The Doctors who Communicate Better, are Better Doctors.

Communication with patients is perhaps the most important component in the overall patient experience at the hospital, yet it is a rare hospital that gets it right. The communication with patients largely involves the clinicians. The nurses, front-office executives, the house-keeping staff and even the security guard manning the elevator too can help deliver a wonderful experience by reaching out with kind words. However, it is really the doctors, whose words make the biggest difference in a patient’s life.

A few years ago, a friend’s husband needed a kidney surgery. The patient was to be wheeled into the surgery at around 10 am in the morning and the surgery was to finish in 4 hours. He was wheeled in for surgery from the hospital room at around 0930 in the morning. When I met the friend’s family a couple of hours later the attendants sat huddled together in the cafeteria, anxious and hopeful in equal measures. The time went by rather lethargically and their anxiety kept mounting. When 6 hours had gone by, the frantic family members approached the doctor’s secretary, who assured them with great panache that the surgery has gone without any hitch and they will soon be able to see the patient. Much relieved, the family members decided to have a celebratory coffee as they waited to see the patient in the recovery.

While they waited to hear from their surgeon, a couple of hours went by. The helpful doctor’s secretary by now had finished work and gone home. The surgeon was no-where to be found and there was just no one who could give them any information about the patient. Again frantic with worry the friend reached out to me to get some information about the patient’s well being and also when can they possibly see him and their surgeon.

Concerned, I made inquiries with the team in the OR and learned that the patient’s surgery had been delayed by a few hours as the previous surgery in the same OT had lasted longer than planned. The surgeon had been busy operating his scheduled cases and did not have the time to step out and explain the delay to the anxious patient’s relatives. The surgeon’s secretary had not heard anything untoward from the OT either and just assumed that everything would have gone as planned.

The patient’s surgery was uneventful and he made a full recovery. However, for the patient’s attendants, this was a harrowing experience. This is a true incident, and we know that something like this happens every day in our hospitals.

I have often pondered over the stark difference in the situation between the surgeon and the patient. Consider this for a minute. For a surgeon, a surgery is something that he does every day (maybe multiple times every day!!!), for a patient it is a frightening and hopefully once a lifetime experience. The surgeon, while operating in his theatre, surrounded by a team that he has perhaps worked with for years is usually confident of his skills and the ability to help the patient. The patient and his family are on the other hand in an alien environment. No one likes to be in a hospital and surgery is scary. The outcome in the patient’s mind is always uncertain. Given a choice, he would be anywhere but the hospital. Such is the power imbalance and asymmetry in the equation between the doctor and the patient, that it is imperative that we use clear communication to keep things on as even a keel as possible.

Patients will always see doctors who communicate well as better clinicians. Patients and their families like their doctors if they step down from their pedestals and treat them as friends. They will readily narrate stories about their interaction with their doctors and tell all their family and friends on how approachable and wonderfully transparent their doctor was. They will readily recommend the doctor to their family and friends and ultimately restore the doctor back on the pedestal!!!

It is very hard for the hospital administrators to mandate processes that define when and how should the clinicians meet their patients. Afterall, this is really a matter between a doctor and his patient and the hospital management isn’t usually welcome as a participant in this relationship.

However, hospitals must encourage their doctors to spend more time with patients and their families and not just fob them off with brusque briefings in the corridors. They must provide infrastructure, where patients and their families can meet their doctors and spend time together.

Doctors who communicate well with their patients can easily transform the hospital experience for a vast majority of patients.  Hospitals will do well to remember that.

The views expressed are personal



Marketing A Laparoscopic Surgery Program

Marketing a surgery program is fraught with risks. Barring surgeons, I am yet to meet someone who looks forward to a surgery. Most people try to avoid surgery as much as they can. They will come up with all kinds of excuses including astrological considerations, the weather not being right (it is either too hot or cold or raining) or waiting for a son or a daughter who lives abroad to arrive before they can go under the knife.

The fear of surgery is universal and whatever the surgeon might say (I have done it a thousand times, I do it every day etc.), the fear of surgery just does not dissipate. Whatever the surgeon may say, the fact remains that patients undergo surgery only when they do not have any other medical recourse. Given a choice between a surgery and any other non-invasive medical procedure a patient will always choose the latter.

Now, marketing a surgical program, which no one wants (or at best agrees to only as a last resort) is to say the least, challenging. With the advancement of technology a whole lot of surgeries can be done using a laparoscopic techniques. This is indeed a great boon for patients, who as I mentioned earlier are extremely reluctant to go under the knife and by corollary once subjected to surgery are very keen to return home to normal life. Laparoscopic surgery, which is also at times called Minimally Invasive Surgery allows surgeons to operate with just a few holes through, which they insert a camera and other equipment necessary for the surgery. Minimally Invasive Surgery is far superior to conventional open surgery as it is a lot safer, allows faster recovery, has less chances of infection and usually involves minimal loss of blood.

To effectively market a laparoscopic surgical program it is essential that the patient understands its huge benefits. Since, patients after a surgery want to return home faster, I would suggest that we brand the laparoscopic surgery program as ‘Short Stay Surgery’ program. This is easily understood by all and has a certain appeal for patients-instead of focusing on surgery, they would rather look forward to a short hospital stay and a quick return to home. Fortunately, many surgical procedures done laparoscopically allows patients to return home with in 24 hours, which is just great.

Once the program is branded as ‘Short Stay Surgery’ program the other benefits of the program must be highlighted all flowing into the core benefit of  a short stay in the hospital. The surgeons in their spiel should highlight this aspect of surgery as much as they can. This is not to say that they should gloss over the risk factors of the surgical procedure, it is just that the prospect of a possible shorter stay in the hospital will make the patient feel a lot better.

The advertising communication should highlight facts such as faster recovery, minimal scarring, less pain, low blood loss  and less chances of infection as clear advantages of laparoscopic surgery. It should then connect this up with the core benefit of a shorter stay in the hospital. I believe such an approach can go a long way in popularising minimally invasive surgery and patients will actively seek a surgical intervention at the right time rather than wait till there is an emergency and waiting may no longer be possible.

The tonality of messaging is just as critical as the message itself. One has to be very careful in not sounding over enthusiastic and too keen in the advertising. One must remember that inspite of all the advantages of laparoscopic surgery, it still is surgery. From a patient’s perspective this involves a detour to the hospital and the attendant risks can not be just wished away. The communication must be couched in a language, which is solicitous, understanding and educative. It should connect with the patient and help him understand that the short stay surgery program lessens risks significantly and allows him to get over the medical crisis faster.

The use of media of course depends on the budget available with the hospital.  Print, Television, Outdoors, Radio, digital and BTL can all be effectively used to create an impactful campaign. The choice of media can amplify the messaging and help more people connect with the hospital.

And choose laparoscopic surgery in time rather than wait till they are left with no choice.

Homeopathy in a Modern Hospital

homeopathyA few days ago I received an sms from Artemis Hospital exhorting me to check out their Homeopathy services! This seemed strange as Artemis Hospital is one of the most advanced centres of medical care in North India and boasts of the highest level of medical advancement. It has invested tonnes of money on advanced imaging equipment such as a 3T MR, a 64 slice CT scanner, a PET CT and a 4D Doppler amongst other fancy stuff.

Artemis has highly experienced doctors and surgeons who literally operate on the cutting edge of technology. Amongst all this Homeopathy seems to be a little out of place.

Ask any doctor worth his salt about homeopathy and other alternate systems of medicine common in India and he will be downright derisive or at best will say that he is not sure of their efficacy. Doctors are trained in the science of medicine and surgery and rely on scientific evidence proven in laboratories and tested on animals and humans in scientifically designed and executed clinical trials. For them to accept homeopathy, ayurveda or the yunani system of medicine as effective treatment is difficult. Yet we have a modern hospital offering the services of a homeopath. I am intrigued.

Now, I have nothing against any system of medicine. I am sure the practitioners of any of these alternate systems of medicine have their own methods of diagnosing and treating people and I would also concede that there are enough people who believe in them. However I do know that God forbid, if I ever need serious medical attention I would head straight to a doctor qualified and experienced in the western system of medicine.  To me that is a straightforward choice.

I am also against mixing the modern western medicine with the likes of homoepathy and ayurveda. They just do not mix well. I would think twice about referring a friend to a modern hospital, which also offers homeopathy and ayurveda. Somehow, it appears that the hospital and the medical folks do not have enough faith in their own system of medicine. It seems like a tacit admission of the fact that these ancient alternative systems of medicines have something to offer even when modern medicine has failed. This I personally find hard to believe.

Arguments about offering a choice of medical systems to patients are also common place. This to my mind is bunkum. The patient wants a cure for whatever ails him. He wants it fast,with minimal pain and with a certain degree of reliability. He cares two hoots about the choice of medical system. If he walks into a hospital, he has already professed his faith in the western system of medicine. Offering anything else to him is downright foolhardy.

Why would Artemis hire the services of a homeopath and than go about promoting it? I can only say that if they are serious about homeopathy, they can always consider launching a homeopathy institute and call it something appropriate. After all Artemis Homeopathy Institute does sound weird. 

Pic courtesy