Humanize medical: The movement begins
By profession, I am a disruptor and a futurist. That means: I look at things which do not work for what they had been designed for, find faults with them and trash them. I do not do that for ego’s sake. But for the sake of a better future and for the generations that will come after me. Not many would agree with a disruptor because his eyes are on a faraway future, and most people are happy to look at things as they are, and not as they could be.
I recently went through a family tragedy.
My younger sister Fatima Gul, with whom I had the best-ever brother-sister relationship, returned to her Creator, inna lillah. Diagnosed with a rare disease called GBS, she was admitted to a private hospital in Lahore and placed in ICU with ventilator on. She lived in Lahore while I was based in Karachi. With my wife Taz, I flew to Lahore, where Taz managed her home, five kids and family visitors while I did the night-attendant duty. After three weeks, Fatima died of a cardiac arrest.
Having spent two weeks at Lahore hospitals with my disruptor and futurist eyes open, this was good enough time to find what ailed the medical profession: apathy, the fundamental flaw in medical education and practice. And I mean, not just locally, but globally. We can easily stretch our imagination.
So, I resolved to myself that medical education and practice need to change, and I am going to start a global movement for humanizing the medical profession. Would you care to join?
I must clarify that this is not a reactionary movement. Because I am not coming out of this event with dying grief or complaining about stereotypical mistreatment or hospital butchery or wrong diagnosis. None of these. We believe in God and the time each individual has on earth. Quite content with what doctors or hospitals could do in this case.
I should also clarify that this movement is not aimed at the bad or ugly of medical profession. It’s about the good guys. The AKUHs, Doctors Hospitals and Shifas of this world – the best we have in our country. So, it’s not about incompetent or corrupt doctors or overcharging hospitals; it’s about the best of the best. Who may be best at what they are doing, but still devoid of the basic: humanness.
The reason: that no one in the profession has bothered to turn around it just because it was handed over to them in this state two centuries ago.
As for my background, I have taught an MBA course in Applied Leadership in Healthcare at country’s prestigious Dow University of Health Sciences’ Institute of Health Management, Karachi. This was aimed at medical superintendents of hospitals. Have also taught short workshops at College of Physicians and Surgeons (CPSP)’s Karachi and Hyderabad campuses.
I also had the opportunity to volunteer time and train doctors at charity hospitals like LRBT in courses like doctor engagement or doctor burnout.
At another time, I had the opportunity to train the Deans and HODs of Peshawar Medical College in new teaching methodologies. Similarly, I trained heads and most faculty from PICO Peshawar in Train The Trainer during last decade.
My other, main profession – executive training – has allowed me to come into contact with the Big Pharma CEOs and sales teams – any name that you could think of. This gave me insight into their role, needs and wants and vested interests. Along with this the equipment manufacturer – the Siemens and Philips of this world. So I have had a 360-degree view of the ecosystem.
The mission is: Humanize the medical education and practice. To bring back the ‘human’ in medical ecosystem.
Here’s my math:
One, five years of hard study at medical school, with bright kids buried under heavy books and disease names looking Latin to them, it’s a sure kill to remove any sentiment for other humans – peers, teachers, paramedics, medics. The focus is on memorizing and passing the exams. Apathy. No affinity with humans. The length of education and the way it is delivered is precisely the reason why we have lost ‘human’ in a doctor.
Two, apathetic, fatigued professors who routinely undermine students’ esteem because of the power they have and awe they carry.
Three, the focus is on disease, sickness and unwellness. Quite ‘negative’ sentiments. Not on wellness or health, which draw positive outlook and energy.
Four, the residency, the house job that goes on for years, with duties stretching 36 hours or 48 hours without proper sleep or break or a place to sit. This is sufficient to snatch any remaining humanity. Add to this the repetitive nature of their work which fatigues them further. Add to this the anxiety of patients and their family or attendants who clamor for information, attention or care.
So, even before doctors get license to treat patients, they have lost the ‘human’ side of their personality. To them, patients are merely a number, or disease-types.
Five, the fellowship/specialization education takes up years of boring study and exams after exams.
Six, now that they are practicing – job, clinic, hospital, the game is upped. The Big Pharma enters with their incentive schemes. Patients are now cash! So overtreatment starts. And if the doctors are associated with a big-name hospital with private patients inflow, other units also need to meet their revenue targets. Lots of necessary or unnecessary tests must be administered.
Seven, overwork, fatigue, burnout and the nature of medical profession where you are mostly dealing with emergencies make it a vicious cycle where patients do not feel cared for even at the best of hospitals.
So, the million-dollar question is: what to do?
- Digitize. With technology and internet making learning and teaching easy and fun, convert the medical-school experience into a playful time. Digitize the whole curriculum. Cut the jargon where you can. Rename body parts, diseases and compositions. Make it all visual. Create tablet-based education with medical and health apps talking to you about anatomy and physiology. Make it problem- and practice-based so the learning lasts. Reduce the length of medical education at each stage: pre-med, school, residency, fellowship. Intervene at three stages: 1) length of study, 2) learning & teaching methodologies, 3) the teacher behaviour towards students.
- Humanize. Since knowledge will be available at the touch of a button, emphasize just one core value during school: it’s a human treating another human being. To the best of their ability.
- Right-size. Redesign healthcare facilities – primary, secondary and tertiary. With Google Glass-type medical technologies, patients can be diagnosed and treated with more precision. Redesign work spaces and work hours. Redesign their salaries and benefits. So they are not thinking about the pay, but they are thinking about their work.
- Educate. Place emphasis on wellness and health. Educate the population on how to live healthy and remain well. So fewer numbers come to the hallways of clinics and hospitals. Governments in partnership with the healthcare facilities have to undertake awareness programs for the general population.
- Energize. Those who are employing doctors – private hospitals or governments – create ongoing programs for doctor engagement. During debriefing, doctor morale and doctor emotions are captured and addressed. That doctors are treated as human beings, and not just a revenue machine. This may address neglect and preventable deaths.
- Penalize. Big Pharma is already under tremendous pressure and they have been fined billions of dollars for paying bribes to doctors to prescribe their medicines. Hoping that the laws get stricter and pharma becomes more responsible, offer low-cost drugs, manufacture it in low-cost factories in the world, and put people before profits over time. This may resolve the overtreatment issue.
In essence, the medical profession needs to be overhauled. We need to humanize the medical education and practice.
The way forward?
We need three types of volunteers:
- Volunteers who could write original content in how the medical education can be digitized and taught differently and who could present at various forums and social media
- Volunteers who could dig existing data about practice flaws and bring it in one place and who could link with similar efforts elsewhere.
- Volunteers who could manage social media channels – like Facebook, LinkedIn and Twitter pages.
In due course, we hope that we can pilot a program at a medical school and implement this new, humane approach at a medical facility, and be able to present this data in a white paper, and at national and international medical conferences. Over a period, this movement hopes to gain momentum and find better leaders to take it to the next level.
Want to join? Visit the #HumanizeMedical website. See volunteers section.
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By Wali Zahid, author of iBook, Great Training in 10 Simple Steps, available from Apple Store for free.