Tuesday, June 19, 2012

What I expect from my patients

Conversation between doctor and patient/consumer.
Conversation between doctor and patient/consumer. (Photo credit: Wikipedia)
Patients have a long list of the attributes they want in their doctor. Because they are spending money on their medical care, they expect their doctor to be skilled, compassionate,  caring and available .

However, just like patients have a list of what they want from their ideal doctor , doctors have a list of what they want from their ideal patient !

In the beginning , when doctors are starting practice, they cannot afford to be choosy about what kind of patients they accept , because they need to make a living . The young doctor is happy to see whoever comes to him. However, over the passage of time , as doctors become more senior, they can afford to be picky and choosy about what patients they want to treat , and which they don’t.

I have a set of criteria which I use in order to select patients who I think are right for me , and for those whom I think I am a good choice, I'm not trying to be arrogant – I just believe that patients get the doctors they deserve , and doctors get the patients they deserve . When both the doctor and the patient are on the same page and have the same philosophy , they are likely to be happy with each other. If not, they are likely to be unhappy , and this is not good either for the doctor or for the patient .

I expect my patients to do their homework and become experts on their problem. I expect my patients to provide inputs into the treatment we offer them, rather than be passive and blindly agreeing to whatever I say. Yes, this does involve a bit of effort on their part , but it’s well worth their while investing time in doing so, because it helps me to provide better medical care for them. As a doctor, I create and provide tools to help them to learn more about their illness.

It's not that I would refuse to treat a patient who didn't meet my criteria – it’s just that the quality of care which I can provide to patients who are willing to work towards meeting my expectations is far better than what I can provide to those who do not. Not only does a doctor’s wish list of an “ideal patient” make for happier patients and happier doctors, it also helps to improve the outcome of medical care.

For example , if an IVF cycle fails , I expect my patient to have been prepared for this failure because she understands exactly what is within our control , and what is not. I expect my patients to have a plan of action – and to have a Plan B, so they do not go to pieces when riding the IVF emotional roller coaster. I expect my patients to be able to interpret their own medical results ; and have an opinion about what their options are , and what is likely to work for them. I may not see with them eye to eye , but am happy to work towards reaching a consensus.

The kind of patient whom I do not want is the one who's completely clueless – the one who says , “Here are your fees, doctor - do exactly what you want and give me a baby ! “These patients worry me , because they have very unrealistic expectations of what I can do for them.

I admire and respect expert patients – those who do their homework, and ask me intelligent questions. They keep me on my toes, and help me to grow.  The really smart ones also educate me, as they teach me to be empathetic and responsive to their needs.

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6 comments:

  1. Dr, if it is so, do you really get enough patients whom you prefer? :). In my opinion even patients who are well-educated are clueless about their treatment. They really do not know what drugs they are taking and how to interpret their medical results. I wonder how they lack interest to know about the happenings in their own body. I ask my friends to read and educate themselves about their problem. But when I ask them about their TSH value they are completely clueless. When the doctor says everything is OK they are happy and never bother to ask for their medical records. They even advise me not to know things as it will add to the stress :) Some people even make fun of me for being so :( Patients must realize that a doctor is a human too who is prone to make mistakes. A doctor sees so many patients in a day and there are lots of chances that he can mess up with the results and interpret it wrongly which can cause havoc to the patient. Blaming the doctor for the shortcoming is of no use because the loss is only for the patient and sometimes once a mistake is made it is irreversible. Now-a-days even for watching a movie people do their home work. They read reviews, talk to their friends, educate themselves about the team which created the movie and then they go and watch the movie in the theatre. Why can’t they do their homework when they are undergoing a process which is of utmost importance in their life? Some say I do not understand biology; everything is Greek and Latin for me. I do not think this excuse is acceptable. I see so many western country women who are experts in their medical problem. Not all of them are scientists. It is just the interest they have, helps them to acquire knowledge which can even help their doctors at times. Educating themselves about their treatment will also help them to expect the unexpected, which will save their peace of mind when undergoing an IVF cycle.

    Adding a picture to your posts really looks good. Instead of taking it from Wikipedia you can use your own pictures. I am sure you will have some taken for publishing in newspaper and magazines. Just a suggestion!

    ReplyDelete
  2. If enough patients started thinking like you did, I'd have more than enough !

    Our focus is not on maximising the number of patients we see. I'd rather see a few patients , whom I enjoy treating, and with whom I can have intelligent discussions and learn new stuff, rather than treat lots of patients ! I respect and like treating patients who are willing to work at getting the best medical care for themselves.

    Fortunately, I have the financial security to be able to do so. Life's too short to do things you don't enjoy doing :)

    Dr Aniruddha Malpani, MD
    Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
    Bombay 400 005. India
    Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

    Helping you to build your family !

    My Facebook page is at www.facebook.com/Dr.Malpani

    You can follow me on twitter at http://twitter.com/#!/drmalpani

    Watch our infertility cartoon film at http://www.ivfindia.com

    Read our book, How to Have a Baby - A Guide for the Infertile Couple,
    online at www.DrMalpani.com !

    Read my blog about improving the doctor-patient
    relationship at http://blog.drmalpani.com

    ReplyDelete
  3. Thanks for the reply :) I could see how busy you are most of the time and I am sure you get more than enough patients than you desire :)Always be as your name suggests ''WITHOUT OBSTACLES'' :)

    ReplyDelete
  4. Hello Sir, I am Dr.Vivek Raskar,MBBS,PGD-EM.During My College days,I came to know about your book on How to start Medical Startup,which is famous among medical professionals.I am not able to gather the name of that book, nor i am not getting that book.As i am desperate to get that book,for my own medical startup. I hope you will help me to get that book.
    Eagerly waiting for reply,
    Thanks.

    ReplyDelete
  5. Hello Sir,Dr.Vivek Raskar,MBBS,PGD-EM.During my college days,I came through your book on How to start own Medical start-up,which is famous among Medical professionals.I am not getting your book anywhere,nor i am not able to recollect the name.As I am on verge to start my own Medical Practice,I desperately need that book.
    I hope that you will help me to get it. Eagerly waiting for your reply.
    Thanks.

    ReplyDelete
  6. Dear Dr Vivek,

    The book is called Successful Medical Practise - Winning Strategies for Doctors. You can read it free online at http://thebestmedicalcare.com/book2/index.htm

    Best of luck !

    Dr Aniruddha Malpani, MD
    Malpani Infertility Clinic, Jamuna Sagar, SBS Road, Colaba
    Bombay 400 005. India
    Tel: 91-22-22151065, 22151066, 2218 3270, 65527073

    Helping you to build your family !

    My Facebook page is at www.facebook.com/Dr.Malpani

    You can follow me on twitter at http://twitter.com/#!/drmalpani

    Watch our infertility cartoon film at http://www.ivfindia.com

    Read our book, How to Have a Baby - A Guide for the Infertile Couple,
    online at www.DrMalpani.com !

    Read my blog about improving the doctor-patient
    relationship at http://blog.drmalpani.com

    ReplyDelete

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