Thursday, December 22, 2005

My doctor told me all my reports are normal

I offer a free second opinion to infertile couples on my website. I request them to fill in their medical details, so I can guide them as to their next course of action. Unfortunately, I find that lots of patients are completely clueless about their test results. The commonest excuse they give is - " My doctor told me they were all normal, but I don't know the actual values."

I feel there are two reasons for this sad state of affairs: 1. many doctors take a patronising attitude and believe that patients will not understand their results, so that just telling them they are " normal " is enough.
2. patients don't bother to ask for details.

This is not acceptable, and it's important that you know what your actual results are, for many reasons. Remember that the eye only sees what the mind knows, and even though your test results may fall in the normal range, they still need to be interpreted correctly, and your doctor may not be doing this. For example, patients with a common disorder called PCOD ( polycystic ovarian disease) will often be told that their blood tests for measuring their levels of FSH ( follicle stimulating hormone) and LH ( luteinising hormone) are "normal". However, even though their levels may be in the normal range, they are actually still abnormal when interpreted intelligently, because the ratio of LH to FSH is abnormal. However, because their doctor did not consider this diagnostic possibility, he did not make this diagnosis ! This ends up hurting the patient !

Patients often complain that doctors do not give them the results. The best way of preventing this problem is by making a request in writing. By law, your doctor has to give you a copy of your records, and there is no reason why he should not do so ! However, it's easy for the clinic to "overlook" verbal requests, which is why it's important to document this request in writing !

Good doctors and bad doctors

Even if we assume that all doctors are technically competent, the major difference between a good doctor and a bad doctor is how they handle the patient's emotional status. We all know that patients are emotionally very vulnerable when they are sick, and they rely completely on their doctor for his professional advise. A bad doctor will exploit this vulnerability, and often scare or precipitate the patient into taking action which is in the doctor's best interests ( and not the patient's) - for example, doing bypass surgery because the patient has chest pain and is in the ICU. A good doctor, on the other hand, is one who is empathetic, and will let the patient know that he understands the patient's pain, and will support him in his illness with competent treatment and sound advice.

Thursday, December 15, 2005

Sending books to India

So how does one go about finding cheap books which would be of use to people living halfway across the world ? The best option is to buy books from library book sales. Not only is this a lot of fun, you can get great books very inexpensively ! You can use the brilliant website at to find the nearest book sale. Do your good deed for the year !

Proud to be Indian !

Agatsya - Project Summary: "Imagine the explosion in innovation and creativity if India could unleash the untapped potential of its gifted population by transforming its education system !" Here's a very bright person, who is using simple techniques to educate village children in India ! Success breeds success, and I hope more people will replicate his ideas all over the world. While this may not be as sexy as the MIT $ 100 laptop for village kids, it has the power to do much more good !

Doctor - please tell me what to do !

One of the commonest questions my patients ask me is - " Doctor, please tell me what to do ! " Some phrase this as, " What would you do if you were in my place ?" While it's easy for me to tell people what to do ( I know most doctors enjoy this !), this is not my style. I believe in non-directive counselling , especially when dealing with such a personal and private area as making reproductive decisions, where treatment is elective, and every couple needs to decide for themselves as to what will give them peace of mind. Patients who are mature understand this, and are happy to use me as a sounding board off whom they can bounce off their options. Others, however, want someone who will tell them exactly want to do, and go off in search of a doctor " who knows more" than I do. I guess doctors get the patients they deserve - and patients get the doctors they deserve !

M-Bag - and how this can change the world !

We all know that books can change the world - but books are expensive and difficult to find, especially in the developing world. People living in the US ( especially citizens from India) revel in the wealth of books they have access to in the US - and many would like to send these books to their friends and relatives back home - and even donate them to the schools and colleges they passed out from. After all, books are available in the US for a song if you know where to look - library book-sales, for example, are a great place to find superb books , for pennies on the dollar. However, shipping books from the US can be an expensive proposition, and this deters most people, as a result of which they often trash books which could change the life of a school child in Africa or India.
Fortunately, the US Government has a very special postage rate for book shipped overseas. This is called the M-Bag rate, and it costs only about 1 dollar to ship a pound of books ! Most people are unaware of this special rate, which is why it is still very under-utilised.
Here's how to do it.
Shipping books (Borrowed from Johannes [[email protected]])

" I sent all the books and other printed stuff via M-Bag (US Mail's "Mail Bag") and here are my experiences:

# M-Bag is one of the cheapest shipping methods available
# First go to your local U.S. Post Office and ask them whether they serve M-Bag
# If yes, pick up a few bags for free, don't buy boxes
# Go to a local supermarket and get old cardboard boxes for free (they shouldnt be huge, but sturdy)
# Get some heavy-duty duct tape rolls (the silver or black ones used for construction work or gig wiring) from a local hardware store
# Pack your books and printed papers (and whatever else you like, since noboday really checks at the Post Office -- at least not in NY) into the boxes. A box should not be too heavy, but it should be full and contents should not have room to move.
An M-Bag can have a maximum of 66 lbs, but packing the books into smaller and lighter units makes handling and shipping a lot easier. Your Post office provides you with any number of M-Bags you wish, so there's no need of stuffing big and heavy boxes in a bag.
# Label each box with delivery address and name, since Bags can tear open
# Massively seal and reinforce the boxes with duct tape. (A lot of work, but it pays off in the end: I received all boxes (and books) completely intact, no damages)
# Put one box in each M-Bag, tighten the bag with one or two knots, and fill out the M-Bag label you got from the Post Office (one for each bag). The M-Bag label will attached to the outside of the Bag at the Post Office, after paying.
# Drag the M-bags, filled with your boxes, over to the P.O, and send them: One lb. costs about one dollar ( no visa or mastercard accepted at most Post offices)
# Four to six weeks later the M-Bags will arrive at the destination. Again, in my case, all the bags, and the boxes and books inside, were completely intact and in original condition."
Michael Patterson, my friend who lives in the US, regularly send us books for HELP. He does this purely as a labour of love - I just wonder why more people don't do the same thing ! Sometimes the US Government can be very enlightened - it is the only country in the world which provides such inexpensive shipping for books !

Thank you Amazon. com !

The other website I love ( and use a lot of) is I love books - and need to buy lots for HELP - the Health Education Library for People. Unfortunately, books on patient education are very hard to find in India, which is why I need to buy them in the US - the booklover's paradise. The problem is that new books are very expensive, and I just cannot afford them ! A friend of mine, Mr Michael Patterson then pointed out to me that is the world's largest second-hand book store ! I now buy all the books we need for HELP from amazon second-hand ( pre-owned is the politically correct term I believe !) We save a lot of money, and this was we can afford to get many more books than we otherwise would be able to !

Why I love google

I am a big believer in the power of information, which is why I run HELP, the world's largest patient education library. The reason I love google is that it's made so much health and medical information so easily accessible to patients. Armed with just a computer with an internet connection, today's well-informed patient has access to much more medical information than even a doctor in the world's leading hospital did just 10 years ago ! Search engines in the past were complex and difficult to use. Google's simplicity allowed many more people to tap into the vast storehouses of medical and health information available on the internet. Allowing such easy access to information has allowed google to dramatically change the doctor-patient relationship - for the better, in my opinion. Today, patients can be as well-informed as they choose to be - and they don't have to depend upon their doctor anymore for educating them ! Knowing that so much information is available - information which can be reliable, updated and easy to understand ( if you know where to look) can empower patients to make their own decisions !

Wednesday, December 14, 2005

How patients irritate their doctors

I feel I am an empathetic and concerned doctor, and try to take good care of all my patients. One of my patients just called me at 10 pm to report, " The medication you put my wife on 2 weeks ago has been causing her a lot of side effects. What can we do about these ?" I tried my best not to lose my temper, but I was curt on the phone and not very helpful. While I was not very proud of my bedside manner, it's the patient who was actually responsible for getting such poor medical advise. If he had been a little more considerate and respectful of my time, there was a lot I could have done to help his wife. Unfortunately, this is not going to happen, and I really don't want to have to deal with such a patient in the future. I am going to request him to find another doctor, who does not mind being troubled at such a late hour by someone who has no consideration for the doctor's personal life. If you don't respect the doctor, why should you expect the doctor to respect you ?

What sort of patient are you ?

Pre-infertile - the worried well

I am now seeing an increasing number of couples who do not have any medical problem, but are worried about their fertility. I call these couples "pre-infertile". This is not a word described in a medical textbook, but I think it describes them well. They are worried that they may have problems conceiving, which is why they are seeking medical advise . These are the "worried well" - they don't have an illness, but are concerned that they might. All they really need is an explanation about the fact that Nature takes time to make a baby, and some reassurance; and for most, this is enough to help them promptly get pregnant on their own ! Others will want tests done to confirm that all is well, and even though I don't feel this is an appropriate use of medical testing, sometimes it's worth it for the peace of mind it gives them !

Dealing with your doctor - professional or technician ?

I have noticed there are two kinds of patients: those who treat their doctors as professionals; and others who treat their doctors are technicians. Actually, both models are fine, depending upon how sure you are about your own medical decision ! You pay a technician to carry out a certain skilled procedure with technical competence, and this is one of the key functions of a doctor. However, a doctor can also provide you with guidance and advise, and this is where he behaves as a professional. Finding good technicians is relatively easy - finding a doctor who is a professional is a little harder !

Tuesday, December 13, 2005

How demographic "experts " mislead us

There is a hue and cry going on in India about the unbalanced sex ratio and how it will adversely affect "girl children" in the future.( As an aside, aren't all girls children ? isn't using two words when one will do ridiculous ? it's like saying "men adults" !) These demographic experts warn of increased instances of rape and prostitution, and their scare techniques have resulted in miles of newspaper coverage.
It amaze me how short a memory we have ! Just a few years ago, these same demographic experts were warning us of the danger of unbridled population growth; about how the "population explosion" would kill the country; and how we needed to aim for ZPG -" Zero Population Growth". In just a few short years, these same "extra" citizens have become our most promising asset, and " shining India" now reaps the benfits of this "demographic sweet spot" it finds itself in - thanks to the fact that the average citizen blissfully ignored the "expert's " advise !

The world's largest eye care delivery system

The world's largest eye care delivery system. " Started as a modest 11 bed eye hospital in 1976, Aravind has grown rapidly to become the world's largest eye care system. In the year 2004, Aravind Eye Hospitals handled 1,635,599 outpatient visits and performed 228,894 surgeries."
Not only are they extremely efficient, they are also very service oriented, and as a result of a unique fee system and effective management, Aravind is able to provide free eye care to two-thirds of its patients from the revenue generated from the other third of its paying patients !
Aravind follows the principle that large volume, high quality service result in low cost and self-sustainability. Aravind's network of hospitals has the distinction of being the most productive eye care organisation in the world, in terms of surgical volume and the number of patients treated.
The world's hospitals can learn how to provide quality and affordable medical care to patients from Aravind !
Why aren't more hospital managers and doctors visiting Aravind ?

Monday, December 12, 2005

Why Your Doctor Thinks I'm Crazy!

Why Your Doctor Thinks I'm Crazy!: "Many doctors look down on self-educated patients.

At one point in my treatment, my regular practitioner suggested I visit another doctor to get a second opinion. So my husband called his internist and asked, 'who is the best person you know to deal with thyroid disease.' 'Me, of course,' said the internist. (Doctors are so modest!)

'But up front, I want you to know that my wife is very informed about things, she reads a great deal about thyroid disease,' my husband said.

'Aha,' he said. 'She's a petit papier woman,' said the doctor.

My husband inquired as to what the doctor meant by this. The doctor explained that women who come in with papers, notes, etc. to show to the doctor are often referred in a derogatory way as 'petit papier' (little papers, in French) women. He said most doctors did not like 'petit papier women,' as we're too 'high maintenance.'"

Should You Change Doctors?

Should You Change Doctors?: "'C' if your needs are being met.

A doctor/patient relationship is a lifelong relationship for someone with chronic arthritis. Since the illness is chronic, and without a cure, regular appointments are scheduled with your doctor to diagnose and problem-solve. It's a process and a journey you take together with your doctor. It is imperative that your needs are being met. Consider the 6 C's"

How To Avoid Long Waits at the Doctor's Office

How To Avoid Long Waits at the Doctor's Office: "Hate waiting around at the doctor's office? Here are a few simple steps that can help you avoid a long wait and expedite your trip to the orthopedic surgeon's office."

Patient Education - Can You Know Too Much?

Patient Education - Can You Know Too Much?: "Patient education is for better understanding. It may be time to find a new doctor if you genuinely feel you are smarter than your doctor and are unable to build good rapport. Consider, though, that patient education may have improperly empowered you. Recognize that patient education is for the purpose of better understanding. Patient education must not diminish the role of your doctor who ultimately must lead, direct, and decide the best course of medical treatment for you. In the end, you must be able to trust your doctor and respect his advice. It is with that trust and respect that you build a strong doctor-patient relationship."

Sunday, December 11, 2005

Port in the Storm: How to Make a Medical Decision & Live to Tell About It

Port in the Storm: How to Make a Medical Decision & Live to Tell About It: This is one of the wisest books I have seen, dealing with one of the most complex topics in medicine - how to make a decision.
Dr Giller eloquently describes the 6 key steps in making a medical decision:
Step 1 - Identify your options
Step 2 - Identify the tradeoffs
Step 3 - Discovery of Data
Step 4 - Interpretation of Numbers
Step 5 - Gathering your Beliefs
Step 6 - Contemplation of Meaning
The book is very well and lucidly written, and empowers patients to make their own decisions for themselves.
Realise that everything has risks, but armed with the information in this book, at least you will be able to take on the risks intelligently !

Friday, December 09, 2005

How useful are consumer health libraries in the age of google ?

I run the world's largest free patient education library, HELP ( Health Education Library for People) in Bombay, India. We are trying to find corporate partners who will help us to reach out to more people, so that more people will make use of the free services we provide. However, a common refrain I often hear is - " Now that so much information is available online and can be found so easily with google, what's the need of a library like HELP ? "
Actually, the need for real-world libraries like HELP will increase even more. I feel both online information and print libraries have complementary roles, and they are not in competition with each other ! After all, the very fact that google now wants to digitise millions of books and put them online simply corroborates the fact that books are alive and well !
In fact, the person who searches google to confirm that what their doctor is telling them is correct is exactly the sort of person we want to reach out to !
HELP can offer many additional services to such patients, who are seeking more information.
Often patients get lost on the internet ! They end up at unreliable sites and may end up misinforming themselves, because they are not sophisticated enough to separate the wheat from the chaff. Morever, since so much of the information is US-centric, they cannot find information which is relevant to Bombay !
Also, while it is true that information on websites is instantly available, 24/7, much of it is not detailed or comprehensive enough. A published book, from a reliable author, on the other hand, is a complete information-rich educational product !
Also, a librarian is a "learned intermediary " who can help you hit pay-dirt quickly ! After all, no one wants to waste time searching - you want to "find " stuff !
Just like law books will not make lawyers redundant , the easy availability of information on the internet will not make libraries redundant either !

Lab tests - what you need to know

What you need to know about lab tests : "Understanding why a medical test has been ordered can improve your attitude and preparation for the test. Being well prepared also helps you feel more relaxed and in control of the situation. Ask your physician to explain the reasons for your test and how the test will be conducted."

Thursday, December 08, 2005

A look at the modern doctor who doctors ethics

A look at the modern doctor who doctors ethics:
“Thou shall not steal,” The good Lord said,
But look, I need rich meals.
Besides, I have a better head,
His patients I should steal.
“Like brothers you must treat your mates,”
The good God stoutly said.
Come to my clinic, read my rates,
I charge my patients that much less,
To lure them from my mates.
“You simply cannot advertise,”
The law so very clearly states.
My trumpet I shall so disguise,
With cunning words I’ll self-inflate,
What fault will you then find?
'As doctors you’ll not give kickbacks,”
Our Code has disallowed.
Be practical, look here old chap,
I’m young, I must erase this vow.
To live I must kick-back.
“You swore the Hippocratic Oath!”
The Lord in grief did weep.
“In dishonour you are deeply steeped.
You stole from mates for tarnished gold.
Do you know you’ve lost your soul?”

R. F. CHINOY, Department of Pathology Tata Memorial Hospital Parel, Mumbai 4000 12"

Issues in Medical Ethics

Urban medical practice
The doctor, fashionably attired,
With a long string of alphabets trailing his name,
Emerges from a fancy, air-conditioned limousine,
Driven by a liveried chauffeur.
He sees ‘cases only by appointment’,
In his air-conditioned consultation room,
But, despite the appointment, has little time to spare.
Fancily designed, attractive waiting room,
With television, video- recorder and glossy journals,
And, perhaps, toys for his jaded paediatric clients,
Is presided over by young, beautiful secretary,
Who prefers talking to her computer or the phone.
She collects sizeable fees before patients can enter the sanctum sanctorum,
And instils awe and fear in the already demoralised patient.
Nagged by outrageous competition,
The entry of young whipper snappers into his field,
And, to make matter worse,
The clutches of the Consumer Protection Act,
The doctor routinely lists a score or more of tests,
And prescribes an equal number of pills, potions and pokes,
Thus playing the game of safety - which
incidentally increases his revenue.
Listening desultorily to the patient,
Whilst he dreams of his club, his wife and other attractions,
Prods here, pushes there and lends an ear to the lub-dub
Ere he agrees, with ill-concealed glee,
To accede to the humble request for an
unmerited sick leave certificate - for an
extra cost, of course.
Finally, with a belch that's poorly suppressed,
He dismisses the patient with an airy wave and awaits the next.
Strange thought though it may seem, his patients
admire and adore him,
For he acquiesces to their demands,
And 'cures' rather than prevents.
And the richer he gets,
And the more opulent his materialism,
The greater the throng awaiting him each evening!
Is this really what the public desire?

P Thirumalaikollundusubramaniam, Gizan, Saudi Arabia,
A Uma, Madurai Medical College, Madurai 625 020

Tuesday, December 06, 2005

The doctor as salesman

It may upset many patients, but the fact does remain that one of the roles a doctor plays is that of a salesman. After all, the doctor needs to convince the patient to follow his medical advise. Now, many doctors are extremely good at this; and if you have the good fortune to have a good doctor ( who is a professional and will put your best interests first), this is great, because he will skillfully convince you to do what is in your own best interests.
However, if you are unlucky and have a bad doctor, this same skill can be very destructive, because he may end up convincing you to undergo unnecesary surgery, for example.
This is why it's so important to behave like an enlightened customer when seeking medical care . Caveat emptor - let the buyer beware - is equally applicable to medicine !

eMedicine - develop a differential diagnosis

eMedicine develop a differential diagnosis: "Develop a Differential Diagnosis"
Is your doctor stuck and can't figure out what your problem is ? Ask him to check put this site for more suggestions, if he is stumped !

The McKinsey Quarterly: A foundation for public health in India

A foundation for public health in India

* India's public-health system, much improved since the country's independence, is now threatened by a shortage of quality personnel.
* By improving the quality of public-health education and making the career path more attractive, India can encourage more professionals to enter and stay in the field.
* Plans are under way to develop a foundation that will launch new schools of public health and work to improve the quality of education in the existing schools..".

Monday, December 05, 2005

Recycling Drugs, A New Strategy

Recycling Drugs, A New Strategy: "Recycling Drugs, A New Strategy
by Jerry Flanagan. " It is estimated that $1 billion of unused prescriptions drugs are discarded each year while 1 out of 4 seniors must often choose between buying their prescriptions and paying for food and rent. Oklahoma, Louisiana and Ohio might have hit upon the kind common-sense solution to ease the pain of high-cost prescription drugs that could become a national model: reuse, recycle. Legislation in these states has implemented programs to collect unused drugs and get them to those in need."
An even easier way of saving billions more would be to buy the drugs from India - where they are available at one-tenth of the cost ! I wonder why the US government goes out of its way to protect the US "big pharma" industry at the cost of the well-being of its citizens ?

Business 2.0 - Magazine Article - Printable Version - The $50 Million Giveaway

Business 2.0 - Magazine Article - Printable Version - The $50 Million Giveaway: "$8M HOME PATIENT MONITORING
WHO: David Aslin and Paul Badawi, 3i, Menlo Park, Calif.
WHO THEY ARE: Aslin is a partner in 3i's West Coast office. Badawi, a former genetic researcher for the National Institutes of Health, joined 3i last year as an entrepreneurial fellow. 3i invests $1.6 billion a year in buyouts and venture deals, the majority in health care and IT.
WHAT THEY WANT: A wireless home-monitoring network for recuperating hospital patients.
WHY IT'S SMART: No one likes extended hospital stays. Not patients, not hospitals, and not insurance companies paying bills that can exceed $5,000 a day. For the critically ill, there's no way around lengthy visits. But thousands of other patients could be sent home early if they could be monitored at home or at a lower-cost facility. Badawi and Aslin envision a wireless transmitter that would attach to existing hardware such as portable ECG machines and heart-rate and blood-pressure monitors. The device would send data through a wireless router to a cluster of back-office servers. The servers would function like a call center, routing a patient's vital signs to the right nursing station or on-call physician. Trimming just two days off the typical 10-day hospital stay for stroke victims would be a service worth $2.7 billion.
WHAT HE WANTS FROM YOU: Between you and a partner, you'll need expertise in medical device technology and database management to get a working demo ready to pitch to HMOs or insurance companies. Half a million dollars in seed money should be sufficient to get that far. 'It's not the technology, it's the complexity of navigating the health-care system that's going to be difficult,' Badawi says. If you can sign up an HMO to test the system, 3i promises $7.5 million more to bring it to market.
SEND YOUR PLAN TO: [email protected]"
Want to become a millionaire - and improve healthcare at the same time ? Here's a great opportunity !

The Health Record Network

The Health Record Network: "Starting a Consumer Revolution

The ability instantaneously to access accurate and complete patient health care information is the key to the efficient delivery of quality health services. Despite unprecedented advances in information collection and dissemination technology over the past decade, and recognition of the importance of timely, accurate health care information to the successful provision of the most efficacious treatment, the health care industry in the United States, for the most part, still adheres to paper record keeping. The costs of this failure - untimely and even erroneous diagnoses, repetitive and often incomplete record development, an inadequate ability to monitor health care trends on a timely basis either on a individual patient or on a broader societal basis - need no longer be tolerated. The capability exists to develop a consumer-driven and controlled information data base that necessarily would improve immeasurably the ability to meet individual health care needs on a more timely basis while simultaneously providing a platform for the creation and delivery of innovative health care products and services."

Seductive promises - sounds like the e-healthcare siren song of 1999 all over again ?

informing healthcare | Yasnoff on eHealth

informing healthcare | Yasnoff on eHealth: "There are three categories of evaluation criteria that communities should consider in evaluating a potential health information infrastructure:
# Requirements – does the system do what is needed?
# Feasibility – can the system be built and operated?
# Financial – is there a way to pay for the system and sustain it?

Let’s start with requirements. To answer this question, the functions of the system (at least at a high level) must be defined. Folks experienced with the development of information systems know that there must be a statement of requirements before you start or you’ll never know when you’re done. In plain English, a requirement is something that you will be able to do AFTER you have implemented a system that you cannot do now.

There are at least five requirements in this context:
# 1) privacy
# 2) transition from paper records
# 3) access to information
# 4) incremental steps
# 5) universal availability"

A very good overview of how communities can go about implementing EMRs.

My Family Health Portrait

My Family Health Portrait allows you to create a personalized family health history report . " Information you provide creates a drawing of your family tree and a chart of your family health history. Both the chart and the drawing can be printed and shared with your family members or your healthcare professional. Used in consultation with your healthcare professional, your family health history can help you review your family's health history and develop disease prevention strategies that are right for you." A free rudimentary PHR from the US government. I am sure someone can polish it and make this much better ! A good idea for an IIT summer project !

Thursday, December 01, 2005

Moving Towards Collaborative Health - Microsoft's perspective

Collabortive Health - Microsoft's perspective aTechnology is transforming the healthcare industry at a rapid pace. But healthcare organizations need to
be able to take a more measured approach that balances the benefi ts that specifi c solutions offer against
issues such as cost, the potential for disruption, the impact on existing systems, and more. We recognize
that no healthcare organization can afford to take an all-or-nothing approach to technology adoption,
and that each organization has its own requirements, restrictions, and institutional needs.

Web Based Education for Physicians - Learning from Mistakes

Web Based Education for Physicians - Learning from Mistakes "Physicians historically do not learn from each other’s mistakes. Wu reported that only a minority of house staff informed attending physicians of mistakes. In another study, although ten of eleven physicians involved in major malpractice claims changed their practice in some way after an event, none talked to colleagues about the changes. Most experts agree that both individual and organizational learning from near misses and adverse events is important to creating a sustained improvement in patient safety." Here's a great and painless way of learning how not to make mistakes !

TIME Magazine -- When Doctors Say, "We're Sorry" Print Page: TIME Magazine -- When Doctors Say, "We're Sorry"" More and more hospitals are following the lead of pioneers like the Veterans Affairs Medical Center in Lexington, Ky., and Johns Hopkins in Baltimore, Md., in establishing formal policies requiring medical staff to promptly admit and apologize for mistakes. At a time when hospitals and doctors are desperate to reduce the rising costs of malpractice insurance and litigation, apologizing for medical mistakes may seem to some like legal suicide. But to a widening coalition of players on all sides of the issue--from doctors, hospital administrators and insurance executives to patient advocates, politicians and even trial lawyers--it may actually be a step in the right direction. Since many of these players believe malpractice lawsuits are motivated as much by feelings of frustration as by the almighty dollar, in their view, honesty may indeed be the best policy."
This is so much healthier for both doctor and patient - and wil help to restore the trust patients have in their doctors !

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