Learn How “Digital” Is Powering Incredible Results on Marketing Investment By Doctors & Hospitals

Doctors & hospitals discover 5 essentials on how to use digital technologies to get amazing results from their marketing.

Why is marketing essential for doctors?

Physicians have mixed views on Marketing – Some are vehemently against any kind of marketing while others believe that it is essential for establishing and growing their practices. From my healthcare experience of 35 years (a clinician in a mega government hospital, private practice in a village, CEO of the largest private hospital chains in India, Advisor to PE funds on investment in Healthcare and running my own company) I can confidently say only one thing- Today, Doctors have to market and establish their own brands, they have no choice.

To doctors who work in private “corporate” hospitals and believe that marketing is the responsibility of the hospital and their job is to merely treat the patients who come to them, I have one simple message – Start marketing now. That nice marketing head and CEO have actually no interest in investing in you or your brand, they do it out of compulsion. Given a choice they would not spend a penny on you and once they find another (less expensive) physician they will drop you like a hot potato. I have seen senior consultants (with more than 20 years of practice) being asked by hospitals to leave or denied OPD rights because they are no longer pulling in patient volumes and revenue as per “their” expectations. The “poor” physician finds themselves left high and dry with no patient base, no brand, no practice. It is heart breaking to see their fear, frustration and dejection! Unfortunately, I foresee an increase in the number of such incidents in the near future. The solution lies in understanding this –

“Dear friend, nobody I repeat nobody is interested in promoting you, start doing it for your own self, protect your professional pride and earning capacity by investing in your own systematic ethical marketing”.

How to market ethically yet powerfully?

Remember to build your practice on these two foundational pillars of powerful ethical marketing – Patient education and establishing a deep lifelong Doctor- Patient connect!

In this article I will discuss the 5 top marketing trends in healthcare marketing that can help doctors to develop a better understanding on how to market effectively.

As a doctor or hospital manager/owner your main interest is to gather new leads (enquiries) and convert them into patients who come back year after year while at the same time PROACTIVELY refer your services to their friends and relatives. It is not easy, and will get tougher each year as competition increases, technology changes, and new regulations are introduced. You just cannot afford to continue with these 4 Don’ts :

1. Know how to market
2. Have a plan
3. Have a budget
4. Know how to monitor results

However, don’t be disheartened. In this article I will provide you with basic understanding and tips on how to start or update your marketing strategy to stay ahead of the competition. Establishing and executing a marketing plan that is in line with these current trends will not only help you to outperform your competitors, convert more leads, get more referrals but continue to increase patient satisfaction and retention.

Tip 1: Place the patients experience first

In line with other consumer trends, the expectations of Patients expectations are increasing to the extent that they now evaluate healthcare on the basis of their total experience. So, as I have mentioned earlier in my V-Log, every patient has a journey with multiple touch points (moments of truth) and each encounter defines their overall experience. We must ensure that this experience is not just great but exceptional.

Specialist doctors who do elective procedures, I would like you to ponder on this trend – we have seen in some doctors’ practices that 30 – 50% of new patients are now coming via the digital route, up from 3-5%, three years ago? This statistic itself tells a very clear story – You need to ensure that you have a powerful and effective presence in the digital space!

So, what is this digital experience? What are the must haves in order to be effective and powerful? The first and foremost is to have an effective website.

Tip 2: Get an Effective Website

A website is your virtual clinic cyber clinic which will have far more traffic (visitors) than your physical clinic. Most probably the patient’s first experience with you or your clinic or your hospital will be on your website which will define their future action on whether they come for a consultation. Imagine the loss- spend money to get the patient onto your website and then not being able to convert them to a consultation, thanks to a lousy website experience. Hence ensuring that you have an effective website is crucial for marketing success.

Think, while we are willing to spend millions on our physical clinic – its decor, furniture, equipment etc. we look for the “cheapest” solution with regard to the website. What is a good website?

A website is about the Patient’s experience, technically it is called User Experience (Ux). The design, colour, photos etc. is secondary. So here are 6 points to guide you on how to get a great website developed:

1. The website is about the visitor, in this case a patient – identifying with their problems, feelings and providing them with a solution. It is NOT about you or your equipment of your skills, they come later.
2. The website should engage with the patient – providing tons of text with liberal doses of medical jargon is not patient engagement. Effective patient engagement needs to be simple, visual, personal. Installing a smart chatbot with clinical content is the key differentiator.
3. The website should establish your credibility. Patient reviews are the most powerful.
4. Being Visual is the modern trend, in which making use of video content is most effective.
5. Having properly thought out CTAs (calls to action) will make or break your marketing! Provide multiple ways for the patient to engage with you- Message/Phone/Consult over video (Screen)/ Chatbot/ Book Appointment /Download your App/Mail/ FBM are just some of the methods that should be available on your website. Your patient will choose the one that they are comfortable with. Providing CTAs that are convenient for YOU guarantees sub optimal results.
6. Ensure that your website is designed for mobile phones! More than 80% will access your website on their mobiles.

Food for thought

Your website may be instrumental in getting more consultations or it may be turning away potential enquiries. Net, net there is much more that goes into a website than some colours, designs and photos. Don’t look for cheap solutions, look for effectiveness. If you want to know more feel free to setup a 10 minute call with me or my team.

Tip 3: Social Media

Reputation management is key to converting new patients and the power of digital is immense. It can establish and at the same time damage your reputation. Whatever the case, you cannot afford not to be there!

The essence of social media is to connect people and enable them to share. The sharing could range from their personal journeys to their experiences! Social media is tailor made for healthcare marketing. But it needs to be done properly!

It provides space for you to engage actively with your patients and potential patients. It helps to develop a deep connect between you and your patients. Every Social media platform is different and you will need to identify the platform that will be effective for your specialty, audience and expectation.

Social media can do the following for you:

1. Establish your presence and brand
2. Establish yourself as a thought leader and authority
3. Helps to educate patients
4. Helps to answer their queries
5. Create forums for group interaction and sharing by your patients.

Tip 4: Content

As mentioned earlier content is king! And the future of content is voice.

Using voice in different ways can guarantee amazing results. The best and effective medium is to have videos. Not fancy slick professional stuff, just nice real videos, where you are discussing problems and solutions.

Here are just a few ways to use video in marketing your clinic or hospital:

1. Doctor introductions
2. Patient stories and testimonials
3. Health education
4. Quick health-focused tips and tricks

Tip 5: Get Your own personalised Healthcare App

Your personalised App ensures independence, secures your patient’s data and establishes a powerful connect with the patients. However you should not be tempted to get your own App designed. It is tempting to do so as it appears to be cheap. However bear in mind the following:

1. It is a great hassle!
2. Will need maintenance
3. Will require upgrades and updates
4. In case of an individual developer they will lack bench strength to provide support

Your friendly tech friend or relative will entice you into this but my advice is stay away. You are a practitioner and need to focus on treating patients. Not get involved with SRS/Ui/Ux etc. It is better to identify a company that is well established and has clinical domain experience. Don’t get confused-Healthcare and clinical are not synonymous.

To conclude please keep in mind that the Patient experience is driving success for doctors and hospitals. By creating an excellent patient experience by combining clear simple communication with an excellent digital experience, patients are more likely to not only return, but refer you by mouth and online.

Digital space is increasingly where most of these experiences take place and hence is doing digital right is the key to get outstanding returns from Marketing spend. Your website, social media, content is no longer a “tick off” it is serious investment in your future. This is where your patients are going to come from hence do not take risk. In case it is done well it will guarantee success but done badly it can have serious consequences.

Realizing the crucial need of the healthcare industry across the world, we designed the “Patient Magnet Services”. The Patient Magnet is a one stop solution for individual doctors and hospitals that caters to all their digital requirements. We customise the solution for each individual doctor according to the nature of their practice, specialty and location. In case you are interested to learn more, you can book a free 10-minute call with me or a senior member of my team.

Are you satisfied with the results from your marketing efforts and spend? Would you like your marketing to be more effective and powerful? This article outlines the 5 principles that can explode your marketing returns.

The healthcare industry (Hospitals & Individual doctors) is facing a universal challenge that most doctors and hospitals are grappling with nowadays- Healthcare Marketing. Despite their best efforts most doctors and hospital managers are dissatisfied with the returns that they get on their marketing spend. The level of dissatisfaction ranges from severe discontent to a vague uneasiness about getting adequate returns on the investment made. One always wonders if there is a better way? And the answer is a clear and resounding “YES”.

The fundamental problem that hospitals and doctors are facing is the universal and dramatic change in Buying Behaviour of the patient with the advent of the internet (Dr. Google) and Social media. While other industries have been quick to adapt to this change and have modified their marketing radically, healthcare has yet to reconcile with this change.

The cash paying patient’s decision-making behavior regarding their treatment has changed. They demand more information, transparency, accountability, support, second opinions and reviews. Unfortunately, doctors and hospitals have not only not adapted well to this but are actually hostile and resentful, hoping that somehow things will get back to “normal”. The sooner we accept this as the new normal and modify our thinking, strategy and planning the more effective we will be.

So, in this article I introduce FIVE basics that form the core of contemporary Healthcare marketing and are absolutely essential to build a powerful and effective marketing response

• 

1. Integration
2. Ensuring Ease of Access
3. Powerful Engagement
4. Follow-up for Conversion
5. Post-treatment Engagement

Integration

All hospitals and doctors engage in a myriad different types of marketing activities that involve a serious investment of time, money and bandwidth. However, what is sorely lacking, is a system to integrate these activities and track the leads or enquiries generated. Some of us use rudimentary methods but they lack comprehensiveness. Typically, post lead generation follow-up is done via CALLS. Calling patients without taking prior permission is quite intrusive and can be a big “No – No” for the modern discerning patient. Most patients don’t like to be pushed into and making decisions regarding treatment over telephone calls. This can be seriously counterproductive. Remember Hard selling causes mistrust!

The solution lies in building an Integrated system that captures these enquiries and then engages with the patient at their own desired pace and using the channel or medium of their choice. This is explained in detail in the next section.

Ensure ease of access

The hospital or the clinic must incorporate all available methods for a patient to connect and engage as per their preference. This implies that the mouth of your Sales funnel must be as wide as possible. You can learn more about the healthcare sales funnel here. Some of the portals that need to be created are:

• Website
• Facebook business page
• Active Facebook messenger
• Consultations over video
• Your personal App
• Trained call centre (secretary)

The effectiveness of these portals is critical for success and incorporation of modern technology in these is a must. As an example, an effective and user-friendly website should incorporate the following:

• Be Mobile friendly
• Fast loading time
• Ease of navigation
• Capture patient interest
• Messaging based on visitor personas
• A Smart- Bot that engages meaningfully with the visitor
• Google analytics and Facebook pixel

 Again, you need to have all of these modalities in one platform. Having separate vendors providing these services is not just ineffective but can cause leakages that seriously impacts performance and returns on investment.

Powerful Engagement

The key to success is not just providing easy access to your system but providing patients with quality engagement. So, ensure that you equip each modality adequately to effectively respond to ALL the patients. Using AI based smart-bots which are personalised to you, your specialty and your practice is effective way to ensure quality interactions with your patients. It guarantees higher engagements and conversions!  In case you are interested you can drop an enquiry at Catex Health which provides all these services under one roof.

Follow up For Conversion

This is one of the biggest lacunae in our healthcare marketing. We are able to generate enquiries, patients may even come to the doctor for a consultation but then afterwards disappear. We don’t know if they decided to seek treatment elsewhere or not get treated at all. However, we would like to know what happened and respond accordingly! We could provide information that will support them to decide or in case they went to another doctor it would be good to get feedback in order to take effective corrective measures. Again, an integrated system driven by AI based smartbots available on all channels (Your own App/ Website/ Facebook messenger) is the most powerful method to drive this.

Post treatment/ discharge Lifelong engagement

After the patients have been discharged, it is very difficult to stay connected. Some doctors are of the opinion that compliance and follow up is the patient’s choice and problem. This is not true, it is our responsibility to support treated patients to comply and follow-up.  However, this takes gets neglected due to the paucity of time. Those who understand and invest in post discharge engagement are sure winners! The quality of the post discharge engagement is important. It has to be timely, easy to access, easy to understand and personalised to the patient. Again, technology-based services are the answer.

In conclusion, the changed environment demands an appropriate response form us doctors and hospital managers. By integrating access, patient education, follow up and long term engagement in one platform creates a powerful marketing machine that is unstoppable.  

In case you are interested to learn more about the “Patient Magnet” the most powerful Integrated service to grow your practice please reach out or drop a mail.

The Government of India has recently issued a Gazette notification for Medical Diagnostic Laboratories. Learn more about the notifications, who they cover and how they may affect you?

Clinical diagnosis and treatment protocols are now highly dependent on different types and kinds of test/Investigation reports. This style of practice is referred to by an umbrella term called “Evidence based Medicine”. The shift to Evidence based Medicine is driven by changes in patient’s disease profile and the environment.

While the merits of this dependence on “report-based treatment” continue to be debated, the fact remains that modern diagnosis and treatments are no longer empirical based. A clinician is dependent on these test reports in their practice and in the case where these reports are erroneous both the diagnosis and treatment can go horribly wrong.

Till date there were no clear-cut guidelines for Medical Diagnostic Laboratories to follow but now that has been rectified. The Government of India has issued a gazette notification on the “Minimum Standards for Medical Diagnostic Laboratories”

The Minimum Standards for Medical Diagnostic Laboratories (or Pathological Laboratories) cover every clinical establishment relating to diagnosis or treatment of diseases, where pathological, bacteriological, genetic, radiological, chemical, biological investigations or other diagnostic or investigative services, are usually carried on with the aid of laboratory or other medical equipment. These institutions must comply with the minimum standards of facilities and services as specified in the Schedule.

This notification has classified these establishments under the following three categories of entities

• Basic Composite
• Medium
• Advanced

The requirements for each category of establishment have been further divided into “desirable” and “essential.” The standards cover the following areas:

• Infrastructure
• Human resource
• Instruments and medical diagnostic equipment
• Processes and protocols
• Legal & statutory requirements
• Record maintenance

Any move taken towards standardization of quality of treatment is to be lauded. Creation of such standards is a step in the right direction taken by the government in the interest of protecting the patient and doctors.

For more details please download and read the complete gazette notification by clicking here.

Yes, that is correct, you read it right. Google initiated significant changes to its algorithm in the last days of March which has resulted in medical sites taking a HUGE hit on rankings.

Medical websites that got a rank boost by back links through Private Blogging Networks, were hit most. Those having high quality content with natural back links got a spike.

According to the data provided by SEMRush, Healthcare websites saw a massive fluctuation in traffic and rankings after the recent March 2019 Core Update.

According to the website the top 3 losers were:

MyLVAD

PainScale

Medbroadcast

MyLVAD

 Is a community and resource for people suffering from advanced congestive heart failure and relying on an LVAD implant. An in-depth analysis of the site reveals that there is poor compliance with the Google E A T quality.

The material shared on the websites is not authenticated and credited to specialist doctors. Contact details along with people responsible for the website are not available.

PainScale

Is a website, which also has an App that helps to manage pain and chronic disease.

It provides information on pain management. However the authority of the content shared is questionable. More importantly there is a toll to manage pain which has a quiz. However the website asks users to share certain health details before free sign up. Google has an aversion to this method and the algorithm punishes hard.

Medbroadcast

Provides information about diseases, health conditions with treatment options. However authenticity of the authors is not available.

5 Musts To Manage & Protect

1. All Blog Posts Must Have The Author By Line

Websites in YML category that include healthcare, wellness, and finance sectors must have authors who are experts in that field. AVOID getting your content written by content writers. Authenticate all content.

2. Remove Scraped & Duplicate Content

Google scores your website by analyzing individual posts and pages. If you’re engaging, scrapping or duplicating content from another website, the chances are that you may get hit by an algorithm update. Remember paraphrasing of content doesn’t make it unique, and Google can identify these types of content very easily. Please remove all thin, scrapped or rewritten content.

3. Invest in Personal Branding

Ensure that your website has an “About Us” page and you’re providing valuable inputs to Google in the form of a schema mark up.

Provide positive testimonials and customer reviews, both within the site and outside to boost the trustworthiness of your website.

4. Focus on the quality of back-links More than on quantity

Do NOT “buy” back links and try to game the Google algorithm. Use blogger outreach as part of your SEO strategy to get high-quality links.

5.  Secure your site with HTTPS

Security of its users is a priority for Google, and that is why it’s pushing websites to get SSL certified. HTTPS is now one of the ranking factors, and it’s also one of the ways to improve the rating of your website. Buy the certificate.

The world of healthcare has changed!  Healthcare is “Commoditised ” Doctors are called “providers”, Patients “consumers” & the patient’s behaviour reflects this change. Wishing things will get back to “normal” is living in denial. So what should we do?

Globally, Healthcare delivery is undergoing turbulence. Almost everyone has an opinion owing to the sensitive nature of the subject. Varied Opinions on causes of ailments and diseases, treatments, cures, doctors, hospitals, policies, healthcare systems, pricing, profitability etc. are widely circulated thanks to the internet and social media. These unqualified opinions contribute to confusion and acrimony!

Some common misguided notions that people entertain about doctors today include:

• Doctors have become money minded
• Doctors are callous and indifferent towards patients
• Doctors don’t spend adequate time with patients
• Doctors refuse to understand patient’s issues
• Doctors are arrogant and unapproachable
• Doctors don’t communicate properly or adequately
• Doctors don’t respect patient rights
• Doctors hide facts from the patient
• And many more…

Without going into the validity of these claims, I am troubled by so much angst against a profession that used to be “noble”. Perhaps, The answer lies in the fact that the world has changed and doctors have failed to do so. The changes affecting us today include:

The Power of Internet & Social Media

The internet and social media have changed human thought and behaviour drastically and irrevocably! People now have platforms to share their opinions, feelings, thoughts experiences easily, freely and globally! And guess what? health related issues are one of the most favourited topics of discussion globally. Unfortunately, this has serious repercussions for us doctors

There is a virtual “tsunami” of healthcare related information being freely bandied about. Some of it genuine, some fake and even downright fraudulent. Gullible people consume and even act upon this fake information with disastrous results. Antivaxxers, Natural therapies that guarantee 100% results, anti-medication rants… the list is endless. Patient desperately clutch at these straws

So what can we doctors do?

We must occupy this space, provide genuine information to our patients in a language and medium that they can understand and consume. A look at the average doctor patient communication will reveal that it is full of “medicalese” – medical jargon that is Greek to most patients!

So doctors, brush up your understanding of social media .develop the right skills, find out, learn, choose your social media strategy wisely. Most important! choose your vendors wisely – website designer, SEO, Facebook etc. They MUST have domain knowledge about your specialty and practice. One size does NOT fit all. You can attend one of my free Web master classes on this subject by registering here.

 Changed Buying Behaviour

Almost all industries have accepted the fact that consumer behaviour has changed drastically over the last decade. People are far more discerning when they buy. They go to the internet and check! They look for information, reviews, customer testimonials before making their choice. Most industries and businesses have now not just accepted but aligned their marketing strategies with this changed behaviour. We, in Healthcare lag behind sadly! We harbor deep resentment towards patients who use “Dr. Google” and we are hoping against that this Dr. Google nightmare will end soon! Let me deliver the bad news. It is not going to go away, in fact it is only going to get worse.

We have to change our understanding of “marketing” completely and then ensure that we are out there in the world doing the right stuff! Integrating our marketing, and building an “Integrated Sales Machine” is the key to ethical marketing and success.

 Empowered Patients

The modern-day patient is knows their rights and wants a choice. Patients are looking at being partners and not just recipients in managing their health. Unfortunately the response from most doctors is disappointing. A majority of them say – “My patients do not understand all this. They are not interested”. We could not be more mistaken. In front of us they may be docile and unquestioning, but they are not just interested but seriously concerned about receiving the best treatment.

 So, when we doctor’s don’t educate them they go to Dr. Google or the nearest quack or their grandmother or their barber… And guess what? All of them have opinions and answers! As their treating doctor they have put their faith in us but we fail to measure up and allow third parties to get in the way of our relationships with our patients.

So once again we must learn how to educate, answer queries, support compliance and adherence, track and monitor to get superior clinical outcomes! The only way we can do this effectively is by using technology-based services. Again, we must learn and educate ourselves. Our clinical expertise is not enough!

 Hostile environment

The environment has become hostile ! It appears that there is a conspiracy by the media, politicians, bureaucracy to “get us”. The environment is demanding transparency and accountability from doctors and hospitals. We may well express resentment and have a victim mindset – asking why us? Why not lawyers, judiciary, other professionals, politicians etc. However the burden to bring in transparency and accountability in our dealings lies with us. Unfortunately, this is where our roles may be limited by the “management”.

So what can we do? One way is to lament and curse and the other is to take back “hospital management” and/ or influence management decisions and policies. Unfortunately, because we lack the basic knowledge of Leadership, Management, Finance and Marketing, we cut a sorry figure in management meetings. I have first-hand experience of sitting in hundreds of management meetings where doctors have betrayed their lack of understanding of these basics. So, what do we do? Again, the answer is learn and empower ourselves. These are not difficult.

To conclude my dear doctor friends and colleagues, my earnest plea is for you to wake up and smell the coffee, stop living in denial. The world has changed and will not revert to “normal”. We need to be ready for this world. We must empower and equip ourselves with the basics of Leadership, Management, Finance and Marketing in order to lead healthcare in all respects.

I have a passion to empower and teach doctors, hospital managers on these vital subjects.

Do check the details by clicking here!

“The ethical duty of all doctors is to ensure effective care for their patients. This would mean that their own conduct should in no way harm their patient. Sexual relationships between doctors and patients invariably harm both the patient and the doctor. Trust, which is central to an effective doctor-patient relationship, is inevitably damaged. In view of the power gradient that invariably exists in the doctor-patient relationship, the onus is on the doctor to ensure he or she does not enter into a romantic or sexual relationship with a patient.”

The Official website of the MCI recently posted these guidelines on “Sexual Boundaries For Doctors” that were initially meant for the members of the Indian Psychiatry Society members. The highlights of the guidelines touch upon the following points:

They are gender neutral

The nature of “power gradient” in a “doctor- patient” relationship

The importance of trust and how such behaviour destroys it

Non consensual relationship is a crime under the Indian Penal code

Consensual relationship may not be illegal but is a sexual boundary violation

Inappropriate behaviour during physical examination & sedation is a violation

Relationship with “Former or Ex” patients is discouraged & considered a violation

Guidelines apply to family members of patients

They also advise on how to handle false allegations.

To download the complete guidelines please click here.

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Chronic diseases account for 53% of mortality today. If that isn’t disheartening enough, this figure is projected to increase to 67% by 2030. The need of the day is to look beyond traditional ways of delivering healthcare and develop service offerings that would expand the domain of care delivery.

As far as healthcare in India is concerned, there are two major factors that currently prevent effective and easy management of chronic diseases.
1. Access:
Presently, chronic disease management facilities, such as specialty hospitals or large medical centres equipped to provide all types of medical service under one roof are concentrated in major cities. In a country where over 70% of the population lives in rural areas or small towns, this means that access to such facilities is difficult for large segments of the population.

2. Management at Home:

The second gap is the lack of support for these patients to manage their health from home which inevitably results in high travel costs, delay in treatment and increased discomfort to the patient and the family.

The most efficient solution to combat these issues would be to adopt and increase the use of Digital Connected Care Technologies. These are products and services that employ technology to be used in enhancement the traditional healthcare delivery system.

An ideal connected care solution would support medical professionals (doctors, psychologists, counselors, dietitians, physiotherapists, etc.), hospitals, diagnostic centres and pharmacies to ensure that patients receive the right service and treatment at the right price.

The following are some services that Digital Health technologies could provide:

Not only would such services significantly improve the quality and penetration of healthcare in India, it would also work at the most basic level to provide benefits to patients that are listed under.

Benefits to Patients

• Improve quality of their life
• Save money by reducing the cost of travel and accommodation in big cities
• Save time
• Have easy access to top specialists
• Have better control over disease parameters through early detection, management and reduction of complications

In the last few years, many IT players have introduced applications, software and hardware, such as activity trackers, etc. by which they have attempted to provide solutions to these problems. The issue is that most of them are providing services in bits and pieces, and a comprehensive offering which would provide all these services under one roof is still awaited. It is also worth noting that none of these solutions have proved to be game changers, as they attempt to create a system of delivering healthcare by reducing the role of healthcare providers. Understandably, patients are not ready to accept this system, as the role of human element in delivery of healthcare is critically important.

The 5 keys to success are:

1. Build “Services” that use “Technology” as a tool
2. Ensure ease of use by both patients and care providers-Nurses and Doctors
3. Get buy in from Doctors by engaging with them and clearly defining “What is in it for them?”
4. They must be comprehensive- as bits and pieces do not attract doctors
5. They should use sound acceptable clinical basis and protocols as a foundation

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Violence against doctors and front-line health workers is a global phenomenon that is now showing an ugly upward trend especially in India. According to a study conducted by the Indian Medical Association (IMA) 3 out of 4 doctors (75%) have been subjected to violence in their careers. These acts of violence range from verbal abuse, threats to physical beatings and even murder.

There has been much anger by the doctor community and a lot of effort has been made to identify the causes that lead to this violence and steps to prevent these. In fact recently while I was speaking at a medical conference during the question and answer session a  large number of doctors raised their concern and asked for solutions on how to tackle a mob that is baying for blood.

 Based on my more than 30 years of experience ranging from working  as a consultant at one of the largest public hospitals in Delhi to the CEO of the largest private sector hospital chains in India my answer

is that there is NO single one-shot solution.

Knee jerk reactions after every such episode is going on strike and asking for more security personnel and are cliched! They are needed but are definitely not solutions.

So, what can be done to ensure that such events are mitigated if not eliminated. A Multi- faceted approach is the answer!

Deterrence:

Strict Implementation of the law with perpetrators getting exemplary punishment is very important. Having a law (Violence against Doctors Act) is not the solution. Prompt action, investigation and trial by a fast track court may go a long way to stop this. Unfortunately, the responsibility for this lies with the Police and Judiciary. The only way to make this happen is for us as a community to maintain sustained pressure on the authorities to act. Additionally, it is important to ensure that evidence is preserved and eye witnesses accounts recorded at the earliest. Unfortunately, after the heat of the moment has dissipated most of us go back to business as usual and hence the crime continues.

Prevention

The key principle for prevention lies in Restoring trust in healthcare. How can we do that?

Here there is a large role that we doctors have to play. We must change our styles of practice and evolve them to be effective in the current environment. Five ideas that may help include:

Build deep doctor patient relationship

Most doctors understand this and unfortunately take it for granted. My patient will never go against me. Are you aware that a dentist was killed in China by an aggrieved patient 27 years after he was treated? DO not take your patients for granted. Start investing in the doctor patient relationship. Provide them what they are looking for: Honesty transparency and empathy are the big ones. We did a survey on what patients are looking for from their treating doctors and are happy to share the result. Please message on face book messenger and we will share the graphic.

Educate and instruct patients

Patients are looking at being partners in managing their health. Unfortunately the response from doctors when I talk with them is disappointing. A majority of them state – “My patients do not understand all this. They are not interested”. My dear doctors you could not be more mistaken. In front of you they may be docile and accepting but believe me they are interested. Not merely interested by seriously concerned about learning what is wrong with them and the getting the best treatment options

 

So, when you dear doctor don’t educate them they go to Dr. Google or the nearest quack or their grand mother or causing or the barber… And believe me All of them have an opinion! As the treating doctor they have put their faith in you but you fail to measure up and hence allow third parties to get in the way of your relationship with your patients.

We have created a Patient Engagement Service that enables doctors to do this vital function without expending any time or energy. In case you are interested to learn more about these services please click here.

Set Realistic patient expectations

I quote an FIR lodged recently – “She added that the surgeon informed her on April 14, 2018 that the surgery was successful. However, a couple of hours later, he told her that they had to perform another surgery to address an undetected hole in the valve. Thereafter, he was put on ventilator support and the doctors kept telling her that he was kept in a state of unconsciousness as part of treatment. On the afternoon of April 17, 2018, the hospital staff informed Sunita that her husband’s condition was critical and a few hours later told her that he had passed away.” 

Imagine the shock that is delivered to a patient when the doctors suddenly share an adverse outcome. They are not emotionally prepared for bad news. Whose responsibility is it to prepare the patient’s relatives for untoward incidents? This is the second critical thing that doctors are neglecting at their own peril. We do not counsel the patient appropriately because of various reasons which I am not going into here. The consequences are that the patients has unrealistic expectations abut their treatment. Imagine the rude shock that is delivered to the patient and their relatives once they experience the reality that is different from what was conveyed to them or conveniently not revealed. In India most patients believe that if they spend “enough” money they will get “cured”. Who has the responsibility to ensure that the patients and their relatives do not harbour any unrealistic expectations? Patients or doctors or both?

Respect our colleagues

“Which fool was treating you till now? Thank God you have come to me otherwise…” How many of us have heard these words or have used them ourselves? You may be right but how will it help the patient? In our endeavour to appear superior and more knowledgeable we undermine and under cut our poor colleague who had been treating the patient. Do we realise what we just did? We have created doubt in the patient’s mind. He will now look at every doctor with suspicion including yourself. For me it is inexplicable why we doctors continue to compete with each other till the end of our lives. For goodness sake our last competition was the PG entrance! Live in peace

Work with the media

Most doctors believe that the media is hostile to them, which is probably true. So how do we handle this? Each one of us has the responsibility to influence the media and we usually get it wrong. I underwent training on how to handle the media and press conferences. So, let me share a couple of learnings -Facing the media requires serious planning and preparation. You need to make sure that the facts and your narrative is in synch. Secondly use your skill to get them on your side or at best to be neutral. Never antagonize them. Do not be arrogant. Last do not tell untruths. It is best not to comment than tell an untruth!

To conclude there is no single miracle bullet that will solve this problem. I am sure there would be few other things we can do to protect like maintaining records, maintaining good relationships with local policemen, identifying potential trouble makers early etc. Those are discussions for another time.

  However, it will require us to  change & evolve our medical practices to ensure that they are effective and in line with current environment.

Look forward to hearing other opinions!

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