World Suicide Prevention Day: Why Doctors Are Killing Themselves?

The COVID-19 pandemic has created a world environment that is harsh and seriously detrimental for everyone, but have you ever wondered how difficult was it for the frontline workers? This is the most important time to focus on suicide prevention. It’s time actions should be taken to prevent these tragedies on a global scale.

Every year, suicide is among the top 20 causes of death around the globe for people of all ages. It is responsible for more than 800,000 deaths, which comes down to one suicide every 40 seconds. Every life lost is someone’s partner, child, parent, friend, or colleague.

Suicide Among Doctors

Ever since the beginning of the pandemic, more than thirty doctors have died by suicide across India. Most of them were young doctors. Suicide in doctors is a complex, deep issue that has been plaguing for several decades. But, the arrival of the pandemic and its ill effects on one’s mental health has caused insult to the injury.

Doctors face different struggles at different stages of their careers that affect their mental health and physical well-being. Which in turn provokes them to choose suicide as an escape.

Interns and residents have the highest suicide rates when compared to others. Toxic environments, long working hours, no job satisfaction, and violence against doctors are a few challenges the doctors face, that eventually leads them to take such extreme steps.

High suicide rates in medical colleges across the country surely reflect the suicidal pattern among medical students as well. Medical students and interns face exam-related stress, insomnia, bad living conditions, and competition from peers. Among students, maximum suicides usually take place during exams, showing the amount of stress and anxiety brought in by the evaluation system.

Is this pandemic adding to the tally?

A junior doctor from AIIMS committed suicide after writing a blog on his suicidal tendencies and the depression he was suffering from. His last blog suggests that he knew everything regarding his mental conditions except how to get out of it! This is one of the many other incidents that happened all over India during the pandemic.

The only way which works in these extreme situations is finding a release, whether it is music, cooking exercise or plain meditation, but the most important among these factors is finding someone to talk to and not losing ourselves in this chaos because let’s face it; life keeps on putting us through one challenge or the other but rather than giving up let’s try to bring some happiness for ourselves.

So never put a full stop after LIFE, follow it with a comma!

5 tips for effective practice management

1. Make sure your team is delivering the right message

All members of the team need to be on the same page when it comes to the various benefits of the treatment options that you offer, as they need to be able to provide patients with at least basic clinical information when they make inquiries.

This is particularly important when it comes to treatment, as the modality can require a greater investment of time and money by the patient than other treatment options. If the team member they speak to is confident about discussing the process — regardless of who they are within the practice — this is more likely to instill confidence in the patient to proceed.

All members of our team are therefore trained to deliver the same response to certain questions. This standardizes the patient experience from the moment they ask about treatment through to appointment booking, clinical examination, treatment and on-going care. The team should also know how to explain differences between treatment options to patients who can either have the treatment performed by myself, or through a student clinic at a reduced cost and they are made aware of what each option would entail from the outset.

Not only does this standardization improve the patient experience, it also streamlines the experience of referring dentists. All members of the team can describe the different ways in which we work with referring practices and the state-of-the-art technology we use to provide a good service. This ensures complete clarity for the referring dentist from the very beginning, no matter who picks up the phone or deals with the email.

2. Know what’s in your Inventory!

It’s always good to be prepared for any patient who walks through the door, in particular potential patients, by ordering implant products in advance and in bulk. I find that if you have the components ready to go, you appear better organized and professional to the patient. It also means that treatment can be offered much quicker — the patient can take as much time as they need to make an informed decision, but once the decision is made, treatment can commence at their earliest convenience. Most people are happy with the efficiency of such a service and are less likely to shop around. To complement this, try to develop a good relationship with your dental laboratory, technicians and dealers. Further ensure a fast turnaround time for any prosthetic work requested.

3. Delegate and share responsibility

One of the greatest challenges of practice management is compliance with the ever-growing number of regulations. There is a lot of red tape to get through and while it is absolutely necessary, it does occupy considerable time. Balancing the administration tasks with clinical care is difficult — particularly for a smaller practice such as our own — but it can be achieved with careful management of the diary and delegation. A fairly new practice or a beginner, might not have a dedicated practice manager, but for those who do, this person can take on a lot of the compliance and daily management responsibilities. This allows the clinicians to focus more on patient treatment.

4. Make the most of positive patient reviews

In my experience patients trust other people’s reviews more than practice-led marketing efforts. The vast majority of new patients who come to our practice do so as a result of word-of-mouth, meaning we rely heavily on positive patient recommendations. Aside from this indirect method of promoting our practice, our website offers more information to support any details provided by the team to the patients.

5. Use trusted products and systems

Any practice small or big ,is initially set up with simple equipment and products that would streamline day-to-day processes. As your practice grows, try putting in most of the earning from your patients back into your practice. Get better equipment and if you are one of those practitioners who like keeping state of the art instruments then be proud to belong in that handful of doctors.

Are you taking your auxiliary staff for granted?

 

How has your routine changed since you are locked up ?

It’s been approximately 40 days and you have still not seen your clinic. Based on the scenario outside and not to mention the paranoia among the doctors, do you think it would be easy for us to get back on the horse? With the fear of a crumbling economy, the forecasts by these “gurus” about an upcoming recession is enough to raise the hair on our spine.

But among these underlying fears, did you realize that there are some people without whom you cannot start your practice and how often do we speak with them let alone your assistants and reception staff, these people are a different story. Here I am talking about your daily maid who cleans your clinic before you even enter the clinic, your garbage collector, your raddiwalla. These are a few people who leave your clinic sparkly clean and smell free. Imagine when the garbage collector misses out your home for one day the smell that fills up your house.

How many of you ever stopped and thanked these people genuinely during the COVID -19 crisis? These are the people who are still working relentlessly day and night, collecting hospital waste, your home waste, and are still made to feel unwelcome in your home.

Let us just go back and think once, as much as you are afraid to bring back your closed clinic to the same glory as before, some of them are scared that they might not even get their jobs back and will have no means to put food on the table.

We did put posts on social media thanking those people on labor’s day, but was that post even meaningful enough?

Don’t you think we are the more blessed people who are still safe in our homes thinking about our next plan of action for our business, jobs or families whereas them, they might be having sleepless nights thinking how they are going to save their homes from loss of money, from a disease which has no cure as of now and they are on a certain risk of infecting their near and dear ones.

Let us take a moment to thank them, because if not the backbone they still are a very vital organ of your practice and I am pretty sure that even if they take a day of absence you will not pick up the broom and mop and start cleaning your clinic.

A note to thank those who are left invisible.

Why Home-Based Primary Care Has Taken A Backseat Over Expensive Hospitalization?

In today’s high octane lifestyle prevalent in society, it is common to see that healthcare spending in India takes up to 50% of the annual income of the majority of the population.

The patients I am talking about tend to be frail, elderly and have multiple chronic illnesses while many have unmet behavioral and mental health needs as well. Each family has one or two elderly patients who require monthly checkups, prescription refill and blood tests. Come to think of it, home visits to patients is not a bad idea if seen through the eyes of the patient and their families. This not only saves a lot of time and money on hospitalization and miscellaneous hospital bills, but also provides care for the patients where they are most happy (their homes) making it easier for them to recover.

The basic idea is to provide care from the comfort of their homes. This will lead to half the expenditure of what traditional Medicare programs spend on severely sick patients. Much of the savings will result from keeping patients healthy enough to avoid high-cost hospitalizations.

High-cost, high-need patients tend to spend almost all of their time at home. They’re often elderly seniors who live alone. Many lack access to reliable transportation that can get them convenient and in some cases immediate appointments with doctors. Instead of demanding that patients come to us to receive care, what if we went to them?

In doing so, we could eliminate barriers concerning access to quality medical care for the patient and convenience to the worried family members. But for this concept to succeed, we’d have to restore the lost practice of making house calls. After all, gone are the days of charming doctors showing up on doorsteps with medical bags in their hands [Remember the old Hindi movies? Except for the basic services offered by home care agencies, healthcare at home has taken a backseat over the “trend” set by the new mushrooming hospitals’ chains.

The idea is to treat the patients within the comfort of their homes, just as we would in a medical office setting, fine-tune medications, examine & dress wounds and make diagnoses.

But Home-Based Integrated Care is so much more than that. For this idea to succeed, there need to be teams made up of primary care physicians, nurses, case managers, medical assistants, social workers and other professional caregivers who work in tandem to provide comprehensive care to include preventive, chronic conditions, urgent and post-discharge care.

On visiting new patients, the medical professional shall assess their mental and physical health; ensure that they’re filling prescriptions and taking their medications appropriately. For their convenience, we can try to develop a strong relationship with local pharmacies who deliver pre-packaged medications to patients and can ensure timely alterations in medication regimens.

Seeing patients at home adds a certain familiarity to the doctor-patient relationship, which often gives long lasting positive results.

White-coat and the “Tab” — The Digital Saga

Many doctors are still reluctant to shake hands with technology, Email access, online scheduling, and electronic records would all make healthcare so much easier for patients. This is why some doctors are still reluctant to modernize.

Change is not for all:

The world is changing and it’s changing fast but not for all. Doctors these days, especially the ones who are more experienced, find it harder to accommodate newer technologies and newer methods of practice management in their clinics. For instance, my baby’s pediatrician who is 77 years of age finds it hard to use an app as simple as Whatsapp.(How to deal with this one!)

The only problem faced in this scenario is when a patient wants to show a specific medicine at the counter they have to buy it show it to the doctor and come back again to get it changed if it is in this case not what was recommended for the kid.

This small problem could have been easily resolved if the doctor was open enough to accept a simple technology.

The World is spinning

A few healthcare providers or doctors are so confident in working with robotics, computerised invasive surgeries etc., but when it comes to using a tab to explain a certain procedure to the patient or add simple data in the patient’s e file they are at a loss.

Most doctors ask their assistants to do this (dirty work) as most of them find it time consuming and honestly, plain old boring.

To feed or not to feed

Feeding data in the tabs is easier for new doctors who are more technologically compliant than the senior ones who learned to prescribe using paper compared to the ones who use tabs to even feed complaints and medicine.

Rise of the new world

It is next to impossible to keep track of old patients in the form of hard copies which might in case be needed for medico-legal issues. Also, with the never ending inflation, decreasing sizes of clinics where are the doctors supposed to keep all this paperwork?

Don’t you think a laptop with online backup will be easier to keep track of daily patients, accounting, prescriptions and what not!

We would love to know and understand if this is just stereotypical or doctors are more accepting this new world with a storm!

For more updates and articles download, Indian Doctors Network.

10 Things You Should Never Say to Your Patient

Don’t threaten a break-up

If you threaten your patients, you may regret it later. “It shows that you’re not truly committed to your job, making your patient feel rejected and preventing them from feeling safe trusting you.” When a patient comes to you, he/she is apprehensive, as a new patient will definitely take time trusting you for he/she had his/her own reasons to leave his/her previous dentist. So, if by any chance you are having a bad day (it’s OK, we are all humans), tell the patient politely that you are swamped today and you would really appreciate if you can give them the evening/next day’s appointment. This will give you time to understand his/her issue and understand the exact problem they are facing. Believe me, it helps build trust with your patients as they see that you have kept a “special time” exclusively for them.

Don’t call him or her a liar

“Trust is imperative for any successful relationship”. If you suspect the patient is being untruthful about anything, telling them straight out that you don’t believe him/her will usually backfire. Instead say, “I’m having trouble believing you’re telling me the entire story.” It’s less inflammatory and accusatory. Focus on asking questions about a particular incident to fully open the lines of communication. The idea is to listen rather than fire off harsh statements. By gathering all the facts first, you’ll be in a much better position to understand your patient’s behavior, disease, history and then react appropriately.

Don’t tell them how to react to something

Let’s get one thing down for sure, they are in pain, they are not sure and all they want is relief. Words like “Calm down” and “You’re being too sensitive” will make the patient feel you cannot empathise. Sometimes doctors make comments like these to stop their patients who are upset, but it can make the patient feel like their emotions aren’t justified, valid or being heard. You want your patients to feel safe showing and voicing their vulnerability without fear of judgment. These phrases are perceived as demeaning directives that belittle and degrade your patient; and he’ll respond with anger, volatility and/or hostility. Rather than telling them how to feel and react to the matter at hand, you’ll be better able to resolve things by letting them vent and listening carefully to what they are saying.

Don’t be passive aggressive

When a patient is at your clinic, it’s obvious that something is wrong, maybe something serious. So, when you say “nothing or everything is fine” you’re being passive aggressive and you make it seem like you’re afraid of bringing up something that could be serious. Being able to communicate with your patients is the only way to work through and make them trust you completely. Sit down and talk it out as calmly and respectfully as possible.

Don’t speak in absolutes

“You’re always late”, “You never take a complete course of medicines” — when you use these phrases, they’re rarely truthful or productive and always hurtful. You’re telling your patient that they can never do anything right and that you don’t think they can change. When you say these words, you’re essentially conducting a character assassination. Studies show that when you put your patient’s character down, you’re even more likely to head for a break up, meaning — you may be the most talented dentist in the whole city, but if you lack communication skills, get ready to go down the hills and lose potential patients. Next time, explain the logic behind taking complete course of medicines (patients appreciate if you involve them) or plan a time according to their schedule if they are always late on your appointed time. A little adjustment will go a long way.

Don’t test their loyalty

“You don’t trust me?” — your patients shouldn’t feel pressured to do something to prove his loyalty. You’re basically testing your patient when you say things like this. Instead, make a request in a non-confrontational and direct way.

Don’t insult their career

Do NOT share a treatment plan according to their social status, it is unethical and you never know, sometimes patients surprise you. I have come across many senior doctors who do not tell their economically weak patient a complete treatment plan. They go straight away with extractions, never even mentioning Root canal treatment, crown and bridge, let alone implants. You have to respect each and every patient you have. You don’t want to belittle, emasculate or marginalize your patients by saying things like “You cannot afford our advanced treatment.” Poof!! Your patient is gone.

Don’t make them feel dumb

No one likes to be told they’re dumb or feel belittled. The unspoken and unwelcome message is that you’re smarter than they are in what you do. They have all the right to get an explaination of the treatment plan, post-op instruction or pre-op instructions without them feeling that you think they are dumb. It takes time for some patients to absorb or they want to be extra careful, there is nothing wrong with repeating an instruction 4 or 5 times, if the patient wants so. if it is difficult to conduct easily and/or there is a series of instruction or treatment plan that you follow with all of your patients, then keep printed copies and handover to them.

Don’t be overly sarcastic

The habit will not go on its own. “Do I look like I am here to brush your teeth?” “Do I look like a babysitter?” Words of sarcasm may seem harmless at first, but they can be used to take a dig at your patient and communicate that you’ve been frustrated by an unmet expectation. Sarcastic comments that put your patient down will erode the relationship and are likely to leave your patient feeling frustrated. Deal with the issue in a loving and genuine manner, which shows that you truly care.

Don’t bring up the ex

You know you are talented, you know you are better than others, but don’t forget you are easily replaceable. If you keep on shaming down the patient that “his ex-dentist was a quack” or “that he destroyed their oral cavity” or words like “I could have saved this if you came first to me”, will not only send the patient on a guilt trip, but will also make him/her feel that you are too proud. Keep your feet on the ground.
This goes vice versa too, your patient might keep on comparing you with his ex-dentist and will make you feel frustrated at some point of time. Have patience, you don’t need to fill someone’s shoes. You have a personality of your own, talents of your own. Let them see that through your work.

Always remember

Happy Patient = Successful Practice

Subtle signs of a toxic relation that you have been ignoring because “it’s practice”

 1) It’s making you insecure:

To the limit of obsession. You have put in all your time and energy into your practice. Needless to say sweat money and blood into it. But your practice is not performing enough and is making you worry to the extent of taking a toll on your health. You might have taken loans thinking your practice will pay it off and now it is giving you nightmares.

2) It is holding you an emotional Hostage :

Whenever you take a day off to yourself, you feel guilty about it. You feel guilty over the stuff you really have no control over, like patients not walking in, or you expecting more from a day’s work.

3) Overstepping of Limits:

If your practice is what is on your mind, and your practice is all that you do then you need to think rationally. Your practice is dominating your life without giving you a break.

4) Pulling you down?

Do you feel your good work is not getting the right appreciation that you deserve. Basically, if at the end of the day you have hijacked your good mood. You need to rethink where exactly are you? Is it because of your skills as a dental surgeon or the “employer” the clinic at who is driving you crazy and making you question yourself? Are they making you feel worthless or putting you down in front of your patients?

Take a break. Think Hard.

Realize what is wrong, where are you going wrong? Are you giving enough time to yourself and your family? Are you stuck in a stagnant relationship with your practice?

Once you realise what is wrong, do not hesitate to take help. If you are a fresher and have a new set up find mentors who will help you with managing your practice. Maybe they will point out a few reasons why your practice is taking all your energy and giving you nothing in return. You can always find many courses online to make you better at the skills you lack and give you valuable lessons of life.

Find time and pamper yourself at least once a week. Don’t forget that you are also growing older every day. Take care of your health diet and be happy even if you had just one walk in. Have patience things will change.

As for your toxic relation with your employer, you need to figure out your shit. There are many many people who will pay you and value you as a dental practitioner. They might even be mentors to you to help you set your own practice once you are experienced enough. You can find employers looking for associate doctors on Indian Doctors Network app from all over India. You can search have one on one talk with them before deciding to join their practice.

If you keep on staying in a relationship like this it can take away your mental peace, confidence and eat away your happiness and sense of freedom so discreetly, that you wouldn’t even know what is happening.

You are the protagonist in your story. It’s your job to do everything in your hand to shine in your story.

O WoMANia!

On the occasion of women’s week, every nook and corner of social media must be filled with how the world is indispensable without women. IT IS! The caregiver, the one who can do anything, the one who can do everything literally.

I am not going to add more to the bulk of posts lying around everywhere on the internet. My thoughts, my ideas have taken another tangent. What about men, the guys who opened up and embraced the woman inside? There should be no shame in writing, saying or accepting that. Even Lord Shiva is incomplete without Shakti.

I came across women who juggled through the pandemic between housework, daily chores, kids and cooking like pros, but there came men who disregarding many things

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and tasks which are so gender biased that the stereotype was impossible to break! And that’s what this pandemic did, it made people learn about equality in a wonderfully weird way.

To the men who cooked, cleaned and dusted while their spouse was in a meeting. To the men who made sure that their better half was well rested just by taking a truckload of her work and to the men who entered the kitchen for the first time; you might get mocked, you might get called upon but fear not you are the ones who are worthy of the respect you deserve.

To the men who enjoyed a warm bath and a face pack after a hard days work, agree to disagree but we all know how much you enjoyed it :P

Disregarding the “Man-Woman” fight I am hopeful that one day there will be no women’s day or men’s day to create a divide to begin with.

What do you have to say about this?

Why is your patient lying to you?

 

Did you know about 80% of patients lie to their doctors. I wonder how many of you have realized that and how many of you knowing the fact that your patient is lying to you and still go ahead with the treatment.

Here is something interesting:

• 46% lied about smoking.
• 43% lied about exercise.
  
• 38% lied about drinking.
  
• 29% lied about their sexual partners.
  

 Here are a few reasons why and here is what you can do about it 
1: They are embarrassed:
This might be because they are ashamed of their habits, knowing the fact that an unhealthy diet or a sedentary lifestyle is harmful they still go ahead with it and end up lying to their health care providers.
What can you do about this?
Do not judge,let them trust you and they might come back to you maybe telling half the truth.

2: They are unable to understand your instructions:
This happens even to the geniuses , why is that ?
You ask your patients to take a medication in a certain way or follow a routine when they are under your medication. Do you follow up after the instructions whether they understood or not, if not then it’s on your head why your patient lied to you.
Make sure before your patient  leaves your office they have understood all your instructions.

3:They're worried about being pigeonholed as someone who doesn't make good decisions :
Every patient wants their doctors to think highly of them, when they end up with an ailment or a problem; the patients tend to believe that they have lost the respect of their healthcare provider. Make sure your patient knows, whatever be the situation you are always there with them.

4:Doctors overlook patients overall experience:
It is your duty as a doctor to make sure your patient feels confident in revealing all their confidential information without feeling embarrassed or worse that you are not worth trusting.

What is your lesson here?

1. Don’t start shouting at  patients who admit to an unhealthy habit. One man said he lied about his smoking habit  to avoid a lecture from his doctor and this is the tip of the iceberg.
   
2. Realize people may not be truthful if a family member is in the room. One young woman said she lied about her sexual activity because she didn’t want her sister to know what she was doing.
   
3. A 10 second pause can sometimes pull out the truth. All it takes is not responding when they lie to you and the silence makes people respond with the truth.
   
4. Don’t be judgmental. Try not to look judgmental because you want them to feel welcome to correct themselves and not hide further,Usually when they see that you are on their side and not their enemy they will open up and  tell you things they have shared with no one else.
   
5.  Don’t get confrontational if you think your  patient is lying.Try not to get in arguments and usually will hear patients out but these relationships usually become toxic and patients will often seek out another physician,Let patients know that you have their best interests at heart. You should make them understand that as a doctor you have no other motives than to help them.
   
6. Make patients aware of the consequences of lying. For example, if they lie about medications they take, they might be prescribed something that interacts and can have serious health effects. Some people will say they have problems or symptoms to get a treatment, but the treatment can cause serious problems as well, and they are putting themselves at unnecessary risk.
   
7. Recognize that some lies can be dangerous. The most prominent example is patients taking dangerous medications in a way that the doctor did not prescribe and then lying to the doctor about it.
   
   To get more thoughts and ideas on patient management download Indian Dental Network and Indian Doctors Network.