It’s not a person’s mistakes which define them - it’s the way they make amends. Freya North

Increasing tension between doctors and patients

The relationship between patients and doctors has changed significantly in the last few years. Patients now think of themselves as being healthcare consumers , and because they are better informed, they expect more accountability, transparency and professionalism from their doctors, replacing the earlier paternalistic approach, based on blind faith.

Increased awareness, rising expectations, escalating costs, medical advances and medical laws have made it more challenging for doctors to meet their patient’s expectations. Consequently, we have been seeing a steep increase in medico-legal litigation because of the rising discontent over the manner in which health care services are currently being delivered. As a practicing gynecologist and medical teacher, I have myself witnessed the tragic consequences of unintended medical errors. International data reveals that one out of ten patients seeking health care services is likely to be harmed by his doctor. It can safely be assumed that the burden of harm may be higher in developing countries like India.

Often, when things go wrong, some doctors sulk, some curse their luck, but a few, more responsible ones, try to figure out what went wrong and how to prevent the problem from recurring. In India, many doctors expect that their patients should accept the error as part of their fate, but this is not the right approach.

An error can cause death, disability, loss of income, and untold suffering to the patient and his family. Some patients may take legal recourse and drag their doctors and hospitals to the court of law. But nothing can adequately compensate for the patient’s personal loss, which can be immense.

Doctors, who have been trained to be healers, find it hard to accept the fact that they were instrumental in causing someone’s death or disability. I know of a few cases where a remorseful doctor committed suicide after making a grievous error. Even where a doctor is sincere and competent, errors can occur. However instead of passing the buck, it is worthwhile to explore productive ways of eliminating such errors.

The Patient Safety Alliance

After receiving advanced training in Patient Safety through the Commonwealth Professional Fellowship, with the help of few like-minded people , I founded an organization called “Patient Safety Alliance” (www.patientsafetyalliance.in) that aims to empower patients and support doctors in preventing medical errors in a blame-free environment. We have produced an educational film in Hindi on preventing medication error that is available free on YouTube. We have created simple low-cost paper tools to assist patients. For example, our medication card helps to reduce errors by allowing patients to maintain accurate and up-to-date information on the various medicines that different doctors have prescribed to them in a single place. We have also designed a simple checklist which patients can use before getting admitted to a hospital to protect themselves from harm. All these tools are available on our website for free download.

At Patient Safety Alliance, we believe that any attempt to improve health care delivery can be successful only when it makes things easier, simpler, faster and more efficient for all stakeholders. One of the exciting projects that we are currently working on is “Safe Rx”, a software application that assists doctors in prescribing medicines in an error-free manner. It allows doctors to prescribe safely, without making any changes in their writing style! We conduct a seminar called “Be Alert” for communities and consumers, aimed at sensitizing them about sources of medical errors. We discuss subjects such as “How to communicate effectively with your doctor” ,“How to ask the right questions of your doctor”, and “How to search the internet for authentic and evidence-based information”. Anyone can request us to present our seminar at their workplace, club house or housing society.