Wednesday, October 21, 2009

Why don't Indian doctors publish more ?

Indian doctors have a well-deserved global reputation for their clinical skills. They are usually technically proficient, hard working and take pride in their professional skills. They are very busy and manage a huge clinical work load efficiently and effectively.

However, the one thing they don't do well is share their knowledge.

This is sad. Even though they see lots of patients daily and have accumulated a lifetime's worth of clinical wisdom, they rarely write about their experiences.

Why don't they document their experiences so others can learn from them, rather than carry their lifetime of clinical wisdom to the grave ? After all, they are good doctors and should be happy to display their proficiency and expertise to others !
Most have good English skills, because medicine is taught in English in India, so that communication in this international language should not be hard for them to master.

Let's look at some of the reasons why Indian doctors publish so much less than doctors in the US do.

In the past, doctors would write only to share information with other doctors. They would publish their experiences only in medical journals. Since most of these journals were published in the West, their editors would often turn down articles which came from developing countries because they were considered to be of poor quality or unreliable. This understandably put many Indian doctors off publishing all together ! After all, if the articles were going to get rejected, then why take the trouble of writing them ?

However, this is no longer true and there are many high quality Indian medical journals which will accept articles online, thus simplifying the submission of case reports and original scientific articles.

Most importantly, doctors no longer need to write only for doctors ! Today, thanks to the web, writing for patients has become even more important - after all, this is a much larger audience - don't forget that there are over 1000 patients for every doctor, and patients are thirsty for information !

The great thing about writing for the web is that this is a very democratic platform and there are no entry barriers. Everyone who wants to write can do so - you just have to want to do so ! Set up your own blog or website and start.

I feel Indian doctors don't write because of the hurdles they perceive - most of which are only mental blocks !

1. I am too busy taking care of patients. I just don't have the time to write. In fact, it's the busiest doctors who have the most insights to share and doing so should be high on their priority list.

2. Why should I bother ? What value does it add to my life ? My job is to take good care of my patients, and I do this well, thank you ! Sharing your wisdom with your patients and colleagues will help you to get even more patients, because you will be seen to be the expert in your community.

3. I am in private practise. Writing articles in medical journals in the job of lecturers and professors in medical colleges and teaching hospitals - not mine ! Every doctor has insights to share - and these are not the monopoly of teaching hospitals. Every patient has something to teach - you just have to be willing to learn !

4. I cannot write well. I know lots of interesting stuff, but don't know how to put in in words. Writing is a very hard skill to master, and I don't have the ability to master this. I could never write well in school, and am too old to learn now. Writing well can help you enhance the quality of your life ! It opens new worlds and keeps you mentally young. It's a valuable skill which is well worth learning !

5. I am just an ordinary doctor, who sees regular patients. I really don't have anything special or different to share ! How do you know until you try ? The fact that you are a doctor means you know more than your patients - and educating them is a laudable goal. If you don't do this, then who will ?

Part of the problem is that there is no pressure to publish , unlike in the West, where doctors consider it prestigious to see their name in print !

Indian doctors need to understand that the world has changed and they need to change with it ! Most of these "reasons" are just excuses and are actually easy problems to crack. Think of them as opportunities, rather than as hurdles - and once you discipline yourself and start writing regularly, this skill will allow you to shine and differentiate yourself from the rest of the crowd !

It's true that doctors are busy. However, you don't need to do the writing yourself. You can easily employ a secretary to transmute your thoughts into words. Don't think of this secretary as an expense. She can actually be an asset - and is an investment who will help you build your practise ! The secret for success for many leading doctors today is the fact that they have a superb secretary who organises their life for them. A good secretary is worth her weight in gold - trust me !

Doctors are often unsure about their editing skills or their ability to craft a well-honed sentence. Yes, this can be tricky, but you can always find an editor to polish your work. There are many "virtual assistants" available online, who can edit your articles and improve their readability !

I think we need to learn from US doctors. Even though they see far fewer patients, they publish far more. Their paper: patient ratio must be ten times that of Indian doctors ! Why do Indian doctors continue to hide their worth in the four walls of their clinic ?

I remember working with Dr Patrick Walsh at Johns Hopkins Hospital many years ago. He worked extremely hard - but not just at seeing patients ! He had 3 secretaries: one full-time secretary for the book he was editing, Campbell's Urology; one to organise his busy clinical practise; and one to help him with his hospital administration, since he was the Chairman of Urology at Johns Hopkins.

Skilled human labour is so much more inexpensive in India - why don't we leverage our strengths ? Why do we skimp on hiring good assistants ?

I feel it's time to stop making excuses and claim a leadership role - just like Indian IT companies have done !

If you don't want to write long articles, then just publish case reports. Videos and photos are very welcome as well ! And if you think of English as being a second language, then publish in your own mother tongue - the opportunities are even larger here, because there is much less competition !

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