LEARN INSURANCE

" Interactive health is about making health knowledge, supportive care, and motivation available to us, anytime and anywhere, so that we can integrate this wisdom into our daily actions to live longer, healthier, happier lives. Welcome to the new era of Interactive Health."

We are very nearly there now ! Everyone will have their PHR in the cloud; doctors and other medical professionals will use their EMRs to upload your medical data to this PHR, so that the medical information is automatically updated and complete. You can share portions of your PHR with others - and your doctor can prescribe Information Therapy to you, tailored to your needs !

While patients in the US are deluged with information, patients in India are usually starved for this. They have to depend upon US websites for information ( much of which is not applicable to Indian conditions and diseases); or upon their doctor ( who is often too busy to educate them !)

One of the major issues is that the importance of educating patients has still not become a pressing issue for doctors. Traditionally, Indian doctors have always been quite paternalistic; and most Indian patients are quite happy to follow the doctor's orders.

While it's true that times are changing, and that the younger generation of doctors is more willing to be open ad to invest time in discussing treatment options with their patients, another limitation has been the acute shortage of patient educational materials designed for India.

Another major issue has been the fact that there are so many regional languages in India - and many Indians are illiterate.

The good news is that this challenge is actually a great opportunity - and clever startups like PEAS India ( in which I am an angel investor) are now developing a library of patient educational DVDs , customised for India !

As i have written earlier, the primary job of a doctor it to teach patients. After all, medical care does not just consist of making a diagnosis or prescribing a medicine. Teaching patients about their illness; what they can do to manage it; and what they can do to remain healthy is an integral part of a doctor's job.

However, as important as teaching is learning. Doctors need to learn all the time. Medical science makes dramatic advances all the time, and doctors have to invest time, money and energy in ensuring they knowledge base is updated and current . This is why doctors read medical journals and medical conferences !

However, a very important teaching tool ( which many doctors sometimes overlook) are patients. Patients can be your best teachers - if you give them an opportunity to teach you ! Patients will not teach you just about the medical details of the disease ( though reading medicine about patients you have actually seen is the best way of making sure that the knowledge "sticks" !) .

Patients can teach doctors how to live; and how to cope with adversity ! Expert patients know a lot about their disease, and can teach a doctor a lot about how his patients can learn to live with their disease.

( And if you are lucky, and your patient is an investment consultant, he can also teach you how to invest in shares and stocks ! )

“What can you possibly learn from your doctor that is not available on the Internet?” We suspect we'll hear such radical sentiments increasingly in the future. Knowledge is said to be power, and some of the past imbalance of power between patient and doctor may be equalized. But information and knowledge do not equal wisdom, and it is too easy for nonexperts to take at face value statements made confidently by voices of authority. Physicians are in the best position to weigh information and advise patients, drawing on their understanding of available evidence as well as their training and experience. If anything, the wealth of information on the Internet will make such expertise and experience more essential. The doctor, in our view, will never be optional."

Actually, there are some things which the internet can teach patients far better than the doctor
can ! Youtube videos ( on how to take your IVF injections for example) can be played and replayed - and websites don't lose their patience with patients ! Also, many doctors are often not very good at teaching because they cannot stop using medical jargon.

Websites and doctors are all tools which a smart patient should have in their medical tool box. The real mark of a wise patient is that she knows which tool to use at which time !

Many doctors are still worried that it's unethical to have a personal website.They feel that this amounts to advertising, and that a website is a way of soliciting patients.

I strongly disagree. In fact, I feel it's unethical for a doctor not to have their own website ! The word doctor is derived from the word, " docere", which means to teach. This clearly means that one of the key responsibilities of a doctor is to teach their patients. While many doctors do this face to face, the amount of teaching which can be done this way is very limited - and a conversation is not the best way of transmitting information.

Doctors who publish their own websites communicate with their patients online - and a website is a much more powerful tool of reaching out to thousands of people who are looking for information ! If the doctor wants to be sure his website is popular and gets lots of traffic, he needs to provide information on his website which is of value to patients, which means his website has to be full of patient educational content . Good doctor's websites are not all about the doctor - they are all about the patient !

A website allows a doctor to provide authentic , reliable updated information to patients. This information is local - and can be provided in the regional language ! Since it's provided by a trusted figure, patients are much more likely to trust this information.

Doctor's websites are a great way of reducing medical myths and misconceptions; and educating society at large !

Equally importantly, having a website forces a doctor to be transparent and honest. He cannot tell a lie on his website, as this will get him into serious trouble. This is good for patients - and doctors as well ! It also teaches the doctor to be much more patient-centric as he has to use simple words which his patients can understand when talking to them online !

If I were the Health Minister of India, the first thing I would do would be to make sure every doctor had their own website. This would create a win-win situation, which would help both doctors and patients !

What makes a good doctor good is the fact that he has good clinical judgment. This is a term which is hard to define, but basically a good doctor is one has seen and treated and learned from lots of patients, each of whom adds to his knowledgebase and clinical wisdom. As the saying goes, "Good judgment comes from experience. Experience comes from bad judgment."

However, the mere passage of time does not provide good judgment . After all, 20 years of being a doctor could simply mean 20 years of doing the wrong thing ! It's important that doctors learn from their experience - and the only way they can do so is by tracking the outcomes of the patients they treat.

Unfortunately, this rarely happens in real life ! Let's take 2 patients whom a family physician treats for abdominal pain. One gets better and moves on with his life. He does not tell the doctor he is better, because who goes to a doctor when they are fine ? The other may get worse and may end up needing an appendectomy. However, he's not likely to go back to the doctor either ( unless he is angry and wants to sue !). This means that both patients who get better and those who don't rarely provide feedback to their doctor in real life.

However, without this feedback, how is the poor doctor going to learn ? He naively assumes all his patients have got better - and he loses track of those who do not improve , because unhappy patients will do their best to find another doctor.

How can doctors practise evidence based medicine ( EBM) without any evidence ? They need feedback from patients, so that can learn whether what they are doing doing is useful or not ?

EMRs can be a great tool in facilitating this kind of patient feedback ! One week after every clinical encounter, the system can automatically send an email to the patient, asking for feedback. This will provide very useful data - for which each doctor can learn about what he did right - and what he messed up.

Many doctors will agree that it can be very frustrating to treat an "interesting patient" - and then never find out how the story ends, because the patient never comes back and is "lost to followup" !

Not only will this data help doctors to learn and improve , it can also be very useful as a clinical practice builder , because patients are touched when their doctor reaches out to them proactively. Patients are happy when they learn that the doctor is interested in finding out how they are doing - and happy patients make for happy doctors !

I want all my IVF patients to become an expert on IVF , which is why we spend a lot of time and energy in educating them; and in creating unique online educational tools to help them to learn more about IVF.

Now, I am not trying to teach my patients how to do IVF in their bedroom ! The reason we want them to know as much about their treatment as possible is because this is the best way of explaining to them why we are so good at what we do - and what makes us better than other IVF clinics . The outcome of any IVF treatment is always uncertain, and no matter how good I am , there is no certainty that the IVF cycle will be successful. Also, it's a very competitive field, and there are over 40 IVF clinics in Bombay itself ! Sadly, most patients are quite clueless, and do not have the ability to differentiate between a good IVF clinic and a bad IVF clinic.

If we actively involve patients in their IVF treatment, they are better able to understand what makes us one of the best IVF clinics in India. When they understand the science behind IVF, they appreciate all the time and effort we take in monitoring them and in personalising their treatment . We work hard in order to help our patients to have a baby, but only well-informed patients can truly appreciate all the effort which goes on behind the scenes !

Also, well-informed patients have realistic expectations from the IVF treatment . They understand that human reproduction is not an efficient enterprise and do not go to pieces when the IVF cycle fails.

Most IVF clinics are extremely stingy about providing patients with information about their medical treatment. They seem to take the approach that patients are stupid and will not be able to understand anything about their IVF treatment because it's very complex ! Some don't even bother to provide a treatment summary - while very few provide photographic documentation of the embryos.

We routinely provide our patients with photos of their embryos . Making embryos is the heart of what an IVF clinic does and we take pride in our work ! This is a tangible end point I can deliver and seeing high quality embryos reassures the patient that they have received high quality medical care - and this helps to build patient loyalty. Many will frame these photos and use them to start their baby's album !

Educating our patients is an investment in helping them to achieve peace of mind that they have received high quality medical care, so that no matter what the final outcome, they know that they have had their best possible chance at having a baby by taking treatment in our clinic !

On Sunday, the quasi-governmental organization, Quality Control of India will introduce the accreditation process with the first stop of healthcare for most consumers: neighbourhood doctors. "Once the government passes the Clinical Establishments Act, it will be binding on all healthcare providers to seek accreditation," said QCI secretary general Dr Giridhar Gyani.

How will Cliniq 21st help patients? It will mean that a doctor with the brand has been attending continued medical education (CME) lectures, he or she will provide health checkups for his/her staff and the clinic will have minimum required emergency care equipment and the place will be fumigated once a week. "Once patients or their relatives see this Cliniq 21st board outside a doctor's chamber or a clinic, they can expect a certain standard of treatment and infrastructure," said Dr Ravi Wankhedkar of the Indian Medical Assocation's state branch. The need for such an accreditation process cannot be underlined enough. "This is a step towards standardizing healthcare delivery organizations," said P Gadgil of an NGO, Forum for Enhancement of Quality in Healthcare, an interface between the medical community and QCI.

One of the reasons my blog has been a little neglected lately is that I have been trying to learn Sanskrit. Learning a new language is hard work – especially for someone like me, who has poor aural skills ! What have a learnt during this journey ?

The key is to find a good teacher, and I have been very fortunate in finding a superb guru ! This is Mr Sudhir Kaicker who teaches Sanskrit out of the love of his heart – and keeps me going when I falter or feel that I am never going to make any progress ! He never criticizes and is extremely patient and supportive. He’s taught me a lot – and not just Sanskrit, but how to help others to learn !

However, the surprising lesson for me was the discovery that I learn a lot from other students ! We are all in the same boat – and while struggling to swim, we end up teaching each other quite a bit. The other student with me is Mr Ravi Gogte, who is far more advanced than I am, so it’s very helpful to have someone I can ask for help when I am stuck !

To teach optimally, teachers should organize students in small groups ( of 2 or 3) so they can help each other to progress. The best way to learn is by teaching someone else – and it’s much easier to learn from your peers, as the problems you encounter are very similar and you are on the same wavelength. Also, a little bit of friendly competition helps to keep you on your toes.
I also find that it takes me a long time to learn a new concept – and it’s much easier for me to understand this when it is presented to me in many different formats ( until it finally sinks in !) This is why I have bought a lot of books; and study from all of these in parallel. Each book has strengths and weaknesses – and by using them together, I can learn more efficiently.

Incidentally, all my Sanskrit classes have been online on Skype. Using a blended model of online learning with books helps me quite a bit – and there are a not a lot of clever online resources I enjoy exploring. I especially like the Sanskrit Ipad app called Sanskrit primer.

So why am I learning Sanskrit now ? Good question – and one I’ll answer later !

Patientology is the study of patients - and this is a core skill which all doctors need to learn, even though there is no textbook or syllabus for this !

One way all doctors can become better patientologists is by teaching their patients how to become better patients ! Good patients make for good doctors - and it's possible to provide patients with a toolbox of skills which they can learn to help themselves.

These tools include teaching patients :

how to keep good medical records
how to talk to doctors
how to ask questions
how to do their homework
how to take care of themselves when they are in hospital

All good doctors are good patientologists. They are empathetic; and understand what the patient's fears and worries are, so that they can help them to manage them.

How does a doctor become a good patientologist ? Unfortunately, these skills are never taught formally in medical college. Some doctors have a great bedside manner, because they have a high EQ ( emotional quotient). Others learn how to improve their patient skills by emulating their teachers who are good clinicians. Others learn " on the job", primarily by listening to their patients . However, teaching doctors these skills still seems to be a hit and miss affair.

I have observed that most doctors become dramatically better at dealing with patients when they fall ill and need medical care themselves. Being a patient ( even for a short while) quickly teaches doctors to see things from a patient's perspective. After all, the best kind of learning is experiential learning - and if patientology is the study of how to be a good patient, the best way to master this skill is by actually being a patient yourself !

An easy best way to implement this would be compulsorily hospitalise all medical students for 2 days ! This will teach them what a patient goes through - and once they have viewed life from the wrong end of the stethoscope, they are likely to be much more caring and careful when dealing with their own patients.

HELP is India's largest patient education resource center. We want to establish patient education resource centers all over India, to promote Information Therapy. We are now looking to recruit doctors to spearhead this initiative. You will need to create India-specific relevant information for patients; build closer relationships with physicians, pharma and health insurance companies; and help to set up patient education centers at hospitals and train patient information officers.

This is an exciting and unique opportunity with helps to Put Patients First !

Please send your resume to : helplibrary@gmail.com

HELP is the world's largest free patient education library, located in Mumbai.

We are looking for Patient Information Officers, to help promote Information Therapy in India.

You will help to empower patients with information.

If you are interested in this exciting job which please email your resume to: malpani@vsnl.com !

A book which I have found very useful in helping me to grow my practise is Dr Marshall Zaslove's text book, The Successful Physician - A Productivity Handbook for Practitioners.

Dr Zaslove emphasises that there are 3 tools you need to master if you want to become a successful doctor.

1. Time management, to improve your efficiency. Remember that you are a daily-wages earner - and the more productive you are, the better your clinic will run ! Doctors are often a major bottleneck in a clinic's efficiency ( but are often not smart enough to realise this , or too clueless to fix the problem. )
2. Relationship management ( which includes dealing with patients, staff and colleagues)
3. Knowledge management

In this post, I'd like to focus on knowledge management. The reason patients come to doctors is because doctors have expertise in a specific domain - medicine. However, the half-life of medical knowledge is very short in this day and age, when technology makes rapid advances every week. Doctors cannot afford to become outdated if they want to maintain their cutting edge.

Sadly, the truth is that most doctors in India, once they start practise, very rarely invest any time or energy in ensuring they are uptodate. While they will attend medical conferences for continuing medical education, most conferences are primarily social networking events which allows doctors to take a break and catch up with friends, rather than a means of learning more.

The USP for a doctor is his medical knowledgebase - and woe betide a doctor who does not read the latest medical journals and books. This is something which doctors in the US take for granted - but which most Indian doctors ignore, because they do not treat themselves as professionals who need to constantly hone their expertise and domain knowledge. ( Most Indian doctors have not bought a medical text book after they graduate; and many have never read a medical journal in their life after completing their MD). Most doctors depend upon their friendly medical representative to educate them - and we all know that the quality of the information which pharma companies provide is highly suspect !

There are many excuses for this sad state of affairs.

I am too busy.
I already know all this.
Medical journals are too expensive !
All these medical books are written by US doctors, so they do not apply to my practise
Who needs all this theory anyways ? Medicine is a practical science - and I am a master at this ! None of my friends bother to read, so why should I ?


However, if you become outdated, you will end up losing your patients to well-equipped specialists in corporate hospitals. This can also be embarrassing , when patients with internet printouts know more about their disease than you do ! Also, this failure to update yourself with the latest medical knowledge can result is lawsuits for medical negligence – the doctor’s biggest nightmare.

While you may try to use the internet to keep updated, the sad truth is there is very little high quality medical information available on the net !

The good news is that now for less than Rs 30 per day, Indian doctors can subscribe to the world's largest online medical library, MDConsult . This allows you to remain uptodate by providing online instant access to the FULL-TEXT of over 40 respected medical books and 50 prestigious medical journals which are constantly updated. This means you will never need to buy another medical book in your life ! MDConsult provides convenience and peace of mind – at your desktop - for only Rs 9995 per year ! This is a highly discounted price for Indian doctors only . You can take a free tour at http://info.mdconsult.com/tour/

In order to subscribe to the MDConsult Core Collection ( www.mdconsult.com), please mail a Demand Draft, for Rs 9995 only, payable to Health Education Library for People. For a little more than Rs 20 per day, you now have your own personal medical library, which is constantly updated, so you never need to buy another medical text book again in your life !

I know that using MDConsult has made a world of a difference to my practise. For example, while I know a lot about infertility, many patients with genetic diseases come to me for PGD treatment. Thanks to MDConsult, I now have instant access to reliable information on all genetic diseases - no matter how rare they are. I can share this with my patients, and my expertise dazzles them. Also, this knowledgebase allows me to impress my colleagues ; and helps me to prepare papers and presentations for medical conferences. It's also very useful when I need to talk to reporters and journalists.

Doctors are usually quite smart. They are academically bright , as proven by the fact that they managed to get into medical college inspite of intense competition; and have successfully graduated from a demanding course. Also, while not all doctors are brain surgeons, most are intelligent and have a high opinion of their own intellectual abilities.

However, some of them are quite badly behaved. They are rude to their patients - and make them wait interminably in their waiting rooms, for no good reason. Since doctors are in the business of saving lives , some of them start behaving as if they were demiGods. It's quite easy for them to delude themselves into having a very high opinion of their worth. This is often bolstered by their patients, who look upto doctors and often worship them. ( As a pithy saying goes, the reason doctors are on pedestals is because patients are on their knees !)

There are many reasons which contribute to this inflated opinion doctors have of themselves. For one thing, many doctors interact primarily only with their patients . Because they have a very limited worldview, they view themselves as being masters of their ( little) world. Also, they are top guns in the hospital hierarchy, and are used to having nurses and assistants obey their every little whim - something which reinforces their view that they are the best !

Also, not only does a big ego seem to be an occupational hazard, it also seems to be a contagious disorder. Residents learn to acquire their "high and mighty" style from their bosses in the hospital during their rounds - and this is a trait which seems to run in certain departments ( for example, heart surgeons). It's also much commoner in doctors who work in hospitals ( as compared to those who own their own clinics).

However, I think the real reason some doctors have such an inflated ego is because they have low self esteem - and an inferiority complex, which they try to hide . Many of them earn much less than their peers - and it's well known that MD postgraduates earn a fraction of their MBA colleagues. This burns many doctors up - especially when they recollect that these same MBA grads did much worse than they did in school. This is why some doctors need to primp and preen to show their patients who is the boss !

Good doctors, who have high self-esteem, do not need to put on these false airs and waste their time in posturing !

But talking about doctors and egos does remind me of this old joke.

A man dies & goes to Heaven.

Upon arriving at the Pearly Gates he is told "Welcome to Heaven, everyone is equal here."

The man is then given a tour of Heaven and finds that it is indeed true.

The man decides he's just got to try the food & goes & stands in the cafeteria line.

While waiting ,a man in green scrubs goes rushing to the front of the line & gets his food ahead of all the others.

"Hey, I thought everyone is equal here. Why did he jump the line?"

"Oh, him?" says St Peter, "That's God, he is just playing at being a Doctor ."

Traditionally, the term patient education refers to the act of doctors teaching patients about their disease. However, it could as well refer to an equally important activity - one in which patients teach doctors about their illness !

Why don't more patients educate their doctors ? This kind of patient education has a long and respected history ! While writers have shared what it's like to be a patient for hundreds of years, one of the most important books which taught doctors to re-look at things from the patient's perspective was Norman Cousin's classic, Anatomy of an Illness.

In fact, there is now an entire a genre of books which does this very well. This is called pathography - a " narrative that gives voice and face to the illness experience, by putting the person behind the disease in the forefront " !

Pathography is a very useful teaching tool ! It helps doctors to learn empathy, so they can learn to see things from the patient's perspective ! For example, though I am an IVF specialist, I am not infertile myself. By reading first person accounts of the trials and tribulations faced by infertile couples, I learn a lot about the difficulties my patients have to deal with - stuff they may not be willing to talk about when they meet me for the first time .

All doctors learn medicine from their patients. They usually remember their most technically challenging patients or their most complex and difficult cases. It's true that these exceptional patients teach us a lot and good doctors treasure these exceptions , because they learn the most from them. These are a doctor's " memorable " patients - many of whom teach us what not to
do !

Good doctors learn from patients all the time, but this can only happen if patients are willing to teach them ! These are the " expert patients" - those who are articulate and treat their doctors as partners in their medical care.

However, doctors can learn from all patients - if only they would learn to speak up , and we would learn to listen . Patient feedback helps doctors to improve their services - and even complaints are gifts, when taken in the right spirit !

Unfortunately, there are still many barriers to getting feedback from patients. Most patients are inhibited and scared and do not have the courage to displease their doctor by telling him the unpleasant truth. Similarly, most doctors are too busy to ask for feedback - and most continue deluding themselves that they do a perfect job with every patient !

Hopefully, the internet will allow patients to offer critiques and criticism more easily. There are now many doctor - rating websites, where patients are encouraged to provide their opinion about their doctor. This kind of patient- generated content will help doctors to get their act together, if they are willing to keep an open mind and try to correct problems.

If patients want their doctors to do a better job, they need to learn to speak up. Most dis-satisfied patients today just walk out of the doctor's clinic and never return . They find a better doctor - but by failing to give the doctor frank feedback, they have lost an opportunity to help him to improve and do a better job with his next patient.

How will doctors learn , unless patients teach them ?

This is one of the commonest complaints patients have about their doctor. It's true that doctors are very busy and have lots of patients to see. While it would be great if your doctor had all the time and patience and energy in the world to answer your questions, the truth is that the amount of time you have with your doctor is going to be limited.

It's part of a doctor's job to educate his patients. A doctor who does not do this is not a good doctor, simple. However, it can be very boring for a doctor to answer the same questions again and again - and doctors are human too - they get fed up and bored as well !

How can you help your doctor to make the most of the limited time you have with him, so he can clear your doubts and answer your queries ?

The best way to to do this is to get your doctor to respect you, so that he treats your concerns and doubts with courtesy . However, you need to earn this respect. The best way of doing so is by being well-informed; and you can do this by educating yourself as much as possible about your problem, both before you visit your doctor , and afterwards. This will allow you to be
considerate with the doctor's time, so that you can ask him specific, pointed queries . ( Doctors are smart and most like answering clever questions - it's the ones they are asked all the time which they find boring !)

Some patients just ask questions for the sake of asking these. These just waste the doctor's time and irritate him - causing you to lose his goodwill and respect. Thus, many question are best answered by the support staff , rather than the doctor. ( If you need to know what the clinic timings are, please ask the receptionist, not the doctor !)

Other patients have a long laundry list of questions. While I approve of the fact that patients have taken the time and trouble to write their questions down, it also bothers me that they have not bothered to find out the answers to these questions by just taking the time to visit our website at www.drmalpani.com ! I do get upset by intelligent patients who do not take the effort to go online and educate themselves about their problem. If they will not take the trouble to help themselves, why should they expect their doctor to go out of his way to help them ?

If a doctor gets irritated with your questions, this means he does not respect you. This is not acceptable behaviour. If he is very busy , he does not need to do the basic education himself - he can do it through his website; with DVDs; or with the help the help of a nurse. Clever doctors will get an assistant to explain the basics, so they only have to explain advanced concepts ( as to how the treatment will be tailored for the individual patient) .

I prefer answering my patient's questions by email . Most questions are ones other patients have asked me in the past, so it's quite easy for me to answer these quickly and efficiently. Because the answer is documented , there is less confusion and this saves the patient time and anxiety ! This is far more efficient than asking questions face to face, or with a phone call !

Taking time to educate yourself has lots of advantages. The doctor does not need to waste time going over the basics ; and because he knows you've done your homework, it helps him to have a more high level discussion with you . Remember, the squeaky wheel gets the grease !

In an ideal world, doctors would be able spend as much time with the patient as he needed. They would understand the patient's personal beliefs and preferences; empathise with his worries and concerns; educate and inform the patient about his treatment option; and draw up a treatment plan which the patient was happy with.

Sadly, in real life, the only kind of people who are going to get this type of care today are billionaires who own their own hospitals. Today, most doctors are just too busy to be able to even talk to their patients for an uninterrupted ten minutes ! When they are young, they are rushing from clinic to clinic , trying to grow their practise . When they are senior, they have so many patients who have lined up to see them, that they just cannot devote the time needed.

As a result of this busyness, the first casualty is often patient education. Because doctors are not able to spend enough time with the patient, they are often not able to explain how they plan to fix the medical problem. As a result of this breakdown in doctor-patient communication, patients often have unrealistic expectations from their medical care - and if something goes wrong, the doctor is the one who bears the brunt of the patient's anger and resentment.

This is why patients now often spend hours on the internet, trying to educate themselves and learn as much as they can about their medical problems. While this is very good, the reality is that the quality of information on the net leaves a lot to be desired - and patients often get confused or misled by unreliable websites, making a bad situation even worse !

This is why librarians can be such a useful source of Information Therapy ! Librarians are information specialists, who have been trained to search for and retrieve high quality information.

In fact there are many reasons why librarians can do a better job at dispensing information therapy than doctors can !

They are trained professionals, who are expert at taking an interview with the patient, to determine what his information needs are. Because they are not medical professionals, they are able to provide objective, reliable information with no vested interest ! In fact, the information provided by an expert medical librarian is often better than that provided by a doctor. Unlike a surgeon who is quite likely to push for surgery, a librarian has no conflict of interest or hidden agenda and is quite happy to present all possible options, without any bias !

Equally importantly, patients are often more comfortable talking to librarians, who are seen to be non-threatening peers who encourage questions and take delight in providing high quality answers ! Doctors, on the other hand, can be quite intimidating - and most patients are very reluctant to ask their doctors questions, even when they are completely confused and do not understand what is going on !

Even better, librarians can help patients to make sense of the information they retrieve, because they are taught how to rate the quality of information. While patients will often get lost on the net, librarians can help them to judge how good the quality of the information is, based on a number of objective criteria. Of course, whether this information then can be applied to the individual patient is something which only the patient ( and his doctor) can decide ! Thus, while a surgeon may pooh-pooh a medical treatment option ( because he would rather do surgery than prescribe medicines !), a librarian can help the patient to explore all the available alternatives, with an open mind. Also, librarians do not use medical jargon to obfuscate the information they provide. They ensure that the patient understands the information - and because librarians are also lay-people, they are often much better at speaking the same language the patient does ( unlike doctors, many of whom do not seem to be able to communicate with their patients in simple English !)

There are many advantages of using this combination approach !

It fosters and encourages team work in medicine, and allows patients to get the benefit of multiple perspectives !
It keeps doctors honest, as they know that patients will be counter-checking the information they give them
The information is provided by information specialists, which means it is reliable, and current
Interestingly, doctors can also learn from the information which librarians provide. It's not going to teach them about medicine, but will teach them how to explain complicated medical concepts to their patients , and help them improve their communication skills
It can also help doctors to keep updated, if they have an open mind. Thus, these information searches are likely to teach them about alternative medicine options , which they would not otherwise be aware of
This kind of partnership can save the doctor time. He can focus on providing the medical care, because he is confident that the information needs of his patients are being met by trained professionals
It also helps the patient to be more confident that they are getting the best care , and will help them develop more trust in their doctor, because they have verified the information he has provided using independent sources provided by the librarian.
This approach will also help to reduce the difficulty patients often encounter when they search for medical information on the internet, because the librarian will make sure the information is authentic and current !

Salman Khan is my hero ! Not the Bollywood star, but this Harvard grad, who has created a 1600+ video library which has become " the most-used educational video resource as measured by YouTube video views per day and unique users per month. " His next step is to " complement this ever-growing library with user-paced exercises--developed as an open source project--allowing the Khan Academy to become the free classroom for the World."

What do I love about him ?

1. It's the work of one person - which proves that it takes just one person to improve the world
2. He started small - without waiting for funding !
3. He dreams big !

For most doctors, keeping uptodate means participating in continuing medical education ( CME) programs by attending conferences or reading medical journals.

I feel a much better way today is to publish your own website and encourage online patients to ask you questions !

When you answer these, you will end up learning a lot ! Some questions can be very sophisticated; and many internet positive patients are very intelligent and well-informed. They have done a lot of research and will often cross-question and challenge your authority.
This is very helpful if you are willing to keep an open mind !

Some of them will help you to question traditional wisdom; while others will encourage you to
push the envelope and try out new unconventional stuff in their quest for the best medical care !

Answering questions will teach you to be respectful. For every question you answer, smart patients are likely to ask 2 more - and then you often have to think more deeply than you ever did ! You may find yourself questioning your most basic assumptions and you may even find that a lot of what you are doing can be easily improved.

The world has become a small place and patients will ask why you do not have certain advanced equipment which clinics in other parts of the world possess. You may find you have to invest in new equipment - or have to polish your skills, so you do not become obsolete and irrelevant.

Clever patients will force you to remain uptodate with the medical literature ! Some will refer you to articles in medical journals which you may have overlooked - and most of us do need pushing and prodding to ensure we maintain our competence. It's best if this push comes from our own patients, rather than some faceless nameless bureaucrat !

Answering questions will help you to improve your communication skills . You need to learn to write well in order to communicate cogently - as Bacon said, writing maketh an exact man !

We all know that the best way to remember stuff is to use it and apply it. Answering your patient's questions in writing will ensure that the new information you imbibe becomes a part of your knowledgebase, because you have made use of it !

Your website will help you to become empathetic . Patients will often talk openly about their personal feelings more easily in an email. This may not be intuitive, but the truth is that patients are reluctant to share their feelings when sitting in front of the doctor , because they do not want to waste the doctor's precious time; and are not sure how the doctor will respond if they burst out crying, which is why they will often bottle up their feelings. However , in an ongoing email conversation, they have time to sit down and spill their guts - and are often more comfortable doing so, because they are protected and anonymous.

Email conversations with patients will teach you humility as well. Your patient may follow a course of action which is diametrically opposite to what you advised - and end up getting dramatically better, proving that your advise was incorrect. While most of us do not like being proven wrong, if you keep an open mind and are willing to learn , you will learn a lot from these patients !

We have always been taught that doctors learn medicine best from their patients. This is still as true today as it was in the day of Hippocrates - it's just that we can now use the internet to do
so !