Patients can contribute to Information Therapy

2nd Annual Conference on Using Information Therapy to Put Patients First in India: Register Now !

What patients can contribute to Information Therapy?

Doctor Sourav Bose was finding it difficult to manage Mr Aditya Rao’s diabetes. Though he had changed the dose of the insulin thrice, his blood sugars remained high. He was at his wit’s end and did not know what to do. He put it down to “non-compliance” and wrote Aditya off as a “ difficult
patient “ ! He failed to recognize that by spending more time with his patient, delving into his lifestyle, and asking him why he was having a hard time with following the treatment plan, he could have come up with an effective solution. Aditya was as much to blame ! He should have discussed the practical difficulties he was facing with taking the insulin injections in his office, as advised by the doctor, instead of meekly accepting his doctor’s advise – and then failing to follow it !

Information Therapy traditionally means the prescription of the right information to the right person at the right time to help make a better health decision. However, if we accept the fact that patients are at the center of the medical universe and that it is patients who are the true experts on their illness, then an equally important part of information Therapy should be the provision of information from the patient to the doctor! After all, communication is a two-way street and the patient’s personal perspective is as important as the medical perspective through which the doctor views the world.

Why has this been neglected so far? Why don't more patients provide Information Therapy to their doctors? This kind of patient education has a long and respected history! While writers have written on what it is like to be a patient for hundreds of years, one of the most important books that taught doctors to re-look at things from the patient's perspective was Norman Cousin's classic, Anatomy of an Illness. In fact, there is now an entire a genre of books that does this very well. This is called pathography - a narrative that gives a voice and face to the illness experience, by bringing the person behind the disease to the forefront!

Pathography is a very useful teaching tool! It helps doctors to learn empathy, so they can learn to see things from the patient's perspective. For example, though I am an IVF specialist, I am not infertile myself. By reading first person accounts of the trials and tribulations faced by infertile couples, I learn a lot about the problems that my patients face – problems that they may not be willing to talk about when they meet me for the first time. All doctors learn medicine from their patients. As Sir William Osler said, ‘He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all.’ Unsurprisingly, his best-known saying was ‘Listen to your patient, he is telling you the diagnosis,’ which aptly emphasizes how much a good doctor can learn from a patient!

Doctors usually remember their most challenging patients or their most complex and difficult cases all their life – these often form the defining moments in their professional career. It is true that these exceptional patients teach us a lot and good doctors treasure them, since they learn the most from them. These are a doctor's ‘memorable’ patients - many of whom teach us what not to do ! Intelligent doctors learn from their patients all the time, but this can only happen if patients are willing to teach them! These are the ‘expert patients’ - those who are articulate and treat their doctors as partners in their medical care.

Doctors can learn from every patient, but only if patients learn to speak up, and doctors learn to listen. It is not that doctors are going to learn medical facts from each patient – but each patient is unique and has valuable insights to offer. Patient feedback helps doctors to improve their services, and even complaints are gifts, when taken in the right spirit! Unfortunately, there are still many barriers to getting feedback from patients. Most patients are inhibited and scared and do not have the courage to displease their doctor by telling him the unpleasant truth. If patients want their doctors to do a better job, they need to learn to speak up. Most dissatisfied patients today just walk out of the doctor's clinic and never return. They find a better doctor - but by failing to give the doctor honest feedback, they lose the opportunity to help him improve and do a better job with his next patient. Similarly, most doctors are too busy to ask for feedback, and most continue deluding themselves that they do a perfect job with every patient!

Hopefully, the Internet will allow patients to offer critiques and criticism more easily. There are now many doctor-rating websites, where patients are encouraged to provide their opinion about their doctor. This kind of patient-generated content will help doctors to get their act together, if they are willing to keep an open mind and try to correct problems. Thanks to the Web, smart patients have adopted a number of clever initiatives towards improving medical care. These e-patients, of whom the most prominent is Dave, are speaking up and claiming their rightful place in the healthcare ecosystem, so that patients now have a voice which is heard, and more importantly, respected.

Online patient support groups have a lot of clout – and crowdsourcing the collective experiences of hundreds of patients can actually help advance medical research, as proven by innovative sites such as PatientsLikeMe (www.patientslikeme.com). Patients are also collaborating to fund clinical studies, so that doctors can do research on topics that are of interest to patients , and not just on areas which pharmaceutical companies find remunerative . Patients have also taken a lead role in simplifying medical research so that it becomes understandable to other patients. Cochrane Collaboration (www.cochrane.org) is a fine example of how it is important for researchers, providers, practitioners, and patients to collaborate. 28,000 people from over 100 countries work together to help healthcare providers, policy makers, and patients make informed decisions about healthcare. Such collaboration is imperative in today’s times. When individual knowledge turns into collective knowledge, medical care is substantially enhanced!

Second Pre-Conference Seminar@HELP - 3 Sep'11 11.30am

Invitation to

Second Pre-Conference Seminar@HELP on

Using Information Therapy to Put Patients First

on Saturday, 3rd September, 2011at 11.30a.m. at

HELP LIBRARY - Phone: 22061101, 22031133

Pls click here if you are unable to read this email:

Using Information Therapy to Put Patients First

Speaker	Topic
Dr.Taufiq Panjwani	A medical intern’s perspective on the application of Information Therapy.
Dr.Ninad Maniar	Information therapy and the medical student – a feasible symbiosis
Dr.Akanksha N.Thakkar	Using information therapy to effectively deal with neurodevelopmental disorder related childhood stress
Dr.Mihir Gangakhedkar	Information Therapy and Tackling Pandemics In Developing Nations

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Why hospitals need to provide Information Therapy

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Using Information Therapy to Put Patients First in India: www.patientpower.in






Why Hospitals Need to Provide Information Therapy - Dr.Aniruddha Malpani, MD
CRM ( customer relation management ) is a tool which all service industries to keep their customers happy. While one would expect hospitals to use CRM routinely, unfortunately, most hospitals still do not bother. Given the large patient:hospital bed ratio in India, most hospitals continue to take the approach that patients do not have a choice as to where they can go for their treatment, which is why most hospital staff adopt a high-handed attitude towards patients . Stories of hospital staff rudeness and arrogance are innumerable – and this is reflected in the increasing number of incidents of violence against doctors and hospitals.

Progressive hospitals are willing to learn lessons from the hospitality industry , and are willing to implement CRM to help their patients have a better experience when they come to the hospital. However, when I am talking about PRM, I am referring not to Patient Relationship Management ( something which all hospitals need to learn to do, but most still do badly !), but rather to Patient Relative Management.

The need for this is much more acute in Indian hospitals ! When most patients come to a hospital in India, they are accompanied by a bevy of friends, neighbours and relatives ! These people are extremely important in India, but sadly, they are often ignored and neglected by the hospital staff and management. Most hospital staff members consider them to be a nuisance and tolerate relatives as a necessary evil – and there are very few amenities available for family members , even for those who are on a 24-hour vigil outside the ICUs !

This is a very short-sighted approach ! Relatives are understandably concerned and worried about their patient’s health. They are key decision makers, and need to be educated and informed about what to expect. They need to be addressed politely and kept updated about the clinical status of their patient.

Unfortunately, this is rarely done. Doctors ( and sometimes, the more senior they are, the worse their habits !) seem to take a perverse pride in making relatives wait for ever and ever ( often for completely flimsy reasons). They are not willing to share information about what goes on behind the intimidating doors of the Operation Theater and ICU. This is why family members often get angry with doctors, and when their patient dies, are eager to vent their frustration by burning down the hospital or beating up the doctors.

Doctors are very busy – and many may not have enough time to talk to even their patients, leave alone their relatives ! This lack of communication can cause frustration; and after bottling it up, relatives will often vent their resentment when a mishap occurs – even if the doctor was not to blame.

This is a systemic problem, which can be addresses proactively by the hospital management. In order to protect doctors, who are now feeling very vulnerable, the government is passing laws and hospitals are beefing up their security. However, this is a very short-sighted fix.

It’s far more important that hospitals start investing time, money and energy in educating patient’s relatives, so they have realistic expectations of the outcome of the medical treatment.
Dissatisfaction arises when there is a mismatch between expectations and reality – and helping relatives to have realistic expectations will help in reducing dissatisfaction with doctors and hospitals !

The most effective way of doing so is by setting up Patient Education Resource Centers in the hospital. The PERC will be run by nurses and librarians; and will help to educate patients and their relatives, so they know what to expect during their hospital stay.

As Indian hospitals strive to attract medical tourists and match global standards ( for example, by getting JCAHO accreditaion), documenting that patient education has been provided is going to be an integral part of patient care. The PERC will become an important department of the hospital . In the Mayo Clinic, the Dept of Patient Education occupies an entire building !

Not only are PERCs important for risk management, they are also very cost effective. All these relatives are prospective future customers for the hospital ( after all, we are all going to fall ill some day !) If they are treated with respect, they are likely to come back to the same hospital for their own medical care when they need this !

We all know that the best kind of marketing is word of mouth marketing . Instead of wasting money on advertising in the press , it makes much more sense for hospitals to invest it in PRM ! Relatives ( and the patient’s visitors ) are potentially a captive customer base – why not educate them about health and illness ? In a hospital, everyone has a much more heightened sense of their own mortality. When you visit a friend who is sick, you are much more acutely aware of your own frailty – and much more health conscious ! ( What can I do to make sure my husband does not get a heart attack like his elder brother did ?) Reaching out to these relatives through a Patient Education Resource Center to help them learn more about their health can pay big dividends for the hospital , because they are much more likely to seek medical assistance in a hospital which has taken the time and trouble to educate them !

PERCs can also be very useful for educating and training paramedical staff. The hospital support staff
( such as ward boys and the janitorial staff) play a very important role in serving the patient’s daily needs. However, they are often not very well informed about hospital procedures . The PERC can be used to educate and train them, so they are more responsive to the patient’s special needs .

HELPTALKS - Dr.Jimmy Modi on Aspects Of Hypnotherapy

This video is a talk by Dr.Jimmy Modi at HELP on 26th August, 11. Topic "Aspects Of Hypnotherapy".Dr.Jimmy Modi can be contacted at 9870027801.This is part of the HELP Talk series at HELP,Health Education Library for People, the worlds largest free patient education library www.healthlibrary.com

HELPTALKS - Mr.Kamlesh Solanki on Relaxation Technique In Yoga

This video is a talk by Mr.Kamlesh Solanki at HELP on 25th August, 11. Topic "Relaxation Technique In Yoga".Mr.Kamlesh Solanki can be contacted at 9820770138.This is part of the HELP Talk series at HELP,Health Education Library for People, the worlds largest free patient education library www.healthlibrary.com

MD Consult India: Testimonial from Dr.Subrahmanyam Karuturi, MD

Dr.Subrahmanyam Karuturi, MD, General Physician & Founder, DoctorsHangout.com

To subscribe click here: MD Consult India

If you want to pick just one website, which would answer all your information needs, try out www.mdconsult.com which labels itself as "What Doctors need to know". This site provides access to the ultimate digital online medical library. The full text medical reference books which are the standard authoritative texts and cover all fields of medicine include Nelson Textbook of Pediatrics, Cecil Textbook of Medicine, Devit: Cancer: Principles & Practice of Oncology, Rakel: Conn’s Current Therapy, Rowland : Merritt’s Textbook of Neurology, Ryan: Kistner’s Gynecology: Principles and Practice, Sabiston: Textbook of surgery, Braunwald 's Cardiology and Cambell’s Urology. You can search the entire collection at the same time, then pinpoint the information you need within the so summate text on the subject.
The site also provides access to the complete text of all the articles in the famous clinics of North America, the entire series of year Books as well as many leading journals. These include the American Heart Journals, American Journal of Obstetrics & Gynecology, Chest, Journal of Pediatrics, Medicine, Neurology, and Pediatrics, so that you are no longer restricted to abstract only. You can also search the MEDLINE database. The section on practice guidelines offers you the complete text of over 600 peer-reviewed clinical practice guidelines contributed by more than 50 medical societies and government agencies.
An additional bonus is the ‘Patient Education’ section, which offers you access to any of 2,500 acclaimed patient education handouts. You can add your own comments to customize them for your practice, and then print the handout, complete with your own special instructions, practice name, and contact information!
The Drug Information section provides regularly updated prescribing information on over 30,000 medications from an independent drug reference source. While all the brand names are for US drugs, this is very valuable information, which allows you to find the right drug for the right problem.
MD consult has been laid out so that it provides answers to clinical queries, and also has a section which allows regular updates. The ‘updates’ section offers many choice. The ‘Today in Medicine’ division allows you to stay informed about the newest development in medicine. It reviews new developments from major journals, government agencies, and medical conferences, and provides you with concise clinical summaries and links to related information.
The ‘In this week’s Journals’ allows you to keep up with all the major weekly journals by presenting you with all the major weekly journals by presenting you with the key contents of the big six journals-JAMA,BMJ, lancet, NEJM, Archives of Internal Medicine and Annals of Internet Medicine in an easy-to-scan format, including concise article summaries which help you quickly stay abreast.
Clinical Topic Tours offers a new tour each week and lets you explore current thought and accepted wisdom on consequential topics in medicine through a focused collection of information from journal articles, books, drug data, practice guidelines, educational materials and useful Websites.
What makes MD consult the best is its impeccable clinical content and its superb structure, so that less than three web pages have to be viewed in order to find an answer to any original query. MDConsult is comprehensive since it covers all areas of medicine, and since it is subscription-based, it is free from advertising and all the irritating and distracting banner ads so common on other sites. You can get a free demo of the power of MDConsult by logging on at www.mdconsult.com

- Dr. Subrahmanyam Karuturi, MD
General Physician & Founder, DoctorsHangout.com
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HELP TALKS - Mr.Rajiv Sethi on Good Health Without Medicines

This video is a talk by Mr.Rajiv Sethi at HELP on 23rd August, 11. Topic "Good Health Without Medicines".Mr.Rajiv Sethi can be contacted at 9702344444.This is part of the HELP Talk series at HELP,Health Education Library for People, the worlds largest free patient education library www.healthlibrary.com

HELP TALKS - Dr Shankar Khuje on Use Of Homeopathy Medicine

This video is a talk by Dr.shankar Khuje at HELP on 23rd August, 11. Topic "Use Of Homeopathy Medicine".Dr.Shankar Khuje can be contacted at 9820088188.This is part of the HELP Talk series at HELP,Health Education Library for People, the worlds largest free patient education library www.healthlibrary.com

HELP TALKS - Dr.Bashisht Mishra on Bypass And Angioplasty Debate Continues

This video is a talk by Dr.Bashisht Mishra at HELP on 22nd August, 11. Topic "Bypass & Cardiology : Debate Continues".Dr.Bashisht Mishra can be contacted at 9619107666.This is part of the HELP Talk series at HELP,Health Education Library for People, the worlds largest free patient education library www.healthlibrary.com

Patient as a Teacher for his Doctor

There is no doubt that the one person who will look after his own interests the best is the patient himself. You need to do your homework thoroughly, find out more about your problem, and then discuss the results of your research with your doctor. This is your right and your responsibility as well! Every honest doctor will agree that his patients are his best teachers!

Using Information Therapy To Put Patients First in India

Yoga Workshop @ HELP

Speaker: Ms.Khush Dubash
Fees: Rs.1000/- per month
Duration: 4 months
Date: Starting from 5^th Sept
Days: Monday, Wednesday Timings: 10:30am–11:30am

Benefits of Yoga:

• Feeling very energetic & youthful
• Improved Concentration & memory
• Feel relaxed & Stress free.
• Improved Digestion system, and bowel movements & good sleep
• Relief from backache, spondylosis, & arthritis.
• Weight, Blood pressure and diabetics brought under control.
• Great sense of well-being & overall fitness – no more
Depression
For registrations contact HELP Library: 22061101, 22031133, 65952393/94.

When you play the Role of a Communicator

It is vitally important that you be open and honest with your doctor. When in doubt, ask questions, listen to the answers carefully and take notes. A prudent measure would be to write down your questions before your appointment, so that you do not forget important matters during the stress of consultation. Remember, the only stupid question is the one you don't ask! So, to re-emphasize, don't hesitate to ask questions! And if you don't understand the answers, the fault is not all yours; it could be that your doctor is not explaining the facts well!

Patient Community Meeting : Pre - Conference Seminar

The first pre-conference was held at HELP on 20th August, 2011.

Young doctors and medical students shared their thoughts on how Information Therapy will help patients and doctors to get better medical care.

Some interesting ideas presented by Dr.Shaivi, Dr.Soumil, Dr.Manasi and Dr.Amar were:

1. The problem is not too little but too much information - how should the patient sieve through all the information
2. Patients are not aware of resources at hand;
3. Support groups are found to be helpful; online support groups equally helpful;
4. What makes the patient happy - is sitting down and talking to the patient - they don't care if the doctor is better known or better qualified;
5. Convert patients from being passive to active
6. Group therapy works better than individual therapy
7. How can IT be used: every hospital should have
- all health information available for patients
- EMR for each patient to help patients and also for research for specific populations
- information should be easily accessible
- translated information
- online access to pharmacies to purchase/refill medicines
- easy communication with your doctor (email/sms)
- obviate need of human communication
- online services should be interactive
8. End Goal of Information Therapy should be Happy Patient ...... Happy Doctor + Staff
9. A website to put up reviews of doctors/services by patients.
10. Arrange the hospital sections to provide a single window to patients for all services including information therapy.
11. Dr.Amar working at Tata welcomed the idea of patient education center at all hospitals.

When you play the Role of a Financial Manager

Medical treatment can be very expensive these days, and you must make it a point to know the costs involved. Many patients are hesitant to talk to their doctor about money matters, but this reluctance can prove to be very costly! Also, if you are claiming reimbursement (either from an insurance company or from your employer) you must make sure that you have complete records of payments made along with their receipts.

When you play the Role of a Medical Record Keeper

You must keep all your records safely, and this can be very helpful especially if you have a complex problem a chronic disease, or need to change doctors or get a second opinion. File all your records in reverse chronological order; and number all your documents in sequences. Also prepare a one-page summary sheet of your medical experiences. Software packages are available nowadays, which help you document all medical details very efficiently.

HELP TALKS - Dr.Juvekar on Nakshatra And Your Health

This video is a talk by Dr.Juvekar at HELP on 20th August, 11. Topic "Nakshatra & Your Health".Dr.Juvekar can be contacted at 9969951658.This is part of the HELP Talk series at HELP,Health Education Library for People, the worlds largest free patient education library www.healthlibrary.com

Dr.Juvekar - His Experience On Giving A Talk At HELP Library

This video is a feedback by Dr.Juvekar,his experience on giving a talk at HELP Library.At HELP, we organize talks everyday by doctors/specialists on different health related topics, issues. These talks are recorded and uploaded on our website, youtube, facebook, orkut, twitter.Are you a doctor? Would you like to give a talk at HELP Library? Feel free to contact us at HELP - 22061101, 22031133.For more details log in to our website www.healthlibrary.com

Feedback - Nakshatra & Your Health

This video is a feedback by one of readers on the HELP TALK - Nakshatra & Your Health conducted on 20th July 2011. For more details log in to our website www.healthlibrary.com

When you play the Role of a Treatment Decision Maker

You will have to decide which treatment to choose among the alternatives. Sometimes the choices are straightforward, but sometimes they can be very confusing. A good doctor will offer you all the options and help you to decide, but ultimately, you have to exercise your right (and responsibility!) to select a course of treatment. You cannot afford to leave everything to god, or to the doctor either!

Getting doctors to prescribe Information Therapy

2nd Annual Conference: Sunday, 9th October'11 Nehru Center, 10.30a.m.

Mr Rathod had been experiencing pain in his abdomen, so he went to his GP for a check-up. After examining the test reports, his doctor told him that he had ‘Choledocholithiasis’. Mr Rathod was taken aback, thinking it was a serious disease, only to breathe a sigh of relief when he was informed that the simpler definition for his ailment was ‘gallstone in the gallbladder’, a fairly common condition which is easily treatable. When it comes to interacting with patients, using simple, jargon-free language is of the essence. Imagine if a doctor told you that you had ‘Xerostomia’? You would think ‘oh, woe is me.’ Well, all it means is that you have a dry mouth! So how do doctors communicate in an unambiguous manner to their medically uninformed patients? Information Therapy to the rescue, again!

The word doctor is derived from the Latin word, docere, which means to teach! Teaching patients is a doctor’s second nature, right? Most doctors definitely think so! The majority of doctors feel that they have impeccable bedside manners and excellent communication skills. Illusory superiority is a cognitive bias which afflicts doctors as well. Doctors are not immune to the Lake Wobegon effect (named after Garrison Keillor’s fictional town where ‘all the children are above average’). Communication, however, is a two-way street, and sadly, most patients do not think that doctors are good teachers. Naturally, all patients want detailed information regarding their ailments and subsequent course of treatment, and they feel that their doctors do not bother devoting enough time explaining them their problems. Additionally, many patients feel that when doctors do explain, they use complicated medical jargon that is beyond the understanding of the average person. Patients also feel that sometimes their doctors seem too caught up and unapproachable, so they hesitate in asking too many questions.

If doctors are indeed smart and know that patients want more information about their illnesses, then why don’t doctors routinely prescribe Information Therapy? There is no conspiracy of silence here ! The sad truth is that most doctors simply do not understand the importance of Information Therapy. It is not that doctors enjoy keeping their patients in the dark, so they can extract money from them! Most doctors are happy to share information with their patients, and educating them will not turn them into doctors. Patients will still need to come to their doctor to get the treatment they need! The core problem is that educating patients is still not a top priority for doctors. They have a completely different worldview. Since they are doctors and know a lot about medicine, they sometimes assume that their patients are equally well-informed, which of course is not the case. Many will use jargon without even realizing that it is going above the patient’s head. ‘Medicalese’ has become their primary language!

Doctors suffer from the ‘curse of knowledge’, just like all of us. We know what we know, and we know it so well that we assume that everyone else knows it just as well as we do. This is why doctors sometimes overestimate the ability of their patients to understand what they are talking about – they naively believe that if they know all these medical terms, their patients will too! Moreover, most doctors’ primary focus is providing clinical care. Sometimes, they are so busy doing this that they just don’t have time to educate their patients. There is no question that doctors are busy people, and they will always remain busy. However, if doctors can provide their patients with tools that make it easy to for them to prescribe Information Therapy without disrupting their workflow, they will be happy to do so!

The trick is to make the patient do the work, using the self-service model supermarkets do, versus the old fashioned kirana shop! In the kirana store, all products are fetched by an assistant from shelves while customers wait in front of the counter and indicate the items they want. This is very labor-intensive and therefore also quite expensive. The shopping process is slow, since the number of customers who can be attended to at one time is limited by the number of staff employed in the store. The concept of a self-service grocery store was developed by American entrepreneur Clarence Saunders who started ‘Piggly Wiggly’ stores in 1916. Today, supermarkets stock shelves at night so that customers, the following day, can obtain their own goods and bring them to the front of the store to pay for them. This way, they can service a much larger number of customers by making them do the work! Similarly, Information Therapy tools allow patients to serve themselves, so their doctor’s precious time can be used for more productive and empathetic patient interaction.

What can we do to persuade doctors to prescribe Information Therapy routinely?

1.Some will start doing so when they realize the value that Information Therapy adds to their practice – and to their patients. These are the ‘early adopters’ – who pick up on new trends, and use them cleverly. They take pride in delighting their patients; and will use new technology and tools to do so.
2.Many will prescribe Information Therapy when they see leading doctors doing so regularly. We are all social animals, and the herd mentality is strong amongst doctors as well!
3.Some will start when they are pushed into doing so by their patients. Patients do have clout, even though they often do not realize it! Doctors cannot survive without patients, and if enough patients start clamouring for information, doctors will toe the line and start offering it!
4.Let us not forget that doctors are rational human beings, and will respond appropriately to the right financial incentives. Once they get paid for providing Information Therapy (either by the government or by health insurance companies), many will routinely start providing this to their patients.
Doctors must be provided with access to a wide variety of inexpensive, easy-to-use tools, so that they can easily prescribe Information Therapy. Different doctors have different working styles and their patients have different learning needs. The good news is that it is possible to use technology cleverly and efficiently, so that we can cater to these diverse requirements by using a combination of text, audio and video, which can be tailored to the individual patient’s and doctor’s needs. Sadly, many doctors are still unaware of the wide variety of tools which are already available for educating patients; this is why they still don’t make effective use of them. Perhaps, some technology therapy needs to be prescribed to doctors first so that they are well-equipped to dispense Information Therapy to their patients!

Register for the 2nd Annual Conference on Using Information to Put Patients First : www.patientpower.in

HELPTALKS - Mrs.Ratna Khemani on How To Keep Your Marriage Alive

This video is a talk by Mrs.Ratna Khemani at HELP on 19th August, 11. Topic "How To Keep Your Marriage Alive".Mrs.Ratna Khemani can be contacted at 9423886836/ 020 25851976.This is part of the HELP Talk series at HELP,Health Education Library for People, the worlds largest free patient education library www.healthlibrary.com

When you play the Role of a Medical Team Manager

You will have to find, evaluate, select, hire - and sometimes fire - members of your medical team. As an enlightened patient, you need to remember that you are the one in charge of your body --- and that it's your medical team you are managing!

HELP TALKS - Mr.Peter Theobald on Yogic Sukshama Vyama

This video is a talk by Mr.Peter Theobald at HELP on 18th August, 11. Topic "Yogic Sukshama Vyama".Mr.Peter Theobald can be contacted at 9324507156.This is part of the HELP Talk series at HELP,Health Education Library for People, the worlds largest free patient education library www.healthlibrary.com
The Complete Talk On Yogic Sukshama Vyama Will Be Continued By Mr.Peter Theobald on 8th September 2011

INFORMATION THERAPY AND THE RTI ACT

2nd Annual Conference on - Using Information Therapy To Put Patients First in India: Sunday, 9th Oct'11 at 10.30a.m.

Being afflicted with a serious disease is a difficult period for a patient. So when Mrs Shah was diagnosed with cancer, she wanted to know everything from her doctor. “Why do I need radiation?”, “Is there any alternative?”, “What are the possible side effects of such a treatment,” “What stage of cancer is this, and will I be completely cured?”, “What is the success ratio of radiation treatment?” were some of her queries. Years ago, such questions would not even occur in a patient’s mind, and he or she would trust her doctor blindly. Even worse, many doctors would not even bother to explain the treatment options to patients. However, today, just like the RTI Act has made government officials accountable and thus enhanced the relationship between the government and the public, information therapy helps to build a more transparent doctor-patient relationship.

The Right to Information (RTI) act has come as major breakthrough in good governance. It encourages transparency and inspires citizens to be more assertive about their rights, because bureaucrats are now more accountable to the public. Earlier, some government officials abused their power with impunity. They could easily manipulate the ‘rule book’ to suit themselves, as a result of which, ordinary citizens ( who were usually in the dark about their rights) were rendered helpless. However, with the advent of the RTI Act , citizens are now in a position to ask questions – and demand written answers ! The concerned official has no choice but to respond with the needed documentation. This has resulted in a healthy respect for the average citizen among officials and bureaucrats , who now think twice about hiding information from citizens.

If Information Therapy was similarly made compulsory, this would help to improve the doctor-patient relationship as well – after all, good doctors have always been happy to share information with their patients !

Unfortunately, some doctors still do not believe in leveling with their patients. This is why patients feel they are at their doctor’s mercy, and every word from their doctor’s mouth is treated as the gospel truth. When doctors had the upper hand and were used to making all the decisions, this resulted in a paternalistic style of practice. While this might have been advantageous in certain situations, it does not fit in with today’s times. Patients today want to play a more active role in making decisions that impact their lives. They do not like feeling handicapped as a result of incomplete and insufficient information. Good doctors understand the importance of having a well-informed patient and will do all they can in their capacity to provide information therapy. Some doctors may not be so proactive, and will require patients to ask for information before they dispense any. In the US, progressive health insurance companies are making it mandatory for doctors to keep patients in the loop about any risks or complications arising from their treatment, however small or insignificant. Even better, they are actually reimbursing doctors for dispensing information therapy, and this incentive is helping to create a win-win situation for everyone !

There is a great opportunity in India today for the IRDA ( Insurance Regulatory and Development Authority) to make the documentation of information therapy compulsory every time a patient claims for medical treatment expenses against his health insurance policy. This will ensure that patients are kept fully informed , and will also help the insurance company to reduce their expenses, as unnecessary surgery and overtreatment will be nipped in the bud.

Patients have the right to be thoroughly informed about their illnesses. Doctors who invest that extra effort in providing their patients with substantial doses of information therapy initiate a positive cycle , where there is transparency in the relationship. This helps foster confidence among patients , who feel that their doctors are interested in helping them get better, and that the relationship between them is not just a monetary one. Doctors also benefit from intelligent patients who ask questions ! Healthy discussions might reveal some issues that a doctor might have overlooked, which could have resulted in a poor outcome.

Empowering citizens with the RTI Act has helped to encourage them to take a proactive role in governance, thus helping to create a more vibrant democracy. Similarly, embedding Information Therapy within every medical encounter can also help to patients to take a more active and involved role in their healthcare – and this can make for happier patients – and happier doctors!

To register for the conference log in: www.patientpower.in

When you play the Role of a Medical Information Researcher

The more knowledgeable you are about your problem and its treatment, the better are your chances of getting the right treatment. Educate yourself: you need to become an informed participant in your medical care in order to ask the right questions and to participate in making decisions about your treatment. This step will also help you to critically assess media reports about 'new breakthroughs in medical treatment', and whether these 'breakthroughs' are relevant to your problem or not.

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This video is a talk by Dr.R.C Shah at HELP on 17th August, 11. Topic "Divine Healing - II".Dr.R.C.Shah can be contacted at 24082531/ 9769082137.This is part of the HELP Talk series at HELP,Health Education Library for People, the worlds largest free patient education library www.healthlibrary.com

Your role as a Patient

While you obviously have a vital interest in your medical treatment, unfortunately, you lack the specialized medical knowledge and skills to be able to take decisions in this context alone. This is why the concept of a team - which consists of you and your doctor, becomes very important. As a patient, your responsibilities are wide and varied. And you'll need to play several "roles" at various times.

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HELP TALKS - Dr.Dilip Nadkarni on Knee Problem No Problem, How To Avoid Knee Surgery

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Your Responsibility as a Patient

As a patient, you have to shoulder a wide variety of responsibilities, some of which are as follows:

1. You should provide your doctor with accurate and complete information about your medical history, past illnesses, allergies, hospitalizations and medications.
2. You should report changes in your condition (however minor they may seem to you) to your doctor - don't keep him in the dark!
3. If you do not understand what your doctor says or wants you to do, you should let him know without any hesitation!
4. You should strictly follow your doctor's treatment plan.
5. You should keep your appointments on schedule, and if you cannot do so for any reason, let your doctor know well in advance.
6. You should pay your medical bills promptly!
7. You should follow hospital rules and regulations without fail.
8. You should have realistic expectations of what the doctor can do for you. Everyone would like to get well completely, but one should always bear in mind that the doctor is not a miracle worker.
9. You should help your doctor to help you! If you cannot stick to a particular treatment plan, let your doctor know, so that he can formulate an alternative plan.
10. You should maintain good health habits.
11. You should participate actively in your medical care. Patients who are highly motivated get better faster: in other words, help your body to heal it!
12. You should ask questions to clarify any doubts or dispel any misconceptions in your mind. A doctor or nurse may not know when you're confused, uncertain or just want more information. Therefore, do not refrain from asking questions.
13. You should respect the doctors and the nurses. The medical staff deserves your respect and courtesy: treat them the way you would like to be treated by them!
14. You should not ask for false medical certificates or padded medical bills (in order to get additional reimbursement).

The Ideal Doctor's Code of Practice

The People's Medical Society in the USA encourages doctors to display the following code of practice in their clinics. This code comprises are excellent guidelines for all doctors to follow, and you might consider sharing it with your doctor!

The code runs as follows:

I will assist you in finding information resources, support groups and health care providers to help you maintain and improve your health. When you seek care for specific problems, I will abide by the following code of practice:

1. I will post or provide a printed schedule of my fees for office visits, procedures, testing and surgery, and provide itemized bills.
2. I will provide certain hours each week when I will be available for non-emergency telephone consultations.
3. I will schedule appointments to allow the necessary time to see you with minimal waiting. I will promptly return your phone calls and inform you if your test results.
4. I will allow and encourage you to bring a friend or relative into the examining room with you.
5. I will facilitate your getting your medical and hospital records, and will provide you with copies of your test results.
6. I will let you know your prognosis; including whether your condition is terminal or will cause disability or pain, and will explain why I believe further diagnostic activity or treatment is necessary.
7. I will discuss diagnostic, treatment and medication options for your particular problem with you (including the option of no treatment) and describe in understandable terms the risk of each alternative, the chances of success, the possibility of pain, the effect on your functioning, the number of visits each would entail and the cost of each alternative.
8. I will describe my qualifications to perform the proposed diagnostic measures or treatments.
9. I will let you know of organizations, support groups, and medical and lay publications that can assist you in understanding, monitoring and treating your problem.
10. I will not proceed until you are satisfied that you understand the benefits and risks of each alternative and I have your agreement on a particular course of action.

Patient Community and Pre-Conference Seminar@HELP

Patient Community Meeting and Pre-Conference Seminar@HELP

on Saturday, 20^th August, 2011 at 11.30a.m.

Dr.Shaivi Desai	Sourcing Information the Right Way
Dr.Amar Udare	Communicating Information to the Patient- TheRight Way
Dr.Manasi Soni	Bridging the gap between information technology and information therapy
Dr.Soumil Patwardhan	Support groups and their Role in Coping

Dr.Shaivi Desai - Sourcing Information the Right Way

Dr. Shaivi Desai is a physiotherapist from Seth G.S. Medical College and K.E.M. Hospital who is passionate about health care and health economics. She has written 3 papers and made presentations at the national level during her student life. She believes 'Information therapy' plays a key role in Patient management and is keen on forwarding the goal for betterment in the health care delivery sector.

Abstract: The doctor-patient relationship puts the doctor in a position on power because of the gross information imbalance, but disseminating information works in bringing the patient to a level where he takes responsibility for his health himself. In today's scenario the patient relies on his faith in the doctor (and God) and feels helpless because he is ignorant. This is a pity especially since there are a lot of sources available and accessible, but the patient is unaware and hence does not make use of it. With the spread of computers it has become much easier to spread awareness and educate the patient. But while the internet is a boon for disseminating information, not all the material available online is reliable. One must learn to sieve the required information from the abundant sources available.

Dr.Amar Udare - Communicating Information to the Patient- The Right Way

Dr.Amar Udare graduated from the Seth G.S.Medical and K.E.M. Hospital, Parel and is now working at Tata Memorial Hospital as a First Year Resident in Radiology. K.E.M.H. and TataHospital are both premier institutes of the country and these hospitals handle a huge load of patients on a daily basis. Having worked at these Institutions, I have realized that a lot of complications arise because of the lack of the Information with the patients; or rather due to the failure of the concerned doctor to convey the Information. At a Tertiary Care Centre such as K.E.M. H. we deal with patients predominantly from the lower section of the society. This coupled with the huge patient load that they handle, patients end up left uninformed and feeling helpless. Also the recent rise in the assaults against doctors can be attributed to the failure of doctors to convey the appropriate information regarding the complications of the procedure involved. So, Is am of the opinion that a lot of problems concerned both with patients as well as doctors can be ironed out by help the patient understand his disease. I feel the solution lies in communicating information to the patients at the right time in the right way.

Dr.Manasi Soni – Bridging the gap between information technology and information therapy

Why does information get lost in transit between patient and doctor? What role can information technology play to reduce this loss?

Dr.Manasi Soni, a physiotherapist from Seth G S Medical College,Mumbai uses her experiences at KEM hospital to investigate into the lacunae of healthcare delivery and what can be done to fill them.

Dr.Soumil Patwardhan – Support Groups and Their Role in Coping

Soumil S. Patwardhan is a 3rd MBBS (Final year) student from Seth G. S. Medical College

& K. E. M. Hospital, Mumbai. He has participated in various research activities and medical quizzes, representing his institution, and has won laurels in them. He presented his paper at an international medical conference in WashingtonD.C. His essay on Ethical Issues in HIV/AIDS won him a 2nd prize in a city level essay writing competition on ‘Ethical Issues in
Health Care’ which he presented at a conference in Asia Pacific, Panchgani, Maharashtra.
Besides studies, Soumil has also participated in various extra-curricular activities. He was
part of a delegation from India attending the World Youth Festival, 2009 held in Stuttgart,
Germany to increase awareness on Climate Change and Global Warming amongst the
youth. He was the English Editor for the annual college magazine, Gosumag, in 2010. He
has secured distinctions in both, the HSC as well as the SSC examinations conducted by
the Maharashtra State Board, which he gave from D. G. Ruparel College & Our Lady of
Perpetual Succour High School, Mumbai, respectively. He is a winner of the prestigious
National Talent Search scholarship sponsored by the Government of India. He enjoys reading both fiction and non-fiction works and his favourite authors are Stephen King & Isaac Asimov. He also writes poems, songs and short stories as a hobby.