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Most Indian hospitals have their own websites which clearly means that they understand the importance of having an online digital presence. However, most of them use their website purely as a branding tool which means their sites are just digital brochureware. Inspite of being an IT global powerhouse, Indian medical websites have lagged behind. The biggest tragedy is that with just a little bit of effort, they could become world-class, given the fact that India has an unbeatable combination of medical and IT expertise !

Just compare www.mayoclinic.com with any Indian hospital’s website ! Or look at the Alexa ratings or Google page ranks for Indian hospital websites . They get only about one tenth the traffic which much smaller US hospitals do. While it’s true that the number of internet users in the US is more than in India, this is irrelevant. The internet has become a global playing field, where hospitals are doing their best to attract patients from all over the world ! And it’s not about the cost of the website or the use of clever flash graphics or Web 2.0 tools either. The reason for the poor traffic is much more basic – it’s poor quality content !

Most hospital websites are chockful of information about the hospital , but they have precious little content which is designed for the patient ! Remember that when someone is sick and is looking for medical care, they will not do a search for Fortis Hospital or Care Hospital ! They will google for more information about their disease – and because Indian hospital websites provide precious little information on just a few diseases, they rank very low on a google search !

The solution is simple – hospital websites need to offer a comprehensive library of online information for prospective patients. However, this is a surprisingly challenging and complex task. Most webmasters have no medical expertise and they naively expect the hospital doctors to provide them with the content for the website. However, most doctors are very poor at communicating and are of little help . Generating high quality content for patients can be a very expensive and time consuming exercise – especially when you need to keep it uptodate and error free . Also, hospital management is worried that they may get sued if they provide incorrect information, which is why they often prefer not providing any information at all !
So what do they do ? Some will get their doctors to provide a few pages of content – material which is badly written, full of medical jargon and hard to understand. Others will source free health information - for example, from Wikipedia. However, this is often of patchy quality – and these hospitals get what they pay for ! The other option is to license this information from US and UK publishers– but this can be very expensive !

The good news is that HELP, in partnership with Healthwise , the leading provider of patient educational content in the USA, now offers Healthwise content to Indian hospitals who want to improve their websites. This means that Indian hospitals can now get the exact same content which Healthwise provides in the USA - at a fraction of the cost ! Both HELP and Healthwise are non-profit organizations, whose mission it is to promote Information Therapy to help patients to make better decisions !

This means that hospital webmasters can get an instant painless Transfusion of Information Therapy ! This authoritative patient education library called the Healthwise Knowledgebase can be whitelabelled and plugged into your existing website within one week , thanks to our Technology Partners, Plus91.

As a result of including this Healthwise content, we are sure you will see a dramatic jump in your online traffic ! If this translates into even one more additional patient per week , you will recover your investment very quickly ! In fact, we are so sure about this, that we are happy to provide a free trial for one month. You need to pay for an annual license in advance. If your traffic does not improve by at least 50%, we will refund your money back.

What do you have to lose ? Please email me at malpani@vsnl.com and I'll be happy to provide more information !

Many medicines are available over the counter ( OTC) . These are usually safe drugs, which have been used for many years . They are effective for common problems; have few side effects; and do not need a doctor's prescription. However, most medicines are still available only with a doctor's prescription. This is because medicines can be powerful , and while they may be very good at treating certain problems, they may also have undesirable side-effects. Experts need to make a decision regarding the risk-benefit ratio of these drugs, so they can select which drugs are so powerful that they can only be dispensed with a doctor's prescription.

Medicines form an important tool in the medical armamentarium. However, not all illnesses need medicines, and an increasingly important addition to the medical arsenal today is Information Therapy.

It's useful to remember that while Information Therapy can be effective and inexpensive, just like any other therapeutic tool, it can have side effects as well ! This is especially true with online medical information, because a lot of this is unreliable, outdated and plain wrong. Unfortunately, many people do not have the ability or sophistication to differentiate between good quality and poor quality information , and wrong information can actually harm a patient. Thus, patients with blocked tubes may end up wasting thousands of dollars on pursuing ineffective therapies such as Clear Passage ( massage therapy which claims to open blocked tubes) rather than do IVF; while men with low sperm counts end up getting frustrated after spending hundreds
on " herbal medications" which claim to boost low sperm counts but are completely useless !

Not only can unreliable information harm patients, it can also waste a lot of the doctor's
time, because he now has to remove the myths and misconceptions which patients have acquired online from unreliable websites, which are just out to earn a quick buck by peddling cures !

Just like powerful medicines need to be "prescribed" by a doctor, it's a good idea for doctors
( and hospitals and governments) to "prescribe" reliable information. Information Therapy is powerful medicine - and it needs to be promoted, so that patients benefit from it.

The best way to do this is to use reliable patient educational content, designed by non-profits such as Healthwise. You can see how well this works in real life by going to www.informationtherapy.in !

The Institute for Health Technology Transformation is a US based organisation that brings together private and public sector leaders to foster the effective use of technology across the healthcare industry.

Their report, "Top Ten Things You Need To Know About Engaging Patients' is a compilation of what key health IT experts from across the U.S. think are the most important things to know about engaging patients in the digital age along with four key recommendations for practical action.

Mostly common sense. Doctors just need to ask a simple question - How would you like your lawyer to communicate with you ? Use the same principles to open as many communication channels with your patients, so it's easy for them to connect with you !

• About 42% physicians use an electronic health record solution to document their patient care and about 1 in 3 uses an EHR during a patient encounter.
• Overall, 62% of physicians and 81% of patients have a positive perception of documenting patient care electronically.
• Forty-five percent of patients had a "very positive" perception of their physician or clinician documenting patient care with a computer or other electronic device.
• More than 60% of physicians feel the best benefit to using EHR is the access they have to patient records in real time.
• Physicians also believe that the ability to seamlessly share information with other doctors, pharmacies and payers are one among the most important benefits.

" In an earlier column, I complained that IT spends a lot of time providing electronic tools for clinicians--electronic health records (EHRs), computerized physician ordering systems (CPOS), etc.--but not enough time developing tools to improve patient education.

I was wrong. Digging deeper into this area has convinced me that there are all sorts of practical technology-based resources to help patients understand their treatment and how to comply with their doctors' advice. Computer-generated questionnaires, medication resolution programs, and sophisticated videos are making a difference in patient care. "

India can be a market leader in this space !

This is a guest post from a very thoughtful patient of mine. I know many IVF patients will be able to identify with her experience . I just wish more doctors would read this as well, so they can provide more support to IVF patients !

When you do ivf as a medical tourist soon you'll find out you have become a traveller between the worlds. Between continents and between medical worlds: "normal" obstetrics and ivf. Unexpectingly it turns out to be much easier finding an ivf doctor in India than finding an obstetric gynecologist in your home town. And once you are lucky enough to get an appointment, you are faced with different treatment concepts: pregnancy in obstetrics and pregnancy in ivf are a world apart it seems.

Unless you are already established with an ob gyn - not so likely; you would not be an ivf patient if you had made it into the normal gyn world - getting an appointment with a gynecologist becomes a real challenge.

After returning from India I called a gyn I had seen once to schedule appointments for the row of betas after the two week wait. She reluctantly ordered one blood test and told me right away that she was not willing to deal with ivf patients in general, much less with ivfers from abroad and that she was not an obstetrician anyway for that matter.

I then contacted other obgyns in my area but they were so fast in telling me that there were no appointments available any time soon that I did not even had the chance to explain the vital importance of the row of betas in ivf and that this was why I needed an appointment much sooner. Since this was my fourth ivf cycle, as a recurrent ivfer I had by now acquired a daunty respect for those fearful beta numbers and their always heart-wrenching doubling time. During the two weeks of wait for the first beta, the tension grows denser and denser and the only thing that can ease your strain, slightly, is a good doubling time. I had to find a beta-willing gyn at any cost.

A certain familiarity with the medical establishment led me to the conclusion that local doctors in private practice might have arbitrary freedom as to wether accept new patients and therefore insisting on small private practice doctors would lead nowhere. I had to find a public structure with more inclusive patience acceptance. I called the medical faculty associates office at a the local university. Among the options at the answering machine : "if you are pregnant ..."That sounded promising.

I pressed the required key and a friendly voice said, he would now check for available appointment dates. I explained right away that I was doing ifv abroad and that I needed two blood tests and a scan done on specific dates. He was listening for a while and after what seemed to me a long stretch of silence he was trying to find out where in his scheduling scheme I could possibly fit in with my outlandish request for a row of betas. "A row of betas ? I don't think the doctor will do that for you". He appeared to want to be helpful, but just could not comprehend my urgency for blood tests. He suggested to do a home test in the meantime.

I did not want to lecture on the difference between qualitative and quantitative bhcg testing for fear this might ruin his sympathetic attitude towards me. I just began to understand myself that timing in ivf was far away from timing in normal obstetrics. The beta frenzy was a thing exquisitely ivf. He was willing to give me an appointment to see a doctor on a day that luckily turned out to be the day my ivf doctor wanted me to have my first scan, in 10 days to come. I gratefully accepted. I had to find another way to find relief from beta hell. There was no way I could wait 10 days without knowing my beta numbers' fate.

When dismissed from Dr. Malpani's clinic, he will ask you to inform him on your beta results. I emailed him that I was not able to obtain blood tests and therefore could not inform him. Within a few minutes he replied sending me a link to a online lab. What a relief. I would have had to pay for the tests privately though. Relief from awful beta-anxiety has no price.

The beta numbers came in, anxiety stayed. Doubts about adequate doubling time and no doctor to talk to. Again I emailed with Dr. Malpani and was reassured.

While my appointment with the obgyn was approaching, I imagined that I would have to go through at least two assistants before I could talk to the doctor. They would both ask me the same questions again ,checking the same checklist. Why was I so hypercritical ? I should be thankful that someone was paying attention to me no matter how formal.
This doctor turned out to have one assistant only and she was indeed simply friendly and asked me where I had my ivf done. "India ? That's pretty far away".
"Only on the map" I replied thinking of how easy it was to get advise from my ivf doctor by email while I hadn't yet seen the local doctor. I was so tense about seeing the doctor and whether he would have me have a scan done, that I made no attempt to explain this apparent contradiction. Whatever her assumption regarding my state of mind that moment , she was surely right.

And then she asked me about the due date. The due date ? WTH ? Heavens, I am doing ivf ! I am not in the usual pregnancy business. In ivf the due date is an almost non-existing concept. In ivf you go from hurdle to hurdle, from beta to beta, from scan to scan, day by day, week by week. The relief of one doubling beta lasts the blink of an eye and you start worrying about your next beta two days from now. And once you made it to the ultra sound level and you are lucky enough to see what could be a a gestational sac, a black little hole, you start getting very nervous when your next appointment approaches: will there be a heartbeat ? You will never forget that flimsy flickering filament and life appears to be so fragile and delicate, a friable thread of silk.

"The due date", I said, "I never got that far". A look at her told me that she considered my situation to be too complex. She did not inquire and I was glad I did not have to go over my ivf history. I handed her my discharge papers. Without having a look at them she said the doctor would be here soon and left.

The doctor stepped in, I explained I was doing ivf abroad. I told him my beta numbers and he decided they were too low. The feeling of desperation took over. I had the impression that maybe he was not used to see beta numbers at such an early stage of pregnancy and that was why he considered them too low. But I had not enough energy to find that out. I would ask Dr. Malpani.

By now I have become an established patient with both the pregnancy worlds. Pregnancy symptoms might be the common interface. I learned to navigate myself through the "normal" obgyn world being aware that I am confronted with a somewhat different obstetric culture. There is no "clash of civilization" in obstetrics, no self-fulfilling prophecy of conflict. After all, a pregnancy is a pregnancy, no matter where.

" Guiding patients to better online sources of medical information should be a new physician responsibility for the digital age. Not only should doctors expect and be receptive to questions patients raise from Web research, they need to proactively engage patients online in order to dispel falsehoods and guide them to legitimate sites."

This is why I feel every doctor should have their own website ! It forces them to search for reliable health websites ( to which they can link) so they can guide their patients intelligently, rather than getting upset when patients come with many sheets of internet printouts ! Even better, it will encourage thoughtful doctors who are not happy with the quality of the information they find on other sites , to publish better customised content on their own website, thus helping lots of
other patients !

" 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 !

This may be a terrible confession for a doctor to make, but when I have a medical problem, I'd trust an expert patient rather than a doctor. Let me explain.

I have chronic back pain and this can be quite severe at times. However, I am very reluctant to go to an orthopedic surgeon, because I know pretty much what he is going to say. He's going to do a cursory examination and then ask me do do a MRI scan. The MRI scan will find some bulges in my intervertebral discs - and the radiologist will happily report this as prolapsed intervertebral disk ( slipped disc, in layman's terms). The doctor will be happy he's made the right diagnosis; and will advise bed rest; pain-killers ; and physiotherapy - with the caveat that if it gets worse, he'll be happy to do "minimally invasive surgery" to fix the problem.

This is the standard medical paradigm for managing back pain - and while it's completely reasonable ( and follows medical textbook advise) , it's does not add to the quality of my life. I want to continue playing tennis daily - and want advise on how to manage my back pain without having to stop my tennis ! This is not something most orthopedic surgeons know much about, because they spend more time in the Operating Room than on the tennis court !

I'd much rather talk to a tennis player who has had back pain for many years, and ask him how he's managed it. He is the true expert on my problem and I'd be happy to learn from him. For one, his advise would be much more applicable to my problem - and for another, he has no hidden agenda !

Of course, not every patient is an expert patient. I want someone who's smart, well-read and well-informed - and who has taken the time and trouble to explore his options. ( If he also happens to be a doctor, that's an additional bonus !)

While doctors are good at making the right diagnosis, how to live with the disease ( how to manage what medical textbooks call "activities of daily living" ) is something patients can learn much better from other patients. This is not an area in which doctors are well-informed , because it's not something which interests them !

Really smart doctors will refer their newly diagnosed patients to other expert patients , to help them cope better with their illness !

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 ! )

For older infertile women, AMH ( anti-Mullerian hormone, also known as MIS ( Mullerian inhibiting substance) has become the new FSH . AMH is a very good marker for egg quality - and provides us with a quantitative measure for egg quality and quality.

In the past, we had to depend upon FSH levels. A high FSH level suggests poor ovarian reserve, but FSH levels are not very reliable, because they vary according to which day of the cycle the test is done; and can also be artificially suppressed by a high estradiol level

AMH is a much better marker for ovarian reserve. It does not vary from cycle to cycle; and remains the same throughout the cycle. A low AMH suggests you have poor ovarian reserve - but even if your level is low, this does not mean you should panic !

Remember that it's just a test - and good doctors do not treat tests - we treat patients !

Step number one is to repeat it again - preferably from another lab.
Step number two is to run additional tests to check your ovarian reserve.

You have 2 options: an ultrasound test called the antral follicle count ?
and a blood test called a clomid challenge test.

Even if these are poor, this does not mean you cannot improve it ! While Western medicine does not have much to offer, there are alternative medicine options you can try to improve your ovarian reserve

These include the following:

1. Yoga
2. Acupuncture
3. DHEA, 25mg thrice a day.
4. Wheat germ daily
5. CoQ 10, 100 mg daily
6. Vit D3 ( Calcirol), 60000 IU, once a week for 10 weeks

Read the book, Inconceivable.

Re-test your AMH level after 12 weeks to see if it improves.

Even if it does not improve this does not mean you cannot get pregnant ! Patients with low AMH levels do also get pregnant on their own ( though their chances are reduced). After all, levels provide information about groups of women , and there can be a lot of individual variability !

If you have poor ovarian reserve, IVF is often your best option as it maximises the chances of a pregnancy. IVF allows you to make the best use of the few eggs which are left, by telescoping time.

Plan B would be to use donor eggs, if you are willing to consider this option. This has a much higher success rate

It's well known that most patients will google their symptoms and signs when they fall ill. Patients use the internet extensively to research their disease; to check on the treatment options available to them; to connect with other patients; and to select the right doctor.

However, if there so many patients are online, why don't more Indian doctors have their own websites ? Indian doctors are considered to be well-read; well-informed; and their clinical skills are usually excellent. Moreover, India is an IT powerhouse , which means one would logically expect that most Indian doctors would have their own website, which they could use to attract more patients; and to educate their existing patients.

While many Indian doctors now do have their own email address ( though many senior doctors still do not use email; or get their secretary to read and write their emails for them), most still do not have their own website because they do not see the need for this.

Senior doctors who have a flourishing practise without a website are quite happy to continue coasting along on their reputation. They do not think a website will add any value to their practise , and are not interested in exploring this new platform. Some are suspicious of these new-fangled fads; while others will actively criticise doctors who have websites, because they feel they are a form of advertising - something which is below their dignity !

Other doctors understand the value of having their own website, but because they are not computer-savvy, they are not sure how to go about getting one. They are worried that having a website is a very expensive option - and are not willing to invest the time and energy in creating one. They'd rather continue muddling along in the fashion to which they are accustomed - and they are quite contented getting patients through kickbacks and referrals because they cannot think out of the box.

Many doctors are employed by corporate hospitals; and they feel that the corporate hospital website provides enough of an online presence for them. Some doctors have had an unhappy experience with website companies in the past. They have burned their fingers badly, and are no longer willing to trust computer professionals any more. Others have done a half-hearted job ( using free websites offered to them by pharma companies) ;and because these did not result in any tangible benefits, they have jumped to the wrong conclusion that it's not worth creating a website because not enough Indian patients are online.

This is a major error on their part. Internet penetration is increasing by leaps and bounds in India - especially with the introduction of 3GH services and inexpensive smartphones. Doctors who do not have their own website will start losing patients to doctors who are online - and this gap will increase progressively over time !

If you are in practise, you cannot afford to be left behind - and this is especially true of the younger generation of doctors, who need to establish their practise and attract patients.

Rule Number 1 for any successful doctor is - go to where the patients are ! In the past, the patients were in hospitals, which is why hospital attachments were so actively sought after. Today, it's a completely different world - and the best place to reach out to patients is the online world !

Clever companies such as Plus91 ( in which I am an angel investor) have realised that there is a huge opportunity for a startup in India which specialises in providing websites for doctors only. They have married technological expertise with medical knowledge, to create a great portfolio of websites for Indian doctors. Since this is their only niche, they have a lot of expertise and experience in this space, in which they have become market leaders ! They can set up a customised website for a doctor ( with your own domain name) within 3 days ! You can check out their work at www.websitefordoctors.in !

“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 !

Doctors are having a hard time surviving. Even though small 20-bed doctor-run nursing homes are the most cost effective way of delivering medical care for common problems ( such as elective surgery and childbirth) , it's getting harder and harder for doctors to start a nursing home in India because of the license raj and government bureaucracy. Most doctors are being forced to join corporate hospitals, where they are extremely unhappy because they are exploited and ill-treated by the management.

Why are doctors so unhappy in many corporate hospitals ? Doctors have a bottom up approach. They have been trained to be patient advocates and do everything they can to help their patient to get better. This is their primary professional focus - and this is what makes them special. This is what patients expect from them and doctors take pride in their ability to provide the best possible medical care for their patient – and they will move heaven and earth to do so. They are so focused on each individual patient’s well-being , that they will often not consider extraneous factors such as the patient’s ability to pay.

The management’s world view is very different. From their point of view, the hospital is another business – and the bottomline comes first. They understand that until they continue to remain profitable, they will not be able to survive – and if they do not survive, how will doctors be able to provide care to their patients ?

Both these approaches are perfectly valid and sound – and usually there’s no conflict. Most of the time, it is possible to provide cost effective care profitably to patients, and everyone is
happy ! However , there are times when financial considerations and medical priorities do clash. This is when the divide starts.

Bad hospitals focus only on financials . They reward doctors based on their turnover and throughput – and do not care about the quality of their care. They pressurize doctors into doing unnecessary procedures; micromanage doctors; and their primary focus is on paperwork and forms. The management often treats doctors disrespectfully; hires and fires at will; and skimps on the amount of money they pay to their doctors. Good doctors will often walk out of such hospitals when they are treated badly – and this demoralizes the rest of the staff.

Good hospitals , on the other hand, understand that their interests are aligned with those of their medical staff. They involve doctors in important managerial decisions; provide doctors with staff, tools and technology to help them to improve their productivity; treat them as important team players; and provide interested doctors with training in business management . They invest in their doctors and try to create a life long bond with them !

Doctors also come in different flavours ! Bad doctors are good at playing games of one-upmanship. They may be medically incompetent, but they are very politically savvy – and will suck up to the management to try to keep one step ahead of the other doctors, whom they treat as competitors, rather than as colleagues !

Good doctors focus on the well-being of their patients. They will not sell themselves short; and take pride in their professionalism. They expect to be treated with respect and dignity; and try to understand the basics of how the hospital runs, so they can provide constructive inputs

We need to allow doctors to get on with their job of providing good care to their patients. The only reason a hospital exists is to take care of patients – and they can only do this is they have motivated doctors, who feel they have the support of the management.

The sufferers as a result of this divide is the poor patient, who feels neglected and uncared for, even though he is paying an arm and a leg through his nose for the 5-star ambience of a brand name hospital !

Have you got fed up of waiting for ever and ever at your doctor's clinic ?
Are you upset when your doctor talks down to you or uses jargon ?
Do you resent the fact that it's impossible to make sense of your hospital bill ?
Why can't hospitals be more patient friendly ?
Why can't doctors be more transparent ?

Instead of just complaining, here's an opportunity for you to provide some answers !
Remember , if you are not part of the solution, you are part of the problem !


You are invited to attend the launch of
The Patient Community@HELP
on Thursday,7th April, 2011 at 11.30a.m.

Introduction and launch of The Patient Community@HELP

Dr.Aniruddha Malpani, M.D., IVF Specialist, Founder, HELP and Patient Advocate- "How Patients can Heal a Sick Healthcare System".

Mr.Kanu (Harshad) Kamdar, Member, Parkinson's Disease and Movement Disorder Soc. of India - will speak on "Partnering with the Health Care Team for Graceful Aging".

Dr.Shantanu Nagarkatti, M.D., Surgeon, Professor, Expert in mind body medicine will speak on "Improving Patient Communication - Learn how to talk to your doctor !"

Mr.P.K. Rao, - Founder, JASCAP will speak on "Converting A Personal Tragedy Into A Socially Useful Project".


The first meeting of The Patient Community@HELP will be held on Saturday, 14th May, 2011 and every second Saturday of the month thereafter.

Goal: To provide a platform for patients and doctors to connect, to help improve the doctor-patient relationship

Get Involved ! Whether you are a medical student, a physician, a patient or a caregiver, we need you.

If you are doctor, you can take a workshop ! If you are an expert patient, you can help other patients ! We are inviting registrations to The Patient Community @ HELP. Call us on 022-65952393/94 or send us an email.

Be there and contribute!
For more Information Click here.

Everyone is worried about the escalating costs of providing medical care. Many solutions to this problem have been based on the premise that the reason medical care is a mess today is because health care delivery is not being properly "managed". The siren song is that if we can "manage" healthcare delivery properly, we will be able to provide better medical care to more patients at a lower cost !

Management seems to have become the panacea to all ills - and it's a very tempting idea ! After all, isn't it obvious that managing something can just help to make it more efficient and effective ?

Sadly, in real life, this is not true. In order to manage healthcare, we need managers who have special training and expertise in management; and then inject them into hospitals to manage doctors . All this ends up creating is an additional layer of people between doctors and patients - a layer which has no medical expertise - and which just adds to costs and paperwork !

Interestingly, this is as true in education as it is in medicine. A great book by Philip Howard called Life Without Lawyers has a thought-provoking chapter titled - Bureaucracy Cannot Teach ( from which I've lifted the title of my post).

He writes - " All these reforms have been based on an unspoken assumption: that better organisation is the key to fixing whatever ails schools. The theory is that by imposing more organisational requirements - better teacher credentials, more legal rights, detailed curricula, the pressure of tests - schools will get better. That's the theory. The effect, however, is to remove the freedom needed to succeed at any aspect of teachers' responsibilities - how they teach, how they relate to students, and how they coordinate their goals with administrators."

Applied to healthcare, this would read, He writes - " All these reforms have been based on an unspoken assumption: that better organisation is the key to fixing whatever ails hospitals. The theory is that by imposing more organisational requirements - better doctor credentials, more guidelines, more legal rights for patients, detailed medical curricula, testing for performance - hospitals will get better. That's the theory. The effect, however, is to remove the freedom needed to succeed at any aspect of doctors' responsibilities - how they treat , how they relate to patients , and how they coordinate their goals with administrators."

Bureaucracy often ends up smothering teachers - and doctors as well ! When we try to manage something, we often end up mismanaging it !

Most management principles are simple applied common sense - and rather than try to have more managers, it would make much more sense to teach doctors basic managerial skills, so they can do a better job managing their patients - and themselves !

Dr Vartabedian has an interesting blogpost. " I was thumbing through Seth Godin’s Poke the Box and stumbled on this quote. I couldn’t help but put it in the context of physicians and their obligation to make content:

I hope we can agree that there’s a moral obligation to be honest, to treat people with dignity and respect, and to help those in need.

I wonder if there’s also a moral obligation to start.

I believe there is. I believe that if you’ve got the platform and the ability to make a difference, then this goes beyond “should” and reaches the level of “must.” You must make a difference or you squander the opportunity. Wasting the opportunity both degrades your own ability to contribute and, more urgently, takes something away from the rest of us."

Some old-fashioned doctors still think it's unethical for doctors to have a website. They fell this is like advertising - and not something which medical professionals should do !

It's interesting to see Dr Vartabedian's viewpoint, which I agree with completely ! The word doctor is derived from the word "docere" = to teach; and I feel doctors have an ethical obligation to do so. They need to teach not just the next generation of doctors, but their patients as well. The internet is a very powerful means of teaching and doctors who do not use it to educate their patients are doing a disservice - to themselves, the medical profession; and their patients !