Five steps to better patient-doctor relations

FIVE STEPS TO BETTER PATIENT-DOC RELATIONS

 

Monday's patient-doctor clash at civic-run KEM Hospital underlines the need for legislation to protect doctors. Health activists and doctors say even hospitals need to take certain steps to prevent such ugly situations

 

REDRESSAL SYSTEMS

It's not always a death that precipitates a situation, it may simply be a harried patient or relative who is confounded by hospital procedures. Often, such assaults on hospital staffers occur due to a total breakdown of communication. "There is a perception of negligence among patients and relatives, which should be addressed before the situation flares up,'' says Anant Phadke of Jan Swasthya Abhiyan. He suggests that hospitals introduce an independent committee of people from consumer organisations, which can be used as troubleshooters/ombudsmen.

 

GRIEF COUNSELLING

The death of a family member is hard to accept and there is a need for hospitals to introduce social workers or grief counsellors to gently break the news and lend a willing ear to grieving relatives. Hospital administrators also need to sensitise doctors and medical staffers on "how to deal with death''. "Medical staffers see death every day and may be desensitised to it. It's time we have counsellors or psychiatry departments to train medical staffers to deal with such issues with sensitivity,'' says Dr Lalit Kapoor, who heads the medico-legal cell of the Association of Medical Consultants.

 

PATIENT EDUCATION

Patients and relatives often fail to grasp hospital procedures or medico-legal requirements. In the KEM case, too, relatives were reluctant to allow a post-mortem. "There is a need for patient education so that everyone understands the legal requirement of post-mortems. This will also help dispel notions that post-mortems are against religious tenets,'' says Dr Kapoor. Another doctor suggests that pamphlets, pictorial if need be, on patient rights, disease information etc should be circulated among waiting relatives.

 

RESTRICTIONS ON VISITORS

In many of the recent cases of hospital violence, it's not been patients' relatives resorting to violence as much as political and "social" activists who egg them on. Relatives in Monday's KEM Hospital attack too said they were "incited'' by someone. "There were talks of restricting the number of visitors to public hospitals to increase safety, but that hasn't happened in reality,'' says Dr Suhas Pingle of IMA. While private hospitals have fixed visiting hours and issue passes for visitors, public hospitals are lax in this matter.

 

IMPROVEMENTS IN HOSPITAL SERVICES

Public hospitals need better services—less waiting time, better technology and improved infrastructure—to regain the trust of patients/relatives. Dr Pingle suggests that the civic body can work out a system whereby patients with minor ailments are treated at smaller hospitals, rather than crowding superspeciality hospitals such as KEM, which currently receive 15 lakh out-patients annually. This will allow doctors to give every patient the time and attention he/she deserves. Private hospitals should clearly display costs of tests, rooms, procedures and doctor's fees to avoid any confusion, say experts.