Dr. Rajan Shah

The doctor-patient bonding (relationship) is central part of healthcare and the practice of medicine. For any relationship, trust is essential and in the medical field it is even more critical. Quality connection and bonding between a patient and physician is very important to both the parties.
The doctor and patient's values and perspectives about disease, life, and time available play a role in building up this relationship. A strong relationship will help the patient have perception of better care, make them feel more comfortable and honest. With more trust, they are more likely to open up and disclose information when talking to you about their health. Enhancing the accuracy of the diagnosis and increasing the patients’ knowledge about the disease all come with a good relationship between the doctor and the patient. They have greater acceptance to recommend treatment and adherence to it. It also lowers anxiety. Thus, all this results in greater patient autonomy and shared decision making.

Today's Scenario
There has been erosion in the doctor-patient relationship over recent years. Sadly, doctors seem not to be respected to such esteem as it was when we were kids. Patients today are much less likely to trust, but they rather see doctors as being driven by profit. Social media amounts to gossip whirlwind where unpleasant and unverified stories are shared.
Though there could be some bad apples, there certainly are so many big stories of heroic doctors that need to make headlines, but sadly it does never happen. People see the bad side more than the good side. In this century, where people are impulsive and sadly doctors are blamed for every casualty. This makes the doctors feel like losing the game before they even get start to serve people.
Back here in Dadeldhura Hospital, similar sorts of thing happened when I joined here almost 2 months back, because of the past mishaps. I was unable to make them understand at first, as one negative review could stick like glue on a hospital's name, and it could mean the patient may lose trust even before the relationship begins.
I didn’t try to fight negative reviews in public or with anyone behind the scenes regarding the hospital’s past incidents. I instead preferred to ask my patients to rate my medical service and practice one-on-one.
Thankfully, a few negative reviews couldn’t stand up to a flood of positive reviews. So things started changing for good slowly.

Improving trends
According to the present data of the Hospital, during the last month of Magh (January/February), there were around 120 vaginal deliveries and 21 cesarean section (c-section) performed at the Hospital. This data shows service seekers have increased up to three times than the previous months. The surgeries that had been stopped for years, have now been re-started.
Even in the first 10 days of the current month of Falgun, six hysterectomies; (two vaginal deliveries and four abdominal) have
been successfully performed at the Hospital.
Hira Devi Joshi, 45, a resident of Amargadi Municipality, was troubled with complaints of heavy and prolonged menstruation for years, a case of Adenomyosis. Joshi was delighted to get her operation done successfully here at her own home town, just minutes from her home.
Like her, there are many other examples of satisfied patients, who have benefitted once the trust has been built up. The number of patients visiting the Gynecology department too is increasing day by day, which is very encouraging.

Experience and suggestions
Seeing this improving trend is a great relief for me as a doctor. My experience here has helped me a lot to build rapport. As a gynecologist, based on my experience the key I think is to communicate effectively and listen actively. It means we need to always involve our ears, listen more than speak. Being a good listener is just as important and it is not good to reach a conclusion too fast.
Doctors should work well and spend more time with patients. Most doctors tend to spend only 5-10 minutes with the patient in the Out Patient Department (OPD).
Besides spending more time, other critical point includes: taking vitals by ourselves; being calm and polite; able to empathize-without being emotionally overwhelmed ourselves; and honestly admitting when we do not know anything so to be honest of our faults if any.
I think time has now come where the important bonding between the doctor and the patient needs to be re-established for its integrity.
This can be achieved with joint efforts of everyone involved including the patients (the service seekers), the community and the public, the regular media plus the social media and we as health professionals.

(Dr. Shah is a Consultant Obstetrician & Gynecologist at Dadeldhura Hospital  in Sudurpaschim State)