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Pareto’s law states in fiscal terms of running a hospital business, 80% of the income comes from 20% of the patients and 20% of the income comes from 80% of the patients. Thus in such a situation, it would be wise to conclude that practice of modern medicine by physicians has become biased more towards the financial aspect, rather than the wellbeing and quality of care offered to patients.The diagnosis is usually hidden in the patient history, thus history taking and communication had always been a strong area of interest to a physician’s decision making and mode of practice. But these days, history taking is mostly left to medical assistant, nurses or other allied health professionals.
But in view of the rising medical negligence, patient dissatisfaction and questions on ethical practice of medical professionals, would it be wise to say, a patient is less likely to sue or complain with regards to quality of care offered by physicians, if 80% of his treatment is offered by subtle communication and empathy, and other 20% of it is actually the medications for a certain section of patients.
Specialist and consultants are hardy involved these days in the process of history taking and rely mostly on the notes entered by a healthcare worker lacking a complete insight into the disease process and treatment outcomes.
The Health educators are well trained to communicate and have a greater understanding of health behaviors modification techniques( prevention is better than cure) when compared to Medical assistants or Nurses, so would it be wise to have 40 - 60 minutes session between patient and health educator for history taking, checking vitals, clearing any doubts in the patient mind with regards to his disease condition/ treatment and what question to seek clarification on or what to expect at the next follow up appointments with busy time bound specialist/ consultant physicians.
I’m sure depending on the training and educational program for Health education across the globe, some cross training of clinical skills will be mandatory. But has anyone tried this approach, in their clinical practice in India, UK, Middle east or USA, please feel free to comment below.
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Dr Sharif Zahooruddin