October 21   2015, Wednesday
EDITORIAL
Dr KK AggarwalDr KK Aggarwal
WMA General Assembly, Moscow 2015

Delegates from almost 60 national medical associations attended the annual General Assembly of the WMA in Moscow from 14 to 17 October. Among the issues discussed were:

Mobile health

New regulations to protect patients who use mobile health devices were adopted by the Assembly. These include devices, such as mobile phones, patient monitoring devices, personal digital assistants and health promotional apps used by people to log their calorie intake or daily activity. A new policy document urges patients and physicians to be extremely careful when using mobile health because of the potential risks and implications.

Well-being

The medical profession should do far more to prevent and deal with stress and illness among physicians, delegates agreed. They adopted new guidance calling for a series of measures to improve physicians’ wellbeing. Sir Michael Marmot, President of the WMA, said: ’We are urging better wellness promotion, prevention strategies and earlier intervention to help lessen the severity of mental and physical illnesses and help reduce incidence of suicide among physicians, physicians in training and medical students.’

Declaration on alcohol

New legal and regulatory measures as well as social policy interventions were called for to combat the problem of alcohol-related harm, which the Assembly agreed had become a global health scourge. These included the strengthening of health systems, increased alcohol prices, regulating non-commercial alcohol, tightening the prohibition of selling to minors, regulating alcohol marketing and limiting the role of the alcohol industry in alcohol policy development.

Nuclear weapons

The Assembly approved a Statement condemning the development, testing, production, stockpiling, transfer, deployment, threat and use of nuclear weapons and requesting all governments to work in good faith towards their elimination. The WMA Council heard that there were more than 16,000 nuclear warheads held by nine countries, the vast majority by the United States and the Russian Federation, and that the use of even only a small percentage of these warheads would be a global catastrophe.

Street children

Urgent action to tackle the global health problem of street children was agreed. The Assembly adopted a statement declaring that child maltreatment is a world health problem and that prevention, early identification and comprehensive treatment of child abuse victims remain a challenge for the world medical community.

Riot control agents

Governments should stop using riot control agents in any circumstances because of the risks to health and life, the Assembly agreed. Sir Michael Marmot said: ‘Governments are currently required to ensure that these agents are used in a manner which minimises causing serious injury and death. But how they are used determines the concentration to which individuals are exposed. If they are misused it could lead to serious harm or death. What delegates decided is that Governments should no longer use these control agents and also that in riot situations there should be unimpeded and protected access of healthcare personnel to allow them to fulfil their duty of attending to the injured.’

Promotional mass media appearances by physicians

Following serious concern over the increase of physicians’ appearing on the mass media to recommend unproven treatments or products, delegates agreed new guidelines. These are aimed at contributing to patient safety by ensuring physicians provide accurate, timely, and objective information and preventing physicians from being involved in commercial activities that may compromise professional ethics.

Medical school curricula

The Assembly agreed that medical ethics and human rights should be taught at every medical school as obligatory and examined parts of the curriculum, and should continue at all stages of post graduate medical education and continuing professional development. Delegates agreed that failures of individual physicians to recognize the ethical obligations they owe patients and communities can damage the reputation of doctors both locally and globally. Therefore it is essential that all doctors are taught to understand and respect medical ethics and human rights from the beginning of their medical school careers.

Vitamin D insufficiency

National medical associations were urged to support continued research and education about vitamin D deficiency which effects about a third of the population. The Assembly declared that this was an important health issue globally with many studies showing that vitamin D deficiency was linked to impaired growth and development. Because of widespread occurrence of vitamin D deficiency it was important to focus attention on adequate preventive actions in populations at risk, such as young children, the elderly and pregnant women.

Social determinants of health

The WMA’s policy on the Social Determinants of Health was retitled the Declaration of Oslo.

Election

Sir Michael Marmot, Director of the Institute of Health Equity at UCL, University of London and a former President of the British Medical Association, was installed as President for 2015/16.

New members

An application for membership from the Panhellenic Medical Association was accepted, bringing the total number of WMA National Medical Associations and constituent bodies to 112.

Separate press releases were issued on:

• Health Care for Refugees
• Hospital Bombing
• Healthcare Attacks in Turkey
• Transgender
Breaking news
Man with Parkinson’s disease walks again after cancer drug trial

In a small phase 1 clinical trial by Dr. Charbel Moussa, PhD, and Dr. Fernando Pagan, PhD, both of Georgetown University Medical Center in Washington (GUMC), Nilotinib, a drug used in the treatment of chronic myelogenous leukemia, improved and even reversed impaired cognition, motor skills and non-motor function in patients with Parkinson's disease and Lewy body dementia. Tau and p-Tau decreased significantly, suggesting the clearance of toxic proteins in the brain, while alpha-synuclein, amyloid beta-40/42 increased. Dopamine production increased in some patients to the extent that their usual dopamine-sparing drugs prescribed for Parkinson's (L-dopa therapies), could be lowered or stopped. (Medical News Today)
Dr Good Dr Bad
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Specialty Updates
• Altered connectivity in the developing brain may underlie neuropsychiatric disorders and motor impairment associated with preterm birth, suggest two new studies presented at the Society for Neuroscience 2015 Annual Meeting.

• A new study suggests that infections in childhood, such as such as typhoid fever, measles and chicken pox, are linked to an increased risk of early heart attack. The findings were presented at the Acute Cardiovascular Care conference.

• Bariatric surgery improves fertility and reproductive outcomes in obese women, but the potential risks of each type of surgery must be weighed carefully against the benefits, and it should be a last resort, suggested a new scientific impact paper released by the Royal College of Obstetricians and Gynecologists (RCOG).

• Patients who underwent colorectal surgery fared better when they received the opioid receptor antagonist alvimopan than when they did not, suggested a retrospective cohort study presented at the American College of Surgeons (ACS) Clinical Congress 2015.

• Supplementation with high-dose vitamin D may help improve cognition in patients with multiple sclerosis who have low blood levels of the vitamin, suggests new research presented at the Society for Neuroscience meeting.

• New research suggests that human intestinal flora regulates the levels of the body's main antioxidant, glutathione, which fights a host of diseases. The findings, published in the scientific journal Molecular Systems Biology, could lead to new probiotic-delivering foods, and a better understanding of the metabolic processes behind diseases such as type 2 diabetes.

• High cholesterol levels are associated with tendinopathy, reported a review of studies published in the British Journal of Sports Medicine. Researchers noted that tendinopathy was significantly associated with higher total cholesterol, higher low-density lipoprotein cholesterol and higher triglycerides, as well as lower high-density lipoprotein.

• A new study suggests that a daytime nap can boost the consolidation of learning that is linked to rewards. Researchers noted that sleep appears to increase links between three areas of the brain that are important for cementing memory and processing reward. The findings are published in the journal eLife.

• Having more than 11 moles on one arm indicates a higher-than-average risk of skin cancer or melanoma. Counting moles on the right arm was found to be a good indicator of total moles on the body. More than 100 indicates five times the normal risk. (British Journal of Dermatology)

• Aortic valve replacement for severe but asymptomatic stenoses was associated with better long-term outcomes than "watchful waiting" for symptoms to develop. (JACC)

• "Reflexive epilepsy" is characterized by seizures prompted by external stimuli like reading, calculating, touching, warm bathing, game playing, or noise.
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Media
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eSPIRITUAL
9th Chaitra Navratri: Siddhidatri
Siddhidatri is worshipped on the 9th day of Navratri. SHE gives all the eight siddhis – Anima, Mahima, Garima, Laghima, Prapti, Prakamya, Iishitva and Vashitva. SHE rides on a lion or on a lotus. SHE has four hands and looks pleased.

Spiritual message on the 9th Navratri: By the 9th day of spiritual detoxification, one gets all spiritual powers.
Medicofinance
Asset protection: Personal residence

The final available alternative to protect a personal residence is by transferring the ownership of the residence to a trust commonly referred to as a personal residence trust (PRT). This is a trust established initially for the benefit of the doctor and the doctor’s spouse and later for the benefit of the doctor’s children or other beneficiaries. Because, the trust is irrevocable it is treated as the owner of the residence, although the doctor retains full control over his residence by appointing a friendly trustee. The trust allows the doctor to sell the existing home, buy a new home and refinance. In practice, PRTs have proven to be a simple and an extremely effective way of protecting a personal residence.

(Source: IJCP)
Industry News
Government makes Aadhar Card mandatory for registering startups: The government of India has made it mandatory to Aadhar number along with the application in order to register a new business of an entrepreneur. However, this rules seems to be against the Supreme Court’s ruling that made Aadhar card to used voluntarily for few social welfare schemes only. The startups cannot fill a new online form for registering new enterprises which was introduced last month unless the Aadhaar credentials of their promoters are validated online. (Thetechportal.in - Jeet Suthar)

Valuation of e-commerce start-ups up by 167%: Average enterprise valuation of late stage companies have seen an increase from Rs 881 crore in the 2010 - 2012 period to Rs 5,095 crore during 2013-15, an increase of 5.78 times. Revenue multiples for e-commerce investments are the highest overall (10.19), followed by that of IT&ITES (4.8) and revenue multiple for early stage investments were higher than that of the growth and late stage, according to 7th Annual Report on the Indian Venture Capital and PE industry. (Business Standard - TE Narasimhan and Gireesh Babu)

India’s banking sector reforms will help small entrepreneurs: Prime Minister Narendra Modi on Monday said the government has initiated a series of banking reforms including re-capitalisation of PSU banks, change in rules for hiring top management and paper-less transactions to curb the black money menace. “The banking sector is seeing changes. Mobile banking is coming up. Banking will be premises-less and paper-less,” he said at the launch of IDFC Bank in New Delhi. Modi further said India is slowly moving towards a situation where the currency printing cost will come down and stressed the need for banks to focus on rural areas as they have immense potential. (Yourstory - PTI)

Start-up Capital conferences planned for Delhi and Bengaluru: Start-up Capitals 2015 will be held in New Delhi on October 27, followed by one in Bangalore on October 29. The conferences are a thought-leadership brainstorming on the innovation hotspots and start-up ecosystem of cities that are making a mark on the world map, said the Singapore-based organisers, Start-up Capitals today. (Business Standard – PTI)
Inspirational Story
Run your own RACE and wish others WELL

I was jogging one day and I noticed a person in front of me, about 1/4 of mile. I could tell he was running a little slower than me and I thought, good, I shall try to catch him. I had about a mile to go my path before I needed to turn off. So I started running faster and faster. Every block, I was gaining on him just a little bit. After just a few minutes I was only about 100 yards behind him, so I really picked up the pace and push myself. You would have thought I was running in the last leg of London Olympic competition. I was determined to catch him. Finally, I did it! I caught and passed him by. On the inside I felt so good.

"I beat him" of course, he didn’t even know we were racing. After I passed him, I realized I had been so focused on competing against him that I had missed my turn. I had gone nearly six blocks past it. I had to turn around and go all back. Isn’t that what happens in life when we focus on competing with co–workers, neighbors, friends, family, trying to outdo them or trying to prove that we are more successful or more important? We spend our time and energy running after them and we miss out on our own paths to our God given destinies.

The problem with unhealthy competition is that it’s a never ending cycle. There will always be somebody ahead of you, someone with better job, nicer car, more money in the bank, more education, better behaved children, etc. But realize that "You can be the best that you can be, you are not competing with no one." Some people are insecure because they pay too much attention 2 what others are doing, where others are going, wearing & driving.

Take what God has given you, the height, weight & personality. Dress well & wear it proudly! You’ll be blessed by it. Stay focused and live a healthy life. There’s no competition in DESTINY, run your own RACE and wish others WELL!!
Practicing Doctors working as full-time Faculties: Bombay HC confirms disciplinary action initiated by Medical Council of India (Read Judgment)

Anju Cletus | October 17, 2015 (Live Law.in)

The Bombay High Court Division Bench comprising of Justices S.C. Dharmadhikari and B.P. Colabawalla dismissed Writ Petitions involving common challenge to the orders of Medical Council of India (MCI) and Maharashtra Medical Council (MMC) against doctor-petitioners for breach of professional code of ethics. All the petitioners who had allegedly furnished false information regarding appointment of faculty members in various institutions of medical education during inspections carried out by the Council were removed by MMC from the State rolls for 5 years as per the direction of MCI.

The petitioners pointed out that Section 24 of Indian Medical Council Act, 1956 has envisaged only a consultative or supervisory role of Medical Council of India and the disciplinary jurisdiction over the doctors on state rolls was vested with the State Medical Council. According to them, MCI has no powers to initiate disciplinary actions. They also submitted there were no compliances of natural justice in terms of fair enquiry, hearing and opportunity to cross-examine the witnesses against them.

On the other hand, it was contended on behalf of the MCI that if the standards of medical education and practice are prescribed by it and it is empowered to do so in law, then equally for its breach and its violation, MCI can take disciplinary measures and actions. MCI also submitted that it cannot remain a silent spectator where some doctors became part of a systemic breach and violation of Indian Medical council Act, 1956, its Code of Ethics and Regulations, for petty financial gains. It has to be ensured that standards of medical education and integrity of the noble professions of doctors and teachers have to be upheld and protected at all costs.

After having considered the rival submissions the court observed that merely fact that the doctor is registered as such by a State Council, does not mean the MCI has no power to deal with and proceed against him. “Such a stand would render Regulations 8.1 and 8.2 of the IMC Regulations nugatory and meaningless. Thus, the MCI has power to order the removal of the petitioners’ name from the register altogether or for a specified period,” the court said.

We are in complete agreement, therefore, with Mr. Gole that the Council has original and appellate power as well in terms of the IMC Regulations. Once these Regulations and all the chapters thereof are read together and harmoniously, it is evident that nothing which is a misconduct or an infamous conduct, can go without a disciplinary enquiry and unpunished.
If the larger public interest is to be served and bearing in mind the role of medical practitioners and physicians, then such comprehensive regulations and measures have to be enacted. Having enacted them, a meaning will have to be placed on its clauses enabling the Councils to deal with the misconduct and/or infamous acts. That would be advancing the remedy. A narrow or restricted interpretation is likely to frustrate and defeat the IMC Act itself. Therefore, we are not in agreement with the learned counsel for the Petitioners insofar as the jurisdiction, power and authority of Council are concerned”.
The Court added.

The court also observed that petitioners were heard by the Ethics Committee and thereafter it submitted its report to the Board of Governors. The Board of Governors took the ultimate decision by accepting the report and the petitioners had admitted that they had obtained the appointments wrongfully and illegally. “A bare assertion of breach of principles of natural justice without a proof of resultant prejudice cannot, therefore, be accepted and such a complaint cannot be upheld,” added the Court.
eMEDIPICS
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Cardiology - Yesterday, Today & Tomorrow - A CME was organized by IMA HQs on World Heart Day at IMA House, New Delhi
MTNL Perfect Health Mela 2015.

Pls click here for details
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BIOETHICAL ISSUES IN MEDICAL PRACTICE
Defensive Medicine

Smita N Deshpande
Head, Dept. of Psychiatry, De-addiction Services
PGIMER-Dr. Ram Manohar Lohia Hospital
New Delhi

The rate of cesarean section deliveries is growing all over the country. Obstetricians are often accused of using cesarean section to increase their income. On the other hand, issues such as increasing maternal age, precious babies, mothers’ insistence, safety and ease, parents’ schedule preferences, and preferences for doctor’s and hospital’s office hour delivery all result in increasing operative deliveries. However all doctors believe that ‘natural is the way to go’ in pregnancy. Yet operative deliveries are undertaken to avoid the smallest risk to mother or child. What do you think?

a. Is caesarean section a part of defensive medicine?

b. Do you agree to cesarean section deliveries in general?

c. Can such sections lead to complications for the baby such as prematurity and therefore, should they be always avoided?

d. If no to cesarean section, then what is the alternative?

e. Should there be definite essential requirements for cesarean section?

Adapted and shortened from: UNESCO, 2011. Casebook on Human Dignity and Human Rights, Bioethics Core Curriculum Casebook Series, No. 1, UNESCO: Paris, 144 pp.

Do write in with views and your solutions!
Breaking news
Health Ministry permits transfer of blood between Blood Banks

The Ministry of Health & Family Welfare has identified two major initiatives towards better utilisation of blood and blood components, as part of its commitment to ensure safe blood and enhanced access to blood products, on the recommendation of the National Blood Transfusion Council. The first step is permitting the transfer of blood from one blood bank to another. This was not allowed earlier and will help in transfer of blood to places of scarcity. Detailed guidelines for proper and efficient transport of blood between banks have been prescribed.

The second step is fixing of an exchange value for surplus plasma available at some blood banks in the country. In the absence of the enabling provision, surplus plasma was traded or sold by the blood banks without any regulation whatsoever. Now an exchange value of Rs.1600/- per litre of plasma has been fixed and the blood banks with surplus plasma can exchange it for consumables, equipments etc. or plasma derived products, as per their need. This exchange, however, cannot be in terms of cash. This step is expected to increase the availability of essential life saving medicines like human albumin, immunoglobulins, clotting factors, etc. which are all derived from plasma. This step would also reduce the country’s dependence on import of these products.

The National Blood Transfusion Council under the Ministry of Health & Family Welfare is the apex body for formulating policy matters pertaining to the organisation, operation, standards and training of a sustainable and safe blood transfusion service for the country, set up under the directions of the Hon. Supreme Court of India. (PIB)

Note: IMA is a member of this committee
MAKE SURE
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IMA Satyagraha, suggested slogans
• Writing prescription drugs by a non-MBBS is injurious to health of the community.
• Writing prescription drugs by unqualified people can be dangerous.
• Allow doctors to treat patients irrespective of patients’ income.(If compensation is not capped, we can't do this)
• When there is capping of Rs 2 lakh for a sterilization death, why not for other procedures?
• When there is a compensation of Rs 30,000/- for a sterilization failure, why not for other procedures?
• Allow us to treat poor and rich equally.
• Non pelvic ultrasound providers should be out of PCPNDT Act.
• Unless caught doing sex determination, no criminal offence shall be registered.
• If any prospective parent asks for sex determination, they should be booked under a non bailable offense.
• More patients will die if doctors are not provided protection during duty hours.
• Death does not mean negligence.
• Money spent does not mean you will get a cure.
• Including single clinic and small establishments under Clinical Establishment Act will make treatment costly.
• How can we treat patients using outdated standard treatment guidelines made by government?
• How can government decide the charges of a clinical establishment?
Team IMA, We would like to draw your kind attention towards some decisions taken by Jharkhand State Govt., which are against the prestige and dignity of State services doctors. The Govt has passed an order through its cabinet that Doctors posted in PHC, have to report to the village Mukhiyas for their attendances, and leave. Only on the recommendation of Mukhiya, will the concerned doctor get their salary. Similarly Civil Surgeon cum C.M.O. of district has to report to District Board Chairman for their leave and other, instead of Dy. commissioner. The entire medical fraternity in the state has taken this very seriously. IMA Jharkhand and JHASA (Jharkhand Health Services Association) have jointly protested and have sent a Fax to Chief Minister to withdraw the cabinet decision immediately.

Few days back a notification was issued by the Principal Secretary Health ordering the DC to form a raiding party of officers, mostly junior officers against doctors working in the district and on a recommendation of that party, four govt. doctors posted in Dumka district were immediately suspended. We protested and raised voice against this suspension and that notification, as such the suspension order has been withdrawn. We have organized a joint meeting with JHASA on 25th October and decided to take a massive rally against this with a plan to gherao the CM… we will decide further line of action.

Dr Arun Kumar Singh
State President, IMA Jharkhand

Team IMA: The national IMA is taking up the issue at a National level.
IMA JIMA
IMA Digital TV
GP Tip: 10% weight loss

Never lose more than 10% in a weight loss program or it will come back very rapidly. By reducing 500 calories a day (250 extra burn, 250 reduced intake) one can lose one pound of weight every week.

(Source: IJCP)
Medical profession urged to do more on physicians' ill health
The medical profession should do far more to prevent and deal with stress and illness among physicians, the World Medical Association has said.

In new policy guidance adopted at its annual Assembly in Moscow, the WMA calls for a series of measures to improve physicians' wellbeing. It says that the medical profession often attracts highly driven individuals with a strong sense of duty. Physicians have to complete long and intense educational requirements and are subject to high expectations from patients and the public. But these expectations can contribute to prioritizing the care of others over care of self and feelings of guilt and selfishness for managing their own well-being.

Physicians often delay seeking help because of their concern about confidentiality and feeling ill at ease in the patient role. However they should be assured of the same right of confidentiality as any other patient when seeking and undergoing treatment. Prevention, early assistance and intervention should be available separately from any disciplinary process.

The guidance says that physicians and physicians in postgraduate education often confront emotionally challenging and traumatic situations including patients' suffering, injury and death. Physicians in postgraduate education and medical students can also be victims of harassment and discrimination during their medical education. Due to their position within the medical hierarchy, they may feel powerless to confront these behaviours.

Sir Michael Marmot, President of the WMA, said: ‘There is no doubt that physicians are often adept at hiding their own illnesses and continuing to work without seeking help until they become incapable of carrying out their duties. There are many potential obstacles to an ill physician seeking care, such as denial, confidentiality issues, and fear of disciplinary action and potential loss of privileges. Because of these obstacles doctors are often reluctant to refer themselves or their colleagues for treatment.

‘So we are urging better wellness promotion, prevention strategies and earlier intervention to help lessen the severity of mental and physical illnesses and help reduce incidence of suicide among physicians, physicians in postgraduate education and medical students.'
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Readers column
Dear Sir, thank you for sending the daily eMedinewS. It’s a daily update for doctors like us who are working at Primary centers. Thanks & Regards: Dr Raj
eMEDI QUIZ
Referred pain from ureteric colic is felt in the groin due to involvement of the following nerve:

1. Subcostal.
2. Iliohypogastric.
3. Ilioinguinal.
4. Genitofemoral

Yesterday’s Mind Teaser: All of the following muscles are grouped together as muscles of mastication except:

1. Buccinator.
2. Masseter.
3. Temporalis.
4. Pterygoids.

Answer for Yesterday’s Mind Teaser: 1. Buccinator.

Answers received from: Dr Jainendra Upadhyay, Daivadheenam Jella, Dr Poonam Chablani, Dr K V Sarma, Dr K Raju, Dr Avtar Krishan.

Answer for 19th October Mind Teaser: 4. Condyles of tibia.

Correct Answers received from: Daivadheenam Jella, Dr Poonam Chablani, Dr K V Sarma, Dr K Raju, Dr Avtar Krishan.
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eWELLNESS
Older people ‘should exercise to build muscle even into their 80s’

Older people should exercise to build their muscles even into their eighties, according to a review which suggests it will help them with everyday tasks.

Climbing the stairs, housework, walking and even washing was made easier if elderly people worked out 2 or 3 times a week, said Chiung–ju Liu of the Department of Occupational Therapy at Indiana University.

People lose muscle as they age, which can make daily chores more difficult. Working out by using small weights or elastic bands can help to rebuild these muscles.

By "walking well", however, you power yourself around all day using muscles in your bottom, midriff and the backs of your thighs. This brings dramatic, sustainable results.
Legal Quote
Indian Medical Association vs VP Shantha & Ors on 13 November, 1995, 1996 AIR 550, 1995 SCC (6) 651

“There may be cases which do not raise such complicated questions and the deficiency in service may be due to obvious faults which can be easily established such as removal of the wrong limb or the performance of an operation on the wrong patient or giving injection of a drug to which the patient is allergic without looking into the outpatient card containing the warning (as in Chinkeow v. Government of Malaysia, (1967) 1 WLR 813 P.C.) or use of wrong gas during the course of an anesthetic or leaving inside the patient swabs or other items of operating equipment after surgery.”
Humor
While proudly showing off his new apartment to friends late one night, the drunk led the way to his bedroom where there was a big brass gong. "What’s that big brass gong for?" one of the guests asked. "Why, that’s the talking clock" the man replied. "Watch", the man said, giving the gong an ear–shattering pound with a hammer.

Suddenly, someone on the other side of the wall screamed, "F’gosh sakes, you idiot, its 2am in the blankety–blank morning!"
Press Release
Non-violent and emphatic communication facilitates better treatment of patients

Effective Communication is the key to building relationships, businesses, a career and it equally affects everything in this universe. However, we often do not realize that in addition to just transmitting information, a good communication strategy also positively effects the outcome and if not done properly, it can lead to unwanted disruption and miscommunication.

An effective non-violent communications strategy can help medical professionals in their career and in the treatment of the patients. Communication forms a core part of every doctor-patient relationship. To effectively treat any chronic disease, it is important for the doctor to know in detail the medical history of the patient. A positive communications approach helps a patient feel at ease with his doctor encouraging conversation about lesser known factors that can aggravate an individual’s heath deterioration like stress, depression or any other personal issues.

For patients suffering from lifestyle disorders like diabetes, heart disease, their relationship with their doctor is a life-long one. For successful lifestyle management of diseases, it is extremely important that the doctor has a detailed understanding of the patient and his tendencies so as to overcome hurdles effectively. In addition to this, it is also important that the patient trusts the doctors advice to be able to implement his suggestions. Speaking on the issue, Padma Shri Awardees Dr A Marthanda Pillai National President Indian Medical Association and Padma Shri Awardee, Dr K K Aggarwal – Honorary Secretary General IMA and President HCFI, “When medical professionals try to create emphatic surroundings for their patients, the patient satisfaction levels and improvement rates are found to be much higher. The three Cs of violent communication are – condemn, criticise and complaint. By eliminating these while interacting with one’s patient, a harmonious relationship can be established. Hostility, aggression, anger all are linked to directly or indirectly violent communication. The chances of a patient adhering to the lifestyle changes directed by the doctor are much higher if communicated to in a emphatic manner as opposed to in a stern and angry fashion.”

Nowadays, as such there is no special training given to the doctors or to physicians, on how to effectively create positive relationships with their patients. On one side a doctor is expected to be non-emotional when it comes to their patients and on the other emphatic. A clear professional relationship is ideal based on trust, honesty and direct communication.

In addition to this, non-violent communication also helps strengthen the relationship between medical practitioners and their subordinates. Doctors must address and interact with their colleagues with respect and should not condemn or criticize them in public or behind their back. Similarly if a positive relationship is established with one’s juniors, nurses, hospital staff, better healthcare delivery is guarantee.
Digital IMA