Musings on the EHAC curated panel discussion and interaction session with medical students at LVPEI on 22 Aug’19

September 3, 2019

By – Dr. Pavitra Mohan
(Basic HealthCare Services)

I was moderating a panel consisting of leading doctors and healthcare professionals, who have spent their lifetimes providing, managing and leading ethical, equitable and high quality healthcare services.

In the audience were young doctors or doctors in making, who had come to listen and seek answers to some of their deepest concerns: How can I stay ethical in this profession? Why do not patients and their families not trust doctors? What role can we play in improving healthcare in remote, rural populations? I do not want to get in the rut of working in corporate hospitals and make more and more money, what options do I have?

Panelists spoke passionately-ethical practice is fundamental to the profession, it is your north star, they reaffirmed philosophically. You may drive a smaller car in the day, but you would sleep well at night, another one said, on a more earthly plane. Practicing ethically is like a marathon, you need to have a long term perspective, a third one said, who himself has been a marathoner, rising up to become CEO of a large, chain of maternity hospitals, that provide high quality care with dignity to everyone who enters their doors, irrespective of their ability to pay. Their own lives brought authenticity to what they said, medium being the message in this case.

“Practicing in a rural area for a year brought me immense joy and satisfaction, much more than my several years in a specialized hospital” One of the young doctors in the audience shared wistfully, but with pride. Providing primary healthcare in under resourced settings is not poor quality care. It in fact often requires more skills: clinical, social and communication skills have a higher premium in these settings than in resource replete settings. Practicing in resource poor settings can be extremely satisfying professionally, another panelist confirmed, drawing on his years of experience providing healthcare in rural areas.

“How do we build trust with patients? Increasing violence by patients is an indicator that there is loss of trust on either sides.” Building systems that are compassionate, where compassion towards patients is in DNA of the organization itself, is the beginning (to build trust with patients). Having empathetic communication with the patients, in a transparent manner also fosters trust. Finally, if something untoward happens, having courage to apologize and explain is critical, the panelists opined.

“We tried stopping corruption in our own hospitals where we were residents. But no one listened, nothing changed, what should we do in such a situation”, asked one young resident. I wanted to say, sorry, we (our generation) have failed you. But I put the question to the panelists for their advice. One panelist, based on his experience, advised that if you persevere, things do change. Other suggested that engaging others in the team, including those who are corrupt, help in creating a positive environment. A third one suggested to wait it out, and raise some of these more thorny issues when you have more authority.

Compassion, Communication and Courage, the three words kept ringing in my ears. Be compassionate, communicate empathetically and clearly, and have courage to deal with situations that go wrong. Nothing more can I ever advice the young physicians at the threshold of their careers. Practice these three, and the world would be yours. And such a world would be a much, much better place.

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