boring to repeat the It can be quite boring to repeat the same stuff again and again. same stuff again and again.

Encourage questions !Encourage questions !

Some doctors feel threatened by a Some doctors feel threatened by a patient’s questions. This is not the patient’s questions. This is not the right perspective at all. Remember: right perspective at all. Remember: both doctor and patient have a similar both doctor and patient have a similar goal – to make the patient better – and goal – to make the patient better – and questions should be encouraged and questions should be encouraged and answered, rather than leaving doubts answered, rather than leaving doubts to fester – a situation that can create to fester – a situation that can create unnecessary problems in the future.unnecessary problems in the future.

Benefits of patient education - 1Benefits of patient education - 1

Happier patients , because they Happier patients , because they have been treated as intelligent have been treated as intelligent adults. adults.

Patient education is important as a Patient education is important as a practice promoter: patients practice promoter: patients appreciate that the doctor has taken appreciate that the doctor has taken the time and effort to inform and the time and effort to inform and teach them.teach them.

Benefits - 2Benefits - 2

Patients forget over half of what the Patients forget over half of what the doctor tells them, because of the doctor tells them, because of the stress of the consultation. Giving stress of the consultation. Giving them printed materials to read at them printed materials to read at home will help prevent midnight calls home will help prevent midnight calls . .

Printed educational materials help to Printed educational materials help to increase patient complianceincrease patient compliance

Benefits - 3Benefits - 3

Patient education helps to improve Patient education helps to improve public health. Educational materials public health. Educational materials are read by the entire family, and are read by the entire family, and community health awareness can community health awareness can help to reduce quackery . help to reduce quackery .

People respect the printed word – People respect the printed word – especially when given by the doctor ! especially when given by the doctor !

Best form of CME for the Best form of CME for the doctor !doctor !

Remember that the inquiring and Remember that the inquiring and well-informed patient can teach you well-informed patient can teach you much more about medicine than any much more about medicine than any textbook !textbook !

A patient’s questions will make a A patient’s questions will make a good doctor think about things that good doctor think about things that otherwise he or she might take for otherwise he or she might take for granted. granted.

Best form of CME for the Best form of CME for the doctor !doctor !

Help you to improve the quality of Help you to improve the quality of your medical practice. The well-your medical practice. The well-informed patient may help make you informed patient may help make you aware of advances occurring in other aware of advances occurring in other parts of the world that you – as a parts of the world that you – as a busy doctor – might otherwise busy doctor – might otherwise overlook.overlook.

Helps to improve empathyHelps to improve empathy

Reading information intended for the Reading information intended for the patient can teach you to look at patient can teach you to look at things from the patient’s point of things from the patient’s point of view. This helps to increase your view. This helps to increase your empathy – a very desirable goal.empathy – a very desirable goal.

Reduce risk of complicationsReduce risk of complications

Patient education can actually Patient education can actually reduce the risk of inadvertent reduce the risk of inadvertent complications. After all, doctors are complications. After all, doctors are human and may make errors . The human and may make errors . The well-informed patient can sometimes well-informed patient can sometimes point out possible problems with a point out possible problems with a treatment plan that the doctor may treatment plan that the doctor may have overlooked (for example, have overlooked (for example, patients with G6PD deficiency)patients with G6PD deficiency)

Reduce quackeryReduce quackery

Educating patients will help prevent Educating patients will help prevent health fraud and quackery. If doctors health fraud and quackery. If doctors teach their patients about what can teach their patients about what can be done to help them, as well as the be done to help them, as well as the limits of what we can offer them, limits of what we can offer them, they are unlikely to be cheated by they are unlikely to be cheated by quacks.quacks.

Reduce medicolegal risksReduce medicolegal risks

Educational handouts offer proof that Educational handouts offer proof that the doctor has informed the patient the doctor has informed the patient of possible complications and risks . of possible complications and risks . Patient education is an integral part Patient education is an integral part of “risk management” in medical of “risk management” in medical practice today, and will reduce the practice today, and will reduce the risk of doctors being sued if risk of doctors being sued if complications do occur.complications do occur.

Patient education – key Patient education – key component of informed consentcomponent of informed consent

Don’t tell the patient what to doDon’t tell the patient what to do

Present the information and the Present the information and the treatment options – and allow them treatment options – and allow them to make up their own mind !to make up their own mind !

Empower patients with information – Empower patients with information – they will respect you for this !they will respect you for this !

Printed brochuresPrinted brochuresPrinted pamphlets form the core of Printed pamphlets form the core of patient education. It’s easy to adapt, patient education. It’s easy to adapt, modify, translate and print modify, translate and print educational leaflets produced educational leaflets produced elsewhere – don’t waste time elsewhere – don’t waste time reinventing the wheel ! reinventing the wheel ! You can find many examples to copy You can find many examples to copy at HELP !at HELP !Test them on your patients !Test them on your patients !

Printed brochuresPrinted brochures

Remember that patients have Remember that patients have different levels of reading skillsdifferent levels of reading skills

Leave these in your waiting room, so Leave these in your waiting room, so that patients can gainfully use their that patients can gainfully use their time while waiting for you time while waiting for you

Printed brochuresPrinted brochures

Encourage your patients to take Encourage your patients to take the leaflets and read them at home the leaflets and read them at home at leisure – this is a good way to at leisure – this is a good way to promote your practice as well. promote your practice as well.

You can also give them the You can also give them the appropriate leaflet at the end of the appropriate leaflet at the end of the consultation.consultation.

Please Prescribe Information !Please Prescribe Information !

All the information in the world can All the information in the world can never replace the doctor ! never replace the doctor !

Information can help you become a Information can help you become a better doctor – and also help your better doctor – and also help your patient to become a better patient !patient to become a better patient !

Doctor.comDoctor.comDr Malpani, MDDr Malpani, MD

http://www.drmalpani.comhttp://www.drmalpani.com

Why bother ?Why bother ?

Doctors have practised medicine for Doctors have practised medicine for many years without the Netmany years without the Net

Isn’t this just another new-fangled Isn’t this just another new-fangled toy for kids to play with ?toy for kids to play with ?

Isn’t the boom over ?Isn’t the boom over ?

I’m too old to learn !I’m too old to learn !

MDConsult.comMDConsult.comFull text of over 30 medical textbooks, Full text of over 30 medical textbooks, medical journals and Clinics of North medical journals and Clinics of North AmericaAmericaNo advertisingNo advertisingSpecially discounted price for Indian Specially discounted price for Indian doctorsdoctorsSubsciption can be provided by a Subsciption can be provided by a pharmaceutical companypharmaceutical company

MDConsult.comMDConsult.com

For less than Rs 30 per day, you will never For less than Rs 30 per day, you will never need to buy another medical book or need to buy another medical book or journal in your lifejournal in your life

Constantly updated all the timeConstantly updated all the time

Excellent patient educational information Excellent patient educational information as well, which you can print out for your as well, which you can print out for your patients !patients !

Get on the NetGet on the Net

Today, it’s not enough to just have a Today, it’s not enough to just have a net connectionnet connection

You need to have your own website !You need to have your own website !

Symbolic of how rapidly times are Symbolic of how rapidly times are changing !changing !

Start your own website !Start your own website !

Patients are hungry for reliable Patients are hungry for reliable informationinformation

The internet is an excellent source of The internet is an excellent source of information, but a lot of this can be information, but a lot of this can be wrong and dangerouswrong and dangerous

Provide reliable information to your Provide reliable information to your patients through your own websitepatients through your own website

Very cost effective !Very cost effective !

Why is this important for you ?Why is this important for you ?Why should you take the time and Why should you take the time and trouble of setting up your own trouble of setting up your own website ?website ?

To promote your practice !To promote your practice !

This is the simplest and easiest This is the simplest and easiest answer – and the one most doctors answer – and the one most doctors will understand !will understand !

A website is a very cost-effective way A website is a very cost-effective way of getting more patients , because it of getting more patients , because it lets patients all over the world know lets patients all over the world know about your special skills !about your special skills !

Think global – act local !Think global – act local !

How does a website help ?How does a website help ?Provide value-added services for Provide value-added services for your existing patients.your existing patients.Provide clinic details ( how to get to Provide clinic details ( how to get to the clinic, clinic timings)the clinic, clinic timings)You can answer email queriesYou can answer email queriesYou can provide reliable medical You can provide reliable medical information about “hot” topics – such information about “hot” topics – such as the leptospirosis scareas the leptospirosis scare

How does a website help ?How does a website help ?For example, you can put up a FAQ For example, you can put up a FAQ ( frequently asked questions) ( frequently asked questions) section, which answers the section, which answers the commonest queries patients usually commonest queries patients usually ask you. You can “refer” patients to ask you. You can “refer” patients to your website at the end of the your website at the end of the consultation, so they can educate consultation, so they can educate themselves ! Patients appreciate this themselves ! Patients appreciate this – and word of mouth will help you get – and word of mouth will help you get more patients !more patients !

How does a website help ?How does a website help ?

Your website can help you to attract new Your website can help you to attract new patients ! Bombay is a medical center, patients ! Bombay is a medical center, and Indian medical care is very cost-and Indian medical care is very cost-effective. Valuable for attracting NRIs, effective. Valuable for attracting NRIs, for examplefor example

Soon, it will become as routine for Soon, it will become as routine for patients in India to do “ research “ about patients in India to do “ research “ about doctors, as it is in USA. Your website doctors, as it is in USA. Your website can help patients to find can help patients to find you ! you !

Website benefitsWebsite benefitsYour website lets your patients know Your website lets your patients know that you are upto date and familiar that you are upto date and familiar with modern technology !with modern technology !At our website at At our website at http://www.DrMalpani.com - we - we answer over 10 queries a dayanswer over 10 queries a dayGet direct patient referrals from all Get direct patient referrals from all over the world !over the world !

Internet positive patientsInternet positive patients

Well-informedWell-informed

DemandingDemanding

AffluentAffluent

Cannot afford to not use the Net Cannot afford to not use the Net

Integral part of medical practice for Integral part of medical practice for the futurethe future

Communication with patientsCommunication with patients

Communication with chemists, lab Communication with chemists, lab results, consultants, colleaguesresults, consultants, colleagues

Billing – insurance companiesBilling – insurance companies

E-healthcareE-healthcare

Patients will demand medical Patients will demand medical services to suit their convenience services to suit their convenience

Smart doctors need to be preparedSmart doctors need to be prepared

Better to be proactive rather than try Better to be proactive rather than try to catch up laterto catch up later

Doctors with their own websites will Doctors with their own websites will always be web-savvy and “clued-in”always be web-savvy and “clued-in”

Medical TourismMedical Tourism

Enormous scope for Indian doctors to Enormous scope for Indian doctors to “export” their expertise without “export” their expertise without leaving the country !leaving the country !

Can provide online round the clock Can provide online round the clock videoconferencing with patients, one videoconferencing with patients, one on one, for a feeon one, for a fee

TelemedicineTelemedicine

Can help patients in the US to save Can help patients in the US to save money and time by offering money and time by offering personalized medical consultations – personalized medical consultations – at a fraction of the cost in the USAat a fraction of the cost in the USA

Provide expert second opinionsProvide expert second opinions

Very attractive for third party payors, Very attractive for third party payors, insurance companies, HMOsinsurance companies, HMOs

Matter of timeMatter of time

What happens in the US will happen What happens in the US will happen in India after a few years in India after a few years

The pace of change is rapidly The pace of change is rapidly accelerating and we are catching up accelerating and we are catching up quicklyquickly

We can learn from the experience of We can learn from the experience of doctors in the US !doctors in the US !

Improving the doctor-patient Improving the doctor-patient relationshiprelationship

Today’s Health Care Today’s Health Care SystemSystem

Patient

Health Insurance

Government

Information Overload

Media

The Physician

The foundation of the relationshipThe foundation of the relationship

Based on Based on TRUSTTRUSTTrust needs to be earned !Trust needs to be earned !

The pastThe past

The Family DoctorThe Family Doctor

Doctors were held in high regardDoctors were held in high regard

Worked hard, were paid little, but Worked hard, were paid little, but were trusted and respectedwere trusted and respected

Held in high esteemHeld in high esteem

The presentThe present

Today, doctors get beaten up Today, doctors get beaten up because patients or their relatives ) because patients or their relatives ) perceive they are getting poor perceive they are getting poor medical care. medical care.

Medical negligence lawsuits Medical negligence lawsuits increasing increasing

The presentThe present

The doctor-patient relationship is The doctor-patient relationship is breaking downbreaking down

Patients feel exploited and believe Patients feel exploited and believe that the medical profession has that the medical profession has become crass and commercializedbecome crass and commercialized

Doctors feel unappreciated, Doctors feel unappreciated, overworked, victimised and overworked, victimised and threatened. threatened.

How do we fix the problem ?How do we fix the problem ?

Two playersTwo players

DoctorsDoctors

PatientsPatients

It’s hard to change anyone else – you It’s hard to change anyone else – you can only change yourself !can only change yourself !

Polish your bedside mannerPolish your bedside manner

The most important intangibleThe most important intangible

Your patient needs to know how Your patient needs to know how much you caremuch you care

Technical competence is usually Technical competence is usually taken for grantedtaken for granted

Simple measures – be polite; sit Simple measures – be polite; sit down while talking to the patient; down while talking to the patient; smile; don’t interrupt ! smile; don’t interrupt !

What do patients expect from their What do patients expect from their doctors ?doctors ?

Expertise ( be well-informed and Expertise ( be well-informed and uptodate)uptodate)Professionalism – look out for the Professionalism – look out for the patient’s best interestspatient’s best interestsAccountability – be answerable; say Accountability – be answerable; say Sorry ( if there is a mistake)Sorry ( if there is a mistake)Transparency – no unnecessary tests and Transparency – no unnecessary tests and referralsreferralsRespect their desires and their timeRespect their desires and their timeTreat them as intelligent human beingsTreat them as intelligent human beings

What do doctors expect from their What do doctors expect from their patients ?patients ?

Doctors expect that patients will:Doctors expect that patients will:Treat them with respectTreat them with respectWill say “Thank You” when things go Will say “Thank You” when things go

wellwellWill have realistic expectations of their Will have realistic expectations of their

treatmenttreatmentWill not unfairly blame the doctor Will not unfairly blame the doctor

anytime there is a problemanytime there is a problemWill pay their professional fees promptly Will pay their professional fees promptly

and gracefullyand gracefully

Good doctorsGood doctorsGood doctors spend a lot of time talking Good doctors spend a lot of time talking

to their patients.to their patients.

They have an excellent bedside mannerThey have an excellent bedside manner

They build a relationship in which their They build a relationship in which their patient can trust that the doctor will do patient can trust that the doctor will do what is in the patient’s best interests. what is in the patient’s best interests.

This is the hallmark of the true This is the hallmark of the true professionalprofessional

Good doctorsGood doctorsA doctor who is a good professional A doctor who is a good professional

has a very close relationship with his has a very close relationship with his patients, because he knows that he patients, because he knows that he is in the service industry. is in the service industry.

All good doctors are empatheticAll good doctors are empatheticJust talking to the doctor can be Just talking to the doctor can be

therapeutic for many patients - after therapeutic for many patients - after all, doctors are active healing agents, all, doctors are active healing agents, who are often far more potent than who are often far more potent than an antibiotic ! an antibiotic !

Good doctorsGood doctorsDoctors need to earn their patients’ Doctors need to earn their patients’

trust – and they can do this by: trust – and they can do this by: • being generous with their being generous with their

knowledge; knowledge; • showing their patients that they showing their patients that they

care; care; • respecting their time; respecting their time; • and fulfilling their promises. and fulfilling their promises.

Good doctorsGood doctors

This is why senior doctors value their This is why senior doctors value their reputation so much – it is built on the reputation so much – it is built on the foundation of a lifetime of hard work foundation of a lifetime of hard work – and even though it is intangible, it – and even though it is intangible, it represents the fact that patients represents the fact that patients have trust in them. have trust in them.

Good doctorsGood doctors

Professionalism should be taught at all Professionalism should be taught at all levels of medical education , so levels of medical education , so future generations of doctors will still future generations of doctors will still be proud to be a part of this ancient be proud to be a part of this ancient and respected profession. and respected profession.

Dehumanising doctorsDehumanising doctorsUnfortunately, we do not encourage Unfortunately, we do not encourage

our medical students to develop their our medical students to develop their emotional skills, and medical college emotional skills, and medical college usually drains whatever natural usually drains whatever natural empathy students have. empathy students have.

Students get marked for their Students get marked for their academic excellence, cramming academic excellence, cramming ability and surgical virtuosity – not ability and surgical virtuosity – not their ability to establish a rapport their ability to establish a rapport with their patients ! with their patients !

Bad doctorsBad doctors

Don’t respect patients - treat them as Don’t respect patients - treat them as mentally defective idiotsmentally defective idiots

Don’t respect patients’ Don’t respect patients’ – TimeTime– Preferences Preferences – BeliefsBeliefs

Doctors are unhappy tooDoctors are unhappy too

* They are stressed out, because of the * They are stressed out, because of the large number of patients they need to large number of patients they need to seesee

* They feel that patients expect too * They feel that patients expect too much from them. much from them. * The feel that patients unfairly blame * The feel that patients unfairly blame doctors for all bad outcomes. Doctors doctors for all bad outcomes. Doctors are easy targets are easy targets

Doctors are unhappy tooDoctors are unhappy too• The press enjoys doctor-bashing. This The press enjoys doctor-bashing. This

makes a bad situation worse, and the makes a bad situation worse, and the entire profession suffers because of a entire profession suffers because of a few bad doctorsfew bad doctors

• Many doctors also feel that patients Many doctors also feel that patients waste their valuable time by asking waste their valuable time by asking stupid and irrelevant questions; because stupid and irrelevant questions; because they are too disorganized; and don’t they are too disorganized; and don’t bother to educate themselves or do bother to educate themselves or do their homework. their homework.

Today’s problems in healthcare are Today’s problems in healthcare are because:because:

* Everything is doctor-centric - the * Everything is doctor-centric - the doctor is the center of the medical care doctor is the center of the medical care system system * Healthcare is therefore fragmented * Healthcare is therefore fragmented and disorganised and disorganised * Too many specialists , most of whom * Too many specialists , most of whom have tunnel vision have tunnel vision

We need to reform the healthcare We need to reform the healthcare ecosystemecosystem

Put patients at the center Put patients at the center Patients are the largest untapped Patients are the largest untapped healthcare resource !healthcare resource !Patients ( or their relatives and friends) are Patients ( or their relatives and friends) are intelligent and capable; and because they intelligent and capable; and because they have a lot at stake , they are motivated to have a lot at stake , they are motivated to get good health careget good health careWe need to provide the tools directly to We need to provide the tools directly to patients !patients !

Patient centered healthcarePatient centered healthcare

* Self-care * Self-care * Personalization* Personalization* Transparency* Transparency* Quality * Quality * Control * Control

The doctor-patient relationship is a The doctor-patient relationship is a two-way streettwo-way street

Teach your patient how to be a good Teach your patient how to be a good patient !patient !

A well-informed patient understands what A well-informed patient understands what the doctor is doing and why; has realistic the doctor is doing and why; has realistic expectations;  and also understands that a expectations;  and also understands that a doctor is not God, and that complications doctor is not God, and that complications and mishaps can occur.  and mishaps can occur.  

How to talk to your doctor –How to talk to your doctor –SAFEly !SAFEly !

Story:Story: S is your Story. S is your Story.

In chronologic order, starting with when In chronologic order, starting with when you first started feeling unwell. you first started feeling unwell.

List all your symptomsList all your symptoms

Write them down Write them down

Try to be as objective as possible - it's Try to be as objective as possible - it's helpful to pretend you are a third party, helpful to pretend you are a third party, reporting on the symptoms.reporting on the symptoms.

How to talk to your doctor –How to talk to your doctor –SAFEly !SAFEly !

Assessment:Assessment:

What do you feel is wrong with you ? What do you feel is wrong with you ? You don’t need to diagnose your own You don’t need to diagnose your own problem - just to let your doctor problem - just to let your doctor know what you feel is responsible for know what you feel is responsible for your problem. After all, you are the your problem. After all, you are the expert on your own body !expert on your own body !

How to talk to your doctor –How to talk to your doctor –SAFEly !SAFEly !

Fears:Fears:

What are you worried may happen to What are you worried may happen to you as a result of your illness. Are you as a result of your illness. Are you worried this will affect your you worried this will affect your ability to play tennis ? work ? affect ability to play tennis ? work ? affect your future fertility ? The best way to your future fertility ? The best way to overcome your fears is to discuss overcome your fears is to discuss these with your doctor.these with your doctor.

How to talk to your doctor –How to talk to your doctor –SAFEly !SAFEly !

Expectations: Expectations:

What do you want from your doctor ? What do you want from your doctor ? Do you want him to run some tests Do you want him to run some tests to reassure you that all is well ? Do to reassure you that all is well ? Do you just want pain relief ? Do you you just want pain relief ? Do you want an accurate diagnosis from want an accurate diagnosis from your doctor ?your doctor ?

Today - Doctor v/s patientToday - Doctor v/s patient

This is sad !This is sad !

We are all on the same side !We are all on the same side !

How do we fix the problem ?How do we fix the problem ?

Information TherapyInformation TherapyDoctors need to “ prescribe Doctors need to “ prescribe information “information “Patients will then have realistic Patients will then have realistic expectations of what their doctor can expectations of what their doctor can do for them . do for them . Information therapy - “ Prescribing Information therapy - “ Prescribing the Right Information to the Right the Right Information to the Right Person at the Right Time” is the best Person at the Right Time” is the best way of bridging the doctor-patient way of bridging the doctor-patient communication gap today !communication gap today !

Non-verbal communication - Non-verbal communication - SOFTENSOFTEN

S- SmileS- Smile

O - Open postureO - Open posture

F- Forward leanF- Forward lean

T – Touch. This is a privilege – use T – Touch. This is a privilege – use

it !it !

E – Eye contactE – Eye contact

N - NodN - Nod

Develop empathyDevelop empathy

Learn from Munnabhai, MBBSLearn from Munnabhai, MBBS

Polish your EQ skills !Polish your EQ skills !

A high EQ is far more important than A high EQ is far more important than a high IQa high IQ

Patients don’t care how much you Patients don’t care how much you know – until they know how much know – until they know how much you care !you care !

BATHE techniqueBATHE technique

B = Background. What’s going on ?B = Background. What’s going on ?

A = Affect. Feelings. What do you A = Affect. Feelings. What do you feel feel about it ?about it ?

T = Troubles. What troubles you T = Troubles. What troubles you about this ?about this ?

H = Handle. How are you handlingH = Handle. How are you handlingthis ?this ?

E = Empathy. It must be hard.E = Empathy. It must be hard.

Stress management – Stress management – Preventing BurnoutPreventing Burnout

Learn to say NoLearn to say No

Learn to take care of yourselfLearn to take care of yourself

Balance your professional and Balance your professional and personal prioritiespersonal priorities

Develop a strong support systemDevelop a strong support system

Stress management – Stress management – Preventing BurnoutPreventing Burnout

Cut back on the routine work you Cut back on the routine work you find boringfind boring

Challenge yourself dailyChallenge yourself daily

““Physician, heal thyself” ! Follow the Physician, heal thyself” ! Follow the advise you give your patients, advise you give your patients, regarding not smoking, not drinking, regarding not smoking, not drinking, a healthy diet and exercising !a healthy diet and exercising !

Become a Professional – Become a Professional – The Trust EquationThe Trust Equation

T = C + R + I/ S, where T = C + R + I/ S, where

T = TrustworthinessT = Trustworthiness

C= CredibilityC= Credibility

R= ReliabilityR= Reliability

I = IntimacyI = Intimacy

S= Self-orientationS= Self-orientation

Become a Professional – Become a Professional – The Trust EquationThe Trust Equation

Credibility = can your patient trust what Credibility = can your patient trust what you say ?you say ?

Reliability = can he trust your actions, Reliability = can he trust your actions, confident that you will act honorably ?confident that you will act honorably ?

Intimacy = is he comfortable discussing Intimacy = is he comfortable discussing his feelings and emotions with you ?his feelings and emotions with you ?

Self-orientation = can he trust your Self-orientation = can he trust your motives, knowing that you care about him, motives, knowing that you care about him, and will act in his best interests ?and will act in his best interests ?

The joy of practising medicine – The joy of practising medicine – how to be a happy doctorhow to be a happy doctor

Care for your patients. Treat all your Care for your patients. Treat all your patients like VIPs . patients like VIPs . A healthy doctor-patient relationship A healthy doctor-patient relationship nurtures both patient and doctor ! nurtures both patient and doctor ! Savor your patients. When a patient Savor your patients. When a patient thanks you , relish that moment. thanks you , relish that moment. Those moments are the real reward Those moments are the real reward for being a doctor, if you can slow for being a doctor, if you can slow down to let them in. down to let them in.

The golden ruleThe golden rule

Patients are the practisePatients are the practise

Everything else is just paper work !Everything else is just paper work !

The joy of practising medicine – The joy of practising medicine – how to be a happy doctorhow to be a happy doctor

When it comes to getting positive When it comes to getting positive feedback, no profession in the world feedback, no profession in the world comes close to medicine ! comes close to medicine ! A good doctor can have the best A good doctor can have the best emotional income in the world !emotional income in the world !Be thankful daily that you have the Be thankful daily that you have the opportunity for helping others – opportunity for helping others – expressing gratitude will help you expressing gratitude will help you find contentment and self-worth find contentment and self-worth

Money !Money !

Doctors are daily wage earnersDoctors are daily wage earners

Don’t work – don’t get paidDon’t work – don’t get paid

Need to plan for the futureNeed to plan for the future

Develop stream of “passive income”Develop stream of “passive income”

Learn to use other people’s time andLearn to use other people’s time and

other people’s money to make more other people’s money to make more money !money !

MarketingMarketing

Marketing is NOT a dirty wordMarketing is NOT a dirty word

Doctors have always marketed Doctors have always marketed themselvesthemselves

Traditionally, it has been “word of Traditionally, it has been “word of mouth” marketingmouth” marketing

This is still the best type, but it takes This is still the best type, but it takes time. This is most worthwhile time. This is most worthwhile investment of your time !investment of your time !

Promoting your practisePromoting your practiseAdvertising can be very expensive, Advertising can be very expensive, and is usually not cost effectiveand is usually not cost effectivePublic relations firms have become Public relations firms have become very popular amongst doctors very popular amongst doctors recentlyrecentlySatisfied patients are your best Satisfied patients are your best marketing tool – concentrate on marketing tool – concentrate on keeping them happy !keeping them happy !

Risk managementRisk management

Medicolegal problemsMedicolegal problems

How to prevent themHow to prevent them

Risk managementRisk management

How to deal with themHow to deal with them

Practical problemsPractical problems

Dealing with difficult patientsDealing with difficult patients

Handling the angry patientHandling the angry patient

How to talk to relativesHow to talk to relatives

Networking with other doctorsNetworking with other doctors

IQ versus EQIQ versus EQ

Most doctors have a high IQMost doctors have a high IQ

This is NOT enoughThis is NOT enough

Need a high EQ to do well in practiseNeed a high EQ to do well in practise

These skills can be learntThese skills can be learnt

Doctors are smart !Doctors are smart !

Employees !Employees !

Can be your biggest asset – as well Can be your biggest asset – as well as your biggest problem !as your biggest problem !

Keep your employees happy, and Keep your employees happy, and they will keep your patients happythey will keep your patients happy

Don’t skimp on their salariesDon’t skimp on their salaries

Train them wellTrain them well

Key test – how well does your clinic Key test – how well does your clinic run when you are not there ?run when you are not there ?

Many other issuesMany other issues

Time managementTime management

Learning to keep upto dateLearning to keep upto date

How to buy medical equipmentHow to buy medical equipment

How to keep medical recordsHow to keep medical records

How to grow and expandHow to grow and expand

Balancing family and careerBalancing family and career

RetiringRetiring

EthicsEthics