tag:blogger.com,1999:blog-30668025667106102632024-03-14T02:01:06.305+05:30PATIENTS FIRSTPatients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.comBlogger300125tag:blogger.com,1999:blog-3066802566710610263.post-60702827481398438192013-12-06T15:15:00.002+05:302013-12-06T15:15:52.263+05:30Patient Advocacy: Photo Album<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="background-color: white; color: #333333; font-family: arial, sans-serif; font-size: 12pt; font-weight: bold; padding-bottom: 0.6em;">
You are invited to view Help Library's photo album: <a href="https://picasaweb.google.com/lh/sredir?uname=110558071463836742596&target=ALBUM&id=5948667444773607729&authkey=Gv1sRgCKLkuuycg6uxag&feat=email" style="color: #1155cc;" target="_blank">November 21, 2013</a></div>
<div style="background-color: whitesmoke; border: 1px solid rgb(204, 204, 204); color: #222222; font-family: arial, sans-serif; font-size: 13px; padding: 0.8em;">
<table cellpadding="0" cellspacing="0"><tbody>
<tr><td style="margin: 0px;" valign="top"><div style="background-color: white; border: 1px solid rgb(204, 204, 204); padding: 7px;">
<a href="https://picasaweb.google.com/lh/sredir?uname=110558071463836742596&target=ALBUM&id=5948667444773607729&authkey=Gv1sRgCKLkuuycg6uxag&feat=email" style="color: #1155cc;" target="_blank"><img src="https://mail.google.com/mail/u/1/?ui=2&ik=ea8bbc437d&view=att&th=142c74adc877725b&attid=0.2&disp=emb&zw&atsh=1" style="border: 1px solid rgb(127, 127, 127);" /></a></div>
</td><td style="color: #666666; margin: 0px; padding-left: 0.7em;" valign="top"><div style="color: #333333; font-size: 11pt; font-weight: bold; padding-bottom: 0.1em;">
November 21, 2013</div>
<div style="display: inline; font-size: 10pt; padding-bottom: 0.2em;">
Nov 21, 2013<br />by <b>Help Library</b></div>
<div style="border-bottom-color: rgb(179, 179, 179); border-bottom-style: dotted; border-bottom-width: 1px; margin: 0.5em 0px 0.3em; padding: 0px;">
</div>
<div style="line-height: 1.3em;">
<a href="https://picasaweb.google.com/lh/sredir?uname=110558071463836742596&target=ALBUM&id=5948667444773607729&authkey=Gv1sRgCKLkuuycg6uxag&feat=email" style="color: #1155cc; font-size: 10pt; font-weight: bold;" target="_blank">View Album</a><br /><a href="https://picasaweb.google.com/lh/sredir?uname=110558071463836742596&target=ALBUM&id=5948667444773607729&authkey=Gv1sRgCKLkuuycg6uxag&feat=email&mode=SLIDESHOW" style="color: #1155cc; font-size: 10pt;" target="_blank">Play slideshow</a> </div>
</td></tr>
</tbody></table>
</div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com4tag:blogger.com,1999:blog-3066802566710610263.post-3347035872361281762013-11-20T16:51:00.000+05:302013-11-20T16:51:30.852+05:30The Book: Patient Advocacy - Giving Voice to Patients<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div class=" container_24" style="background-color: white; border: 0px; color: #6b6a6a; font-family: 'Trebuchet MSe', Arial, 'Liberation Sans', FreeSans, sans-serif; font-size: 12px; line-height: 18px; margin: 0px auto; padding: 0px; width: 960px; zoom: 1;">
Dr.Aniruddha Malpani, MD launched his latest book on Patient Advocacy: Giving Voice to Patients</div>
<div class=" container_24" style="background-color: white; border: 0px; color: #6b6a6a; font-family: 'Trebuchet MSe', Arial, 'Liberation Sans', FreeSans, sans-serif; font-size: 12px; line-height: 18px; margin: 0px auto; padding: 0px; width: 960px; zoom: 1;">
Click on the image to read the book online.</div>
<div class=" container_24" style="background-color: white; border: 0px; color: #6b6a6a; font-family: 'Trebuchet MSe', Arial, 'Liberation Sans', FreeSans, sans-serif; font-size: 12px; line-height: 18px; margin: 0px auto; padding: 0px; width: 960px; zoom: 1;">
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.slideshare.net/malpani/dr-malpani-patient-advocacy"><img border="0" src="http://2.bp.blogspot.com/-EbsuBa_WwEc/Uoyax5uhqKI/AAAAAAAAARo/Ud7qPdKDsh0/s1600/new+book+image.jpg" height="320" width="256" /></a></div>
<div class=" container_24" style="background-color: white; border: 0px; color: #6b6a6a; font-family: 'Trebuchet MSe', Arial, 'Liberation Sans', FreeSans, sans-serif; font-size: 12px; line-height: 18px; margin: 0px auto; padding: 0px; width: 960px; zoom: 1;">
<br /></div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-39041983030384929992013-11-06T16:32:00.001+05:302013-11-06T16:44:24.376+05:30Patient Advocacy: Becoming a Professional Patient-Advocate<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://4.bp.blogspot.com/-1clunmjq4Dw/UnohaQFEelI/AAAAAAAAARY/A2770sndtsg/s1600/banner+ad+-+2.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-1clunmjq4Dw/UnohaQFEelI/AAAAAAAAARY/A2770sndtsg/s1600/banner+ad+-+2.JPG" height="46" width="400" /></a></div>
<div class="separator" style="clear: both; text-align: center;">
www.patientpower.in</div>
<div class="sites-canvas-main" id="sites-canvas-main" style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; min-height: 150px; padding-bottom: 5px; padding-top: 15px;">
<div id="sites-canvas-main-content">
<table cellspacing="0" class="sites-layout-name-one-column sites-layout-hbox" style="margin: 0px; table-layout: fixed; width: 724px;" xmlns="http://www.w3.org/1999/xhtml"><tbody>
<tr><td class="sites-layout-tile sites-tile-name-content-1" style="padding: 10px; vertical-align: top;"><div dir="ltr">
<div>
<span style="color: #333333; font-size: x-small; line-height: 19px;"><b>Private, professional patient advocacy is a new, non-certified practice</b></span></div>
<div>
<span style="color: #333333; font-size: x-small; line-height: 19px;"><br /></span></div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">There is no diploma or degree programme offered in India to get certified as a patient-advocate. The profession is so young that there is no accrediting agency or licensing body that has developed standards for certifying the skills of patient advocates.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Even in other parts of the world, there are just a few “certificate” courses but no universally agreed-upon standards for certification. Further, since institutes offer different curricula, have different eligibility criteria for admission and follow different approaches to programme delivery (online or offline), the quality of their student output varies accordingly. For example, while Sarah Lawrence College (http://www.slc.edu/) in New York offers a Master’s level programme in health advocacy, Cleveland State University (http://www.csuohio.edu/) runs an online programme on patient advocacy, and both are in demand.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">How to choose the right programme?</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Begin with a need gap analysis – figure out what is needed in your skill-set to best serve your clients and then scout for a school or a programme that most effectively addresses that knowledge gap. Next, determine your budget. How much can you spend? The key is to weigh value against possibilities. Figure out how much you can spend by determining how easily you’ll be able to pay yourself back. If you are already employed somewhere, taking a long sabbatical to finish a one-year programme may not be practical. In that case, hunt for an online programme. You’ll find plenty of courses that answer your specific training needs. Maybe a short series of weekend courses would give you a better return on your investment.</span></div>
</div>
<div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">If your means are limited, find out about scholarships, equated monthly installments (EMI)</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">schemes, discounts and other funding opportunities that would spread out your outflow over</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">a period of time.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;"><br /></span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Who makes a good patient advocate?</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Generally, anyone with empathy makes for a good advocate. Advocates who assist elderly</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">patients and children need plenty of patience. Those who prefer to work with insurance and</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">billing clerks need to understand how these departments work and they must be good at</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">number-crunching.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;"><br /></span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Good training will teach you how to…</span></div>
</div>
<div>
<ul>
<li style="list-style-position: outside; list-style-type: square; text-align: justify;"><span style="background-color: transparent; font-size: x-small; line-height: 1.5;">Improve patient and family experience in a hospital</span></li>
<li style="list-style-position: outside; list-style-type: square; text-align: justify;"><span style="background-color: transparent; font-size: x-small; line-height: 1.5;">Engage patients and families in the patient’s care</span></li>
<li style="list-style-position: outside; list-style-type: square; text-align: justify;"><span style="font-size: x-small;"><span style="background-color: transparent; line-height: 1.5;">Promote patient-and family-centered </span><span style="background-color: transparent; line-height: 1.5;">care</span></span></li>
<li style="list-style-position: outside; list-style-type: square; text-align: justify;"><span style="font-size: x-small;"><span style="background-color: transparent; line-height: 1.5;">Reduce medical errors by educating </span><span style="background-color: transparent; line-height: 1.5;">and empowering patients and their </span><span style="background-color: transparent; line-height: 1.5;">families about the care plan</span></span></li>
<li style="list-style-position: outside; list-style-type: square; text-align: justify;"><span style="font-size: x-small;"><span style="background-color: transparent; line-height: 1.5;">Give voice to healthcare consumers </span><span style="background-color: transparent; line-height: 1.5;">and their families in a complex </span><span style="background-color: transparent; line-height: 1.5;">healthcare scenario</span></span></li>
<li style="list-style-position: outside; list-style-type: square; text-align: justify;"><span style="font-size: x-small;"><span style="background-color: transparent; line-height: 1.5;">Reduce fragmentation and duplication </span><span style="background-color: transparent; line-height: 1.5;">of work</span></span></li>
<li style="list-style-position: outside; list-style-type: square; text-align: justify;"><span style="background-color: transparent; font-size: x-small; line-height: 1.5;">Assist in cost reduction</span></li>
<li style="list-style-position: outside; list-style-type: square; text-align: justify;"><span style="font-size: x-small;"><span style="background-color: transparent; line-height: 1.5;">Reduce frustration and restore patient </span><span style="background-color: transparent; line-height: 1.5;">trust in the deteriorating healthcare </span><span style="background-color: transparent; line-height: 1.5;">system</span></span></li>
<li style="list-style-position: outside; list-style-type: square; text-align: justify;"><span style="font-size: x-small;"><span style="background-color: transparent; line-height: 1.5;"> Practice a new model of care </span><span style="background-color: transparent; line-height: 1.5;">coordination</span></span></li>
</ul>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Nurses, lawyers, medical assistants, medical billing clerks, retired doctors and counselors have</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">the right employment history and experience to be ideal candidates for this job. Some patient</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">advocates also specialise in health care reform, public education, and legislative matters.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Hospitals also provide in-house training to new recruits which is important, as patientadvocates</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">need to be knowledgeable about the systems and processes of their employer.</span></div>
</div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;"><br /></span></div>
</div>
<div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Patient-advocates need to wear many hats and master many skills.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Be professional</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">If you don’t exemplify professionalism, how</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">will you be able to expect it of others? Make</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">sure you have a website that your patients can</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">log onto for all their health information needs.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">The design, messaging and layout of your site</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">should be extremely simple and accessible to</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">lay patients. The navigation should be smooth</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">and the design must be uncluttered.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Be accessible</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">As smart phones are becoming more popular,</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">it’s essential to have a mobile version of your</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">website. Encourage patients to call you from</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">their smart phones to seek directions to your</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">office, schedule appointments or find out</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">about your services.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Be knowledgeable</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">One of the best ways to secure the trust and</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">respect of your patients is to demonstrate to</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">them that you are an expert in your field. Display your loyal patients’ testimonials on your</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">website. Maintain a patient library or begin to run a blog so that patients come to you looking</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">for help, instead of Googling for information.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Build trust and loyalty</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">A happy patient should be treasured. She will be happy to sing your praises to others - and</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">word of mouth marketing is worth its weight in gold. Successful patient-advocates wield a lot</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">of clout. If you do well, hospitals will roll out a red carpet for you and doctors will treat you</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">(and your patients) as VIPs because you are a good source of patient referrals.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Be able to communicate</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Patient advocates serve as liaisons between the patient and his family and doctors, nurses and</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">health insurance companies. You need to engage with a wide spectrum of people. You have <span style="background-color: transparent; line-height: 1.5;">to be an active listener and be able to present your patients’ concerns to the doctors in a</span></span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">manner that gives them access to the right care.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Be well organised</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Patient-advocates must be good record-keepers. You have to fix appointments and follow-up</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">with doctors, as well as maintain and update patient records in a timely fashion.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Be able to solve problems</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">A patient advocate’s job is challenging, but if you like tackling problems, the role can be</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">extremely satisfying. You need research skills and analytical abilities to master problem-solving</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">techniques, and should be able to sift through loads of information and keep yourself updated</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">all the time, much like investigative journalists.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Be patient</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">You will need tons of patience, if you want to learn to protect yourself from burn-out.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Questions you should ask your trainer</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Before you join an institute or enrol for a programme, it might be a good idea to ask your</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">trainer:</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">99 What is the career path for patient advocates?</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">99 How long do they typically stay in their jobs?</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">99 What kind of training and educational programmes do you offer?</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">99 Are these courses certified?</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">99 How much would the programme cost and what would be its duration?</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">99 What do you cover in your content? Do you follow a case-study approach?</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">99 What are the most challenging aspects of patient advocacy?</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">99 What are the most engaging aspects of patient advocacy?</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Since it’s a long-term investment that you are making in yourself, choose your programme</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">with care, and after doing in-depth research on the available options.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">The truth is that the practice of patient advocacy, just like the practise of medicine, is</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">complicated; it is an art as well as a science. A good patient advocate is learning all the time. A</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">patient advocate masters her profession by investing years of training and experience, so that <span style="background-color: transparent; line-height: 1.5;">she can identify a problem; make the right decision; and react within a few minutes, till this</span></span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">ability becomes nearly instinctual. When navigating the healthcare system, time can be critical,</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">hence the need for humility, experience and expertise.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">As with any other profession, patient advocates need to follow a Code of Ethics. The following</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">principles are very useful as a guideline.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Principle 1</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Objectivity: The role of the Professional Patient Advocate is to represent the patient</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">and family first and foremost, regardless of who employs them.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Principle 2</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Scope of Practice: The Professional Patient Advocate must work within her scope of</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">practice. Other members of the healthcare team should be utilized as needed to meet</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">the demands of her patient.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Principle 3</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Full disclosure of services, fees and length of time services will be performed:</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">The Professional Patient Advocate must provide to the patient and his family a document</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">that fully discloses her role and function, as well as the fees and services the patient</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">advocate will perform.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Principle 4</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Confidentiality: A Professional Patient Advocate should obtain a consent that</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">authorizes the patient advocate to speak and act on behalf of the patient.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Principle 5</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Promoting Autonomy: The Professional Patient Advocate’s role is to educate and</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">empower the patient to make informed decisions based on his individual wishes and in</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">keeping with his cultural, spiritual, religious and ethical beliefs.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Principle 6</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Accountability: The Professional Patient Advocate is held accountable for the work</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">done on behalf of her patients.</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Principle 7</span></div>
</div>
<div>
<div style="text-align: justify;">
<span style="font-size: x-small;">Continuous Learning: The Professional Patient Advocate commits to continuous <span style="background-color: transparent; line-height: 1.5;">learning in order to keep up to date on clinical matters and with trends and advances </span><span style="background-color: transparent; line-height: 1.5;">that impact patient care.</span></span></div>
<div style="color: #333333; font-family: Georgia, serif; line-height: 20.796875px;">
<div style="text-align: justify;">
<i><span style="font-size: x-small;">The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</span></i></div>
</div>
<div style="color: #333333; font-family: Georgia, serif; line-height: 20.796875px;">
<div style="text-align: justify;">
<i><span style="font-size: x-small;">The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</span></i></div>
</div>
<div class="separator" style="clear: both; color: #333333; font-family: Georgia, serif; line-height: 20.796875px; text-align: justify;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><span style="font-size: x-small;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></span></a></div>
<div style="text-align: justify;">
<span style="font-size: x-small;"><span style="background-color: transparent; line-height: 1.5;"></span><br /></span></div>
<div class="separator" style="clear: both; font-family: Georgia, serif; line-height: 20.796875px; text-align: justify;">
<a href="http://patientpower.in/2013/" style="text-decoration: none;" target="_blank"><b><span style="color: black; font-size: x-small;">Register for the Conference Here</span></b></a></div>
<div style="text-align: justify;">
<span style="background-color: transparent; font-size: 1em; line-height: 1.5;"><br /></span></div>
</div>
</div>
</div>
</td></tr>
</tbody></table>
</div>
</div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-13018362253806686522013-11-05T14:30:00.000+05:302013-11-05T14:30:02.503+05:30Patient Advocacy: Providing Access to Alternative Treatment<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.patientpower.in/"><img border="0" src="http://2.bp.blogspot.com/-IyO3MTrxlhI/UnDltCz-LrI/AAAAAAAAARE/pRXj1MPvfIc/s1600/banner+ad+-+2.JPG" height="46" width="400" /></a></div>
<br />
<h3 align="left" id="sites-page-title-header" xmlns="http://www.w3.org/1999/xhtml">
</h3>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.patientpower.in/"><img border="0" src="http://2.bp.blogspot.com/-IyO3MTrxlhI/UnDltCz-LrI/AAAAAAAAARE/pRXj1MPvfIc/s1600/banner+ad+-+2.JPG" height="46" width="400" /></a></div>
<div class="separator" style="clear: both; text-align: center;">
www.patientpower.in</div>
<div>
<br /></div>
<div class="sites-canvas-main" id="sites-canvas-main">
<div id="sites-canvas-main-content">
<table cellspacing="0" class="sites-layout-name-one-column sites-layout-hbox" xmlns="http://www.w3.org/1999/xhtml"><tbody>
<tr><td class="sites-layout-tile sites-tile-name-content-1"><div dir="ltr">
<div>
<ul>
<li><span style="font-size: 1em; line-height: 1.5;">Healthcare is never provided in a vacuum - it is always embedded in </span><span style="font-size: 1em; line-height: 1.5;">a cultural context</span></li>
</ul>
</div>
<div>
Have you ever wondered…</div>
<div>
<br /></div>
<div>
<br /></div>
<div>
<ul>
<li><span style="font-size: 1em; line-height: 1.5;">Why patients from one community often reject one form of medical treatment, but readily accept another?</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Why some patients follow their doctor’s advice, while others do not?</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Why
some people prefer alternative healers for some form of illnesses (e.g.
insomnia, indigestion etc.) but not for others (e.g. diabetes and high
blood pressure)?</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Why one ethnic group has a higher incidence of certain diseases (e.g. diabetes, hepatitis C etc.) compared with another? </span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Why</span><span style="font-size: 1em; line-height: 1.5;"> some
women abruptly change their diet patterns during pregnancy or
breastfeeding in ways which may be harmful to the health of their child?</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Why are some conditions such as obesity regarded as “diseases” in one </span></li>
<li>culture but not in another?</li>
</ul>
<div>
The answer is because every culture has a different world view about the body and health - and</div>
<div>
we all unconsciously absorb this view and look at our health through this prism. Healthcare</div>
<div>
is never provided in a vacuum, it is always embedded in a cultural context. In a perfect world,</div>
<div>
both doctor and patient would share the same prism, leading to optimal health outcomes.</div>
<div>
However, it is when the doctor and patient have differing worldviews that a conflict arises.</div>
<div>
Dissatisfaction with the modern doctor’s obsession with technical minutiae and his desire to</div>
<div>
“treat” lab reports and scan images leads a number of patients (especially among the minorities</div>
<div>
and economically weaker sections) to seek alternative treatment options. Not only do they</div>
<div>
find these more cost-effective, they are also more aligned with their personal perspective on</div>
<div>
health. This has led to the increasing popularity of alternate systems of medical care.</div>
<div>
Western medicine doctors are often not <span style="font-size: 1em; line-height: 1.5;">comfortable with these alternative options</span></div>
<div>
because they do not understand them. They feel <span style="font-size: 1em; line-height: 1.5;">that these have not been adequately studied; that</span></div>
<div>
they have not been subjected to controlled clinical <span style="font-size: 1em; line-height: 1.5;">trials to prove their efficacy; that their scientific</span></div>
<div>
basis is unproven; and that a lot of alternative <span style="font-size: 1em; line-height: 1.5;">medicine practitioners are quacks who prey on</span></div>
<div>
the patient’s gullibility. This often leads to conflict, <span style="font-size: 1em; line-height: 1.5;">where the patient seeks an alternative medicine</span></div>
<div>
doctor, without informing his doctor that he is <span style="font-size: 1em; line-height: 1.5;">doing so. This kind of hide and seek confuses the</span></div>
<div>
patient and his doctor – and leads to poor health <span style="font-size: 1em; line-height: 1.5;">outcomes. It’s far better that the doctor should seek the help of a patient-advocate, who can </span><span style="font-size: 1em; line-height: 1.5;">then refer the patient to reliable providers of alternative treatments and complementary </span><span style="font-size: 1em; line-height: 1.5;">medicine.</span></div>
<div>
Using integrative medicine, advocates help patients combine the best of both the worlds –</div>
<div>
Western Allopathy with homeopathy or Ayurveda, depending upon the patient’s preferences.</div>
<div>
<br /></div>
<div>
Typically, an integrative approach is based on the following principles:</div>
<div>
<ul>
<li><span style="font-size: 1em; line-height: 1.5;">Our body has the ability to cure itself</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Healing practices must be individualized, because every patient is unique</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">People are responsible for their own health. Patient-advocates can only guide them </span><span style="font-size: 1em; line-height: 1.5;">in choosing a set of therapies that might work the best for them</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Healing must aim for a balancing of mind, body and spirit</span></li>
</ul>
<div>
<div>
Let me illustrate this point with the following example:</div>
<div>
A 45-year-old patient was once diagnosed with a cyst on the left side of his neck that biopsy</div>
<div>
showed was cancer. The patient rejected the diagnosis and over time the cyst grew in size</div>
<div>
and eventually turned into an inoperable tumour that had spread to his jugular vein. The</div>
<div>
oncologist knew that chemotherapy and radiation offered the only ray of hope, but since the</div>
<div>
patient was still in a state of denial, the doctor arranged for a consultation with a patientadvocate.</div>
<div>
Along with accompanying him for his chemotherapy and radiotherapy sessions, she</div>
<div>
also arranged meetings with a yoga therapist; and had the patient attend meditation classes.</div>
<div>
The combination of therapies worked. Everybody watched as a robust person, who had got</div>
<div>
reduced to a skeleton and could no longer swallow because the radiation had destroyed his</div>
<div>
oesophagus, started regaining his health bit by bit. Then the day dawned when this patient</div>
<div>
tested negative – the cancer had disappeared. Earlier, he had been given eight months to live.</div>
<div>
It has been over three years now and this patient is still alive and kicking and lives his life to</div>
<div>
the fullest.</div>
<div>
Integrative medicine has many streams, including:</div>
<div>
Osteopathic Medicine: Osteopaths believe in the healing power of the body and in rebuilding</div>
<div>
its strength.</div>
<div>
Functional Medicine: One of its basic principles <span style="font-size: 1em; line-height: 1.5;">is of biochemical individuality, i.e. treatments should</span></div>
<div>
vary based on genetic and environmental factors.</div>
<div>
Traditional Chinese Medicine (TCM): includes <span style="font-size: 1em; line-height: 1.5;">approaches such as acupuncture, and ancient herbal</span></div>
<div>
therapies.</div>
<div>
<br /></div>
<div>
Ayurvedic Medicine: combines herbal therapy <span style="font-size: 1em; line-height: 1.5;">with strict dietary recommendations.</span></div>
<div>
<br /></div>
<div>
Naturopathic Medicine: Naturopathic doctors <span style="font-size: 1em; line-height: 1.5;">(NDs) combine diet, exercise and lifestyle changes</span></div>
<div>
in their treatment approach..</div>
<div>
<br /></div>
<div>
Homeopathic Medicine: This therapeutic <span style="font-size: 1em; line-height: 1.5;">method was developed by the German physician Samuel Christian Hahnemann at the end of </span><span style="font-size: 1em; line-height: 1.5;">the 18th century.</span></div>
</div>
</div>
</div>
<div>
<span style="font-size: 1em; line-height: 1.5;"><br /></span></div>
<div>
<span style="font-size: 1em; line-height: 1.5;"></span><br />
<div>
<span style="font-size: 1em; line-height: 1.5;">QUIZ TIME: Is Your Patient Ready For Alternate Care?</span></div>
<span style="font-size: 1em; line-height: 1.5;">
<div>
As a patient-advocate, before you offer alternate therapy for the patient,</div>
<div>
ask her …</div>
<div>
<ul>
<li><span style="font-size: 1em; line-height: 1.5;">What do you hope to gain out of this therapy?</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Would you like to talk to a patient about their experiences with these therapies?</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Would you like to do more research more about this therapy?</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Are you aware of the side effects of this therapy?</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Will this treatment interfere with the other treatments that you are taking?</span></li>
</ul>
</div>
<div>
A patient who responds satisfactorily to these questions makes for an ideal candidate for</div>
<div>
alternate therapies.</div>
<div>
<br /></div>
</span></div>
</div>
</td></tr>
</tbody></table>
</div>
</div>
<br />
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i></div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div class="separator" style="background-color: white; clear: both; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://patientpower.in/2013/" style="text-decoration: none;" target="_blank"><b><span style="color: black;">Register for the Conference Here</span></b></a></div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-68194879857263852812013-11-03T14:30:00.000+05:302013-11-03T14:30:03.177+05:30Patient Advocacy: Facilitating A Second Opinion<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.patientpower.in/"><img border="0" src="http://2.bp.blogspot.com/-IyO3MTrxlhI/UnDltCz-LrI/AAAAAAAAARE/pRXj1MPvfIc/s1600/banner+ad+-+2.JPG" height="46" width="400" /></a></div>
<br />
<h3 align="left" id="sites-page-title-header" xmlns="http://www.w3.org/1999/xhtml">
</h3>
<br />
<div id="sites-canvas-bottom-panel">
<div id="COMP_page-subpages" xmlns="http://www.w3.org/1999/xhtml">
</div>
<div id="sites-attachments" xmlns="http://www.w3.org/1999/xhtml">
</div>
</div>
<br />
<div class="sites-canvas-main" id="sites-canvas-main">
<div id="sites-canvas-main-content">
<table cellspacing="0" class="sites-layout-name-one-column sites-layout-hbox" xmlns="http://www.w3.org/1999/xhtml"><tbody>
<tr><td class="sites-layout-tile sites-tile-name-content-1"><div dir="ltr">
<div>
Patient-advocates have the right contacts to be able to arrange for a second or third medical opinion for the patient</div>
<div>
Your
doctor drops a bombshell. He tells you that you have a very serious
ailment. The news strikes you like a bolt from the blue. You feel
worried, anxious, defeated and confused, until, your spouse, who is also
concerned about your health, suggests you don’t take the doctor’s word
as final and seek a second opinion. You immediately feel relaxed. In
this case, your spouse has acted as your advocate.</div>
<div>
One of my
patients had an interesting experience to share, “I had a lump in my
neck. It was causing some sinus issues. My doctor sent me for a CT scan
and when the results came back, he told me that it was tumour and had to
be removed right away. I felt shocked and unsure of what to do. I
called my sister who suggested that I call her doctor, someone she had
consulted all these years on all her medical issues and trusted
completely. I sought an appointment with my sister’s doc. He asked to
see my CT scan along with a few other lab reports. Armed with all those
reports I landed at his office. He examined them and said what my doctor
was calling a “tumour” was actually a benign growth and it had been
there for at least one decade without changing in size or shape. He also
said surgery was unnecessary. I felt massively relieved.” In this case,
the patient’s sister played the advocacy role by providing timely
advice.</div>
<div>
Once, at a patients’ group meet, an elderly man in a
wheelchair raised his frail, trembling hand and asked, “How do I know
whether my doctor is giving me the right advice?”</div>
<div>
He had a
point. You can’t go by a single doctor’s advice about a serious
condition - you need to have it cross-checked with another. After all,
your time, money and life are at stake. Doctors, especially busy
doctors, often rush into making a diagnostic pronouncement, without
always dotting all the “i”s and crossing all the “t”s.</div>
<div>
<br /></div>
<div>
<div>
A “patient advocate” can be a God send in such scenarios. He could be a spouse, a friend, a</div>
<div>
brother. Since a caregiver is generally a person on the “inside,” they are in a good position</div>
<div>
to know and understand the needs of a loved one. She may not have the necessary medical</div>
<div>
background, but her knowledge of the patient’s desires are equally important in making the</div>
<div>
best medical decisions.</div>
<div>
Banish the thought that a patient-advocate is an adversarial position. It doesn’t necessarily</div>
<div>
mean being a doubting Thomas, and rushing out and getting a second opinion on every matter,</div>
<div>
or logging on to the internet and conducting your own research and confronting a doctor</div>
<div>
with your findings. It doesn’t also imply slipping on the boxing gloves and declaring, “Hey, I am</div>
<div>
on the other side. So Beware!”</div>
<div>
What it means is that you are careful and wise. You don’t doubt others, but you do crosscheck</div>
<div>
important information. It means that even if you decide to do your own research or</div>
<div>
obtain a second opinion, you will speak about this to your doctor. A good doctor should</div>
<div>
appreciate your transparency and this will strengthen your relationship. Remember, effective</div>
<div>
patient advocates do not breed discontent; they build long-lasting relationships between</div>
<div>
patients and their doctors.</div>
<div>
Physicians are bound by a code of medical ethics that directs them to co-operate fully with</div>
<div>
their patients. If patients want to take a second or even a third opinion, doctors are legally</div>
<div>
bound to share your lab reports, prescriptions, and test results with other physicians. A doctor</div>
<div>
worth his salt would not feel insulted by such a suggestion. In fact, if your doctor discourages</div>
<div>
you from seeking another opinion, you have every reason to suspect his motives – and this</div>
<div>
should motivate you even more to seek another opinion. Generally, a patient-advocate will</div>
<div>
advise a second opinion when:</div>
<div>
You don’t have confidence in your doctor. Patients are less likely to follow a course of</div>
<div>
treatment when it’s prescribed by a doctor whom they don’t trust.</div>
<div>
You think there might be other treatment options. If your doctor tells you there is</div>
<div>
only one course of action, it should raise a red flag.</div>
<div>
Your doctor dismisses your concerns. You know your body best, and if your doctor</div>
<div>
doesn’t listen to you or take your symptoms seriously, go see someone else.</div>
<div>
You’re not getting better. Medicine is as much an art as a science, so a fresh viewpoint</div>
<div>
might make all the difference if you’re not recovering from an illness or surgery at the pace</div>
<div>
you expected.</div>
</div>
<div>
<br /></div>
<div>
<div>
You’re doctor recommends surgery. Anytime your doctor recommends an elective</div>
<div>
surgery to correct such problems as back pain, cataracts, gall stones or hernia, consider a</div>
<div>
second opinion.</div>
<div>
Your condition is uncommon. Some conditions are so rare that a physician may have</div>
<div>
seen only one or two such cases in her career. It’s worthwhile to consult a doctor at a major</div>
<div>
medical centre who has more experience with dealing with rare diseases.</div>
</div>
<div>
<br /></div>
</div>
</td></tr>
</tbody></table>
</div>
</div>
<br />
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i></div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div class="separator" style="background-color: white; clear: both; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://patientpower.in/2013/" style="text-decoration: none;" target="_blank"><b><span style="color: black;">Register for the Conference Here</span></b></a></div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-56540750666286643142013-11-01T14:30:00.000+05:302013-11-01T14:30:08.606+05:30Patient Advocacy: Arranging Concierge Services<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.patientpower.in/"><img border="0" src="http://2.bp.blogspot.com/-IyO3MTrxlhI/UnDltCz-LrI/AAAAAAAAARE/pRXj1MPvfIc/s1600/banner+ad+-+2.JPG" height="46" width="400" /></a></div>
<div class="separator" style="clear: both; text-align: center;">
www.patientpower.in</div>
<div class="sites-canvas-main" id="sites-canvas-main">
<div id="sites-canvas-main-content">
<table cellspacing="0" class="sites-layout-name-one-column sites-layout-hbox" xmlns="http://www.w3.org/1999/xhtml"><tbody>
<tr><td class="sites-layout-tile sites-tile-name-content-1"><div dir="ltr">
<div>
<br /></div>
<div>
A patient-advocate won’t let a patient feel like a medical statistic. He can make him feel like a special customer</div>
<div>
When
Nisha Malhotra got diagnosed with brain cancer, she knew she needed to
make a few urgent decisions and that she needed the help of a
compassionate, knowledgeable patient-advocate.</div>
<div>
Abroad, retired
general physicians often use their years of clinical experience and
expertise to become patient-advocates in order to help patients like
Nisha identify specialists, treatment protocols and facilities which are
renowned for being world-class for treating her disease. Some mature
into specialist patient-advocacy firms, taking on board former
healthcare administrators and registered nurses. They function like
mediators, helping connect patients with doctors and vice-versa. When
required, they also negotiate with insurance companies on patients’
behalf.</div>
<div>
Although many patients are net savvy and can access
most health-related information online, it still takes a lot of time to
research your condition, find the best experts, and negotiate with
insurance companies. In cases of rare or chronic illnesses, accessing
these services poses an even greater challenge.</div>
<div>
<br /></div>
<div>
<div>
Abroad, government-funded wellness programmes offer concierge services and provide</div>
<div>
patient coaching, resource mobilisation, rehabilitation and disease management. These services</div>
<div>
are generally customised to individual patients and their families, and continue long after the</div>
<div>
medical procedure is completed.</div>
<div>
A mother of two who works as a school teacher, Sangeeta Chuhan was finding it difficult</div>
<div>
scheduling a meeting with a paediatrician for her eight-year-old daughter. She was surprised</div>
<div>
how fast the appointment got made through a patient-advocate, in this case a friend of the</div>
<div>
paediatrician’s secretary. In India, since the practice is still evolving, you may not easily find such</div>
<div>
advocacy firms, but there are always people around you, who perform this role informally.</div>
<div>
These people can:</div>
<div>
<ul>
<li><span style="font-size: 1em; line-height: 1.5;">Assist you in locating doctors, specialists, and treatment facilities locally and</span></li>
</ul>
</div>
<div>
nationally.</div>
<div>
<ul>
<li><span style="font-size: 1em; line-height: 1.5;">Help you organise your medical records, including current prescriptions, drug</span></li>
</ul>
</div>
<div>
allergies, past surgical history, and other</div>
<div>
data.</div>
<div>
<ul>
<li><span style="font-size: 1em; line-height: 1.5;">Draw up an individualised medical plan,</span></li>
</ul>
</div>
<div>
based on the doctor’s medical advice,</div>
<div>
set medical goals and explain and help</div>
<div>
you adhere to the various treatment</div>
<div>
protocols.</div>
<div>
<ul>
<li><span style="font-size: 1em; line-height: 1.5;">Avoid irrational drug combinations </span><span style="font-size: 1em; line-height: 1.5;">through diligent case management.</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Let’s face it – it’s not possible to receive </span><span style="font-size: 1em; line-height: 1.5;">good medical care unless you learn to </span><span style="font-size: 1em; line-height: 1.5;">effectively manage that care. Patient advocates </span><span style="font-size: 1em; line-height: 1.5;">can help you do that.</span></li>
</ul>
<span style="font-size: 1em; line-height: 1.5;">In </span><span style="font-size: 1em; line-height: 1.5;">addition, they can:</span></div>
<div>
<span style="font-size: 1em; line-height: 1.5;"><br /></span></div>
<div>
<ul>
<li><span style="font-size: 1em; line-height: 1.5;">Schedule medical visits (physician </span><span style="font-size: 1em; line-height: 1.5;">appointments, lab visits, etc.), when they </span><span style="font-size: 1em; line-height: 1.5;">are due and send reminders to you.</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Accompany you, if no one else from </span><span style="font-size: 1em; line-height: 1.5;">your family is available.</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Take notes during the consultation and </span><span style="font-size: 1em; line-height: 1.5;">make a record of it, afterwards.</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Arrange for your transportation.</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Co-ordinate visits with allied health professionals, such as social workers, physical/</span><span style="font-size: 1em; line-height: 1.5;">occupational therapists, nursing home staff members etc.</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Make alternate living arrangements (e.g. assisted living facilities) for you, so that your </span><span style="font-size: 1em; line-height: 1.5;">dignity, independence, safety, and social life are not compromised by your illness.</span></li>
</ul>
<div>
<div>
Given the vast number of hospitals and medical specialists who claim to deliver cutting edge</div>
<div>
care, it’s becoming impossible to manage and understand all the information flying around.</div>
<div>
Patient advocates sift and sort through this information, de-codify it and present it back to</div>
<div>
you in lay-friendly language. In this process they:</div>
<div>
<br /></div>
<div>
<ul>
<li><span style="font-size: 1em; line-height: 1.5;">Relay physicians’ diagnosis and lab results in a simplified language, devoid of all</span></li>
</ul>
</div>
<div>
medical jargon.</div>
<div>
<ul>
<li><span style="font-size: 1em; line-height: 1.5;">Sort your medical records and help in storing these in an orderly fashion.</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Co-ordinate crisis management and are available on a 24/7 platform.</span></li>
<li><span style="font-size: 1em; line-height: 1.5;">Keep family members informed of the patient’s progress.</span></li>
</ul>
</div>
<div>
Health care advocates are trained professionals who are familiar with the ropes of the health</div>
<div>
care system. When Neeti Chandra’s husband got diagnosed with bladder cancer, she was in</div>
<div>
such a state of shock, that she did not know whom to contact or where to seek help from.</div>
<div>
The doctor had made his depressing pronouncement but thanks to the consultation offered</div>
<div>
by a second oncologist recommended by a friend, three years later, Neeti’s husband is hale and</div>
<div>
hearty and thankfully still keeps his bladder. Fortunately, this friend had a nursing background.</div>
<div>
She also had the right contacts. She made appointments, accompanied the couple to the</div>
<div>
hospital; explained their lab results and stood by them throughout the difficult period. She</div>
<div>
would even type out medical notes after each appointment with the oncologist, monitor the</div>
<div>
patient’s progress and obtain regular updates from the doctor’s team. Smita and her husband</div>
<div>
would have been completely lost without her. That’s the kind of invaluable help a patientadvocate</div>
<div>
can render.</div>
</div>
</div>
</div>
</div>
</td></tr>
</tbody></table>
</div>
</div>
<br />
<br />
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i></div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div class="separator" style="background-color: white; clear: both; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://patientpower.in/2013/" style="text-decoration: none;" target="_blank"><b><span style="color: black;">Register for the Conference Here</span></b></a></div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com1tag:blogger.com,1999:blog-3066802566710610263.post-22063107744905215552013-10-30T16:27:00.000+05:302013-10-30T16:27:20.125+05:30Patient Advocacy: Mediating With Insurance Companies<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="text-align: center;">
<b><br /></b></div>
<div style="text-align: center;">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.patientpower.in/"><img border="0" src="http://2.bp.blogspot.com/-IyO3MTrxlhI/UnDltCz-LrI/AAAAAAAAARA/xXgJNb812-M/s1600/banner+ad+-+2.JPG" height="46" width="400" /></a></div>
<div class="separator" style="clear: both; text-align: center;">
www.patientpower.in</div>
<b><br /></b></div>
<div style="text-align: center;">
<b>In the complex world of modern medicine, where hospitals bills are</b></div>
<div style="text-align: center;">
<b>often paid by insurance companies, you need someone to negotiate</b></div>
<div style="text-align: center;">
<b>on your behalf</b></div>
<div>
Two
days after surgery to replace both his knee joints, a social worker
employed by a hospital informed the patient that the insurance company
would not pay for his stay at the hospital any longer. However observing
that the patient was barely able to get to the bathroom unaided, the
patient-advocate, on her own accord, informed the insurance company that
the patient was not ready for discharge and insisted that he be given
at least one more day’s stay in the hospital. The request was granted
and the patient was grateful for the advocate’s timely intervention.
Left to his own devices, he was in no shape to argue his case with the
insurance company call center staff, whose primary goal is to save money
for the company, and who do not care about a patient’s well-being.</div>
<div>
In
the complex world of modern medicine, where hospitals bills are often
paid by insurance companies patients - especially those who are
critically ill, need a patient-advocate -, someone to negotiate on their
behalf with the insurance company, to ensure that they are receiving
the care that they deserve.</div>
<div>
Mahesh Sharma was stabbed in the
neck by unknown miscreants and was seriously injured. He was rushed to a
nearby trauma center, but the problem was that this centre was not
affiliated to the health insurance company from which he had bought a
health insurance policy. Cashless care was therefore ruled out. His wife
settled the hospital bill and six days later Sharma was discharged from
the hospital. Four weeks into his recovery, he received a letter from
his insurance company informing him that his claim for reimbursement was
denied because the trauma centre was not part of their service network!</div>
<div>
He
consulted a friend who informed him about a non-government
patient-advocacy group that mediates with insurance companies on behalf
of consumers like Sharma. Six months later, with the assistance of this
advocacy group, who petitioned the IRDA (Insurance Regulatory <span style="font-size: 1em; line-height: 1.5;">and Development Authority), Sharma won his the case, and besides the cost of the treatment, </span><span style="font-size: 1em; line-height: 1.5;">he was also awarded damages for delay and needless harassment caused by the insurance </span><span style="font-size: 1em; line-height: 1.5;">company.</span></div>
<div>
<span style="font-size: 1em; line-height: 1.5;"><br /></span></div>
<div>
<div>
When you file a claim, you need to study the fine print in your insurance policy carefully. There</div>
<div>
are likely to be terms such as deductible, coinsurance, co-pay, out-of-pocket limit, definitions</div>
<div>
of out-of-network and emergency services; and details of the appeals process, that may not</div>
<div>
be immediately clear, because they are couched in dense legalese. A patient-advocate can help</div>
<div>
you make sense of these !</div>
<div>
Literacy on insurance related issues is extremely low in India. You may think you deserve</div>
<div>
full reimbursement, whereas your policy may provide only for partial pay out. Sit with your</div>
<div>
advocate and understand your entitlement before you file a petition. Remember that besides</div>
<div>
resolving disagreements between patients and insurers, the main responsibility of a patientadvocate</div>
<div>
is to give more information to citizens about health insurance in an objective,</div>
<div>
professional and impartial manner.<br />
<br />
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i></div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div class="separator" style="background-color: white; clear: both; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://patientpower.in/2013/" style="text-decoration: none;" target="_blank"><b><span style="color: black;">Register for the Conference Here</span></b></a></div>
<br /></div>
</div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com1tag:blogger.com,1999:blog-3066802566710610263.post-57555429199872702342013-10-23T14:30:00.000+05:302013-10-23T14:30:02.755+05:30Patient Advocacy: Managing Conflict of Interest <div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://1.bp.blogspot.com/-Uwe6KbhXkbw/Ul-z3UdzeFI/AAAAAAAAAQg/MtkxwPbJvL0/s1600/banner+ad+-+2.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/-Uwe6KbhXkbw/Ul-z3UdzeFI/AAAAAAAAAQg/MtkxwPbJvL0/s1600/banner+ad+-+2.JPG" height="38" width="320" /></a></div>
<br />
<br />
<br />
<div align="center" class="MsoNormal" style="line-height: 14.05pt; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: center; text-autospace: none;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Patient advocates need to learn how to resolve conflicts </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 13.05pt; margin-bottom: 14.0pt; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><br /></span></div>
<div class="MsoNormal" style="line-height: 13.05pt; margin-bottom: 14.0pt; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">A patient advocate once
was concerned that giving chemotherapy to his client was causing him more harm
than good. During the course of the treatment, the patient would often complain
that he was in agony, telling his advocate, “I can’t take it any more” and the
advocate would faithfully relay his misgivings to the doctor team. The head of
the team didn’t see any merit in the advocate’s objections and ruled them out.
Over the next few months, the advocate watched the patient suffer in silence,
through treatments that the advocate believed he would not have chosen had he
been informed in advance about the pain they might cause him. The patient
finally died, but only after the chemo had left him with unstoppable and
painful bleeding in his bladder, robbing him of a more peaceful and comfortable
end. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 13.05pt; margin-bottom: 13.0pt; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Patient advocates have to
perform a difficult balancing act. Their primary role is to help their patient,
but they don’t want to escalate an issue and alienate the hospital staff
either. How do they keep both parties happy? <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The
biggest challenge in medical practice is the growing conflict between doctors
and patients – especially over costs. Disagreements can arise over many issues
– ranging from continuing aggressive treatment for a critically-ill patient to
refusing a patient’s request for antibiotics to treat a viral infection.
End-of-life issues are especially highly emotionally charged, requiring active
involvement of a patient-advocate. When conflict arises, communication channels
break down and it’s left to the patient-advocate to sort things out. A mature
advocate understands that at the heart of such conflicts is usually a clash of
values, and because these are hardest to resolve when everyone is emotionally
labile, his first priority is to defuse the emotions and change the climate of
mistrust to one of common ground. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">A useful
mnemonic which experienced patient advocates use to deal with upset patients is
called RAPSAND. <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">R
= Re-establish rapport (Empathy) <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">A
= Agreement (Get the patient to say Yes) <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">P
= Problem (Define this) <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">S
= Solution <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">A
= Ask Permission (Is the patient happy with the solution you have offered?) <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">N
= Next step (Follow up) <o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; mso-list: l0 level1 lfo1; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">D
= Document <o:p></o:p></span></div>
<div class="Default">
<br /></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The most
worrisome conflicts are those which arise over treatment choices. If they are
not promptly resolved, they can mar the doctor-patient relationship and have an
adverse impact on the patient’s outcome. Resolving such conflict is therefore
the first priority of a patient-advocate. If he has been employed by the
hospital, he has to make sure that he puts the patient’s interests first, and
is not seen to be acting in a manner which suggests that he is an agent
appointed by the hospital to protect their interests. The moment a patient
feels that an advocate is representing the hospital, he is likely to lose faith
in him. Instead what he needs to do is: <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l1 level1 lfo2; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Drive
maximum patient participation in care decisions <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l1 level1 lfo2; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Develop
mutual trust and respect between the doctor and the patient and his family <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l1 level1 lfo2; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Help
improve a patient’s experience of a hospital by explaining the hospital system
to them, and emphasizing care, compassion and connections <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l1 level1 lfo2; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Be
seen as impartial ombudsman, to whom patients, as well as the hospital staff
can provide feedback in confidence <o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; mso-list: l1 level1 lfo2; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Provide
a mechanism for patients and families to cut through the red tape and avoid
delays in emergency care<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; mso-list: l1 level1 lfo2; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;"> </span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l1 level1 lfo2; text-align: justify; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Let’s not forget that patient advocacy is a new discipline in
India. A patient advocate has been introduced as a new component in the care
delivery chain, and can help to provide legitimacy to the patient’s voice when
the healthcare system ceases to listen. If an advocate is appointed by a
government agency (as in the West), he is expected to establish formal
programmes for safeguarding patients’ rights, and assist hospital staff in
understanding their duties and the patient’s rights. As a third party, he is
expected to balance the interests of both parties and provide medical and
non-medical support in both inpatient and outpatient care. They are also a
trusted source of information, referrals, and navigation. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l1 level1 lfo2; text-align: justify; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Once an 80-year-old poor, illiterate woman with breast cancer was
being treated like a senile senior citizen by a resident doctor in a
stuffed-to-the-seams government hospital. A concerned citizen watching this
interaction decided to act as her advocate and came to her aid. To his
surprise, he discovered that the woman was very perceptive. However, because
she was illiterate and new to the city (having just arrived from a village) she
felt intimidated by her surroundings; and because of her illness, she was not
mentally alert enough to be able to make her own medical or financial
decisions. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l1 level1 lfo2; text-align: justify; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">The busy surgeon was treating her like an imbecile, but the
advocate invested his time in talking with her, listening patiently, and asking
her the right questions, so she could understand her treatment options. Later
he took upon himself the job of meeting with her physician. The physician’s
approach to this patient also changed, once he found someone was taking an
active interest in her case and documenting his discussions with the patient.
He quickly became more respectful and thoughtful. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l1 level1 lfo2; text-align: justify; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Because patient advocates collaborate closely with hospital staff
on patient safety and quality-related issues, they can help hospitals identify
opportunities to improve patient satisfaction, and bring about much-needed
improvement, especially for poor, uneducated patients. Whether through position
or persuasion, patient advocates can make good use of medical data, and offer
sensible recommendations so the government hospital can improve its track
record.<o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">A doctor
once had a serious difference of opinion with the father of a little boy, who
had met with a road accident. The father felt that his son would benefit from a
particular type of physiotherapy. The doctor didn’t. The father brought him
loads of health literature but the doctor was not impressed. They argued over
the matter. Finally, they both agreed to get a third – independent – opinion.
The doctor called in another doctor-friend to act as a patient-advocate. This
second doctor read the patient’s report and medical file. Ultimately he agreed
with the father’s point of view and said there was no harm in trying out the
therapy for a short span of time and if it didn’t work, they could always
change it later on. When they heard him, both men laughed. An ego-conflict was
amicably resolved. Later, this second doctor also helped the patient’s father
get the therapy reimbursed by his insurance company. To this day, the patient
remains grateful to the advocate and speaks very highly of the first doctor,
who put him in touch with this advocate. For every health problem – big or
small, he always goes back to the same hospital. <o:p></o:p></span></div>
<br />
<div class="MsoNormal">
<span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 115%;">The moral of this story is - whatever you do;
don’t let a patient walk out of your facility disillusioned, angry or
dissatisfied. When you can’t reach an agreement, get an advocate on board. He
will resolve the issue in the most humane way.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%;"><o:p></o:p></span></div>
<br />
<br />
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i></div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div class="separator" style="background-color: white; clear: both; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://patientpower.in/2013/" style="text-decoration: none;" target="_blank"><b><span style="color: black;">Register for the Conference Here</span></b></a></div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-36908809260424909052013-10-21T14:30:00.000+05:302013-10-21T14:30:01.555+05:30Patient Advocacy: Dealing With Angry Family Members<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.patientpower.in/"><img border="0" src="http://1.bp.blogspot.com/-Uwe6KbhXkbw/Ul-z3UdzeFI/AAAAAAAAAQg/MtkxwPbJvL0/s1600/banner+ad+-+2.JPG" height="46" width="400" /></a></div>
<br />
<br />
<div align="center" class="MsoNormal" style="line-height: 13.05pt; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: center; text-autospace: none;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Patient-advocates can help hospitals deal with angry family
members </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 13.05pt; margin-bottom: 14.0pt; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">When people are anxious or
angry, they may not be able to make sense of what a doctor is saying. When
tempers run high, they find it difficult to express their most pressing
concerns. Strong emotions can make processing new or complex medical
information more difficult. What can be done in such a scenario?<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 13.05pt; margin-bottom: 13.0pt; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Get a patient-advocate on
board. Hospitals are stress-inducing places for all the right and wrong
reasons. Patients and family members may experience a sense of loss of control
in such an unfamiliar environment. They often do not understand a lot of what
is going on and may feel vulnerable, helpless and stripped of all their rights
and options. However this is a wrong perception. Even in hospitals, patients
have rights, as well as, responsibilities. It’s the advocate’s responsibility
to make them understand both.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 13.05pt; margin-bottom: 13.0pt; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Intense anger or anxiety
can get in the way of good treatment and care. Once an 80-year-old patient was
scheduled to undergo surgery for prostate cancer. He and his wife arrived on
time for their early morning surgery. The nurse at the reception told them that
the surgery was delayed until the afternoon. By mid-afternoon, they were told
that — due to several unexpected emergencies — the surgery had to be postponed
to the next day.<o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Already
anxious about the upcoming surgery, the patient and his wife got so angry, they
were ready to walk out of the hospital in a huff, but were calmed down by a
patient-advocate. Yet the patient couldn’t sleep two winks that night, kept
tossing and turning on his bed and his wife, who was even angrier, seemed to complain
about everything in the room, including the AC, the water tap, and the cleaner.
The next day, when the patient-advocate turned up for his visit with the
couple, the wife pounced on him with the words, “Please tell us how to get out
of this hospital?” <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Maintaining
his cool, the advocate smiled, patted the woman’s hand gently and said, “Why
don’t you tell me what can I do to help you get through this tough day?” <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">That
immediately calmed down the two and the wife began to slowly confess her fears
and frustrations to the advocate. The advocate also took his time, explaining
why surgeries have to be postponed when more serious cases arrive, and
requesting them to be a little more understanding and patient with the hospital
staff. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The fact
is that while hospitals are familiar places for doctors and nurses, for
patients and their families they can be extremely scary. Even routine events
and procedures can produce anxiety in such patients. An eye check up can feel
as traumatic as open-heart surgery. Knowing what people feel and helping them
relax with comforting words can make a doctor’s job simpler, and this is what
an advocate is trained to do. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">A doctor
once called up a patient-advocate saying, “This patient doesn’t understand
anything. She refuses to go home. Can you please go and drill some sense into
her thick head?” <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The
patient-advocate went and spoke to the distraught woman. Later he came back and
asked the doctor, “Did you ask the patient why she didn’t want to go home?” <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">“No,”
replied the confused doctor. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">“Because
she’s homeless and has nowhere to go…” <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 115%;">Unprovoked, nameless anger can be an
expression of helplessness. It’s the patient-advocate’s job to see through the
façade and dig out the real source and meaning of that anger and help resolve
the issue quickly and efficiently.<o:p></o:p></span></div>
<div align="center">
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 1184;">
<tbody>
<tr>
<td style="background: #BFBFBF; border: solid black 1.0pt; mso-background-themecolor: background1; mso-background-themeshade: 191; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 235.4pt;" valign="top" width="314">
<div align="center" class="MsoNormal" style="background-position: initial initial; background-repeat: initial initial; margin-bottom: 0.0001pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">When a Family is Angry</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="margin-bottom: 0.0001pt; text-indent: -0.25in;">
</div>
<ul>
<li><span style="font-family: Wingdings; font-size: 10pt; text-indent: -0.25in;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; text-indent: -0.25in;">Don’t argue, even if you know their
complaint is unjustified</span></li>
<li><span style="font-family: Wingdings; font-size: 10pt; text-indent: -0.25in;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; text-indent: -0.25in;">Listen to what family members have to say —
they might calm down if you listen to them and share their concerns</span></li>
<li><span style="font-family: Wingdings; font-size: 10pt; text-indent: -0.25in;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; text-indent: -0.25in;">Do not insist on a meaningful conversation
when families are emotionally upset and are not ready for this</span></li>
<li><span style="font-family: Wingdings; font-size: 10pt; text-indent: -0.25in;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; text-indent: -0.25in;">Healthcare is a joint effort between
patients, families, and health professionals. Be clear and specific about
what each person can do to help</span></li>
<li><span style="font-family: Wingdings; font-size: 10pt; text-indent: -0.25in;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; text-indent: -0.25in;">Encourage family members to participate in
the loved one’s treatment.</span></li>
</ul>
</td></tr>
</tbody></table>
</div>
<br />
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i></div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div class="separator" style="background-color: white; clear: both; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://patientpower.in/2013/" style="text-decoration: none;" target="_blank"><b><span style="color: black;">Register for the Conference Here</span></b></a></div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-69160733927513367932013-10-19T14:30:00.000+05:302013-10-19T14:30:04.232+05:30Patient Advocacy: Helping the Patient File a Complaint<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://2.bp.blogspot.com/-7JDXOrO_Se8/Ul-xeOWA2oI/AAAAAAAAEbM/OphzxdO5Bd0/s1600/banner+ad+-+2.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-7JDXOrO_Se8/Ul-xeOWA2oI/AAAAAAAAEbM/OphzxdO5Bd0/s1600/banner+ad+-+2.JPG" height="48" width="400" /></a></div>
<div align="center" class="MsoNormal" style="line-height: 25.05pt; margin-bottom: 0in; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><br /></span></b></div>
<h2 style="text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="color: blue;">Helping the Patient File a Complaint- Using the Law to Strengthen the Patient’s Voice</span></span></b></h2>
<div align="center" class="MsoNormal" style="line-height: 14.05pt; margin-bottom: 0in; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">When you want to make a complaint but don’t know where to start,go to a patient advocate</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 13.05pt; margin-bottom: 14pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">On January 17, the Supreme Court of India directed a Hyderabad-based super-specialty hospital to pay Rs 2.05 lakh as compensation to the widow of a patient who had died of a heart attack, while being treated at the hospital for a shoulder injury. The National Consumer Disputes Redressal Commission (NCDRC) said the inability of the hospital to explain what caused the patient’s death left many questions unanswered.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 13.05pt; margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Not every medical error is preventable. And despite taking every available precaution, you may still be exposed to a medical error. In the event you are harmed by a medical error, you may be concerned for your health, frightened of the possible consequences, angry at the doctor’s mistake or his callous disregard of the consequences. You may be seething with anger and battling with a sea of uncontrollable emotions. You may be feeling utterly helpless and vulnerable, and may not know what to do next or how to report the incident, or even, who to report it to?<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 14px;">Fret not. Go to a patient-advocate. Since this is not a formally recognized role in India yet, look for a person who is seasoned and mature to act as your advocate before you seek a meeting to sort out issues with the hospital administration.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 15.05pt; margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">What is a “medical accident”?</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 13.05pt; margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">If something goes wrong during medical treatment, this is called a ‘medical accident’ or ‘adverse event’. In some cases, complications are unavoidable risks of a treatment. For example, if an elderly patient chooses to undergo a heart bypass surgery, he and his family should understand that this is a risky procedure, and complications can occur, no matter how careful or competent the doctor is.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 13.05pt; margin-bottom: 13pt; text-align: justify;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">‘Clinical negligence’ </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;">is the legal term used to describe a medical accident where a patient has been harmed, not because of a complication that could not have been avoided, but because a doctor did not deliver the proper standard of care. It doesn’t always mean that the doctor handling the procedure was incompetent – it just means that he made a mistake that he shouldn’t have.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 15.05pt; margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Clinical negligence may include:</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Making a mistake during surgery<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Carrying out a procedure without the patient’s consent<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Administering the wrong drug to the patient<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Making a wrong diagnosis<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 15.05pt; margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Clinical negligence can also include not doing things that should be done, such as:</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Not giving timely treatment<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Not warning the patient or the family about the risks of a particular treatment<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 15.05pt; margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">When you have a complaint…</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 13.05pt; margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Inform the doctor that you would like answers to questions about your care. Be firm but also be polite. Next, have a strategy in hand. Think through all your questions and write them all down. Run these past your patient-advocate. Inform the hospital in advance that a friend will accompany you to this meeting in order to help you understand the medical issues.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 13.05pt; margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Know how much time you have been allotted for the meeting and ask your questions in order – the most important ones first. If your doctor won’t speak to you (which is common) seek an appointment with the hospital’s complaints redressal department (if they have one), or the human resource department. If they ask you to file a written complaint, be careful how you draft this. You may later, depending upon the outcome of your meeting, intend to file a suit against the hospital, in which case, you need to be extra careful about what you commit to paper, because this can be used as evidence.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 13.05pt; margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Don’t be provoked into saying anything that you may regret later. Don’t convey a sense of having been wronged. Read and re-read your questions a few times to make sure that your charges are well-substantiated and that they don’t come across as wild, baseless accusations.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 13.05pt; margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">If you are not successful in resolving the issue, you have three choices in the matter:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">You can file a complaint against the doctor with the State Medical Council<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">You can file a complaint with the State Consumer Court<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">You can file a criminal lawsuit against the erring doctor and hospital in a court.<o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">This last, your patient-advocate might warn you, could turn out to be the costliest route in terms of money and time spent. Consumer court is best if your main purpose is to seek monetary compensation. These cases also get settled faster, typically within a couple of years, but the hospital may appeal at the level of the national commission, which means it may get stuck for another couple of years. In contrast, a civil or criminal suit can take more than a decade or two to settle. Go through the Medical Council of India website (<span class="A6"><span style="font-family: "Arial","sans-serif";">www.mciindia. org/</span></span>) carefully to know the procedure of filing your complaint there. They will investigate the matter and in rare cases, can penalise the doctor by ordering a suspension or cancellation of his medical license.<o:p></o:p></span></div>
<div class="Pa9" style="margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Remember that….</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Doctors aren’t perfect, and they too make mistakes. As buyers of a medical service, patients have every right to raise their voice against medical negligence. You can’t be expected to accept deficient care or poor treatment. Making a formal complaint won’t just benefit you as a consumer, but it may also benefit the community at large, and perhaps act as a deterrent in preventing the doctor or hospital from making similar mistakes in the future again. Most cases of medical malpractice involve negligence or acts of omission by doctors who fail to meet the standards of treatment that their patients both need and deserve.<o:p></o:p></span></div>
<div class="Pa9" style="margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">A patient-advocate, trained in legal matters should be able to help you:</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Establish that a medical duty was owed to you<o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">That the duty owed to you was breached in some way.<o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">That this breach caused some sort of injury or death, and finally,<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">That the hospital now owes you compensation for the damages causes. These damages can be physical or emotional,<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;"> </span></div>
<div class="MsoNormal">
<span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 14px;">Listening is a key skill of an advocate. Even patients know that advocates are not experts in medicine or surgery. But when someone listens to them with empathy, letting them vent, they can heave a sigh of relief. They are reassured that there is someone on their side, who will help them sort out their problem.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, sans-serif; font-size: 10pt; line-height: 14px;"><br /></span></div>
<div align="center">
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none;"><tbody>
<tr style="height: 16.95pt;"><td style="background-color: #d9d9d9; background-position: initial initial; background-repeat: initial initial; border: 1pt solid black; height: 16.95pt; padding: 0in 5.4pt; width: 240.15pt;" valign="top" width="320"><div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">How to Speak Up at the Hospital<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoListParagraphCxSpFirst" style="margin-bottom: 0.0001pt; text-indent: -0.25in;">
</div>
<ul>
<li><span style="font-family: Wingdings; font-size: 10pt; text-indent: -0.25in;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; text-indent: -0.25in;">State your concerns, needs, and expectations clearly.</span></li>
<li><span style="font-family: Wingdings; font-size: 10pt; text-indent: -0.25in;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; text-indent: -0.25in;">Rest assured that complaining will not compromise your care. Hospitals want to resolve your problem as quickly as possible. You should be clear about your own expectations. What do you want? What do you expect the hospital to do? This allows the hospital to know how they can help.</span></li>
<li><span style="font-family: Wingdings; font-size: 10pt; text-indent: -0.25in;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; text-indent: -0.25in;">If you do not receive a timely response, or want to address a problem after you’ve left the hospital, contact the hospital’s customer service</span></li>
<li><span style="font-family: Wingdings; font-size: 10pt; text-indent: -0.25in;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; text-indent: -0.25in;">You can use the staff of the patient and family relations department as patient advocates to discuss your case and how best to proceed.</span></li>
<li><span style="font-family: Wingdings; font-size: 10pt; text-indent: -0.25in;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; text-indent: -0.25in;">It is usually best to resolve problems through face-to-face conversations. These can result in better and faster understanding.</span></li>
</ul>
<br /></td></tr>
</tbody></table>
</div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i></div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div class="separator" style="background-color: white; clear: both; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://patientpower.in/2013/" style="text-decoration: none;" target="_blank"><b><span style="color: black;">Register for the Conference Here</span></b></a></div>
<div class="MsoNormal">
</div>
<br />
<div style="-webkit-text-stroke-width: 0px; color: black; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; margin: 0px; orphans: auto; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px;">
<br /></div>
<div style="-webkit-text-stroke-width: 0px; color: black; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; margin: 0px; orphans: auto; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px;">
<br /></div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-29512849580348211802013-10-17T08:00:00.000+05:302013-10-17T08:00:00.777+05:30Patient Advocacy: How Patient Advocates Can Promote Medical Tourism<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://1.bp.blogspot.com/-ErRzMAKG6BY/UlfAFeG5-0I/AAAAAAAAAQA/MpV7YEL4RKM/s1600/banner+ad+-+2.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/-ErRzMAKG6BY/UlfAFeG5-0I/AAAAAAAAAQA/MpV7YEL4RKM/s1600/banner+ad+-+2.JPG" height="78" width="640" /></a></div>
<i><br /></i>
<i><br /></i>
<div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: center; text-autospace: none;">
<b><span style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt;">An independent patient-advocate can guide an overseas guest to the
right destination </span></b><span style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 14.0pt; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<span style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt;">In 2010, over five million
patients travelled to other parts of the globe in search of better health care.
The growth of medical tourism is driven by two factors: <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; text-autospace: none; text-indent: 0in;">
<!--[if !supportLists]--><span style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt;">Steep rise in the medical costs in developed countries and <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; text-autospace: none; text-indent: 0in;">
<!--[if !supportLists]--><span style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt;">Improved health care infrastructure and better healthcare
standards in developing nations. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 13.0pt; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<span style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt;">A favourable currency
exchange is a major driver for medical tourists. Each dollar spent in Indian
fetches more value for a healthcare consumer than is possible in the US. In
terms of infrastructure, many hospitals in Asia are now equipped with
state-of-the-art medical equipment. Their doctors and surgeons have received
their training in the best medical universities across the world. India is also
home to some of the most fascinating holiday options in the world. Since
resting and relaxing are important ways of recuperating after a surgery, what
can be better than clubbing medical tourism with luxury travel and patient
advocacy? <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 13.0pt; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<span style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt;">Recognising the huge
business opportunity in this field, governments, large hospitals and doctors
are flooding the medical tourism market with attractively packaged deals and
services, making the final choice of a hospital extremely difficult for a
patient. This is where an independent patient advocate can be of service to an
overseas patient. He can impartially advise the patient on what hospital to
choose for a particular procedure, so that they do not get swayed by their
misleading marketing hype. He can educate the traveller on what costs to
expect; who the specialists in each field are; help them get appointments
expeditiously and guide them on where to stay and how to follow-up after the
procedure is completed. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: normal;">
<span style="color: black; font-family: "Arial","sans-serif"; font-size: 10.0pt;">Indian culture has always laid
get stress on treating visitors as respected guests. Medical tourists require a
lot of hand holding, and patient advocates are well-equipped to meet their
needs.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;"><o:p></o:p></span></div>
<i><br /></i>
<i>The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i></div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div class="separator" style="background-color: white; clear: both; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://patientpower.in/2013/" style="text-decoration: none;" target="_blank"><b><span style="color: black;">Register for the Conference Here</span></b></a></div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-91338497930172691132013-10-15T08:00:00.000+05:302013-10-15T08:00:00.677+05:30Patient Advocacy: Engaging Patients to ImproveTreatment Outcomes<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://1.bp.blogspot.com/-ErRzMAKG6BY/UlfAFeG5-0I/AAAAAAAAAQA/MpV7YEL4RKM/s1600/banner+ad+-+2.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/-ErRzMAKG6BY/UlfAFeG5-0I/AAAAAAAAAQA/MpV7YEL4RKM/s1600/banner+ad+-+2.JPG" height="76" width="640" /></a></div>
<br />
<br />
<br />
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Engaging Patients to ImproveTreatment Outcomes</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Dr Dhivya Ramasamy</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Positive health outcomes depend not just on the clinical but also
on the non-clinical aspects of a patient’s treatment plan</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 14pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Over the years, thanks to
rapid advances made in understanding the causes of various diseases and
developing newer methods of managing them, healthcare providers have been
successful in bringing about wide scale improvement in patient care. Today, we
have effective clinical solutions in place to treat most diseases. However,
even those diseases that can be treated through well-established, standard
treatment protocols, such as cataracts or refractive error, remain poorly
addressed –cataract continues to be the number one cause of blindness in the
world, mainly because of non-clinical, patient-related factors that impact
positive clinical outcomes (<i>Source: Donatella Pascolini, Silvio Paolo
Mariotti; Global estimates of visual impairment: 2010; Br J Ophthalmol 2012;
96:614-618</i>). <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Aravind Eye Hospitals in
Tamil Nadu has been grappling with this challenge for years and has striven to
address this issue through active patient engagement. This article explores the
potential of engaging patients in their treatment to achieve better treatment
outcomes. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">When can the treatment protocol be deemed to be effective?</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">How do we measure the
effectiveness of a treatment plan? That’s a tricky question. At any healthcare
establishment, the metric used is the number of patients seen or the number of
surgeries performed. Let’s examine how this metric would apply to an eye care
facility. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Given our
progressive national eye care programme and the wide spread use of
community-based outreach camps, a significant number of patients get examined
and identified for cataract surgery, every year. However only a fraction of those
advised surgery, actually undergo it. The acceptance of cataract surgery is
reported to be around only 14% in the community and 45% in hospital-based
settings. Knowing that surgery is the only solution for treating cataract, how
do we ensure that those with cataract seek care and undergo the surgery? <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Similarly,
children with uncorrected refractive error have a significant disadvantage and
tend to do poorly in studies and sports. This can adversely affect the future
career prospects of the child. While spectacles provide a simple and
cost-effective solution, it has been reported that compliance with spectacle
wear among school children remains as low as 30%.How do we ensure that the
needs of children with refractive error are effectively addressed? <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">As a
third example, patients with glaucoma (a chronic ocular condition) are required
to be on continuous medication and must come for essential annual review
visits. Patients with poor adherence show progressive worsening of the disease.
Yet, adherence to medication is poor. Also, the adherence to the essential
follow visits drops to less than a third by the fourth year. How do we enable
glaucoma patients to have their disease effectively controlled? <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The
inference from these examples is that for any treatment to be truly effective,
it’s important that each and every patient successfully completes his treatment
journey: <o:p></o:p></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://3.bp.blogspot.com/-nRDAmLGYjuM/UlfCCB9geRI/AAAAAAAAAQQ/fGHl-VCl8vI/s1600/Picture1.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://3.bp.blogspot.com/-nRDAmLGYjuM/UlfCCB9geRI/AAAAAAAAAQQ/fGHl-VCl8vI/s1600/Picture1.png" height="48" width="640" /></a></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-no-proof: yes;"><!--[if gte vml 1]><v:shapetype
id="_x0000_t75" coordsize="21600,21600" o:spt="75" o:preferrelative="t"
path="m@4@5l@4@11@9@11@9@5xe" filled="f" stroked="f">
<v:stroke joinstyle="miter"/>
<v:formulas>
<v:f eqn="if lineDrawn pixelLineWidth 0"/>
<v:f eqn="sum @0 1 0"/>
<v:f eqn="sum 0 0 @1"/>
<v:f eqn="prod @2 1 2"/>
<v:f eqn="prod @3 21600 pixelWidth"/>
<v:f eqn="prod @3 21600 pixelHeight"/>
<v:f eqn="sum @0 0 1"/>
<v:f eqn="prod @6 1 2"/>
<v:f eqn="prod @7 21600 pixelWidth"/>
<v:f eqn="sum @8 21600 0"/>
<v:f eqn="prod @7 21600 pixelHeight"/>
<v:f eqn="sum @10 21600 0"/>
</v:formulas>
<v:path o:extrusionok="f" gradientshapeok="t" o:connecttype="rect"/>
<o:lock v:ext="edit" aspectratio="t"/>
</v:shapetype><v:shape id="Picture_x0020_1" o:spid="_x0000_i1026" type="#_x0000_t75"
style='width:524.25pt;height:38.25pt;visibility:visible;mso-wrap-style:square'>
<v:imagedata src="file:///C:\DOCUME~1\Anju\LOCALS~1\Temp\msohtmlclip1\01\clip_image001.emz"
o:title=""/>
</v:shape><![endif]--><!--[if !vml]--><!--[endif]--></span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;"><o:p></o:p></span></div>
<div align="center" class="Pa15" style="margin-bottom: 13pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Figure 1: The Patient Journey </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">While we
advocate this treatment pathway to all our patients, in reality we see patients
drop off at different points along their journey, eventually rendering the
treatment ineffective. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Over the
years, we have experimented with the following strategies to reduce this
drop-off rate: <o:p></o:p></span></div>
<div class="Pa9" style="margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Patient engagement </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Given
that much of the treatment depends on the behaviour of the patient, our
strategy has been to nudge him in the right direction. Actively engaging
patients in their treatment plan can help in positively influencing their role
in seeking care; adhering to the treatment advised; following instructions for
self-care ; and returning for review visits. <o:p></o:p></span></div>
<div class="Pa9" style="margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Helping patients seek timely care
</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Awareness creation through
well-designed health education programmes targeted at the appropriate audience
can help patients identify symptoms and seek timely care. Squint or strabismus
is considered to bring good luck, hence parents in India often do not attempt
to<o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">correct
these conditions. It is important to break such misconceptions. Parents should
be made aware that strabismus can lead to severe visual impairment, so they
must act fast. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Low birth
weight children are at risk for Retinopathy of Prematurity, leading to
degeneration of the retina. This can be controlled if managed within three
weeks of birth. Thus it’s essential to make pregnant mothers aware of this
condition so they can seek timely care for their premature babies. <o:p></o:p></span></div>
<div class="Pa9" style="margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Partnering with opinion leaders
in the community </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">For
conditions that are widespread in the population (such as cataract and
diabetes), it’s important to rope in youth volunteer groups, NGOs, Rotary
Clubs, etc to assist in information dissemination. <o:p></o:p></span></div>
<div class="Pa9" style="margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Helping patients make the right
decision </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">At
Aravind, counselors are an integral part of our clinical team. They ensure that
patients have the opportunity to voice their concerns and clarify their doubts.
Today, the cataract surgery acceptance rate is about 75% in our hospital, and
about 85% in the outreach camps, thanks to the presence of these counselors. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Aravind’s
counselors are recruited when they pass out from high school and are
intensively trained for two years in : the basics of how the eye works; its
diseases; treatment options; and counseling techniques. Regular monitoring and
performance feedback help them perfect their counseling skills on an ongoing
basis. <o:p></o:p></span></div>
<div class="Pa9" style="margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Patient Motivators </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">We’ve discovered that where
patients face emotional and psychological barriers to following medical advice,
peer counseling is very effective. In the early 1990s when cataract surgical
acceptance was poor, Aravind found the use of aphakic motivators was the most
effective means to convince patients to undergo cataract surgery. These were
patients who had undergone the surgery themselves and were able to share their
experience with those being counseled.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">All said and done, patients have
different information needs. Their concerns and questions are unique to the
stage they find themselves in (Figure 2). Patient engagement strategies must be
customized to address these specific needs and the individual’s treatment
goals.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><br /></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://1.bp.blogspot.com/-gtpbuEAs9QA/UlfB56X8B1I/AAAAAAAAAQI/I7LXRZTZ6ns/s1600/Picture2.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/-gtpbuEAs9QA/UlfB56X8B1I/AAAAAAAAAQI/I7LXRZTZ6ns/s1600/Picture2.png" height="209" width="640" /></a></div>
<div class="MsoNormal">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><!--[if gte vml 1]><v:shape
id="Picture_x0020_2" o:spid="_x0000_i1025" type="#_x0000_t75" style='width:524.25pt;
height:161.25pt;visibility:visible;mso-wrap-style:square'>
<v:imagedata src="file:///C:\DOCUME~1\Anju\LOCALS~1\Temp\msohtmlclip1\01\clip_image003.emz"
o:title=""/>
</v:shape><![endif]--><!--[if !vml]--><!--[endif]--></span><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div align="center" class="Pa15" style="margin-bottom: 13pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Figure 2: Information Needs of the Patient </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div align="center" class="Default" style="margin-bottom: 13.0pt; text-align: center;">
<i><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">(Source: The Informed
Patient: Study Report, March 2003; D.E. Detmer, et al; Judge Institute of
Management, UK) </span></i><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">In the final analysis, the
hospital must take full ownership of patient disengagement and find innovative
ways of engaging patients to help them reclaim control over their lost health.<o:p></o:p></span></div>
they will direct you to
another clinician who can. Nurses typically work on 12-hour shifts (i.e. from 6
a.m. to 6 p.m.) so find out when the shift change is and try to wait until the
nurse on duty has the information she needs to answer your questions. <o:p></o:p><br />
<br />
<br />
<div class="Default" style="margin-left: 0in; mso-list: l0 level1 lfo1; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Get
to know the hospital’s discharge planner or case manager. It is their job to
help with discharging your loved one and ensuring that you have all the
information you need before leaving the hospital. She can provide you
information about local resources, referrals to other medical professionals,
when to follow up, etc. <o:p></o:p></span></div>
<br />
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i></div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div class="separator" style="background-color: white; clear: both; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://patientpower.in/2013/" style="text-decoration: none;" target="_blank"><b><span style="color: black;">Register for the Conference Here</span></b></a></div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-40755745695062593602013-10-13T08:00:00.000+05:302013-10-13T08:00:00.239+05:30Patient Advocacy: Meeting the Special Needs of Patients<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://1.bp.blogspot.com/-ErRzMAKG6BY/UlfAFeG5-0I/AAAAAAAAAQA/MpV7YEL4RKM/s1600/banner+ad+-+2.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/-ErRzMAKG6BY/UlfAFeG5-0I/AAAAAAAAAQA/MpV7YEL4RKM/s1600/banner+ad+-+2.JPG" height="39" width="320" /></a></div>
<br />
<br />
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Not all patients will have similar needs. As a patient advocate,
your responsibility is to tailor your services to the specific needs of your
patients</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 14pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">A frail 81-year-old woman
was counting her last few breaths. Her physician met with the family and they
all agreed that comfort care was the best option for this patient. They quickly
shifted her to a quiet corner of the intensive care unit (ICU) where she would
not be disturbed by the regular flow of incoming and outgoing patients. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The entire family of five
sons, three daughters, their husbands, wives, and several of her grandchildren
had gathered at the hospital, waiting to meet her during her final moments.
Although they took turns, there were still too many of them, and they were
crowding the small waiting room. The nurse-advocate assigned to them by the
hospital, took stock of the situation and decided to take the doctor’s
permission to move the dying woman to a different, less-crowded floor of the
hospital. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">She personally supervised all the
preparations and professionally explained to the family that this was in the
best interest of the patient. They agreed and she was shifted uneventfully. The
doctor visited them a couple of times in the night and saw them huddled around
the matriarch, holding hands and praying for her peaceful passage. The dignity
with which they let her go moved everyone who watched them to tears.<o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">In doing
all this and more, the hospital had made no big sacrifices. However by
providing them with a little privacy and quiet, the nurse-advocate had given
them the strength to deal with this difficult hour. After the woman passed away
peacefully in her sleep early the next morning, the nurse-advocate told them to
take all the time they needed to mourn her. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">When they
left, one member of the family quietly hugged the nurse-advocate and said “I am
also a nurse at a private hospital. But today, I learnt an important lesson in
patient care from you. Thank you for being our advocate.” <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">At times
such as these, being an advocate can make a world of a difference to a patient
and her family. The advocate can bend the hospital’s rigid rules, to allow an
often heartless bureaucracy to put the patient first. When a loved one falls
ill, finding the right doctor and getting the right care is all that matters to
a patient’s family. Sick patients and family members are vulnerable and can
easily get lost in the labyrinth of today’s complex medical system. Effective
case management and intervention by patient-advocates can allow the hospital
and doctors to tailor care to meet the family’s needs, by establishing better
communication channels among the patient, her family and health care providers.
<o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">“Did you
get a second opinion?” is the question people often ask a patient’s family.
Arranging for a second, and if necessary, third opinion is another area where a
patient-advocate can make her contribution count. Because time is of the
essence when the condition is serious, patient advocates can be useful in
providing joint consultations and securing speedy appointments; whereas in the
case of chronic illness, patient-advocates can maximize your sense of wellness.
They can monitor your progress on a regular basis, check in routinely with your
doctor and ensure that the appropriate medical protocols are being followed. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Typically,
a patient advocate will meet with the doctor to discuss and outline a patient’s
treatment programme. She will then work with the patient and her family to make
them understand the implications of the disease; explains the various treatment
options; and last but not the least, identify any gaps in care and help plug
those loopholes by meeting with the healthcare service providers on behalf of
the patient. This can require a lot of coordination, because the healthcare
world is often fragmented, and one specialist often has no clue what the other
is doing. Here are a few other categories of special needs patients for
advocacy efforts: <o:p></o:p></span></div>
<div class="Pa9" style="margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Patient-Advocates for young
children </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">A father
was playing ball with his two young children. One of the children got hurt in
the head with the hard ball. She appeared to be fine, but on the third day
after that incident, she started complaining of severe headaches. The alarmed
parents took her to the emergency room of a local hospital, where the resident
doctor even after knowing the child’s head trauma, diagnosed it as a viral
infection and proceeded to send her home to rest. The parents did not feel
comfortable with this advice. Their gut instinct told them that something was
seriously wrong. When they politely suggested a CT scan for the child, the
doctor felt insulted. Refusing to be cowed down, the parents dug their heels in
and the doctor had no choice but to order the test that confirmed the parent’s
worst fears - the scan showed bleeding into the brain, most likely caused by
the head injury. Had the parents taken their child home to “ sleep off the
virus “ that night, their child probably would never have woken up. It’s your
child. Go with your parental gut instinct. Your child doesn’t have a voice, and
you need to stand up and be her advocate. <o:p></o:p></span></div>
<div class="Pa9" style="margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Patient advocacy for the
mentally-ill </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Sunita
Nair (45) got admitted into the inpatient/acute care psychiatric unit after a
foiled suicide attempt. She was kept under observation for two days and looked
clinically depressed. She had poor appetite and no interest in social
interaction. In addition, she expressed ambivalence about acting on her
suicidal thoughts, at times denying and at times endorsing those feelings. On
the third day the patient denied suicidal ideation. The physician decided to
discharge her, because she was no longer actively suicidal. However, her
patient-advocate, who spent much more time with Sunita and had a much better
rapport with her than the doctor, thought differently. She believed that the
patient needed more time in the inpatient unit and the doctor was wise enough
to listen to her reasoning. This intervention may have saved Sunita’s life. <o:p></o:p></span></div>
<div class="Pa9" style="margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Patient advocates and organ
transplantation </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Patient advocate work closely with
hospitals, organ and tissue banks to identify organ donors and ensure suitable
matches for terminally-ill patients in need of transplants. The decision to
donate an organ or undergo a transplant is not a decision families make
lightly. Patient advocates provide reassurance, resources and advice to
patients at that difficult hour.<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="margin: 0.25in 0in 2pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">QUIZ TIME: Advocacy in Special
Circumstances </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Advocates can shine when
your patient has a need and you speak up for them and help them get their needs
addressed. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Your patient has just had surgery. The doctor has prescribed
pain-killers, but they are not taking effect and the patient is still in a lot
of pain. The order says she can’t have another dose for three more hours. What
do you do? <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
</div>
<ul style="text-align: left;">
<li><span style="font-family: Arial, sans-serif; font-size: 10pt; text-indent: 0in;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; text-indent: 0in;">Your patient is a vegetarian but receives meat on her dinner tray.
What do you do?</span></li>
<li><span style="font-family: Arial, sans-serif; font-size: 10pt; text-indent: 0in;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; text-indent: 0in;">Your patient is a Muslim and must offer <i>namaz </i>at least five
times every day. He has even carried a prayer mat to the hospital with him.
What help can you offer this patient?</span></li>
<li><span style="font-family: Arial, sans-serif; font-size: 10pt; text-indent: 0in;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; text-indent: 0in;">A young mother suffers haemorrhage after giving birth to a child.
She is in the ICU and requests that she be allowed to see her baby at least
once, in case she dies. The hospital has a policy – they do not allow infants
into the ICU. To complicate matters, the mother is so ill she can’t be taken to
the nursery. What would you do?</span></li>
<li><span style="font-family: Arial, sans-serif; font-size: 10pt; text-indent: 0in;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt; text-indent: 0in;">A patient is about to be discharged with a long list of
prescriptions. She confides in you that she is a single, jobless woman and
cannot afford some of those costly medications to get better. What would you
do?</span></li>
</ul>
<!--[if !supportLists]--><br />
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Please note that these
questions don’t have any right or wrong answers. But mulling on these tricky
situations and thinking of the appropriate response might help you figure out
your roles and responsibilities as a patient-advocate</span><!--EndFragment-->
; <!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Introduce
yourself to the nursing staff. They will be providing the bulk of the hands-on
care to your loved one. They should be able to answer most of your questions on
medication, treatments or procedures. If they can’t, they will direct you to
another clinician who can. Nurses typically work on 12-hour shifts (i.e. from 6
a.m. to 6 p.m.) so find out when the shift change is and try to wait until the
nurse on duty has the information she needs to answer your questions. <o:p></o:p></span><br />
<br />
<br />
<div class="Default" style="margin-left: 0in; mso-list: l0 level1 lfo1; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span></div>
<div class="Default" style="margin-left: 0in; mso-list: l0 level1 lfo1; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Get
to know the hospital’s discharge planner or case manager. It is their job to
help with discharging your loved one and ensuring that you have all the
information you need before leaving the hospital. She can provide you
information about local resources, referrals to other medical professionals,
when to follow up, etc. <o:p></o:p></span></div>
<br />
<br />
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i></div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div class="separator" style="background-color: white; clear: both; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://patientpower.in/2013/" style="text-decoration: none;" target="_blank"><b><span style="color: black;">Register for the Conference Here</span></b></a></div>
<br /></div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-18154279927276726792013-10-11T14:40:00.002+05:302013-10-11T14:40:54.086+05:30Patient Advocacy: Improving the Hospital Experience for a Patient <div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://2.bp.blogspot.com/-ErRzMAKG6BY/UlfAFeG5-0I/AAAAAAAAAP8/dpNa3kndrOs/s1600/banner+ad+-+2.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-ErRzMAKG6BY/UlfAFeG5-0I/AAAAAAAAAP8/dpNa3kndrOs/s1600/banner+ad+-+2.JPG" height="39" width="320" /></a></div>
<br />
<br />
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">It’s possible to become a patient-advocate without alienating
hospital staff. You can help your patient without getting in the way of
important tests, or hampering treatments<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Doctors
are not super humans and they cannot cure all their patients. However,
sometimes they are so focussed on the technical aspects of the medical care
they provide, that they forget that a pat on the shoulder and a reassuring
smile can make a world of a difference to the patient. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">As a patient-advocate, you
can help doctors and nurses deliver humane, compassionate and empathetic care
to their patients. You have the resources at your disposal. You have the
medical knowledge and you know how the system works. You know where to go for a
second opinion; and you know which hospital has the latest technology and which
doctor has specialised expertise. You know whom to contact in case of an
emergency, what forms to fill out; and what formalities to complete. You can
tap into your skills to ensure that patients are treated with love and care by
the medical staff.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">It’s possible to become an
advocate without upsetting hospital staff. There’s no need to rock the boat and
put your patient’s life in danger. Being an advocate is all about being informed,
present, persistent, and caring. It is not about being loud, arrogant,
adversarial, or obnoxious. It’s a delicate balancing act, rendered with
humility and helpfulness, where everybody has to learn to be a team player.<o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Your
ultimate goal must be to establish a relationship of trust. For as long as you
are in the hospital, try not to throw your weight around, or come across as
uncouth; don’t over react over minor issues or pull strings to fix small
problems. Change the way you approach a nurse or ward boy for help. Use words
like “Help,” “Excuse me,” “May I,” “Thank you” and “Sorry” as often as you can,
before asking for a bedpan, a glass of water, a change of sheets, an extra
pillow etc. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">You thank
people who serve you at restaurants, so why not do it in the hospital too? If
you are polite to nurses and ward boys, they will respond in kind. Have faith
in the system. Believe that everyone wants to be helpful. Saying a sincere
“Thank you” will make hospital staff feel good about their job and they will be
more polite in the future. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">When a
doctor visits, listen carefully before you start bombarding him with questions.
Be prepared with your list of doubts. Don’t waste his time by beating about the
bush – this just irritates a busy doctor. Surgeons will always have one foot
out of the door, so prioritise your questions and get to the point quickly. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Some
staff members may still regard you as a nuisance. A few may appreciate your
efforts and others may feel threatened. Don’t put them on the defensive. Don’t
let the negatives of a situation vitiate the hospital environment. On the other
hand, don’t get cowed down by the hospital staff either. You are not there to
win a popularity contest - you are there to save a life. Not everybody has the
skill or ability of being able to connect with others quickly and easily, but a
good patient-advocate has mastered this art. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Because
patients can’t fight for their rights any better than defendants can argue
their own cases, or citizens can file their tax returns without the help of a
CA, patients need the help of a patient advocate to make their hospital stay
comfortable. In fact, progressive hospitals are investing in employing
professional patient-advocates, whose job it is to make the hospital more
hospitable. Patient advocates help to pamper patients, so that they go home
fully recovered, and full of praise for the hospital and the medical staff. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Most
doctors and nurses are professional and efficient in the discharge of their
duties. But you still need someone who will put the patient first when she is
in hospital - and no one can do this job better than a patient-advocate. An
advocate provides personalised care to the patient. Every patient is entitled
to the highest quality care - the kind a VIP gets when he enters a hospital.
Patient-advocates can help to resolve complaints; gather feedback about
hospital services; and implement suggestions to improve care and enhance
patient satisfaction. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">These
professionals should not be viewed as competitors to the medical team, but as
partners who can fill the gap in services, and assist patients in negotiating
the complex healthcare system. The real value of a patient-advocate lies in her
ability to represent the patient - and every patient is special and unique. She
can assist the doctor in understanding the patient’s experience and her
personal preferences, so that the doctor can customise the solution he offers
to the patient. A patient advocate helps the medical team to deliver friendly
efficient and effective service, tailored to the patient’s needs, by being a
partner, teammate and personal coach. To illustrate, let me give you an
example: <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">A
37-year-old patient with a serious lung infection had to be shifted to a
ventilator and was put in a medically induced coma in the ICU. On the third
day, he suddenly became alert and couldn’t figure out where he was. His arms
were restrained and he could not spot any of his family members around him. He
had had a tracheotomy done two days ago to assist him in breathing so he
couldn’t even speak. When he came around, he naturally panicked and gestured
wildly to the nurse attendant in the ICU. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Thankfully,
she was a good nurse and she recognised that the patient was conscious and
anxious. She rushed to the patient’s side, took his hand in hers and in a soft,
crooning voice addressed him by name, while trying to assure him that
everything was alright and that the doctors were making sure that his lungs
were functioning normally. Then she offered to inform his family that he was
awake. While doing all this, the nurse took care not to let go of the patient’s
hand, made direct eye contact and spoke in a very warm, soft tone. The patient
quickly calmed down - and was full of praises for the loving care he received. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Another
incident that a five-year-old’s father once narrated to me was when he was
taking his toddler to a hospital for treatment of a profusely bleeding wound on
the scalp. He was frantically looking for a wheelchair for his son in the
parking lot, and although it was not his job, the parking attendant on duty
rushed to fetch a stretcher for the little boy, who was placed safely in good
hands in a few minutes. The parking attendant saw the father’s distress and
responded to it with urgency. To this day, this father has not forgotten that act
of kindness. The moral of the story is that everybody working in a hospital,
from the sweeper to the surgeon, has a moral obligation to be a patient
advocate. An example must be set by the senior management team, who should take
daily rounds, and visit each patient personally, so they can resolve complaints
before they snowball. The message will then percolate down all the way to the
ward boy - because staff members imitate what their bosses do - not what they
say. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">All
hospital staff members must learn to read a situation from the patients’ point
of view. Surrounded by a battery of specialists — cardiologists,
endocrinologists, orthopaedists, neurologists, and more, patients are scared,
confused, and vulnerable. Specialists are often too busy to give their patients
the full attention they deserve. That’s when the others around them can step in
to fill the void. If and when the opportunity presents itself, the supporting
battalion of nurses, paramedics, ward boys, hospital administrators, and clerks
must serve as patient advocates. It costs them nothing, but can deliver rich
returns - both from the sense of personal satisfaction such acts of kindness
generate; as well as the resulting enhancement of the hospital’s reputation. At
the bare minimum, this would bring a smile to a harried patient’s face - and a
patient who goes home with happy memories of her hospital stay will become a
brand-ambassador for the hospital. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">While all the hospital staff
(barring a few rotten apples) mean well and want the patient to get well and go
home as early as possible, sometimes they are spread too thin. After performing
ten surgeries in a day, a doctor can be expected to feel a little tired. A
nurse may be feeling low, because she has just done a double shift, or the
billing clerk may be cranky because he got ticked off by his boss – and in
those circumstances, they are not able to give tender loving care to the
patient - after all, they are human too. This is where a personal full time
patient-advocate can shine - and help patients get the care they want and need.
<o:p></o:p></span></div>
<div class="MsoNormal">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Playing the role of a
patient-advocate<o:p></o:p></span></b></div>
<div class="MsoNormal">
<br /></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Even if
you cannot afford a full time patient advocate, there’s a lot you can do
personally to advocate for your patient. Once you arrive at the hospital and
have provided staff with the information needed to admit or treat your loved
one, you should: <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Find
out who the “attending physician” is. This is the person who will coordinate
and oversee your loved one’s care, work with consulting physicians and
specialists, and have responsibility for your patient’s treatment plan. <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Get
the phone numbers for the attending physician and make sure that he knows how
to contact you directly regarding your loved one’s care. <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Keep
a list of questions ready to ask your attending physician. You never know when
the doctor will show up by your patient’s bedside. A typical visit won’t last
more than 10 minutes. If, for some reason you won’t be in the room when the
doctor visits, leave your list with the nurse. <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo1; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Introduce
yourself to the nursing staff. They will be providing the bulk of the hands-on
care to your loved one. They should be able to answer most of your questions on
medication, treatments or procedures. If they can’t, they will direct you to
another clinician who can. Nurses typically work on 12-hour shifts (i.e. from 6
a.m. to 6 p.m.) so find out when the shift change is and try to wait until the
nurse on duty has the information she needs to answer your questions. <o:p></o:p></span></div>
<br />
<div class="Default" style="margin-left: 0in; mso-list: l0 level1 lfo1; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Get
to know the hospital’s discharge planner or case manager. It is their job to
help with discharging your loved one and ensuring that you have all the
information you need before leaving the hospital. She can provide you
information about local resources, referrals to other medical professionals,
when to follow up, etc.</span></div>
<br />
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i></div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div class="separator" style="background-color: white; clear: both; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://patientpower.in/2013/" style="text-decoration: none;" target="_blank"><b><span style="color: black;">Register for the Conference Here</span></b></a></div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-77740702521773275902013-10-09T16:01:00.001+05:302013-10-09T16:01:35.457+05:30Patient Advocacy: The Patient Advocate as Patient Guardian<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><br /></span></b></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://1.bp.blogspot.com/-HKWpk_73Zg8/UlUvqn4S8eI/AAAAAAAAAPs/p7Ei28D4mC0/s1600/banner+ad+-+2.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/-HKWpk_73Zg8/UlUvqn4S8eI/AAAAAAAAAPs/p7Ei28D4mC0/s1600/banner+ad+-+2.JPG" height="48" width="400" /></a></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><br /></span></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><br /></span></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">The
Patient Advocate as Patient Guardian</span></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Donald W.
Kemper and David Foster</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Patient
advocates act as guardian angels when you are in hospital</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 14pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Too many modern hospitals have become intolerably complex. It is
not uncommon for 30 or more health professionals to provide care to the same
patient over a three-day hospital stay. Often three or more clinicians will be
in the patient’s room at the same time but for different reasons (and there may
be even more, for example, when there are shift changes; older patients, who
may have multiple medical problems, will often need many different specialists;
and in hospitals attached to medical schools, who have to teach professionals
in training). <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Even with the best technology available to coordinate care,
complexity is a breeding ground for medical errors, miscommunications and
contradictory orders. Within this complex maze of care, only three elements of
the mix are reliably constant: the patient, the medical record and, if the
patient is lucky, the guardian. Because the patient is often medicated and the
medical record is always mute and often disjointed, the only clear and steady
voice of continuity in the patient’s room is that of the patient guardian.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Patients often feel helpless</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">There are three main reasons why hospital patients feel lost and
helpless:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Hospital patients are generally sick, injured, under stress or
maybe recovering from surgery. They are not at their best, mentally or
physically. Fatigue and confusion commonly cause patients to feel lost and
helpless.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">There is a learned helplessness about being a patient. A patient
is expected to be passive. The doctor gives the “orders.” The medical jargon is
unfamiliar. The building layout is often confusing. And the patient is expected
to ask permission before doing anything.<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; mso-list: l1 level1 lfo1; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;"> </span></div>
<div class="Default" style="margin-left: 0in; mso-list: l1 level1 lfo1; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">The
medications that patients are given often cause drowsiness, confusion and
disorientation. Whether the drug effect is mild or severe, patients under
medication are not able to think as clearly as they normally would. <o:p></o:p></span></div>
<div class="Pa9" style="margin: 8pt 0in 2pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><b><span style="font-family: Arial, sans-serif; font-size: 10pt;">The “Telephone Game” </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin: 0in 0in 13pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Have you ever played the game “Telephone”? One person begins by
whispering a long sentence to the person next to him—just once with no repeats.
Then that person whispers what she thought she heard to the next person, and so
on, until everyone has heard and repeated the message. Then the final message
is compared to the original message. Most of the time, there’s a hilarious
disconnect between the beginning and the end. Much the same can happen in a
hospital, but without the fun and games. <o:p></o:p></span></div>
<div class="Pa4" style="margin: 0in 0in 13pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">A friend of ours got caught up in a round of repeated
misinformation during her hospital stay. She was scheduled for hip replacement
surgery. At the pre-op appointment, she was asked if she had any drug
allergies. She responded that she didn’t have any allergies but she was sensitive
to opioids. She said she could take them, and they worked well, if an
anti-nausea drug was also given. The pre-op nurse made a note in the chart. <o:p></o:p></span></div>
<div class="Pa4" style="margin: 0in 0in 13pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">During the prep period right before surgery, the prep nurse said,
“It says in your chart you’re allergic to opioids.” Our friend said, “No, they
work well for me <i>if </i>I also get an anti-nausea drug with them.” <o:p></o:p></span></div>
<div class="Pa4" style="margin: 0in 0in 13pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">In the hospital room after the surgery, the attending nurse said,
“Since you’re allergic to opioids, we’re giving you Tylenol.” The patient said,
“No, I’m not allergic. Opioids really help control pain for me. I just need to
take them with an anti-nausea medication because they make me nauseous.” The
patient’s spouse heard this exchange three different times while he sat with
his wife in her room. But the message just didn’t get through—the circuit of
misinformation kept getting repeated. <o:p></o:p></span></div>
<div class="Pa4" style="margin: 0in 0in 13pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">It wasn’t until 4:00 in the morning after the surgery, when the
patient was exhausted and crying for pain relief, that she finally was given
dilaudid, an opioid pain medication, and her requested anti-emetic. This
episode played out the telephone game in which the wrong information kept
getting repeated despite the patient’s attempts to correct it. If the spouse
had been included in the patient guardian role, he would have been able to save
his wife the painful experience. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Good
doctors aren’t enough: </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Everyone hopes his or her doctor will be
above average. We want our doctor to be technically competent, be a diagnostic
genius and have a caring bedside manner. Even if that were true for every
doctor, it would not be enough. In the hospital setting, your doctor is often
not nearby. Your doctor cannot be the constant, caring guardian angel you need
to protect you from error. There are too many others providing care whom your
doctor may not even meet. Good doctors are important, and if yours is better
than average, count yourself lucky. But even with the best of doctors, once he
or she is out of the room, you can still be given the wrong medication; be
asked to walk when you shouldn’t; or be given an infection by someone who did
not wash his hands. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Many
medical errors are less about how good your doctor is and more about how good
the system is in coordinating your care among the many professionals who are
there to help you. <o:p></o:p></span></div>
<div class="Pa9" style="margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Medical mistakes do happen </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<i><span style="font-family: Arial, sans-serif; font-size: 10pt;">Primum
non nocere </span></i><span style="font-family: Arial, sans-serif; font-size: 10pt;">is Latin for “first, do no harm.” The principle is taught in every
medical school. Its prominence in medical education foretells the reality that
mistakes will happen unless you are extremely careful to prevent them. In the
U.S., one-third of hospital patients are subject to medical errors, resulting
in about <span class="A6"><span style="font-family: "Arial","sans-serif"; mso-ansi-font-size: 10.0pt; mso-bidi-font-size: 10.0pt;">seven percent who experience permanent
harm or death</span></span>, as per one news report. <o:p></o:p></span></div>
<div class="Pa9" style="margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Mistakes will happen—but they
don’t have to happen to you </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The job
of the patient guardian is to help the care team to prevent mistakes or to
correct them before they harm the patient. Mistakes are preventable, and many
can be prevented by the actions of the patient guardian. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">There are
four main duties of a patient guardian: infection control, medication
monitoring, watching for changed symptoms and shared decision making. Each duty
is targeted at preventing a different type of medical mistake. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Infection
control involves the guardian’s insistence on the staff washing their hands
every time; ensuring the administration of peri-operative antibiotics before,
during and after surgery; following appropriate wound care rules; and keeping
visitors with coughs, colds and fever far away. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Medication
monitoring involves paying attention to what the pills look like and when they
are given, plus asking questions if anything changes. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Watching
for complications or changes in the patient’s condition and pointing out any
changes to the right staff member can be life-saving. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Shared
decision making involves always asking if there are options – and very
importantly, if there is the choice to do nothing. Often, watchful waiting and
attentive inactivity are sensible choices. The guardian needs to ask - what
would happen if the patient delayed or avoided a recommended treatment or test.
Many treatment decisions are “preference-sensitive,” so the right decision
depends on the patient’s preference. The guardian can help to make that
preference heard. <o:p></o:p></span></div>
<div class="Pa9" style="margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Preparing to be a patient
guardian </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">There are
a few things a patient guardian can do before or at the start of a hospital
stay: <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo3; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Interview
the patient about his or her wishes, and ask for copies of the patient’s
advance directives for use if needed. <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo3; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Get
written permission from the patient to see his or her medical records. In the
U.S., this may require a privacy release document. <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo3; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Record
the patient’s baseline blood pressure, pulse and other vital signs for
comparison later. <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo3; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Ask
the main doctor what complications to look for, and record phone numbers for whom
to call if these symptoms appear. <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo3; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Keep
copies of key parts of the medical record with you. This is critical when the
patient is transferred from one facility to another. Sometimes the patient or
guardian’s copy or download of records to a smart phone can be very useful to
the doctors at the new facility because the more formal transfer of information
can consume precious time. <o:p></o:p></span></div>
<div class="Default" style="margin-bottom: 4.4pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo3; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Ask
to see the quality measures for the type of care the patient is expecting to
receive. The <span class="A6">National Quality Forum </span>website
allows you to search quality measures for specific treatments. (<span class="A6">www.qualityforum.org/Qps/</span>)
<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; mso-list: l0 level1 lfo3; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Remember
the guardian’s role is primarily a medical one – to ensure the patient gets the
best medical care. <o:p></o:p></span></div>
<div class="Default">
<br /></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Of course
a guardian can be a friend and supporter too. But performing the role of a
guardian when the situation calls for it – and being willing to be assertive
when needed, is the one function that will make the biggest difference. <o:p></o:p></span></div>
<div class="Pa9" style="margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Getting Help from the Clinical
Record </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Patient
guardians, with the patient’s permission, are increasingly gaining access to
the patient’s chart and medical records. This is an important tool to have. <o:p></o:p></span></div>
<div class="MsoListParagraph" style="text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Many providers offer patient-facing applications or website access
to medical records through standards such as the <span class="A6"><span style="font-family: "Arial","sans-serif"; mso-ansi-font-size: 10.0pt; mso-bidi-font-size: 10.0pt;">Blue
Button</span></span>. (</span><a href="http://www.bluebuttondata.org/"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">www.bluebuttondata.org/</span></a><span style="font-family: Arial, sans-serif; font-size: 10pt;">)</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Laxmi is
a cancer patient at a hospital clinic that allows patients (and other
authorized individuals) to download medical records onto a smart phone. Her
husband did just that. When Laxmi had a stroke and was transported to a
different hospital, the emergency physicians there were not able to access
Laxmi’s medical records at the first hospital. After repeated attempts to get
the records, Laxmi’s husband simply pulled them up on his smart phone and
showed them to the emergency room doctors, who used the lab results from the
first hospital to determine the right course of treatment. <o:p></o:p></span></div>
<div class="Pa9" style="margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Be loud enough to save a life </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">No one
enjoys being a pest. We particularly don’t want our doctors to think we are
rude, ungrateful or “problem” patients. On the other hand, holding back when
you know things are not right can prevent you from saving the life of someone
you love. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Lewis
Blackman was a previously healthy, highly promising 15-year-old boy who was three
days past what was supposed to be a routine surgery to prevent future problems.
His pain had been controllable after the surgery, but on the morning of the
third day it rose to “a 5 on a scale of 5”—and then it got worse. He was on a
pediatric cancer unit because the surgery unit was full. It was the weekend,
and the surgeons had turned his care over to residents. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">In the
afternoon he was even worse. The nurse wrote in the chart, “Gas pains—patient
needs to move around.” In spite of Lewis’s protests, Helen, his mother, and the
nurse helped him walk around the ward. He seemed weaker and weaker to Helen.
The nurse thought Lewis was just feeling sorry for himself. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Helen
asked for an experienced doctor to come and see Lewis. Instead, they sent the
chief resident, but they didn’t tell her he was still in training. She relaxed
because he seemed confident and she thought he was a veteran. He was not.
Lewis’s pain was unbearable. He was sweating and his temperature had dropped. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">On the
morning of the fourth day, the nurses could not measure his blood pressure.
They thought the equipment must be broken. Lewis’s speech became slurred. He
said, very slowly but quite audibly, “It’s going black.” <o:p></o:p></span></div>
<div class="MsoListParagraph" style="text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Only then did the chief resident call for a full “code alert,” and
veteran doctors arrived. But it was too late. Lewis was pronounced dead at 1:23
p.m. that afternoon. An autopsy determined that Lewis’s abdomen held nearly 3
liters of blood caused by the hole that his pain medicine had eaten in his
upper intestine. Lewis had slowly bled to death, and no one but Helen had paid
attention to the signs.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The full
story is here: <span class="A6"><span style="font-family: "Arial","sans-serif"; mso-ansi-font-size: 10.0pt; mso-bidi-font-size: 10.0pt;">www.lewisblackman.net/
</span></span><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Our
medical system should never allow this to happen again. And yet, we know that
it will. If you are a patient guardian, there is no action you might take that
is too rude or too insistent if it results in possibly saving the life of your
child or your loved one. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Many
hospitals are implementing a family-activated “code” to provide an extra layer
of patient safety. If a patient guardian sees that a patient’s health is
changing for the worse and the clinical team is not responding, the guardian
can call a “code” by dialing a phone number, and a response team will be
activated to address the issue. (<span class="A6"><span style="font-family: "Arial","sans-serif"; mso-ansi-font-size: 10.0pt; mso-bidi-font-size: 10.0pt;">Code HELP </span></span><i>at
<span class="A6"><span style="font-family: "Arial","sans-serif"; mso-ansi-font-size: 10.0pt; mso-bidi-font-size: 10.0pt;">www.harrisonmedical.org/ file_viewer.php?id=6115</span></span></i>)
<o:p></o:p></span></div>
<br />
<div class="MsoListParagraph" style="text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Hospitals are not as safe as we wish they were—not nearly as safe.
No one believes that a patient <i>should </i>need a patient guardian. But
unfortunately, they do. No matter who you are and where you are, having a
patient guardian to help protect you in the hospital is a good idea. Hospitals,
even the famous ones, are so very complex that as soon as they work to
eliminate errors in one area, new problems spring up in another. Of the three
constants in the room (the patient, the record and the guardian), the patient
guardian is quite often in the best position to prevent <b>errors </b>or to
spot them early on.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;"><o:p></o:p></span><br />
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><br /></span>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i></div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div class="separator" style="background-color: white; clear: both; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://patientpower.in/2013/" style="text-decoration: none;" target="_blank"><b><span style="color: black;">Register for the Conference Here</span></b></a></div>
</div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-9570967659351742422013-10-05T15:36:00.002+05:302013-10-05T15:36:46.087+05:30Patient Advocacy: Family Physicians as Patient Advocates<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.patientpower.in/"><img border="0" src="http://2.bp.blogspot.com/-MRIjPdApjWA/Uk_jwhushnI/AAAAAAAAAPY/pUyMrhMeoLU/s1600/banner+ad+-+2.JPG" height="48" width="400" /></a></div>
<div align="center" class="MsoNormal" style="line-height: 25.05pt; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: center; text-autospace: none;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">www.patientpower.in</span></b></div>
<div align="center" class="MsoNormal" style="line-height: 25.05pt; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: center; text-autospace: none;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Family Physicians as Patient Advocates<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="line-height: 25.05pt; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: center; text-autospace: none;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Dr Jaya Bajaj<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="line-height: 25.05pt; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: center; text-autospace: none;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 14.05pt; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: center; text-autospace: none;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Advocacy is an important component of the doctor-patient
relationship. Family physicians may be a natural choice as patient advocates
because of the trust they have built over a long time</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 13.05pt; margin-bottom: 14.0pt; mso-layout-grid-align: none; text-align: justify; text-autospace: none;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">I grew up in a small town
and had the privilege of experiencing the kindness of our family doctor. My
siblings and I received all our vaccinations at his clinic and he would
graciously make home-calls when one of my grandparents got sick. I remember him
sitting next to me, reassuring that “everything will be alright” when I got
sick during my HSC board exams. When my grandfather developed heart disease, he
helped my father arrange medical care for him in the nearest town. He was
always available for answering our questions during the long hospitalization of
my grandfather. He even travelled to the hospital when my grandfather was
getting discharged and discussed the prognosis, discharge instructions;
medications etc. with the consulting cardiologist that he then proceeded to
explain to my father in simple terms. Any surprise that he took care of three
generations in our family? <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">These are the kinds of family physicians we had until a few
decades ago. “patient advocacy” and “patient-centred care” were not the terms I
remember being spoken then, but the family physician always put the patient’s
interests first. However the last few decades have brought significant changes
in medical care. The introduction of powerful medications, sophisticated
imaging procedures, and expensive diagnostic techniques has meant that
healthcare delivery has become a very complex process. Patients don’t always
consult family physicians first and many want a specialist consultation even
for minor ailments. The fragmentation in healthcare has actually led to a drop
in the quality of care and there is an increasing need for patient advocates to
protect the patient’s best interests and ensure the delivery of safe care. This
chapter looks at the role of family physicians as patient advocates.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">My
favourite description of family physicians is by Dr. Gayle Stephens, “Family
physicians know their patients, know their patients’ families, know their
practices, and know themselves.” Stephens describes patient management as “the
quintessential skill of clinical practice” and “the area of knowledge unique to
family physicians.” He distinguishes management from treatment, saying managing
implies, “alleviating most effectively the total impact of illness upon that
person.” <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Family
physicians are usually the first point of contact during an illness. Unlike
other medical specialists, who focus on specific diseases or organ systems,
family physicians specialize in seeing patients who may present with multiple
problems that are not slotted into a particular system. Ideally, family doctors
have a long-standing relationship with their patients and therefore have a
sound basis of understanding the patient’s perspectives and needs, so they can
offer options that meet their best interests. They have a holistic perspective,
because they are taught to put the patient first. Globally, healthcare systems
that are considered to provide the best quality care are the ones with strong
primary care, driven by family physicians. <o:p></o:p></span></div>
<div class="Pa9" style="margin-bottom: 2.0pt; margin-left: 0in; margin-right: 0in; margin-top: 8.0pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">When should family doctors act as patient advocates? </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Always! <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Recently,
one of my elderly relatives had to be hospitalized. In his mid 50s, he had been
in good health except for mild hypertension (high blood pressure) that was well
controlled with medicine. He had several episodes of diarrhoea overnight which
he attributed to dining outside. He had his morning tea and breakfast and took
his medication as he always does. Yet feeling sick, he decided to take the day
off, something he rarely did in the last couple of decades, and never for
health reasons. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">This surprised
his spouse as well as concerned her. A couple of hours later she noticed that
he looked pale and was unable to stay awake. She rushed him to a nearby
hospital, where he was diagnosed with acute renal (kidney) failure, atrial
fibrillation (irregular heartbeat), hypotension (low blood pressure as a result
of diarrhoea), cellulitis (soft tissue infection) in the leg and electrolyte
abnormalities (low sodium) leading to confusion. He was given intravenous
fluids and was examined by an internist and a surgeon, who recommended that he
be moved to a tertiary care centre because of the complexity of his illness. He
was immediately shifted to a tertiary care centre in a metropolitan city.
Needless to say, the family was in a state of shock over the developments of
the past 24 hours. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">At the
tertiary care centre, my relative was examined by an army of healthcare
professionals: internist, surgeon, and cardiologist, nutritionist,
physiotherapist, wound care specialists etc. His blood pressure medicine was
stopped and he had to be started on a new set of medicines, mainly antibiotics,
medicine to regulate his heart rate, blood thinner, antacids, multivitamins
etc. Over the next two days, when his infection subsided, he was no longer
confused, yet he complained of a persistent headache. <o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">After
multiple requests, the nurse came around to check his BP which was quite high
as the medical team had forgotten to restart his BP medicine. He was discharged
home with half a dozen medicines and instructions to follow-up with three
doctors who had seen him during his hospitalization. In retrospect, he could
have been spared this ordeal, had his family physician been a part of the
medical team. He would have added value by: <o:p></o:p></span></div>
<div class="Pa9" style="margin-bottom: 2.0pt; margin-left: 0in; margin-right: 0in; margin-top: 8.0pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Eliminating the medical jargon </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Healthcare
has a language of its own. Many times healthcare professionals don’t realize
how insidiously medical acronyms become a part of their normal lingo. A family
doctor who is aware of his patient’s health literacy can explain the diagnoses
in a language that the patient can understand, and prepare the patient for the
next course of action. An important part of this role is helping to curate and
interpret the almost overwhelming amount of information available to patients
today, thus helping them make intelligent personal choices for their own care. <o:p></o:p></span></div>
<div class="Pa9" style="margin-bottom: 2.0pt; margin-left: 0in; margin-right: 0in; margin-top: 8.0pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Strengthening the diagnostic process </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Healthcare
has become more complex and fragmented than ever. A family physician can
facilitate diagnoses in a timely manner by prioritizing problems. He can
educate patients about the best evidence-based treatments available, helping
them to make informed decisions about their care. For instance, in the case
cited above, the family physician could have picked up the warning signs of low
blood pressure and helped coordinate the future course of action. <o:p></o:p></span></div>
<div class="Pa9" style="margin-bottom: 2.0pt; margin-left: 0in; margin-right: 0in; margin-top: 8.0pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Communicating the diagnosis to the family </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">If the
patient so desires, the family doctor can explain to the patient’s family or
care-givers details about the disease and the available treatment options. He
can help patient select the best treatment options available by exploring the
resources and constraints of the patient and the care-givers. <o:p></o:p></span></div>
<div class="Pa9" style="margin-bottom: 2.0pt; margin-left: 0in; margin-right: 0in; margin-top: 8.0pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Offering resources to the patient and family </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">A serious
medical illness can be terrifying and disruptive to the patient, as well as the
patient’s family and care-givers. A family doctor can help patient and family
members tap into community resources. These could be local support groups,
expert patients, health libraries, reliable online information on patient’s
illness, and information on financial grants, as well as information on centers
offering such resources. <o:p></o:p></span></div>
<div class="Pa9" style="margin-bottom: 2.0pt; margin-left: 0in; margin-right: 0in; margin-top: 8.0pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Researching and choosing appropriate a healthcare team </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Family
doctors can help patients find the best possible healthcare team for their
needs, by keeping in mind the patient’s personal preferences and beliefs. <o:p></o:p></span></div>
<div class="Pa9" style="margin-bottom: 2.0pt; margin-left: 0in; margin-right: 0in; margin-top: 8.0pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Exploring alternate treatment options with patients </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13.0pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Patients
are often the first ones to discover “new treatment options” they want to
explore. Sometimes, patients are not able to discuss these with the specialist,
simply because of a lack of access to the specialist, many of whom are
unapproachable and inaccessible. A family doctor can help the patient sift
through relevant information and coach the patient on effective ways of sharing
the information with the specialist. In the case of my relative, the patient
was offered warfarin as a blood thinner for his heart condition. What the
specialist was not aware of was that the patient, who lived in a small village,
would not be able to get the basic monthly lab tests that are important for monitoring
patients on warfarin. A family physician who had this contextual information on
the patient, would have brought this to the specialist’s attention, and
suggested an alternate course of action. <o:p></o:p></span></div>
<div class="Pa9" style="margin-bottom: 2.0pt; margin-left: 0in; margin-right: 0in; margin-top: 8.0pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Ensuring continuity of care </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">An engaged patient-doctor team is needed to ensure continuity of
care. A huge proportion of medical errors can be attributed to communication
breakdowns because of healthcare silos. A family doctor can function as a team
leader, coordinating care between patient, family members, care-givers and
multidisciplinary healthcare providers, thus ensuring clear communication and
continuity of care. This is very important to providing patient-centered care.
Sadly, most medical students are never exposed to these concepts during their
medical education.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;"><o:p></o:p></span><br />
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><br /></span>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i></div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div class="separator" style="background-color: white; clear: both; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://patientpower.in/2013/" style="text-decoration: none;" target="_blank"><b><span style="color: black;">Register for the Conference Here</span></b></a></div>
</div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-79578763307403345152013-10-04T17:35:00.000+05:302013-10-04T17:35:04.339+05:30How Advocates Can Build Trust between Patients, Doctors and Hospitals<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.patientpower.in/"><img border="0" src="http://3.bp.blogspot.com/-gEn02wF09To/Uk6unetGNAI/AAAAAAAAAPI/nc98-U8WBxE/s1600/banner+ad+-+2.JPG" height="78" width="640" /></a></div>
<div style="text-align: center;">
www.patientpower.in</div>
<div style="text-align: center;">
<br /></div>
<div style="text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 14.05pt; margin-bottom: 14.0pt; mso-layout-grid-align: none; text-align: center; text-autospace: none;">
<b><span style="font-family: 'Gill Sans MT', sans-serif; font-size: 14pt;">Patient-advocates employed by hospitals need to be
trained in giving the patient what he is looking for</span></b><b><span style="font-family: 'Gill Sans MT', sans-serif; font-size: 13pt;">A Patient Has the Right to Select Her Advocate<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: 'Gill Sans MT', sans-serif; font-size: 13pt;">Sunita lives in an old-age home in Gurgaon, Delhi. Of late, her
worsening vision and unsteady walk have meant that she spends more of her time
indoors. Her daughter Kamla visits her a few times, every week. Kamla also
takes her mother out for doctors’ appointments. During her first appointment,
Sunita told her doctor, “Please communicate with my daughter on all
health-related matters. My daughter makes all those decisions and I like it
that way. She explains things in a way I can understand and, after all, she’s
the one who takes me around to all of my tests and appointments.</span><span style="font-family: 'Adobe Garamond Pro Bold', serif; font-size: 13pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Times are changing, and
hospitals, doctors and patients are changing too. As patients have become more
savvy and demanding, there is a need for patient-advocates to fill in the
service gaps that hospitals and doctors leave. While they may be great at
performing complex surgical procedures, doctors are often not very good at
providing tender loving care - and patients want to be hand-held when they are
ill. This is something that patient-advocates can do efficiently. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Today, when hospitals
advertise, they no longer flaunt their fancy buildings. Instead, they have
photos of their diva brand name star surgeons, dressed in crisp white coats and
stethoscopes, the idea being to entice patients with their pool of top medical
experts. After all, healthcare is a service and hospitals want to position
themselves as caring, credible service providers. Patients want to ensure that
they get the best medical advice from the top expert in the field, in a safe,
professionally-run hospital environment. As patients are becoming more aware,
they are asserting their rights, and have begun to expect doctors and hospitals
to take an interest in their well-being - and are willing to pay to get
top-notch services. 78 <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; page-break-before: always;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Patient
Advocacy Giving Voice to Patients <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The onus is now on doctors
and their medical teams to ensure that they provide premium quality service, so
they can build a relationship of trust with their patients. Doctors need to
accept that patients are consumers who can get turned off by hospitals that
offer poor-quality service - and go to the competing five-star hospital down
the road. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Typically, hospitals are
unfriendly places, which are designed for doctors and nurses - not for
patients. Often the left hand does not know what the right hand is doing; there
is little coordination; and patients are lost and confused. However, for
patients to have a positive experience in the hospital, it’s important that
they feel heard, understood and respected. One simple way patient advocates can
do this is by collating all medical updates and providing a summary daily
report card on their state of health. A tech-savvy patient advocate can set-up
an online patient portal, where family members can track the progress of the
patient. Using Skype, the patient (or the advocate or the relatives in the
hospital) can hold video conferences with friends and family members, wherever
they may be located. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">If you are not so
ambitious, you can setup a simple Facebook page for the duration of your
patient’s hospital stay, and this can serve as a very valuable online channel
which friends and relatives can use to stay in touch; remain updated; and
provide support, even if remotely. All you need to utilise this kind of a
service is a laptop. This can be especially useful for critically-ill patients
and their families. By providing such innovative, value-added features, you can
establish yourself as a credible, state-of-the-art healthcare brand. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 8pt 0in 0.0001pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Why hospitals are employing patient advocates </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Given the great value which
patient advocates can add, forward thinking hospital CEOs are now investing in
creating a team of patient advocates that patients can turn to in their time of
need. Patient advocates report directly to the CEO and act as ombudsmen. Smart
CEOs understand the value of improving the patient experience and know that
patient advocates can play an important role in both monitoring this and in
improving it. From that prominent and protected vantage point, patient
advocates spearhead efforts to improve care by scrutinizing untoward patient
experiences and advocating timely remedies. Patient advocates are
well-connected within the hospital, and are uniquely qualified to inform
patients and their families of other services available to them while they are
hospitalized, whether in terms of accessing additional health information at an
onsite consumer health library, the availability of spiritual support services,
or requesting a massage on your behalf. Patient advocates are very effective
brand ambassadors, which show that the hospital is a caring service provider
who puts patients first. Some hospitals assign a patient advocate to each
patient at the time of admission. This can be very comforting for a patient who
now has a trusted guide he can turn to in times of need. <o:p></o:p></span></div>
<div class="Pa4">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Patient advocates employed by
hospitals need to be trained <b>in giving the patient what he is looking for. </b>It
could be information, excellent service, compassionate staff, or technical expertise.
Let your patient-advocate forge partnerships that you can leverage as a service
provider. Even though their salary is being paid by the hospital, their primary
job is to delight patients. <o:p></o:p></span></div>
<div class="Pa4">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Good patient advocates share
hospital resources with patients freely and in a meaningful way. </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;">They must
understand that their role is to give patients time and a listening ear. <o:p></o:p></span></div>
<div class="Pa4">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">They go the extra mile in
reaching out to patients, e</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;">specially during an emergency. A patient
advocate can generate a lot of goodwill for the hospital by delighting patients
! <o:p></o:p></span></div>
<div class="Pa4">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The biggest worry an enlightened
hospital CEO has is how to manage unhappy patients. Many patients may
experience difficulties during their hospital stay, but are scared to
articulate these. They have concerns that are never communicated because they
are fearful of repercussions if they complain. They are afraid that the staff
will label them as a complainer and treat them badly. Hospitalization and
illness can be very stressful for the patient and it’s common to experience
emotions that may make it difficult for patients to express their needs and
concerns. They are scared that they might break down and cry; lose their temper
with a hospital staff member; feel intimidated and not say what they intended
to; or be labeled as difficult, which is why they are scared to speak up. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">They end up bottling their complaints, but this resentment can
build up, and can be expressed as violence against the hospital staff, in case
the patient suffers from a complication, or dies. Patients need someone other
than the hospital staff to speak for them, which is where the patient advocate
comes in. Bringing up concerns to the patient advocate is not viewed as being
complaining or making waves – it is viewed as an opportunity to provide you
with support, encouragement, and assistance. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Patient advocates are on call 24/7 - and their goal is to provide
you and your family with the best possible experience during the hospital stay.
A patient advocate is in hospital to help you – she is on your side and her job
is to make sure you are happy, so make the most of her services.<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="line-height: 25.05pt; margin-bottom: 90.8pt; mso-layout-grid-align: none; text-align: center; text-autospace: none;">
</div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-77656562995085650972013-10-03T09:00:00.000+05:302013-10-03T09:00:00.977+05:30Patient Advocate: Researching and Becoming an Expert<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
</div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://2.bp.blogspot.com/-koQ9vOucVbk/UkbAzi_0tuI/AAAAAAAAAOw/D-2fdM8MViI/s1600/for+fb+promotion+1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-koQ9vOucVbk/UkbAzi_0tuI/AAAAAAAAAOw/D-2fdM8MViI/s1600/for+fb+promotion+1.jpg" height="240" width="320" /></a></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Researching and Becoming an Expert<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">You must be actively involved in making decisions about your own
body.If you don’t understand the medical gobbledygook, the fault is not yours
--it’s the doctor’s<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Even the
most complicated concept in medical science can be simplified enough for a
layman to understand it. It is your doctor’s responsibility to explain your
health problem and your treatment choices to you in simple terms. This will
help you to make an informed decision about your treatment and this is
important for obtaining patient-centered healthcare. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">A good doctor must respect your intelligence, your desire to learn
about your medical condition and your ability to understand what procedures he
intends to carry out on you, so that you both can work together as a team in
order to find the best therapy available for you. If your doctor doesn’t have
the time or inclination to do so, or if your communication with your doctor is
like a one-way street, then this is a red flag that you need to find a new
doctor who is willing to actively engage you in your medical care. If this is
not possible, consider hiring a patient-advocate who will help you make sense
of your illness.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Medical
science rarely has straight forward solutions, and what works for one person
may not work for another. Every person is different, and everyone has different
preferences. There are very few cut-and-dried protocols in medicine which can
be universally applied to everyone. This means treatment of many diseases
demands a patient-tailored protocol, depending upon your individual
circumstances and wishes. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Good
doctors encourage your participation in your healthcare, so that you can make
an informed decision about what is right for you, according to your personal
circumstances, beliefs and priorities. For this to happen, you should also
strive to gain knowledge about your health problem. Being passive and dependent
upon your health care provider for all your treatment decisions will not help
you get the best medical care. You must do your own homework to find out what
your options are, so that you can make a well-informed decision, and select a
treatment protocol that you are comfortable with; which will improve your
quality of life and maximise your chances of a good outcome. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The
best-place to look for information is the internet, but not every site is
trustworthy. It’s a good place to start, although not a very good place to end
your search for the right information. It is important to double-check the
online information with your patient advocate, and consult reliable government
health web-sites because these are regularly updated with current information.
The US and the UK governments have been leaders in the field, and their sites (<span class="A6"><span style="font-family: "Arial","sans-serif"; mso-ansi-font-size: 10.0pt; mso-bidi-font-size: 10.0pt;">www.medlineplus.gov/ </span></span>and <span class="A6"><span style="font-family: "Arial","sans-serif"; mso-ansi-font-size: 10.0pt; mso-bidi-font-size: 10.0pt;">www.nhsdirect.nhs.uk/</span></span><i>) </i>are
very useful - please bookmark them. The Indian government has sadly been a
laggard in this field, but if you are looking for India specific information,
try the Ministry of Health and Family Welfare (<span class="A6"><span style="font-family: "Arial","sans-serif"; mso-ansi-font-size: 10.0pt; mso-bidi-font-size: 10.0pt;">www.mohfw.nic.in/</span></span>),
The Department of Health Research (<span class="A6"><span style="font-family: "Arial","sans-serif"; mso-ansi-font-size: 10.0pt; mso-bidi-font-size: 10.0pt;">www.dhr.gov.in/</span></span>),
and The Indian Council of Medical Research (<i><a href="http://www.icmr.nic.in/">www.icmr.nic.in/</a></i>).
<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">When you
are in hospital, here is what you need to know about your medical records: Make
sure you have copies of all your medical records- they are legally your
property. You can give the doctor photocopies of your original reports for his
files but keep the originals with you. They are worth their weight in gold.
Also make sure that you understand what’s in your medical records- you must be
able to make sense of your doctor’s hieroglyphics,, so you can explain your
diagnosis and treatment to another doctor, if you need to take a second
opinion. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="Pa4" style="text-align: justify;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Read up
on your condition: </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Read as much as you can about your problem. A good doctor will arm
you with printed material to read at home. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Read up on the doctor: </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;">You have the right to know the
name of the doctor(s) treating you, their professional qualification, their
special interests and their respective track records. If this information is
inaccessible or not shared on the hospital website, you may need to dig deeper.<o:p></o:p></span></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">If you
think you are not receiving the information or the level of care that you are
entitled to, you can demand a transfer to another facility. <o:p></o:p></span></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Additionally,
you have the right to be informed of the possible financial implications of a
proposed treatment plan at the time of admission. If there is a change in the
medical condition or treatment protocol, and your costs are likely to rise, you
should be told about this in advance and not be presented with an inflated bill
later. You can accept or refuse any part of your treatment, after being
informed of its risks, benefits and likely consequences. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Remember that you are always free to seek discharge against
medical advice, if your dissatisfaction with the doctor or the hospital is
extreme. You may be asked to sign a ’Discharge against Medical Advice (AMA)’
form, but you can’t be forced to stay in the hospital against your wishes - and
if the hospital tries to do this (for example, by insisting that you have to
clear all your hospital bills before they will let you leave), they are
committing a criminal offense).<o:p></o:p></span><br />
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><br /></span></div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i></div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://patientpower.in/2013/" style="color: #999999; text-decoration: none;" target="_blank">Register for the Conference Here</a></div>
<br />
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-8782694741997702662013-10-01T09:00:00.000+05:302013-10-01T09:00:00.731+05:30Patient Advocacy: How to be your own advocate<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://2.bp.blogspot.com/-koQ9vOucVbk/UkbAzi_0tuI/AAAAAAAAAOw/D-2fdM8MViI/s1600/for+fb+promotion+1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-koQ9vOucVbk/UkbAzi_0tuI/AAAAAAAAAOw/D-2fdM8MViI/s1600/for+fb+promotion+1.jpg" height="240" width="320" /></a></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">How to be Your Own Advocate<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">In order to get the best treatment for yourself, you must
changefrom being a passive participant to becoming an active advocate foryour
own health<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Most
patients in India put their doctors on a high pedestal, thus opening themselves
to abuse in case they happen to fall into the hands of incompetent or
unscrupulous doctors. The only way to prevent this from happening is to either
assume full responsibility for your own care, or assign it to someone whom you
completely trust, such as a patient-advocate. That said, there’s a lot you can
do for yourself and you don’t need to outsource advocacy to someone else every
time you see your doctor. You just need to master a set of skills, so that you
are empowered to act as your personal patient advocate. For starters, here are
some resources that you might find useful: <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 8pt 0in 0.0001pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Book Resources</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<i><span style="font-family: Arial, sans-serif; font-size: 10pt;">Hundreds
of Life-Saving Facts, Action Steps and Strategies You Need to Know </span></i><span style="font-family: Arial, sans-serif; font-size: 10pt;">by Dr.
Julia A. Hallisy offers sensible advice on how to lower your risk of being the
victim of a medical mistake, get a second opinion, and safeguard against
hospital-borne infections. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<i><span style="font-family: Arial, sans-serif; font-size: 10pt;">Health
Power 101: The Complete Guide to Patient Empowerment </span></i><span style="font-family: Arial, sans-serif; font-size: 10pt;">by
Jeffrey Brown will teach you about common health problems, medical tests, and
the importance of the early detection of chronic diseases.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 8pt 0in 0.0001pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Online Resources </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Every Patient’s Advocate: (<i>www. trishatorrey.com</i>) provides
information on how to receive better care<o:p></o:p></span></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The
Empowered Patient: (<i>www. theempoweredpatient.com</i>) gives tips on how to
effectively communicate with medical staff-members. <o:p></o:p></span></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Let’s
take the case of Prashant S Dhananka, the Infosys employee who spiritedly
argued his case from a wheelchair after his botched up chest surgery 19 years
ago that left him paralysed from the waist down. The compensation awarded to
him by the Supreme Court was less than the Rs 7 crore he sought, but the
highest paid in India to date - Rs 1 crore. During his trial the software
engineer gave vivid details of the gross negligence he suffered at Nizam’s
Institute of Medical Sciences (NIMS), Hyderabad. You may like to go through the
details of this case (<span class="A6"><span style="font-family: "Arial","sans-serif"; mso-ansi-font-size: 10.0pt; mso-bidi-font-size: 10.0pt;">www.
indiankanoon.org/doc/57638/</span></span>) in order to understand how and why
sometimes things can go so grossly wrong between a patient and a doctor. <o:p></o:p></span></div>
<div class="Pa9" style="margin-top: 8pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">The ABC
of doctor-patient talk<o:p></o:p></span></b></div>
<div class="Default">
<br /></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The first
skill you need to learn is how to talk to your doctor, so that he listens to
what you have to say. Experts recommend the ‘ABC’ model for patients if you
need to be your own advocate, where: <o:p></o:p></span></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">A stands
for Asking the right questions of the doctors who are treating you; <o:p></o:p></span></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">B is for
Being prepared, so you are armed with knowledge about the disease afflicting
you; and <o:p></o:p></span></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">C is
voicing your Concerns to the doctor, so he can address them. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">In order to save your time, and your doctor’s, the Patient
Advocate Foundation (PAF) in the US encourages patients to go to a doctor with
a prepared list of questions such as:<o:p></o:p></span></div>
<div class="Default">
<br /></div>
<div class="Default">
<b><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">What is the goal of my treatment? <o:p></o:p></span></b></div>
<div class="Default" style="margin-left: .5in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">What
are my treatment options? <o:p></o:p></span></div>
<div class="Default" style="margin-left: .5in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">What
is your experience with the treatment of this disease? <o:p></o:p></span></div>
<div class="Default" style="margin-left: .5in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">How
will I receive this treatment? <o:p></o:p></span></div>
<div class="Default" style="margin-left: .5in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">What
will it cost me? <o:p></o:p></span></div>
<div class="Default" style="margin-left: .5in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;"> </span></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">At times,
if the doctor, for whatever reasons, is not very forthcoming with the
information that you seek, it helps to be a little assertive. It’s important to
trust your doctor - but you need to verify his information is reliable. You can
validate it by checking with other medical experts, and seeking out patient
support groups and expert patients. <o:p></o:p></span></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Share
your health history. It’s important to be honest with your doctor. Inform her
about all the treatment protocols that you are following, including alternative
treatment plans. Have you checked out <i>www.healthvault.com</i>? Open a secure
personal account on the site to organise your medical records, imaging films,
test results, doctor’s appointments, and even your children’s immunisation
records. You can save and store your medical history, your past and current
medications, allergies, family history, and daily blood pressure and blood
sugar readings. <o:p></o:p></span></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">When in
doubt, seek a second (or third) opinion. Also, don’t hesitate to negotiate your
final medical bill. If you are financially strapped, many doctors offer a
discount on their consultation fee. <o:p></o:p></span></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">In
everything that you do, remember that you do not need to be aggressive. There
is a world of a difference between being assertive and being aggressive. While
the first approach will get you quick results, the second will only serve to
antagonise your doctor. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">You will
find valuable information on improving doctor-patient communication from my
blog entries listed below: <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Dr.Malpani’s Blog: <i>How to talk so your doctor </i>will listen (<i>blog.drmalpani.com/2012/09/how-to-talk-so-your-doctor-will-listen.html</i>)<o:p></o:p></span></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Where I
talk about cultivating a source inside the doctor’s clinic, seeking other
references, and the importance of taking a friend along to your appointment
with the doctor. <o:p></o:p></span></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Dr.Malpani’s
Blog: How to talk so <i>your doctor </i>honest (<i>blog.drmalpani.com/2012/11/how-to-keep-your-doctor-honest.html</i>)
<o:p></o:p></span></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Ask for
video documentation of any surgical intervention and if your doctor is
reluctant to share this information, this is a red flag which should cause
concern. <o:p></o:p></span></div>
<div class="Pa4" style="text-align: justify;">
<i><span style="font-family: Arial, sans-serif; font-size: 10pt;">Dr.Malpani’s
</span></i><span style="font-family: Arial, sans-serif; font-size: 10pt;">Blog: Why patients need to SPEAK UP! (<i>blog.drmalpani.com/2012/08/why-patients-need-to-speak-up.html</i>)
<o:p></o:p></span></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The more questions
you ask about your treatment, the more careful your doctor will be about how he
treats you. Talking builds trust and leads to better results, quality, safety<i>,
</i>and satisfaction. <o:p></o:p></span></div>
<div class="Pa4" style="text-align: justify;">
<i><span style="font-family: Arial, sans-serif; font-size: 10pt;">Dr.Malpani’s
<span class="A6"><span style="font-family: "Arial","sans-serif"; mso-ansi-font-size: 10.0pt; mso-bidi-font-size: 10.0pt;">Blog: How to talk to your doctor SAFELY </span></span></span></i><span style="font-family: Arial, sans-serif; font-size: 10pt;">(<i>blog.drmalpani.com/2005/10/how-to-talk-to-your-doctor-safely.html</i>):
<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">SAFE is an easy to remember acronym, which will help you
communicate your fears and expectations to your doctor, so he can address them.
Here S stands for your story, A for assessments, F for fears and E for
expectations.<o:p></o:p></span></div>
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><br clear="all" style="mso-special-character: line-break; page-break-before: always;" />
</span>
<br />
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i></div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://patientpower.in/2013/" style="color: #999999; text-decoration: none;" target="_blank">Register for the Conference Here</a></div>
</div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com1tag:blogger.com,1999:blog-3066802566710610263.post-57436998735778040622013-09-29T09:00:00.000+05:302013-09-29T09:00:00.500+05:30Patient Advocacy: How I Became a Patient Advocate<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://1.bp.blogspot.com/-koQ9vOucVbk/UkbAzi_0tuI/AAAAAAAAAOs/dd563DJJJyU/s1600/for+fb+promotion+1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/-koQ9vOucVbk/UkbAzi_0tuI/AAAAAAAAAOs/dd563DJJJyU/s1600/for+fb+promotion+1.jpg" height="240" width="320" /></a></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">How I Became a Patient Advocate</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Prabhakar Rao<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">A father recalls the tragedy of the untimely death of his son -
and how this gave birth to JASCAP</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">AS far
back as I can remember, I’ve always volunteered to play an advocate to someone
or the other. Over the years, I’ve helped a fairly large number of young people
launch or advance their careers and this was done by being their advocate and
mentoring them. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">But,
first things first. Let me introduce myself first. I am a textile technologist
from Bombay University and have spent over forty years in business and industry
in India and abroad. I started, like everyone else does, I suppose, at the
bottom of the pyramid and rose rather rapidly to senior and then chief
executive positions.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Many a
times, youngsters who had worked with me or came in contact with me requested
help in getting placements or promotions and I enjoyed playing the role of
their advocate and helping them succeed. In May 1996, my only son, 30-year-old
Satyajit, died of cancer in the United States where he was working as a
software engineer. I was 60 then and this tragic event shattered our life and
turned it topsy-turvy. I was then the chief executive of a textile company in
Mumbai.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">While in
the US and performing the last rites of my son, I came across a fairly large
number of brochures, pamphlets and booklets on cancer in general and on
lymphoma; the cancer that took him from us. He must have sought that literature
from various cancer support organizations to help him cope with his cancer and
its subsequent treatment. Browsing through that literature during that trip to
the US, a germ of an idea took root in my mind. Upon our return to India, I
gave up my job and my wife Neera and I decided to transcend our grief into a
socially useful project to help cancer survivors in some meaningful way. We set
up a charitable trust to help cancer patients in Mumbai. That marked the birth
of “Jeet Association for Support to Cancer Patients” (JASCAP), a voluntary
organization dedicated to cancer patients, their families and friends. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 8pt 0in 0.0001pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Briefly, our objectives at JASCAP are: <o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin: 8pt 0in 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">To comfort and counsel cancer patients and their families and
instill in them the confidence, courage and determination to fight this
life-threatening disease, thus rendering their medical treatment more effective
<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">To inform and educate cancer patients and their families about the
various treatment options; and their respective physical and emotional side
effects and how to cope with these <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">To help patients and their families do everything possible to
cooperate fully with the medical care team and thus assist themselves towards a
possible cure or to live life as comfortably as possible with this disease <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">To prepare and disseminate printed and audio-visual material
dealing with cancer and its after effects to better prepare cancer patients and
their families to face this disease and remove or alleviate fears, especially
those based on misconceptions and incomplete understanding of the medical
issues confronting them <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin: 8pt 0in 0.0001pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">To achieve some of these objectives, we have taken the following
initiatives: </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Obtain and disseminate up-to-date and accurate information about
cancer, its causes and methods of treatment, medical as well as non-medical <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">To prepare, print, publish and circulate pamphlets, booklets,
slides, posters and other educational material, in English, Marathi, Hindi and
other Indian languages, in order to provide patients and their families with
accurate, scientific, medical and clinical information and knowledge about
cancer; the different methods of treatment, control and post-treatment care
plans for the patients <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">To provide guidance, help, counseling, support and comfort to patients
in various forms in order to pave the way for their rehabilitation into the
community <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">To enlist support of medical professionals, pharmaceutical
manufacturers, social workers, voluntary organizations, government
institutions, dispensaries, hospitals, medical centers; in India and abroad in
fulfilling these objectives of JASCAP <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">To collect funds by way of membership fees/donations as also
gifts, books, equipment and audio-visual communication/education aids for
patients and those around them, as well medicines for patients in need of these
supplies <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">To recruit social workers, nurses and volunteers from the medical
profession, who are interested in lending their support to JASCAP and
strengthen our activities with lectures, seminars and study classes.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">65 11. How I Became a
Patient Advocate <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; page-break-before: always;">
<br /></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">To build strong linkages and partnerships with institutions and
other voluntary/ governmental organizations, hospitals, in India and abroad
that are working for similar causes in order to further the objectives of
JASCAP <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">To carry out public health activities such as supporting
anti-tobacco campaigns, in order to make our society cancer-free <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Pledging
and pooling in my limited financial resources, we founded JASCAP. Friends and
well-wishers scoffed at the idea first, but seventeen years down the line, the
response from cancer-affected patients, the medical fraternity and the
voluntary sector has been overwhelming, and this has reinstated our faith in
JASCAP and the objectives that we set out to achieve. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Our first
big break came in 2001, when the Tata Memorial Hospital at Parel, Mumbai
offered to house us in the hospital premises and despite the space crunch they
faced, allowed us to set-up a small book counter where we could distribute
literature on cancer. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Initially,
all this literature was only available in English, but gradually over the
years, we have managed to have a bulk of it translated in regional languages,
namely Hindi, Marathi, Gujarati, Bengali, Kannada, Tamil and Malayalam. This,
we felt was important, as most patients at Tata Memorial land up from different
parts of the country. Since we could not afford the fees of professional
translators, we sought help from volunteers in crossing this major linguistic
barrier. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The cost
of printing was another big challenge confronting us, besides editing the raw
material, type-setting and proof-reading – but with God’s grace, help kept
pouring in from unexpected quarters and we managed to remain afloat. By fighting
to keep our costs low, we have been able to offer our booklets at extremely
nominal prices to needy patients and their families. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Since we
cannot order a huge print run – because our booklets have to be routinely
updated to keep pace with the new medical breakthroughs – we often struggle to
keep a tight leash on our costs, without sacrificing the value we bring to our
readers. We take inspiration from the millions of other Indians who are
excellent in getting the biggest bang for their buck! <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Small
wonder that until 2012, JASCAP has distributed over 200,000 booklets. We also
offer video CDs and in 2011 we crossed another milestone in launching our
website <i>www.jascap.org</i>, from where our booklets can be downloaded
free-of-cost in different languages. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">At times,
we also arrange financial assistance to poor cancer patients by putting them in
touch with various funding organizations that are doing a yeoman’s job in this
area. As a small unit, we are nimble and try and respond to patients’ needs
promptly. We also do one-on-one counseling with cancer patients and their
families. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">We have
trained counselors amongst our staff and volunteers for this role. To be
honest, the role is more of a LISTENER than a COUNSELLOR, but we have figured
out that listening with empathy is what patients and their families require the
most during this difficult hour. In rare circumstances, we also arrange peer
and expert counseling for patients and their caregivers. The literature that we
distribute covers information-gaps in the following areas of interest: <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Sources of financial assistance for needy cancer patients <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Accommodation options available in Mumbai for patients coming from
different parts of the country <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Location of free or inexpensive eateries for the accompanying
caregivers <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Assistance in paper work relating to admission into Tata Memorial
Hospital <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Navigating through the various services that Tata Memorial
Hospital offers <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Emotional support avenues <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Although
a lot has been achieved, we at JASCAP realize that a lot remains undone as
well. We would, for instance, like to set-up a patient helpline with a toll
free number. The helpline staff could provide information about: <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Other hospitals in Mumbai that treat cancer patients <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Consultants and oncologists in private practice <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Diagnostic centers for running pathological tests for which there
is a long queue at Tata Memorial <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Medical stores that deal exclusively in oncology drugs, provisions
and prostheses <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Individuals and organizations offering financial assistance to
cancer patients <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Affordable accommodation options <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Blood banks and blood donors <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Rehabilitation centers for after-care, once the treatment is over.
<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Organizations helping in gainful employment of cancer survivors <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Hospices for terminally-ill patients <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Dealers in medical and supportive equipment such as beds, walkers,
bedpans, oxygen cylinders and so on <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The road is long. But, we at JASCAP are determined to soldier on.<o:p></o:p></span><br />
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><br /></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i></div>
<div style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://patientpower.in/2013/" style="color: #999999; text-decoration: none;" target="_blank">Register for the Conference Here</a></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-56064241202275854512013-09-26T15:10:00.001+05:302013-09-26T15:10:41.485+05:30Patient Advocacy: Caring for the Bereaved<div dir="ltr" style="text-align: left;" trbidi="on">
<h3 class="post-title entry-title" itemprop="name" style="background-color: white; color: #cc6600; font-family: Georgia, serif; font-size: 18px; font-weight: normal; line-height: 1.4em; margin: 0.25em 0px 0px; padding: 0px 0px 4px;">
Patient Advocacy:Caring for the Bereaved</h3>
<div class="post-header" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px;">
<div class="post-header-line-1">
</div>
</div>
<div class="post-body entry-content" id="post-body-2829817520208549882" itemprop="description articleBody" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 1.6em; margin: 0px 0px 0.75em;">
<div dir="ltr" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.patientpower.in/" style="color: #999999; text-decoration: none;" target="_blank"><img border="0" height="240" src="http://3.bp.blogspot.com/-RJUpLhRuZLU/UkP-9cS7JXI/AAAAAAAAEXo/goPzcu-gME8/s1600/for+blog.jpg" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" width="320" /></a></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 14pt;"><br /></span></b></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 14pt;">As a patient-advocate you must learn to identify the various stages of grief as you help the family cope with their loss<o:p></o:p></span></b></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Talking about death is never easy. In <i>A Grief Observed</i>, author C.S. Lewis writes about his experience of his wife’s death, “No one ever told me that grief felt so like fear. I am not afraid, but the sensation is like being afraid. The same fluttering in the stomach, the same restlessness, the yawning, I keep on swallowing. At other times it feels like being mildly drunk or concussed. There is a sort of invisible blanket between the world and me. I find it hard to take in what anyone says... Yet I want the others to be about me.”<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Everyone experiences bereavement at some point in life, but when it’s sudden and unexpected, the loss can be tremendous. The news can come as a big shock, completely throw a person off-balance and overwhelm him by a rush of emotions. As a patient-advocate, you can lessen someone’s grief by bearing in mind the following principles of care:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Contact relatives promptly and stay with the family throughout, while liaisoning with the rest of the medical and nursing team.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;"> </span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Make available special provisions for the bereaved family, including a quiet place to mourn, and help them access spiritual support.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="Default">
<br /></div>
<div class="Default">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">When bad news is delivered, it must be done gently and honestly, avoiding euphemism and long-winded medical explanations.<o:p></o:p></span></div>
<div class="Default">
<br /></div>
<div class="Default">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Provide both verbal and written information to the survivors: what to do next; mortuary procedures, possibility of a post-mortem examination; organ donation, if the family is interested or the deceased had expressed that wish; and details about grief counselling; and follow-up.<o:p></o:p></span></div>
<div class="Default">
<br /></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Grief creates a whirlwind of emotions, and can be a highly traumatic and devastating experience for some, leaving them incapacitated to deal with the reality of the situation. This is when an advocate’s help is needed the most.<o:p></o:p></span></div>
<div class="Pa9" style="margin-top: 8pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">The various stages of grief<o:p></o:p></span></b></div>
<div class="Default">
<br /></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">As a patient-advocate you must learn to identify the various stages of grief as you help the family cope with their loss. In her pioneering 1969 book <i>On Death and Dying </i>Elisabeth Kübler- Ross identifies the following five stages of grief:<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Denial<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Anger<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Bargaining<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Depression<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Acceptance<o:p></o:p></span></div>
<div class="Default">
<br /></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The intensity and duration of each stage depends on the significance of the change or loss, and also the survivor’s personal resilience. Patient-advocates should use the following eight-step framework to help bereaved families:<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Select an appropriate setting<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Contact the family<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Prepare to speak to the family<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Tell them about the death, as gently as possible<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Study their reactions<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Allow them to view the body and stay close to them<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;"> </span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Co-ordinate the respectful handling of the deceased’s body<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Assist them in follow-up actions, such as organ donation, arranging the post-mortem, getting the death certificate, preparing for the cremation, and so on.<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;"> </span></div>
<div class="Pa9" style="margin: 8pt 0in 0.0001pt; text-indent: 0in;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;"> </span></span></b><b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Notifying death<o:p></o:p></span></b></div>
<div class="Default">
<br /></div>
<br /><div class="MsoListParagraph" style="margin-bottom: 0.0001pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Breaking bad news is one of the most difficult and sensitive tasks that healthcare professionals have to perform, and poor communication skills can leave families confused, angry, scared and scarred. Patient-advocates must avoid elaborate euphemisms. Equally harsh in the Indian context are words such as dead or died. Use soft phrases such as “he has passed on,” “he has slipped away” and “we have lost her” and deliver those words sensitively.<o:p></o:p></span><br /><span style="font-family: Arial, sans-serif; font-size: 10pt;"><br /></span><i>The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i><br /><i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i><br /><div class="separator" style="clear: both; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://patientpower.in/2013/" style="color: #999999; text-decoration: none;" target="_blank">Register for the Conference Here</a></div>
</div>
</div>
</div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-46671256287677700762013-09-25T15:00:00.000+05:302013-09-25T15:00:02.919+05:30Patient Advocacy: Caring for the Bereaved<div dir="ltr" style="text-align: left;" trbidi="on">
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://2.bp.blogspot.com/-_o_lrT3DrkY/UkFpIJom-mI/AAAAAAAAAOM/NqqdrqZx0MA/s1600/for+blog.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-_o_lrT3DrkY/UkFpIJom-mI/AAAAAAAAAOM/NqqdrqZx0MA/s1600/for+blog.jpg" height="240" width="320" /></a></div>
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><br /></span></b>
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><br /></span></b>
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">As a patient-advocate you must learn to identify the various
stages of grief as you help the family cope with their loss</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Talking
about death is never easy. In <i>A Grief Observed</i>, author C.S. Lewis writes
about his experience of his wife’s death, “No one ever told me that grief felt
so like fear. I am not afraid, but the sensation is like being afraid. The same
fluttering in the stomach, the same restlessness, the yawning, I keep on
swallowing. At other times it feels like being mildly drunk or concussed. There
is a sort of invisible blanket between the world and me. I find it hard to take
in what anyone says... Yet I want the others to be about me.” <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Everyone
experiences bereavement at some point in life, but when it’s sudden and unexpected,
the loss can be tremendous. The news can come as a big shock, completely throw
a person off-balance and overwhelm him by a rush of emotions. As a
patient-advocate, you can lessen someone’s grief by bearing in mind the
following principles of care:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 10pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Contact relatives promptly and stay with the family throughout,
while liaisoning with the rest of the medical and nursing team. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 10pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Make available special provisions for the bereaved family,
including a quiet place to mourn, and help them access spiritual support. <o:p></o:p></span></div>
<div class="Default">
<br /></div>
<div class="Default">
<span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">When
bad news is delivered, it must be done gently and honestly, avoiding euphemism
and long-winded medical explanations. <o:p></o:p></span></div>
<div class="Default">
<br /></div>
<div class="Default">
<span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Provide
both verbal and written information to the survivors: what to do next; mortuary
procedures, possibility of a post-mortem examination; organ donation, if the
family is interested or the deceased had expressed that wish; and details about
grief counselling; and follow-up. <o:p></o:p></span></div>
<div class="Pa4" style="text-align: justify;">
<br /></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Grief
creates a whirlwind of emotions, and can be a highly traumatic and devastating
experience for some, leaving them incapacitated to deal with the reality of the
situation. This is when an advocate’s help is needed the most. <o:p></o:p></span></div>
<div class="Pa9" style="margin-top: 8pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">The
various stages of grief </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">As a
patient-advocate you must learn to identify the various stages of grief as you
help the family cope with their loss. In her pioneering 1969 book <i>On Death
and Dying </i>Elisabeth Kübler- Ross identifies the following five stages of
grief: <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="Default" style="margin-left: 0in; mso-list: l1 level1 lfo2; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Denial
<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; mso-list: l1 level1 lfo2; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Anger
<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; mso-list: l1 level1 lfo2; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Bargaining
<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; mso-list: l1 level1 lfo2; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Depression
<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; mso-list: l1 level1 lfo2; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Acceptance
<o:p></o:p></span></div>
<div class="Default">
<br /></div>
<div class="Pa4" style="text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The
intensity and duration of each stage depends on the significance of the change
or loss, and also the survivor’s personal resilience. Patient-advocates should
use the following eight-step framework to help bereaved families: <o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; mso-list: l0 level1 lfo3; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Select
an appropriate setting <o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; mso-list: l0 level1 lfo3; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Contact
the family <o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; mso-list: l0 level1 lfo3; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Prepare
to speak to the family <o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; mso-list: l0 level1 lfo3; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Tell
them about the death, as gently as possible <o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; mso-list: l0 level1 lfo3; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Study
their reactions <o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; mso-list: l0 level1 lfo3; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Allow
them to view the body and stay close to them <o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; mso-list: l0 level1 lfo3; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;"> </span></div>
<div class="Default" style="margin-left: 0in; mso-list: l0 level1 lfo3; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Co-ordinate
the respectful handling of the deceased’s body <o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; mso-list: l0 level1 lfo3; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;">Assist
them in follow-up actions, such as organ donation, arranging the post-mortem,
getting the death certificate, preparing for the cremation, and so on. <o:p></o:p></span></div>
<div class="Pa9" style="margin: 8pt 0in 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;">
</span></span></b><!--[endif]--><b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Notifying death <o:p></o:p></span></b></div>
<div class="Default">
<br /></div>
<br />
<div class="MsoListParagraph" style="margin-bottom: 0.0001pt; text-indent: 0in;">
<!--[if !supportLists]--><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; mso-fareast-font-family: Arial;"><span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span style="font-family: Arial, sans-serif; font-size: 10pt;">Breaking bad news is one of the most difficult and sensitive tasks
that healthcare professionals have to perform, and poor communication skills
can leave families confused, angry, scared and scarred. Patient-advocates must
avoid elaborate euphemisms. Equally harsh in the Indian context are words such
as dead or died. Use soft phrases such as “he has passed on,” “he has slipped
away” and “we have lost her” and deliver those words sensitively.</span><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt;"><o:p></o:p></span><br />
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><br /></span>
<div style="color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px;">
<i style="font-family: Georgia, serif; line-height: 20.796875px; text-indent: 0in;">The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i></div>
<div style="color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i></div>
<div class="separator" style="clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div style="color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<i></i><br /></div>
<div class="separator" style="clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; text-align: center;">
<a href="http://www.patientpower.in/">Register for the Conference Here</a></div>
<div>
<br /></div>
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><br /></span></div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0Mumbai20.3034175184893 73.125-6.7140909815107008 31.816406 47.3209260184893 114.433594tag:blogger.com,1999:blog-3066802566710610263.post-12255520314149848382013-09-24T15:44:00.003+05:302013-09-24T15:44:57.942+05:30Patient Advocacy: How to Deliver Bad News<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://1.bp.blogspot.com/-nqxXVu7zhuk/UkFlb7ZUA3I/AAAAAAAAAOA/0_G_psKsFlU/s1600/for+blog.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/-nqxXVu7zhuk/UkFlb7ZUA3I/AAAAAAAAAOA/0_G_psKsFlU/s1600/for+blog.jpg" height="300" width="400" /></a></div>
<div align="center" style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 25.05pt; margin-bottom: 90.8pt; text-align: center;">
<b><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">One of the main goals of a patient advocate is to support grieving families in accordance with their cultural values and personal preferences</span></b></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; margin-bottom: 0.0001pt; text-align: justify;">
<span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">One of the most challenging tasks for patient-advocates is to deliver bad news about impending death to a family. It is never an easy task, even for the most seasoned of healthcare professionals.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; margin-bottom: 0.0001pt; text-align: justify;">
<span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">Dr Sudhir Bhatia, a senior internal medicine resident receives the lung biopsy results for Tushveen Khanna, an attractive 26-year-old patient, who has her whole life ahead of her and is busy shopping for her wedding planned for next month. Khanna’s test results show she has an advanced stage of lung cancer.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; margin-bottom: 0.0001pt;">
<span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">According to standard medical protocol, Dr Bhatia orders a PET scan and requests a consultation with a cancer specialist. An hour later, a nurse phones to inform him that the distraught patient has refused to undergo the PET scan until she sees her doctor. It suddenly strikes Dr Bhatia that no one from his team has discussed the biopsy results with the young woman and prepared her for what lies ahead. Sometimes, doctors are so focussed on “treating” abnormal test results that they forget about the patient.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; margin-bottom: 0.0001pt;">
<br /></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; text-align: justify;">
<span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">When he finally gets to see her that evening, Dr Bhatia finds her sleeping, with a young man keeping a watchful vigil over her. Dr Bhatia gently wakes up the patient. “Hello, Ms. Khanna. I’m sorry to wake you, but I need to speak with you about your biopsy results. Unfortunately, it’s positive. I’m afraid it looks like you have lung cancer. We need to run another check on you, a PET scan, which would determine the spread of the cancer, but the nurse told me that you have refused it. Meanwhile, I’ve asked Dr Mukhesh Batra, who is a specialist in lung cancer to also come and examine you. Do you have any questions?”</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; text-align: justify;">
<span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">The girl looks at him wide-eyed and scared. Her fiancé is equally bewildered. For a brief moment, they are both silent. Then finally, he speaks up, “I thought she had pneumonia. Now all of a sudden she has cancer?”</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; text-align: justify;">
<span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">Before Dr Bhatia can respond, the poor girl bursts into tears and exclaims, “I don’t want to get any more tests done! I just want to go home!” “She is right. We just want a discharge,” says the young man.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; text-align: justify;">
<span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">Their reaction catches Dr Bhatia off guard. Didn’t the news sink in? Didn’t the girl and her fiancé understand what he has just told them about the biopsy results? Suddenly he is unsure what to do next. He has three more patients to see before he can leave for dinner and home. He tries to calm down the young girl and persuades her to get the test done, but she adamantly digs her heels in. Dr Bhatia suddenly feels helpless and cannot understand why the patient is being so uncooperative. He tries to hide his frustration as he decides to leave to find the oncologist and get him to talk to his distraught patient.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; text-align: justify;">
<span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">No marks for guessing where things went wrong in the first place.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; margin-top: 8pt;">
<b><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">Is it necessary to tell the patient?</span></b></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; text-align: justify;">
<span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">The answer is yes.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; margin-bottom: 0.0001pt;">
<span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">Fifty years ago, it was standard practice in India to withhold the diagnosis of advanced cancer from a patient. Often the relatives themselves pleaded with the doctor to hide the truth from the patient, because they were worried that the patient would not be able to digest the “shock.”</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; margin-bottom: 0.0001pt;">
<br /></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; text-align: justify;">
<span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">However, mindsets have now matured. Studies have shown that patients do want to have the correct diagnosis, even if it is bad news, because they don’t want doctors and family members to play games with them. It is important that patients are given all the medical facts, especially about their own health. They have a right to know, so that they can make informed choices about their medical, personal and legal matters.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; text-align: justify;">
<span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">Undoubtedly, breaking bad news to critically-ill patients can be a challenging task but for the healthcare professional, it’s an occupational hazard that comes with the territory. For a young and inexperienced physician, it can be particularly stressful, especially when the patient, as in this case, is young and there are limited prospects for recovery.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; text-align: justify;">
<span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">This is where a patient advocate can help. She can help all the stakeholders - the doctor, the patient and the family - in managing the medical crisis by providing truthful and accurate information about possible health outcomes, without deflating the patient’s hopes for recovery. Indeed, breaking bad news kindly and managing a patient’s expectations is one of the most important tasks that a patient advocate can discharge. The advocate has to be wise like the Roman God, Janus, and be able to see both the doctor’s perspective, as well as the patient’s, so they can both talk with each other.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; margin-top: 8pt;">
<b><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">Stick to the medical facts</span></b></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; text-align: justify;">
<span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">Patient advocates might find these tips on how to soften the blow useful…Start from what the patient understands. Begin at his level and use words that are devoid of medical jargon, so that a lay person can understand them easily.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Try to substitute non-technical words such as “spread” for “metastasised” and “sample of tissue” for “biopsy.”</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Avoid careless bluntness (e.g., “You are at the terminal stage and unless you get prompt treatment, you are going to die.”). Even if this happens to be the crux of your message, it has to be cloaked in sensitive language.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px;">
<br /></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Hand out information in small, digestible chunks and check periodically to ensure that the patient has understood what you are saying. You may need to repeat what you say, in order to ensure that the information sinks in, so be patient.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px;">
<br /></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0.5in;">
<span style="font-family: Symbol; font-size: 10pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">When the prognosis is poor, avoid phrases such as “There is nothing more we can do.” The truth is that there is always something which can be done to help the patient and even if we cannot cure, we can always relieve pain and suffering. Unkind, fatalistic pronouncements interfere with helping the patient achieve other important therapeutic goals, such as pain control and other symptom relief.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0.5in;">
<span style="font-family: Symbol; font-size: 10pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Never abandon the patient. Always let her know that you are there for her, no matter what.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; text-align: justify;">
<br /></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; text-align: justify;">
<span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">Responding to the patient’s emotional reactions is one of the most challenging tasks for an advocate. The patients’ reactions may swing wildly from silence to disbelief, crying, denial, shock, grief or plain anger. She may use you as a punching bag, so be prepared to act as an outlet for outbursts.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; margin-top: 8pt;">
<b><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">An empathic response calls for four kinds of interventions:</span></b></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Carefully observe and remain alert to any exaggerated display of an emotional reaction, such as stunned silence.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">If the patient appears extremely miserable, use gentle probing questions to nudge them into producing a reaction, even if it entails triggering a rush of tears. Bottled-up emotions can harm a patient, and they should feel comfortable in sharing their deepest fears and worries with you.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Identify the reason for the emotion. If you are not sure, ask the patient.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Finally, after you have given the patient a brief period of time to express her feelings, pledge your support and explain to her that you will stand by her side to hold her hand; and that she is not alone.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px;">
<br /></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; margin-top: 8pt;">
<b><span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">Communication strategies</span></b></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; text-align: justify;">
<span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">Here are a few communication techniques that you, as an advocate, can use with critically-ill patients:</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Warn her that difficult news is forthcoming. You can do this by stating, “I’m afraid the results reveal the situation is more serious than we would have hoped for...”</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">The patient is your first priority. However, if she wants other people present at this time (for example, her spouse), be sure to attend to them as well.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px;">
<br /></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Sit down and speak slowly, clearly and concisely.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Provide the information in small chunks; do not give a long lecture, which can be overwhelming for an anxious patient.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">After discussing each segment, pause to allow the patient to take in what you have stated. This is known as “chunk and check.” To ensure understanding, you must ask the patient to repeat what you have said in her own words. This is called the “teach back” or “show me” method.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;"> </span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Symbol; font-size: 10pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Be honest about the prognosis; do not give false hope. Be sensitive, yet direct.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Symbol; font-size: 10pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Be empathetic (e.g., “I know this is difficult for you.”)</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Symbol; font-size: 10pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Don’t do all the talking. Allow the patient to ask questions and to vent.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;"> </span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; text-align: justify;">
<span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">All said and done, bad news must be delivered after carefully assessing a patient’s level of understanding, compliance, and wishes for disclosure. Speak slowly so that the patient and her family understand. Choose your words thoughtfully and try to avoid causing any unnecessary mental anguish and anxiety.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px;">
<br /></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; text-align: justify;">
<span style="color: black; font-family: Arial, sans-serif; font-size: 10pt;">Last but not the least, a patient advocate can help to reassure the patient that her doctor will abide by three solemn commitments to her critically-ill patient:</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Symbol; font-size: 10pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">That every effort will be made to treat and relieve her pain and other symptoms.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Symbol; font-size: 10pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">That her physician will not abandon her in this difficult hour and will be actively involved in the care process, every step of the way.</span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">That he will support and honour any decisions that the patient or her family makes on her behalf.</span><br />
<i style="font-family: Georgia, serif; line-height: 20.796875px; text-indent: 0in;"><br /></i>
<i style="font-family: Georgia, serif; line-height: 20.796875px; text-indent: 0in;">The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i><br />
<div style="font-family: Georgia, serif; line-height: 20.796875px;">
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i></div>
<div class="separator" style="clear: both; font-family: Georgia, serif; line-height: 20.796875px; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<div style="font-family: Georgia, serif; line-height: 20.796875px;">
<i></i><br /></div>
<div class="separator" style="clear: both; font-family: Georgia, serif; line-height: 20.796875px; text-align: center;">
<a href="http://www.patientpower.in/">Register for the Conference Here</a></div>
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><br /></span></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; margin-bottom: 0.0001pt;">
<br /></div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-62075081700666014982013-09-24T15:01:00.000+05:302013-09-24T15:01:16.251+05:30Patient Advocate’s Responsibilities Towards Critically Ill Patients<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; text-align: center;">
<div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt;">
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
</div>
<b style="line-height: 1.5;"><span style="color: #999999; font-family: verdana, sans-serif; font-size: medium;">Patient Advocacy</span></b></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; text-align: center;">
<b style="line-height: 1.5;"><span style="color: #999999; font-family: verdana, sans-serif; font-size: medium;">Giving Voice to Patients</span></b></div>
<div style="background-color: white; color: #333333; font-family: 'Lucida Grande', 'Lucida Sans', Verdana, Arial, sans-serif; font-size: 13px; line-height: 19px; text-align: center;">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.patientpower.in/"><img border="0" src="http://3.bp.blogspot.com/-98QqjpJ8Yig/UkFbZkaXK-I/AAAAAAAAANw/EFAg4aG_oR8/s1600/header+image+for+blog.jpg" height="240" width="320" /></a></div>
<br /></div>
<div align="center" class="Pa15" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 13pt; text-align: center;">
<b><span style="font-size: 13pt;">Advocates can help a patient or his family make important decisions in an emotionally-charged medical scenario</span></b></div>
<div class="Pa5" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 14pt; text-align: justify;">
<span class="A7"><span style="font-family: Arial, sans-serif; font-size: 10pt;">I</span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">n the ICU (Intensive Care Unit), treatment decisions are based not just on medical grounds or statistical probabilities. They are emotionally-charged decisions, with significant cost implications, that a patient advocate can help the patient deal with.<o:p></o:p></span></div>
<div class="Pa4" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The clinical director of an Intensive Care Unit (ICU) once described a dilemma he faced in having to decide whether to withdraw intensive care treatment from a woman in her mid-seventies. The patient had undergone emergency surgery to repair a ruptured aorta, and subsequently developed pneumonia and renal failure. She was sedated, placed on a ventilator and treated with dialysis. Days passed during which the medical team could not agree on the next course of action - whether to withdraw the life support system and allow the woman to die peacefully, or continue the intensive care at a steep cost to the patient’s family. Was the care futile? Or did they have a chance to save her life?<o:p></o:p></span></div>
<div class="Pa4" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Since euthanasia (mercy killing) is illegal in India, eventually a compromise was reached, which involved waiting a further 48 hours to see if continued ‘full’ treatment produced any improvement in her condition. If not, the doctors decided they would not make any aggressive efforts to save her life and would wean her off the ventilator in a careful, phased manner.<o:p></o:p></span></div>
<div class="Pa4" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">This was an emotionally charged decision – as all such “end of life” conversations can be - both for the doctor and the family. Eventually, a patient-advocate was called in, who served as a useful communication bridge between the two parties. The doctors explained the medical facts of the case to the advocate, who in turn, explained them to the family, in more simplified terms. She gave them enough time to process this information; was patient and answered all their doubts and questions; helped them to play out possible scenarios and outcomes; allowed them to negotiate with each other; and acted as a neutral referee when there were heated arguments. The family members felt comforted that their voices were being heard by the medical team and that they were participants in the decision-making process. Everyone was actively involved and they eventually reached a decision that they were all comfortable with, so she could die in peace, without meddlesome interventions. If they had been left to their own devices, without any support from an advocate, the family may not have been able to make a well-informed decision and would have been forced to passively watch their loved one suffer pain and misery while she progressively deteriorated.<o:p></o:p></span></div>
<div class="Pa4" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">When framed this way, the family did not feel guilty that they were abandoning the patient or allowing her to die, just to save their money. They realised that this was a decision they were all making, in her best interests, because the chances of her being able to lead a productive life were so slim. Such critically-ill patients can be found throughout a hospital - in emergency departments, post-anesthesia recovery units, interventional cardiology labs, pediatric and neonatal intensive care units, and burn units - and a well-trained experienced patient advocate can help both the medical team and the family to make decisions they are comfortable with.<o:p></o:p></span></div>
<div class="Pa4" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Here’s another real life story. A man received a frantic call from his daughter-in-law, asking for help. Her husband had met with a terrible road accident. When he arrived at the hospital, he discovered that his son had several fractured ribs, bruised lungs, and a fractured skull and to make matters worse, he had serious breathing problems that required him to be quickly put on the ventilator for respiratory support. The patient was unconscious and remained in that comatose state for four long weeks.<o:p></o:p></span></div>
<div class="Pa4" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The patient’s father, who is a friend, later confided in me that when he first laid eyes on his son, he experienced a feeling of “terror.” Tears welled in his eyes as he felt a wave of anger and impotence. As a person who always likes to remain in charge, he suddenly found himself in unfamiliar territory, frightened, clueless and helpless; trapped in a situation in which his son’s life lay in balance and all the crucial decisions related to his life were being taken by total strangers. That’s when he decided to bounce back and asked to become a part of the treatment team. He decided to appoint himself as his son’s “advocate.” Fortunately, the medical team was also receptive to this idea and was happy to have him on board. They willingly shared the responsibility for decision making with him. By assuming ownership of his son’s care plan, rather than leaving everything upto the doctors, the father helped his son to make a quick and total recovery.<o:p></o:p></span></div>
<div class="Pa9" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Why do you need a patient-advocate for seriously-ill patients?</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">In reality, you need one in every unfamiliar medical situation. Self-proclaimed experts with half-baked information can strike fear in your mind when you have a medical problem. What if your fibroids are malignant? If you have gall bladder stones which aren’t troubling you, should you allow the surgeon to completely remove the organ? Is the ECG really abnormal, or is the squiggle a normal variant? Should you agree to do the stress test because of your chest pain? Or is it just heartburn, which will get better soon?<o:p></o:p></span></div>
<div class="Pa4" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Someone has to find answers to these questions and it can be a lot better if that person is a concerned family member or a trusted friend in whose judgment you can repose complete faith. Let’s face it: there are good doctors around, but their number is dwindling alarmingly.<o:p></o:p></span></div>
<div class="Default" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">How do you cross-check your doctor’s opinion?<o:p></o:p></span></div>
<div class="Default" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Are there simpler treatment alternatives available which he has not discussed with you?<o:p></o:p></span></div>
<div class="Default" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Will your health insurance company pay for your full treatment cost? Or will they do their best to reject your claim on every flimsy pretext they can think of, to save themselves some money?<o:p></o:p></span></div>
<div class="Default" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<br /></div>
<div class="MsoNormal" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">There can be myriad worries, doubts and questions plaguing you before a complicated medical procedure. Where do you go for help and guidance? While your doctor is naturally your first choice, what happens if he is too busy, or unconcerned? Or if you cannot understand his medical jargon; or if you suspect he has a vested interest in recommending complicated surgical solutions that may not be actually required. Here’s where a patient advocate can be invaluable. Typically, there can be four kinds of events that call for the intervention of a patient advocate:<o:p></o:p></span></div>
<div class="Pa4" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 13pt; text-align: justify;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Life-threatening situations: </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Sudden accidents or emergencies, where you are unable to make an intelligent, informed decision on your own. You may be unconscious, or heavily medicated.<o:p></o:p></span></div>
<div class="Pa4" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 13pt; text-align: justify;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">High-risk situations</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;">: Typically, a high-risk patient faces potential threat to life, limb or organ. Such patients need very alert attendants to watch over them. A patient advocate who bats for you can employ a heightened “sixth sense” that comes from experience and maturity. A high-risk patient’s condition can easily deteriorate, and urgent intervention can prevent a bad situation from getting worse. Doctors, especially big-name specialists, often have to deal with so many patients, that they can’t be counted upon to be fully engaged with one patient. The bigger the reputation, the less likely it is that the doctor will be able to devote his full attention to one patient, howsoever critical her condition may be, unless she has come to her with the right references, either from a medical colleague or a “political connection.” There is no dearth of horror stories related to medical negligence in both public and private sector hospitals all over the world. This is what makes the presence of a patient advocate all the more important.<o:p></o:p></span></div>
<div class="Pa4" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 13pt; text-align: justify;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">You are recovering from severe physical or psychological trauma: </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;">This may not be a life-threatening situation, yet requires decision-making that has serious long-term implications, and you may not be able to think clearly for yourself at this time.<o:p></o:p></span></div>
<div class="Pa4" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 13pt; text-align: justify;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Chronic medical conditions: </span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;">There are many conditions, such as cancer, arthritis, and heart disease, in which even educated well-informed patients find it hard to choose the right treatment option, because there are such a bewildering variety of choices available today.<o:p></o:p></span></div>
<div class="Pa9" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">An advocate mobilises scarce resources</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">For starters, an intelligent, experienced patient advocate needs to know - How many different kind of resources is this patient going to need in order for the physician to treat her most efficiently and effectively? Does the patient need immediate blood transfusion? Financial aid? A second opinion? The patient-advocate needs to draw on her past experience with similar patients, so she can mobilise these resources well in advance, rather than having the doctors make the family members run around at the last minute.<o:p></o:p></span></div>
<div class="MsoNormal" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 0.0001pt;">
<br /></div>
<div class="Pa4" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">An advocate needs to make an accurate assessment of the patient’s condition, to determine what sort of help would be needed over the course of hospitalisation, and to judge how fast it can be delivered. In order to be able to do this, the advocate must be familiar with the hospital’s facilities and also be knowledgeable about “prudent and customary” medical standards of care.<o:p></o:p></span></div>
<div class="Pa4" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Ask yourself, “Given this patient’s condition, what are the main resources that a physician would be likely to utilise?” The resources that we are talking about here can be:<o:p></o:p></span></div>
<div class="Default" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Specialised pathological tests<o:p></o:p></span></div>
<div class="Default" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Blood and blood products<o:p></o:p></span></div>
<div class="Default" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Imported medicines<o:p></o:p></span></div>
<div class="Default" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Consultations with other doctors<o:p></o:p></span></div>
<div class="Default" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-left: 0in; text-indent: 0in;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 10pt;">Sophisticated imaging studies<o:p></o:p></span></div>
<div class="Default" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px;">
<br /></div>
<div class="MsoNormal" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Most of all, a patient advocate needs to empathise. She needs to ensure that a patient is not just a ‘medical case’ for the hospital staff – she is someone’s wife, mother, sister, child or a friend. Every medical decision is going to affect these people as well. There could be so many lives hanging on that one single life, so the decision she takes on the patient’s behalf has to be reached with the active involvement of all these stakeholders.<o:p></o:p></span></div>
<div class="MsoNormal" style="background-color: white; color: #333333; font-family: Georgia, serif; font-size: 13px; line-height: 20.796875px; margin-bottom: 0.0001pt;">
<i><br /></i>
<i>The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients</i><br />
<i>The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.</i><br />
<div class="separator" style="clear: both; text-align: center;">
<a href="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" imageanchor="1" style="color: #999999; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" src="http://1.bp.blogspot.com/-Pvau4rz7spI/UkAVqQfJVNI/AAAAAAAAEXE/UPe37M7aS8g/s1600/patient+advocacy+logo+small.png" style="border: 1px solid rgb(204, 204, 204); padding: 4px;" /></a></div>
<i></i><br />
<div class="separator" style="-webkit-text-stroke-width: 0px; background-color: white; clear: both; color: #333333; font-family: Georgia, serif; font-size: 13px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 20.796875px; orphans: auto; text-align: center; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px;">
<a href="http://www.patientpower.in/">Register for the Conference Here</a></div>
</div>
</div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0tag:blogger.com,1999:blog-3066802566710610263.post-25241318881204321612013-09-17T14:30:00.000+05:302013-09-17T14:30:10.254+05:30The Right to Informed Consentin a Clinical Trial<div dir="ltr" style="text-align: left;" trbidi="on">
<div align="center" class="MsoNormal" style="line-height: 14.05pt; margin-bottom: 0in; text-align: center;">
<b><span style="font-family: Arial, sans-serif;">A patient participating in a clinical trial has the right to know all the information regarding the trial, including its potential benefits and risks, so that he can make an informed decision</span></b></div>
<div align="center" class="MsoNormal" style="line-height: 14.05pt; margin-bottom: 0in; text-align: center;">
<br /></div>
<div class="MsoNormal" style="line-height: 13.05pt; margin-bottom: 14pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Clinical trials are scientific research experiments, conducted on human volunteers in order to find new ways to prevent, detect and cure diseases. Medical science has grown leaps and bounds on the back of such biomedical research. When done properly, such studies are very useful in improving our medical knowledge base.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 13.05pt; margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">However, not all clinical trials are conducted ethically. This is especially true in India, which is fast becoming an attractive destination for carrying out clinical trials, primarily because we have a huge and diverse pool of patients on whom these trials can be conducted fairly inexpensively. Many of the patients chosen are uneducated, who can easily be exploited by doctors, researchers and pharmaceutical companies, alike. Unethical researchers (who get paid huge sums for signing up as many participants as possible) may exaggerate the benefits of a treatment, offer financial sweeteners, or attempt to play down the risks of the trial.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">In 1997, the oncology division of the Indian Council of Medical Research (ICMR) carried out an observational study on cervical cancer in Indian women. The study did not have any ethical clearance from the All India Institute of Medical Sciences (AIIMS) from where the subjects were drawn; nor did the researchers get informed consent from the subjects themselves. Under the ICMR study, 1100 uneducated urban women from Delhi with pre-cancerous lesions were studied between 1976 and 1988. The objective was to study the natural progression of cervical dysplasia to cervical cancer (the most prevalent cancer amongst Indian women) without any medical intervention. So despite the fact that a simple surgery would have removed the cervical lesions, before they could turn cancerous, the women were wantonly left untreated. The outcome was that 62 of these women needlessly developed cancer; and in nine the disease had already spread to other parts of their body.<o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">In another equally scandalous incident, an Indian scientist attempted to inject the bovine HIV strain into a human subject. This research was also not approved by any ethical body. Likewise there have been reports of a pig’s heart transplant into humans; and controversial trials with mepacrine, an anti-malarial drug that is injected into a woman’s uterus for contraceptive purposes, although some doctors suspect it causes cancer. Although every hospital unit is supposed to have its own ethical committee, in our country most are defunct bodies. The National Human Rights Commission (NHRC) guidelines propose that a research group must provide human subjects with printed literature, explaining in simple, non-technical language, the purpose of the study; details of the procedure; the risks involved; the financial or other interests of the researcher; and a commitment to treat, completely and free-of-cost, any complication that may arise during the course of the trial.<o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">The subject too has to certify in writing that she has understood the document and is volunteering to participate in the research, without the promise of any monetary inducement that is not permitted under the Indian law. There are a few other government bodies that monitor clinical trials such as the Drug Controller of India and the Clinical Trial Registry in India (CTRI). Nonetheless, the Supreme Court recently expressed reservations about the unethical way in which most clinical trials are being conducted in the country, and has directed the Ministry of Health to formulate proper guidelines on this, to protect patients’ interests. According to existing rules, an ethically sound clinical trial:<o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Will aim for the enhancement of medical knowledge<o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Will have strong scientific validity<o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Will recruit participants fairly<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Will have a favourable risk-benefit ratio<o:p></o:p></span></div>
<div class="Default">
<br /></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Will have people who independently review, approve, amend or terminate it<o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Will obtain informed consent from its participants<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Will respect the participants privacy and will strive hard to protect their wellness and rights<o:p></o:p></span></div>
<div class="Pa9" style="margin: 8pt 0in 2pt;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Role of patient advocates in clinical trials</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;">Patient-advocates can play an extremely important role in clinical trials. Among other things they are required to:<o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Make sure whether the information about the trial is presented in a format which is easily understandable to the patient<o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Assist the research team in developing relevant educational materials about the trial in lay-friendly terms that is simple and easy to understand<o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Identify and address potential ethical issues in the trial<o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Promote patient safety and confidentiality<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Assist the research team in obtaining valid informed consent from the patients, recruited in the trial<o:p></o:p></span></div>
<div class="Default">
<br /></div>
<div align="center" class="Pa10" style="margin: 0.25in 0in 2pt; text-align: center;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">QUIZ TIME: Informed Consent Quality Assessment Questionnaire</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Pa4" style="margin-bottom: 13pt; text-align: justify;">
<b><span style="font-family: Arial, sans-serif; font-size: 10pt;">Use this form to gauge patient’s understanding of their participation in clinical trials</span></b><span style="font-family: Arial, sans-serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Do you feel that you have been informed how long your participation in this clinical trial will last?<o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Do you think that all the treatments and procedures that the investigator proposed for you are the best for your disease?<o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Do you understand what “randomisation” means?<o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Do you know that no direct medical benefit will derive to you from your participation in this clinical trial?<o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Are you sure that your participation in this trial will not involve any additional risk or discomforts?<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Do you know that because you are participating in a clinical trial, it is possible that the study sponsor, various government agencies, or others not directly involved in your health care could have access to your medical records?<o:p></o:p></span></div>
<div class="Default">
<br /></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Do you know that the consent form you signed lists the names of the contact persons, who must answer any of your questions or concerns about the clinical trial?<o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Do you know that the consent form you signed describes how you will be covered by insurance if you are injured or become ill as a result of participation in the clinical trial?<o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Do you understand that if you do not want to participate in the clinical trial you are free to refuse to sign the consent form? This will not affect the quality of medical care you receive, so you do not need to be scared that your doctor will get angry or upset if you refuse to participate.<o:p></o:p></span></div>
<div class="Default" style="margin: 0in 0in 4.4pt; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Do you understand that you are not obliged to remain in the clinical trial if you decide to withdraw at any point of time?<o:p></o:p></span></div>
<div class="Default" style="margin-left: 0in; text-indent: 0in;">
<span style="font-family: "Arial","sans-serif"; font-size: 10pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt;"> </span></span><span style="font-family: "Arial","sans-serif"; font-size: 10pt;">Explain in your words the purpose of the clinical trial to which you have consented to be a subject.<o:p></o:p></span></div>
<span style="font-family: Arial, sans-serif; font-size: 10pt;">A patient-advocate who uses such questionnaires with patients who have been recruited to participate in a clinical trial will help to protect the patients; and will also ensure that the research team is never caught on the wrong side of the fence.</span></div>
Patients First - Dr.Aniruddha Malpani,M.D.http://www.blogger.com/profile/13944847954498018513noreply@blogger.com0