This is a valuable background for promoting patient centred communication in the society. They did, however, agree on some key expectations that they felt that were unreasonable, but held by a majority These teachings may bring courage and clarity in the minds of healthcare professionals as the long-drawn war against COVID-19 would require utmost patience and perseverance. However in contrast to the perception of the … The concept of civil society developed in the European philosophical and historical experience. The ‘non-attachment’ approach to crisis will allow a clear ‘bird’s-eye view’ of the situation and will help the doctors to perform in more efficient manner. There is no experience with waiting for test results, no understanding of chronic disease, preventive medicine, or self-care. This arrangement remains the core of the social contract. Doctor can also play a crucial role in providing correct patient education. The fears stem out of care and concern for their family and for their patients. With high hopes that Doctors respond to their calling, resolve their dilemmas with timeless teachings of the Bhagavad Gita and rise to the occasion, during this once in a lifetime crisis. Based on clinical acumen, available scientific evidence and patient’s need, Doctors need to perform without any fears in present times. In our first essay, Lizzy Goldsmith ana- Many trainee doctors and medical students believe these values have been put at risk by changes to working patterns, training, limited financial resources, and patient and political expectations. Most respondents (78%) agreed that they expected a doctor to be the leader of the healthcare team. Designed by Elegant Themes | Powered by WordPress, Key Concepts in Cross-Cultural Communications, Using the Cross-Cultural Adaptability Inventory In Healthcare Training, BBC Article Claims “Native English Speakers are the Worst Communicators in the World”. Even in routine clinical practice, the same set of treatment protocols may have variable responses in two different patients and the same will happen during this pandemic, when treatment protocols are not standardized across the globe. The healthcare should move from ‘Volume-based’ to “Value-based’ model in the interest of society. Robert Lewandowski might have lost his only chance of Ballon d’Or, Terms of Use and Grievance Redressal Policy. Dept. If you have access to a journal via a society or association membership, please browse to your society journal, select an article to view, and follow the instructions in this box. Doctors expressed the belief that patients had high expectations of doctors’ performance, especially at tertiary hospitals. It is prudent to use Hydroxychloroquine after due safety precautions rather than waiting for clinical trials. Societal expectations Prepared by Manisha Khadka 2. Dr. Nitin P Ghonge @ A breath of fresh air. Also, one sport isn’t enough. Many of the hospitals we visited showed genuine commitment to delivering person-centred care, with registered nurses, doctors, other care professionals and healthcare staff pulling together to treat the people they cared for with compassion and respect… There is, however, a … If a woman and/or her partner’s expectations are very different from the reality, it can make it harder for them to adjust to life with a new baby. Athletes are those who participate in three or more varsity sports. Doctors are expected to perform their obligatory duties in the best interest of patients, without worrying about the outcomes and circumstances. Mahatma Gandhi referred to Bhagavad Gita as a ‘spiritual dictionary’ for better decision-making at the cross-roads of life. Doctors take responsibility for these judgements and their consequences. “Sever the ignorant doubt in your heart with the sword of self-knowledge. Equanimity of mind: This is the ability to keep the mind steady and balanced in ups and downs of life with serene and peaceful outlook to vicissitudes of life. Expectations from Physicians Expectations from Physicians When in a Public Gathering Oftentimes, we hear such statements from lay people when there is / are a doctor / doctors in a crowd or public gathering. We may even respond with greater confidence if we deem a physician’s alma mater to be an esteemed medical institution. However, while some of these expectations are well-justified, others seem quite unrealistic. Unfortunately reality is somewhat different. more) years later, we graduate not only as doctors, but also as scientists, policymakers, and writers. “The power of God is with you at all times; through the activities of mind, senses, breathing, and emotions; and is constantly doing all the work using you as a mere instrument”. In many traditional cultures of the world, trust is vested in health care professionals based on referrals from very well-trusted sources – usually close friends or family members. The timeless teachings of the Bhagavad Gita offer profound knowledge about the nature and purpose of our lives and are useful for every human being, irrespective of their caste and creed. Unless, there are specific compelling reasons, doctors should continue to provide their services without any fears of catching the infection or harassment. The tough times will soon pass. If we have the benefit of a recommendation from someone we know, all the better, but often that isn’t available. Equanimity of mind will allow doctors to perform at their best in terms of clinical acumen, technical skills and scientific knowledge for the patient’s well-being. The vast majority of science, technology, engineering, medicine and Bhagavad Gita is much more than a religious text, as it offers insight into every aspect of life and is universally relevant. Keep this in mind if the above section seems at odds with what follows. In other words, do we try to act in accordance with the cultural expectations of the patient/family by avoiding the collaborative approach in cross-cultural interactions? “Don’t worry with what you are going to do. Copyright © 2021 Bennett, Coleman & Co. Ltd. All rights reserved. Below are three of some the most common expectations that patients have regarding their doctors. of Radiology; Indraprastha Apollo Hospitals, New Delhi-76, INDIA. It is important to realize that the outcome of human’s action is not only dependent on the work but also on lot of related factors and circumstances. In any health care interaction where personalismo is clearly missing, compliance and health outcomes may be adversely affected; open communication between patient and provider will be difficult to establish. For reprint rights: Times Syndication Service. If you forget all of your questions when you get to the doctor’s office, here are 5 tips for making the most out of your visit. Patients wish for doctors to decide should not be misinterpreted as patient’s dislike to express opinion or being involve in decision-making. Observe your discipline. Act without fears: Doctors are vulnerable to infections which can instill fear, mainly if personal protection equipments are not available. Bhagavad Gita can address the mind’s inner conflicts while treading the noble path to service and guide Doctor’s action during the pandemonium of COVID-19 pandemic. Associate Editor, British Journal of Radiology. Faith thrives in an environment of enthusiasm backed with evidence. Slow down just a little bit, and offer a few words of friendly conversation before getting to the medical issue at hand. The number of complaints and claims has risen year on year, but this has not been shown to be associated with a reduction in the standard of care provided by doctors. Being asked, “What do you believe has caused your illness?” suggests to a patient perhaps that their opinion is equal to the doctor’s, and culturally speaking, this is impossible. The panic response of the society related to the COVID-19 may prove to be a bigger problem than the medical problem alone. The culturally responsive physician anticipates this scenario and is proactive. International Advisor, Srilanka Journal of Radiology [SLJR-online]. This is the time to set high standards for the society in terms of professional commitment, moral obligations, work discipline, compliance with guidelines and good personal health. Though at times challenging and more time-consuming, a culturally-responsive approach to patient care results in clearer expectations, better compliance, reduced medical errors and improved patient satisfaction. Residents of south Chennai want the water crisis in their constituency addressed Society’s Expectations: (I) Society wants to view doctors only as healers with expectations of caring, compassion, confidentiality and dignity. Role theory is the sociological study of role development, concerned with explaining what forces cause people to develop the expectations of their own and others' behaviors. Handling the Stress: In modern society, ‘workplace stress’ has almost become a norm and symbolic of stature in the society. Doctors who don’t ask for patient input about their health concerns may be considered disconnected and unresponsive. Section Editor, Indian Journal of Radiology & Imaging. This issue is also related to the dimension of culture called power distance. Again, the degree to which a patient views a provider as an authority figure is influenced by culturally-based expectations. Get a printable copy (PDF file) of the complete article (284K), or click on a page image below to browse page by page. The physician acts more as an expert offering guidance than an authority figure (except in the case of emergency). She explains that seeking a second opinion in the U. S. is very common and that insurers may require second consultations for certain procedures, though they refuse to pay for them in many other cases. COVID-19 disease VS lockdowns in India: What is causing greater distress? Having faith is not opposed to being reasonable or scientific. Although patients from more traditional cultures may hold expectations for establishing a friendly warm rapport with American providers, they may also react with confusion and even consternation at the collaborative approach of patient-centered care. Father of our nation, Mahatma Gandhi has often acknowledged its profound effect on his life’s decisions – “When disappointment stares me in the face and all alone I see not one ray of light, I go back to the Bhagavad-Gita”. The dimension of culture that we call “individualism vs. collectivism” applies here. Posted Feb 17, 2018 So the question becomes, do we offer patient-centered care only to those who expect it and understand how to be actively engaged in the process? As Mahatma Gandhi has said, “Be the change, you want to see in the World”. Societal expectations • General standard of behavior that individuals who live within a society are expected to uphold • Unique set of normal behavior • Universal social behavior • … Though time is definitely a finite resource in American medical culture, even the busiest health care professionals can do the following: The cultural values of any group of people must bridge the many contradictions presented by practical circumstances of everyday life. In particular, we will look at how trust is vested in medical professionals in different cultures, how social power distance affects the consultation approach promoted in patient-centered care, and how a patient’s cultural background will influence the way he or she goes about seeking a second opinion. Love and respect for nature is an important lesson for the humanity, where doctors can lead. Associate Editor, Korean Journal of Radiology. 1. Finally, it is important to mention the expectations people from different cultures may have about seeking second opinions. The practice of medicine is distinguished by the need for judgement in the face of uncertainty. In choosing a primary care physician at an HMO, we want to read about the credentials of physicians on the organization’s website before we choose our primary doctor. The tendency to stockpile the sanitizers at home, when they are more essential at the hospitals is just one example. Excelling and dedication to one sport is insufficient. Doctors need to respond to their calling, rise to occasion and serve the humanity in these challenging times. Equally, with the rapid progression of medical knowledge, diagnosis and treatment, there is an increasing expectation in society that patients have a right to be cured of all their illnesses, and relieved of all their symptoms. Unreasonable Expectations of the Health Care System Although asked to provide examples of both reasonable and unreasonable expectations of the health care system, Councils focused most of their time on reasonable expectations. It is certainly important to learn from them and embrace the change for the greater good. This article on the 8 areas of employee expectation looks at social expectations in the workplace and their impact on employee engagement. Doctors also need to drive the inevitable change for building a better healthcare for tomorrow, as the dust settles over the COVID-19 crisis. However, with the growing focus on medical errors, the desire for second opinions is more and more common, especially for invasive procedures. Sir William Osler has correctly mentioned that the “best disinfectants are Soap, Water and Common sense”. High power distance in a society means people adhere to their proscribed place on the social ladder. Offer a handshake that lingers a moment and is less business-like than an American professional handshake. The likelihood of establishing warm personal rapport is far less certain with a complete stranger who is often short on time. It was a dialogue between Lord Sri Krishna and great warrior prince, Arjuna about 5,000 years ago on a battlefield, when Arjuna faced similar dilemmas. “When inertia is predominant; ignorance, inactivity, carelessness, and delusion arise”. 5 Ways to Make the Most of Your Doctor’s Appointment. ‘When the going gets tough, only the tough gets going’; simply reminds us of the nature’s basic law of ‘survival of the fittest. The above teachings of the Bhagavad Gita can enlighten the doctors to efficiently handle their dilemmas and continue their selfless service to society during the COVID-19 crisis. Mobile No. Cultural responsiveness in health care describes the capacity to respond to the health care issues of diverse communities. It is helpful to be prepared for what may appear to be a contradiction of values and expectations operating in some cross-cultural interactions. Do everything centered in that equanimity and you will enjoy an undisturbed mind in success or failure”. Doctors  always need to perform their duties with confidence. In a highly individualistic culture, like American culture, it is common for people to believe the locus of control in their lives rests securely with themselves. But no doctor can know everything, and any doctor can be wrong, so competence should include the willingness to admit when you are uncertain and to reevaluate or change course when necessary. Effective cross-cultural communication begins with understanding values-based health beliefs and behaviors – including the expectations different cultures have for physicians. Set high standards: Even today, Medicine is the most respected profession. Truly, “It is always better to light a candle than to curse the darkness”. Change is inevitable:  As in life, the only thing constant in Medicine is Change. How to balance an expert’s authoritative stance with being receptive to things like traditional remedies isn’t always abundantly clear. What is the solution?…. If they do seek a second opinion, thorough discussion of both the initial and second opinions will also be difficult for them. 1. Recent observers have stated that negotiating for these deliverables is one of the characteristics of a contemporary profession . A contract involves obligations from both parties, so it is reasonable for medicine to expect certain deliverables from society. In collectivist cultures, and in societies where a high power distance is the norm, patients are more likely to view providers as authority figures who conduct themselves with utter certainty. Basic sanitation and cleanliness should be promoted by doctors, as their social responsibility. Many Americans bristle at doctors telling them what to do if it feels like being given orders, unless of course the patient has asked for a medical directive. Further, the Company does not make any warranty as to the correctness or reliability of such content. In respect of a doctor's personal qualities, integrity was expected (94%), as was compassion (89%). “The one by whom others are not agitated and who is not agitated by others, who is free from joy, envy, fear, and anxiety, is also dear to Me”. We train physicians to LEARN – listen, explain, ask, repeat, and negotiate – in cross-cultural encounters especially. Patients were perceived to deem tertiary hospitals with skilled doctors and high-tech equipment as places where any difficult and complex medical problem could be cured (Table 2 … “They all attain perfection, when they find joy in their work”. The answer certainly lies in the context of the cross-cultural situation; during a health care visit in this country, the culture of medicine as it is practiced takes precedence. For some people, the crowded schedules of esteemed specialists is actually reassuring – proof of sorts that we are lucky to be the patient of such a highly sought doctor. Patient pressure may be stronger in the doctor's mind than in the patient's Although patients' expectations of general practice consultations influence outcomes, they are not as influential as doctors' assessments. The Bhagavad Gita [meaning ‘Song of God’] is a 700-verse Hindu scripture that is part of the epic Mahabharata. | Nov 17, 2010. “For the protection of the good, for the destruction of the evil and for the establishment of dharma (righteousness), I (the Lord) am born from age to age.”. It is appropriate for doctors to communicate about the scarcity of personal protection equipments, but that should not discourage them from performing their duties. “Equanimity of mind is Yoga. Ask about the family’s well-being, which is a question of great significance in collectivist cultures. Are we fighting COVID-19 pandemic or the Corona-virus? Equanimity and evenness of mind are the greatest assets for Doctors during the present crisis and can be cultivated with regular meditation and radical change in the attitude. Any opinions and views expressed on or through the above content/blogs are those of the designated authors/bloggers and do not necessarily represent views of Times Internet Limited ("Company"). My previous blog: https://timesofindia.indiatimes.com/readersblog/a-breath-of-fresh-air/amidst-pandemonium-of-covid-19-pandemic-the-doctors-dilemma-11892/, beautiful articledr.n.vaishnav, bhavnagar gujarat. According to sociologist Bruce Biddle (1986), the five major models of role theory include: Functional Role Theory, which examines role development as shared social norms for a given social position, Summarizing the solutions:  In this mystical circle of life, the material world often discard the wisdom of one generation as absurdities in the next generation and even vice versa. Trust is not vested in medical professionals the same in all cultures. “I look upon all creatures equally; none are less dear to me and none more dear”. “Whatever is done without faith – whether it is sacrifice, charity, austerity, or any other act is useless. Contact us if you experience any difficulty logging in. The COVID-19 crisis is a once in a lifetime crisis and will be the testing time for doctors in terms of their professional commitment and sincerity to work. Patients/families from cultures that respect physicians as authority figures, and who tend to be high context communicators focused on preserving harmony, will be far less likely to admit wanting a second opinion. Member, Committee for International Radiology Education (CIRE). Treat everyone equally:  It is natural for humans to become judgmental of situations and persons around us. Societal expectations 1. Full text Full text is available as a scanned copy of the original print version. In this cross-cultural communications article we will take a look at one area that is commonly problematic – patients’ expectations of physicians. Protection against COVID-19: An INTEGRATED HEALTHCARE APPROACH. Many of us have come to expect doctors to be hurried and over-busy. If the doctor’s mind remains unperturbed with uncertainties of the present times and is free from attachment, anxiety and fear, he or she can perform much better. Another set of expectations that is related to the sick is the physician's role, a role society has created that defines appropriate patterns of behavior for people who are doctors. Our beloved Prime Minister, Narendra Modi has strongly pitched the Bhagavad Gita as “India’s biggest gift to the world”. The panic response of the society related to the COVID-19 may prove to be a bigger problem than the medical problem alone. Always remember, “The things you are passionate about are not random, they are your calling”. It’s not enough for you to be in a sport for fun or to get in shape. The present crisis is the golden opportunity for the doctors to reform the healthcare, rebuild this trust and regain the same old respect as the ‘Healer’. The concept ofcivil society has much broader significance for the development of democracy around the “Fear not what is not real, never was and never will be. This innovative approach of the “street study” aims to understand what people want from health care. Social power distance affects success with the patient-provider collaboration approach promoted in patient-centered care as well as behaviors around seeking second opinions. Society is a worldwide voice that tells us what is isn't acceptable to do. The Bhagavad Gita, however, mentioned that the doctors should treat all patients with the same lens of impartiality. Email ID    drnitinpghonge@gmail.com                drnitinghonge@rediffmail.com. The doctors should now drive this ‘change’ for building a better healthcare for tomorrow. The greater part of a worker’s day is spent in the work environment, so not surprisingly employees want good relationships with the people whom they spend the majority of their time with: their immediate co-workers, other employees, supervisors and bosses. The Doctors need to set high standards for the society in terms of professional commitment, moral obligations, ethics, work discipline and good personal health. Dr. Nitin P. Ghonge, MD, DNB, FICR, FIMSA. This may sound obvious except for the fact that doctors' assessments of patients' preferences have more influence than those preferences themselves. Factually, the stress is the outcome of inability to efficiently handle the assigned roles and responsibilities. Patients expect doctor empathy, understanding and paraphrasing. Doctors need to remain calm and cheerful, amidst the doom and gloom of COVID-19 pandemic. Does not mean lack of personalized approach, sub-optimal communication/counseling, high healthcare costs and expectations... Elsm ] rule of our existence on this planet your heart with the same of... Arise ” employee engagement expect determines what we experience or to get in shape change is inevitable: in! 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