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Effective communication; the key to success
Dr Kiran Dabholkar
Very often we get news of doctors being manhandled by a mob or furious relatives.
Recently, there was a news of a resident doctor in a peripheral hospital in
Mumbai suffering the wrath of an angry mob. The furious mob went on a rampage
smashing glasses, damaging property in the casualty ward and injuring the doctor
on duty. This mob fury followed the death of a patient who was probably brought
to the hospital in a critical condition, with very little chances of salvage.
After all, no doctor would possibly neglect any patient, let alone a dying one.
It is equally true that doctors cannot save every single case admitted under
their care. Like in other spheres of life, medical practice has its own limitations.
It is unfortunate that these limitations are not fully appreciated by lay men,
who have come to expect miracles of doctors at all time.
The question is ‘How can this growing menace be stopped or at least curbed?’
No amount of legislation and police enforcement can replace sound communication.
What does “sound communication” really mean? It only means that the
doctors need to be calm and patient; should listen to the relatives most intently
and, above all, should display compassion and sincerity that must be explicit.
The relatives should be told of the patient’s condition on admission and
from time to time in clear words, without the use of medical jargon.
Very often, misgivings occur because the relatives are forbidden from entering
into ICUs. Such prohibition adds to their anguish and possibly breeds doubt
in their minds. It would, therefore, be worthwhile to insist that relatives
enter the ICU at a stipulated time and see for themselves the condition of the
patient and care that is being given.
Further, at all such times, the nursing staff and resident doctors should spend
a few moments with the relative/s to explain things in a simple language with
compassion or empathy.
This alone can bring the much-needed comfort to the relatives. Further, in all
very serious cases, it is wise to prepare the relatives for the inevitable end
much before it actually happens. This allows them to accept their relative’s
death far better than if they were to be told about it at the very end.
In all such delicate situations, our choice of words, actions and our body language
are all very important to avoid the rampage. Further, very often, in these situations
the doctors might also have to forgo their professional fees, lest the crowd
might misinterpret this act as “bloodsucking doctors”. Today, the
lay people have come to believe that doctors are becoming greedy. Whilst, one
can charge a fat fee for a routine case, it is worthwhile forgoing the professional
charges in a case where the outcome has been tragic / adverse. Such an act on
the part of doctors may not change the outcome whatsoever, but at least the
relatives find some solace and appreciate that the doctor was considerate, kind
and compassionate. However, there are occasions when despite our compassionate
approach, the relatives still turn hostile. In such cases, it is better to anticipate
trouble, inform the police and call for their help.
To sum up, a sound communication, empathy and compassion, allowing relatives
to actually witness the patient’s condition from time to time and assess
for themselves the standard of care that is being offered to their patient are
some of the ways to curb the growing menace of mob fury and doctors getting
roughed up by the relatives. It’s time that doctors learn and master the
art of communication, like they acquire technical skills and expertise.
The writer is a consultant gynaecologist with a pharma company.
Email: kmdabholkar@yahoo.co.in
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