The epidemic of cesarean sections in private hospitals of urban India has recently been getting increased attention. Doctors and hospitals have been accused of doing cesareans for financial gains. There has been a demand for requiring hospitals to display their cesarean rates3and one politician has called for ‘naming and shaming’ doctors who conduct cesareans only for money.
Some years ago, a farmer from Gujarat came to Sitaram Bhartia with his adolescent son, feeling distressed about his behaviour. He would spend hours standing in front of a mirror in a girl’s clothes and would tell everyone he met that he was not a boy. He had even told people to start addressing him as Vandana instead of Varun,
Many of us do extensive research before buying a mobile phone or car, booking a hotel, or even selecting a new restaurant. But when it comes to choosing a doctor, most of us do little more than get a word-of-mouth reference. Unfortunately, what often drives patient satisfaction and thus recommendation of a doctor is “bedside manners” –
“We discussed this internally but don’t feel we have the bandwidth to travel to Mexico” I wrote to small nonprofit in India, whose target population was very different – middle-class women in Delhi subject to over-intervention in maternity care rather than the most marginalized populations dying from access to care.
My doubts were quickly put aside in the Welcome Event.
“A leader must be able to define an ideal state and get people enthused about moving towards it” said Dr Prab Prabhakar, a consultant paediatric neurologist at the Great Ormond Street Hospital (GOSH), as we sat down together in my office. I had met Dr Prabhakar a few months ago in London and was pleased that he was taking a day out of his vacation in India to visit us.
Every year we celebrate International Nurses Day on Florence Nightingale’s birthday. In our hospital it’s a time when nurses dress up in their best, renew their pledge to serve, collect awards, and put on a cultural program. For the third year in a row I was asked to say a few words. Last year I had discussed how our newly introduced Training Within Industry (TWI) program had helped reduce nursing complaints,
Sixty-four different sites – many with high rates of child poverty and complex long-term conditions; high proportion of ethnic minorities; 14 care-commissioning groups who demand different quality metrics; and a focus on mental health and community care – not the most remunerative areas in healthcare.
All this complexity hasn’t prevented East London NHS Foundation Trust (ELFT) to set itself the audacious goal of becoming the highest quality provider by 2020!
Yes, according to Dr. Farris Timimi , a cardiologist at Mayo Clinic who is medical director of Mayo Clinic Center for Social Media . In fact he goes as far as to say that physicians’ participation in social media is a moral imperative and part of being professional. He says that patients are spending time online seeking health information and support and that represents both an opportunity and a moral obligation for providers.
I skipped breakfast and arrived a good half-hour earlier than the scheduled start time, not wanting to risk being late for my first WHO Expert Consultation. When I had received the invitation to participate in developing a framework for Patient and Family engagement several weeks ago, I remember feeling honored. I was excited by the prospect of making a contribution at a global level and developing new relationships that could help our hospital continue along our journey of improving safety and transparency (see my earlier blog posts on the start of our safety journey and on disclosing our cesarean section rate).
“I have greater assurance about product quality and service quality when I walk into a Sagar for a snack than when I go into a hospital!” (Sagar is a chain of restaurants in Delhi best known for serving South Indian food.) I have often said this to our consultants and managers to illustrate the unacceptably low levels of reliability in most healthcare delivery encounters – including at our hospital.