What Does it mean to be a good doctor.pptx

What it means to be a doctor

1. What does it mean to be a doctor? Chapter 29

2. At the end of this session, the students should be able to Enumerate professional qualities of physician Describe the benefits of lifelong learning. List the methods for lifelong learning. List the roles of physician in health care system. List the roles of physician in the society and community. Specific Learning Objectives

3. The goal of revised Graduate Medical Education Regulation ­– 2017 (GMER) is to create a competent Indian Medical Graduate who should have desired knowledge, skills, attitudes, and responsiveness. He/she should function ethically as a member of the health care delivery system. ATTITUDE, ETHICS, AND COMMUNICATION (AETCOM) COMPETENCIES Figure 29.1: Empathetic approach to the patient

4. Designed to impart competencies to the IMG, which will help him/her to work as efficient physician. Develop an empathetic approach in an Indian Medical Graduate who can deal with patients with efficient communication and good attitude. ATTITUDE, ETHICS, AND COMMUNICATION (AETCOM) COMPETENCIES Figure 29.1: Empathetic approach to the patient

5. The medical student should understand the following terms at the beginning of his career. What is goal? The goal of the curriculum and training programme is to create efficient IMG. What is competency? Lifestyle or habit, or capability of an individual. It includes knowledge, communication, skill, technical skill, clinical reasoning, and ethical behavior. It makes the physician use these competencies in daily practice to benefit patients and society. Concepts

6. What is objective? Expected outcome of a training session. It specifies the statement of what a learner should be able to do at the end of a specific learning experience. The objective can be tested based on the learning domain as follows: To test knowledge: able to do any one of the following: Enumerate, List, describe, discuss, differentiate, define, classify, choose, elicits, or report. To test skill : able to do any one of the following: Identify, demonstrate, perform under supervision, perform independently, document, present, record, or interpret. To test attitude or communication skill: able to communicate, inform or demonstrate the understanding of the given situation. Concepts

7. Core competencies are the essential requisite and must know facts to complete the subject's requirement. Non-core competencies are the optional requisite and desirable or nice-to-know facts of the subject. Levels of Competency Determines the ability of the learner to perform the task with a certain level of proficiency. The levels of competency are grouped as follows : Knows (K): It indicates the competency of knowledge attribute . It can be tested using the ability to enumerate, list, or describe. Knows how (KH): It indicates the competency of higher level of knowledge. It can be tested using the ability to discuss or analyze. Concepts

8. Shows (S): It indicates the skill of the learner. It can be tested using the ability to identify or demonstrate the steps. Shows how (SH): It indicates the learner's higher level of skill attribute. It can be tested using the ability to interpret or demonstrate a complex procedure. It tests the learner's ability to think, knowledge, and behavior. Perform (P): It indicates the mastery of the competency. It can be tested using the ability to perform the skill. It can be grouped under supervision or independently. Concepts

9. Figure 29.2: Levels of competency

10. Definition : Medically trained and licensed person to practice medicine which includes diagnosis, cure, and prevention of diseases. Becoming a doctor is one of the priority ambitions of school-going students. The most common reason behind this is respectful social status and good economic stability. With this social status, responsibilities come to the physician. Learning the course of Allopathic or Modern Medicine is a tough job but is not impossible. It needs time, hard work, and patience. Hence, development of thinking is essential for the beginning of the training course to achieve excellence in the career. WHAT DOES IT MEAN TO BE A DOCTOR?

11. Enthusiasm of student competencies to make them professionally efficient doctors is important. The curriculum is designed to train young minds, but it needs to understand the need for active participation in acquiring clinical skills and other characteristic features of a physician, such as a selflessness, caring attitude, and dedication towards society. The medical profession − one of the most sought-after professions worldwide. Students of the medical profession face many issues due to sudden changes in institutional atmosphere. Medical institutions have different patterns of curriculum. WHAT DOES IT MEAN TO BE A DOCTOR?

12. If students understand the importance of hard work, sincerity, honesty, and devotion to becoming a good doctor, it will become easy for him/her to get success in their career. It is usually seen as a long learning career for doctors than other professions create psychological pressure, and anxiety in students. Delayed settlement in life is seen in doctors, but they can practice for many years. This chapter includes understanding the roles and responsibilities of doctors and need to continue medical education is explained. WHAT DOES IT MEAN TO BE A DOCTOR?

13. Student undergoes training and internship to acquire a degree of MBBS (Bachelor of Medicine and Surgery). He/she can then work as general physician or general duty medical officer. Progress in career to acquire specialization as pediatrician, ophthalmologist, general surgeon, ENT surgeon, and so on. Further, a super specialization also can be done to become cardiothoracic surgeon, neurosurgeon, nephrologist, cardiologist, nephrologist, and so on. A physician should respect all individuals irrespective of their status, such as religion, caste, economic status, health status, and so on. Qualifications and Specialty

14. Qualities are the expectation of the society from the physician. The attributes or qualities of a physician are a set of conductus, habits, requirements, and expectations. These include the following attributes: Personal attributes Professional attributes Qualities of a Physician Figure 29.3: Physician with caring nature

15. A. Personal attributes of physician Each physician being human, he/she should have the qualities that make him/her a good doctor. These qualities include : Caring nature Lifelong learner Civic mindedness Communicator Qualities of a Physician Figure 29.3: Physician with caring nature

16. 1. Caring nature Must be caring for themselves, patients, and society. It forms a foundation of doctor-patient relationship. P rovide care beyond the cure of the diseases, especially in non-curable diseases − helps to build trust and reduces a patient’s anxiety. Qualities of a Physician Figure 29.3: Physician with caring nature

17. 2. Lifelong learner (inquisitive) Committed to lifelong learning as medical science is continuously developing. The updates of knowledge and skills are essential for improvement in practicing outcomes. Need for time to acquire new knowledge and responsibilities. Intellectual curiosity is essential to become lifelong learner. Qualities of a Physician Figure 29.3: Physician with caring nature

18. 3. Civic mindedness Towards the well-being of the society. Beyond the cure of disease − should provide care that prevents diseases and improves the life of an individual patient, his/her dependents, and society. Qualities of a Physician Figure 29.3: Physician with caring nature

19. Work voluntarily to provide services to underserved communities. Redesign the services with the help of their leadership qualities, involvement in research and innovation, and active participation for the betterment of services. Qualities of a Physician Figure 29.3: Physician with caring nature

20. 4. Communicator A communication skill is a basic and essential attribute of a physician. He/she should be able to listen carefully and express themselves effectively. Many times, physician has to declare difficult news with empathy and clarity. Figure 29.4: Physician as a good communicator Qualities of a Physician

21. B. Professional attributes of physician Represent his/her professional efficiency towards the patientcare and social health improvement. These attributes include: Qualification Altruism Accountability Excellence Teamwork Collaboration Empathy Leadership Confidentiality Adaptability. Figure 29.5: Personal attributes of physician Qualities of a Physician

22. Qualification Must have desired qualifications and registration for practice. Physician should practice the skills for which he/she is specialized and permitted. Altruism Belief in disinterest and selfless behavior for wellbeing of others − consists of psychological, behavioral, and biological altruism. Psychological altruism − consists of intentional motivation to help others for their own sake. Behavioral altruism − actions that benefit others. Biological altruism − conditions that decrease the energy of one organism to increase energy of another organism. For example, blood donation. Qualities of a Physician

23. Accountability Includes the responsibility for his/her decisions, actions, and professional behavior in their professional practice. Important for ensuring high-quality, patient-centered care and maintaining trust of patients and society. Physicians must abide by court of laws. Excellence Physician must maintain professional excellence by acquiring and updating skills and knowledge. He/she also should upgrade the facilities and resources for patient safety and services. Qualities of a Physician

24. Leadership Physician − plays a role of leader. Provides guidance and support to team members and society. His/her vision should have capacity to impact the health of society. Leadership quality should be supported with honesty, discipline, creativity, humanity, and respect. Figure 29.6: Physician leading a team (leadership and collaboration qualities) Qualities of a Physician

25. Collaboration Ready to collaborate with peers and colleagues for better services and acquire new knowledge and skills. He/she should involve actively and ethically with other team members for the delivery of the services to save the life, time, and money of the patient. Figure 29.6: Physician leading a team (leadership and collaboration qualities) Qualities of a Physician

26. Teamwork Should work as a member of healthcare delivery system in association with other members. Respect other team members. Figure 29.7: Physician – Quality of teamwork Qualities of a Physician

27. Empathy Understand the concerns, emotions, and expectations of the patients. Developing empathy is ongoing process that comes with time and experience. It helps in gaining trust of patients and positive approach towards humanity. Confidentiality Critical quality of medical field. Bound to maintain professional confidentiality by law. It is important to maintain confidentiality of patient-related data and proper maintenance and disposal of the documents. Physicians should disclose only essential facts to the concerned individual, authorities, and Court of Law.

28. Adaptability Adapt to health care system to provide services. Working in new environments, with new devices and technology, working with new team members, and open-mindedness toward new ideas and approaches. It also includes acceptability of new challenges, stress, and failures. Morality, ethics, and humanity Follow morality and ethics during practice. Humanity is being humble while dealing with patients, their relatives, and others.

29. Figure 29.8: Professional attributes of physician

30. Main pillar of health care delivery system. Undergraduate student understands the roles of physician in health care system, it will help his/her to acquire the desired knowledge and skills and to develop the required behavior. The important roles of physician are as follows : Diagnosis and treatment Diagnose and treat the patients. The physician should utilize the knowledge and skills for dispensing his/her primary responsibility. Role of a Physician in Health Care System

31. Prevention care Focus on prevention of diseases. Get involved in immunization programmes should give advice, and initiate measure for prevention of spread of disease in an individual and society. Advise or prescribe medicine for prevention of infection and nutritional deficiency diseases whenever necessary prevention surgeries should be performed if required, for example, removal of tumor to spread cancer. Role of a Physician in Health Care System

32. Leadership Ready to work in a team as a leader. Physician should decide policies for better delivery of health care. Responsible for ensuring the roles and responsibilities of other team members. Motivate and educate other team members. Shape the policies and procedures to serve in the healthcare organizations. Physicians should actively get involved in management, strategic planning, and communication for improvement of health care system. Health care educator Provide desired and required knowledge to the patient about medical conditions, treatment, procedures, prevention of diseases, and protection of other family members and society. Role of a Physician in Health Care System

33. Encourage and promote health, hygiene, and nourishment practices. He/she should explain the benefit of health food, good habits, routine health check-ups, screening, lifestyle modifications, exercises, follow-ups, and so on. Arrange sessions to make awareness of lifestyle modifications for prevention of diseases − should spread awareness of national health programmes . Research Physician acquires the best knowledge by practicing medicine. Physicians should get involved in research to understand diseases and development of new treatments, therapies, and devices for improvement in patient care. Role of a Physician in Health Care System

34. Follow the guidelines for research given by the government, institutions, and ethical committees. He/she should get required permissions before starting research. Lifelong learner Actively participate in acquiring new knowledge, skills, and qualities for improvement. National responsibilities Physicians should be ready to work in epidemics, national disasters, and other emergencies. Physicians should follow national health policies and guidelines given by the government. Physicians should follow the court of laws and cooperate in medicolegal cases. Physician should report notifiable diseases. Role of a Physician in Health Care System

35. Figure 29.9: Physician – as a researcher

36. Figure 29.10: Role of a physician in health care system

37. Society is a group of people with common cultures, values, and beliefs. Community is a group of people living in a specific geographic area with common interests, values, and goals. Community is defined by physical boundaries such as city, country, or state. Society and community terms are often used interchangeably though they have different meanings. A physician plays an important role in the healthy well-being of society and community. He/she is performing the following roles : Role of a Physician Toward Society and Community

38. Medical expertise Patient who is part of society and community. This primary role is very important as ill health of an individual patient has indirect impact on family members and others. Health promotion Highly respected person in society. People follow his/her advice. Hence, any health promotion-related message given by a physician greatly impacts society's health status. Physicians should promote: National health immunization programme Health behavior and lifestyle modifications Importance of proper food supply and nutrition Importance of maternal and child health Role of a Physician Toward Society and Community

39. Importance of hygiene Measures to prevent communicable diseases Measures to improve mental health and so on. Guide society about the adverse impact of alcohol, smoking, and other habits on health. He/she should spread awareness about chronic diseases such as diabetes, heart disease, cancers, and so on. Communicator and collaborator Physicians should collaborate and encourage participation of community for health awareness. He/she should communicate benefits of community participation to the leaders and members. Role of a Physician Toward Society and Community

40. Administrator Work as administrators for planning strategies and creating cost-effective health service provisions. Government administrative services and try to enhance the speed of health care delivery, reducing cost of health care and so on. He/she can suggest the plans for the improvement of the health of community. Team-work Physicians should with other teams to create positive impact on the health of community. He/she should collaborate with NGOs and government agencies to promote health care measures. Role of a Physician Toward Society and Community

41. Medicolegal roles Physicians should help judiciary in medico-legal cases − witness the proceedings of court of law whenever called by the court. Should report medico-legal cases to police for further necessary actions. Research Based on personal expertise, physicians can decide the research areas required for improving health of community with approval from competent authorities; physician can perform research trials to find out new research data for development of new drugs, procedures, diagnostic tests, implants, and devices. Role of a Physician Toward Society and Community

42. Whistle blower role Report any illegal, ethical, or fraudulent activities within the organization or community to protect patients and community from harm and harassment. Physician should maintain transparency in his/her work. Notifying communicable diseases Health authorities to take required measures to protect the community. In India, dengue, tuberculosis, malaria, and many other diseases come under the category of notifiable diseases, such as chicken pox, AIDS, hepatitis B, whooping cough, measles, rabies, vitamin A deficiency, typhoid, polio, and leprosy. Role of a Physician Toward Society and Community

43. Figure 29.11: Role of a physician toward society and community

44. Process of acquiring knowledge, skills, and competencies throughout the entire life − required, especially in the medical field, due to continuously developing science. Need of lifelong learning Lifelong learning is important for physicians for the following reasons : To keep up-to-date knowledge and technology: Physician should be open minded to acquire newly developed knowledge and acquire the utility of new technology to improve healthcare delivery. Improving clinical competence: Continued education helps physician to maintain clinical competence using new diagnostic and therapeutic knowledge. Professional development: I ncluding promotions, salary hikes, maintenance of practicing license, and so on. Lifelong Learning for Physician

45. Adapting new policies and regulations: Adapt newly developed or changed policies and regulations laid by government, institution, or societies. Enhancing patient outcomes: Acquiring new development help to improve healthcare delivery and patient outcomes. It will also help to provide cost-effective patient care. Research : Continued education help to find gap in the existing knowledge and to plan new research or improve ongoing research. Satisfaction : Acquiring new knowledge and skills always gives satisfaction and happiness. Collaboration : Continued education help to gain knowledge about the various available facilities at different healthcare centers. It opens the doors for planning collaboration for research and better health care delivery system. Lifelong Learning for Physician

46. Figure 29.12: Need of lifelong learning

47. Tools for lifelong learning To upgrade medical knowledge, the following tools can be used: Recent editions of textbooks: Read updated recent editions of textbooks to acquire current updated knowledge. Medical journals and publications: They provide knowledge of current ongoing research, their findings, and trends in medicine. They help in planning new research. Figure 29.13: Physician – Lifelong-learner Lifelong Learning for Physician

48. Documents provided by organizations, government, institutions, and society: Knowledge about new rules, regulations, and laws. They also provide new guidelines for management of diseases and protocols that need to be followed by physicians, other healthcare workers, patients, and community. It is the responsibility of the physician to spread awareness about new guidelines to patients and community. Lifelong Learning for Physician Figure 29.13: Physician – Lifelong-learner

49. Webinars, CME, and conferences: These are helpful to know about the ongoing research and new developments in the field of medicine. Attendance in these events is promoted by medical councils. Online platform, internet, and application: They provide access to recent literature, information, and guidance. They also provide learning platforms. Peer networks and societies: The new skills and knowledge can be easily acquired from peer network with collaborative clinical practice. Lifelong Learning for Physician Figure 29.13: Physician – Lifelong-learner

50. The Physician Charter is a set of professional samples, which have been endorsed by more than 100 medical organizations. It includes three fundamental principles namely: Primacy of patient welfare: This includes altruism, collaborating with others in the healthcare team for providing the utmost care for the patients, and the ability to serve without getting burnt out Patient autonomy: Respecting patient autonomy is another important factor in the physician-patient relationship. Physician Charter

51. Dual sense. One is to protect the privacy of patient information and two is to enable him/her to make own decisions regarding management strategies. In some enigmatic scenarios, the doctor might find it difficult to disclose serious issues without concrete evidence. At the same time, the physician should ascertain whether the patient is of reasonable maturity to receive the information. Social Justice: Become unfair when it succumbs to discriminative and biased factors such as gender, socioeconomic status, and religion Not uncommon that rich people get better treatment compared to their underprivileged counterparts. Physician Charter

52. At critical times like overburdening during COVID-19 times, care received by the patients and eventually their livelihood was disrupted by the above-mentioned dichotomy of care The humanistic physician would ensure that all patients would receive appropriate care regardless of the bias factors and this type of distributive and social justice need to be ensured in any situation. The Physician Charter also includes ten professional commitments which should be bestowed by a humanistic professional: Commitment to professional competence: As mentioned above, unless a healthcare professional is competent in his/her discipline, he/she can’t be of great help to vulnerable individuals. Competence is not a one-time process and it keeps on changing dynamically with inventions and time. Physician Charter

53. Commitment to honesty with patients: The healthcare professional should not lie or mask the information with a vested interest for his/her gain. The commitment to patient confidentiality: Confidentiality pertains to revealing information only to the concerned person or to the legally accepted representative. Commitment to maintaining appropriate relations with patients: In the physician-patient relationship, the patients are vulnerable and exhibit strong dependency on healthcare professionals which might rarely lead to a breach of relationship boundaries. The physician needs to be careful about this and at the same time shouldn’t exploit the patient for his/her motives. Physician Charter

54. Commitment to improving the quality of care Commitment to improve access to the care Commitment to equitable distribution of finite resources in crunchy settings Commitment to scientific knowledge and lifelong learning Commitment to maintain trust by avoiding conflicts of interest Commitment to uphold professional responsibilities. Physician Charter

55. Thank you…