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Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Patient Satisfaction and Pearls of
Practise
Doctor-Patient Relationship
& Medical Professionalism
Magical Facts
About Patients
Satisfaction
That you would die to know
Dr.Sandeep Agrawal
Consultant Orthopedic Surgeon
MS,DNB
Agrasen Hospital
Gondia
Maharashtra
India
drsandeep123@gmail.com
!
www.agrasenortho.com
!
09960122234
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Behave Professionally
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Practise management skills
Every doctor is an entrepreneur
!
Needs to run a business
!
These skills are never taught in medical
college
!
Some doctors never learn them and
struggle to manage their practise
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Patients satisfaction
Satisfied patient 3 other people
!
!
Dissatisfied patient 20 others
!
Satisfying unhappy patients 50 others
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Medical Professionalism : Deprofessionalism
Causes
● Technology – Depersonarlise medicine &
deprofessionalise a physician
!
● Corporatization of Medicine
!
● Specialization – Most patients identified by disease
rather than human beings who happens to have disease
!
● Patients knowing limitation of modern medicine
!
● Greed
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Being a doctor today is not easy
!
too much work
too much hassle
too much competition
too much despair; and
too little reimbursement ?
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Physician motivators
Intrinsic
Serving people
Work interest
Career growth
Ability to support oneself & family
Autonomy
Empowerment
Socio-cultural
Respect
Social rewards
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Physician : lets take lead
● Leadership – genes, charisma, education, wealth,
luck, training, experience
Ethics
do right
!
Reality Greatness vision
Have no think big & new
Illusion
Courage
act with sustained initiation
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Patient Autonomy
Autonomy = freedom to decide
!
Doctors need to :
1. present the options to the patients and
2. allow patients to choose for themselves
!
Informed choice means patients need
information
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Educating patients
Most doctors do not spend much time
educating their patients	

!
Primary role of a doctor should not be
merely treating an illness, but helping people
remain healthy
Patients are the practise
!
Everything else is just paper work !
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Benefits of patient education :
Happier patients
practice promoter
Increase patient compliance
Improve public health
Overall :Helps to improve empathy
Reduce risk of complications
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Communication skills
“ Patients don’t care how much
you know them, until they
know how much you care”
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Communication skills in clinical practice :
“Its an art to talk medicine in the
language of a non medical men”
!
✓ separates successful doctors from
unsuccessful ones
!
✓ include ability to engage with patients
at emotional level, to listen, to convey
information with clarity & sympathy
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Patient education – key component
of informed consent
Don’t tell the patient what to do
Present the information and the
treatment options – and allow them
to make up their own mind !
Empower patients with information –
they will respect you for this !
Information therapy - “ Prescribing the Right
Information to the Right Person at the RightTime” is
the best way of bridging the doctor-patient
communication gap today !
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Start your own website !
Patients are hungry for reliable
information
Internet :Excellent source of
information, but this can be wrong and
dangerous
!
Provide reliable information to your
patients through your own website
Very cost effective !
Think global – act local !
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Improving Doctor-patient
relationship
Based on TRUST
Trust needs to be earned !
!
Patients feel exploited and believe
medical profession has become crass
and commercialized
Doctors feel unappreciated,
overworked, victimised and threatened.
Foundation of the relationship
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Become a Professional – 

Trust Equation
T = C + R + I/ S, where
T = Trustworthiness
C= Credibility
R= Reliability
I = Intimacy
S= Self-orientation
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Become a Professional – 

Trust Equation
Credibility =patient trust what you say ?
Reliability = he trust your actions,
confident that you will act honorably ?
Intimacy = is he comfortable discussing
his feelings and emotions with you ?
Self-orientation = can he trust your
motives, knowing that you care about
him, and will act in his best interests ?
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
What do patients want
- Patient dissatisfaction relate to problems of
communication rather than clinical
competence
!
- They want
● - quality information about their problems
● - risks & benefits of treatment
● - relief of emotional distress
● - to be active participate in medical
decision making
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Educate All Informations to Patient
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Benefits of doctor patient communication
- communication with personal touch
provides treatment beyond drugs
!
- Patients more likely to comply
!
- Overall quality of care & patient
satisfaction improved
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Answering skills
▪ weakest communication skills among
Indian Medical Professionals
!
▪ In Indian context patient satisfaction is
largely decided by the quality of answers &
explanation given by doctors
!
▪ Understand the question clearly, answer
fully, & clearly but briefly
!
▪ Avoid major technical terms
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Barriers to communication
● Work over load on doctors
!
● Shortage of man power- less time for
individual patient
!
● Lack of training in communication skills
during medical education
!
● Individual attitude & personality traits
!
● Under utilization of paramedical staff
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Communication
● 7% - Spoken words
!
● 38% - Voice quality like Tone, Tempo,
intonation
!
● 55% - Body language
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
How do we fix the problem ?
Two players:
Doctors
Patients
!
It’s hard to change anyone else – you
can only change yourself !
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Today’s Health Care System
Patient
Health 

Insurance
Government
!
!
Information
Overload
Media
Doctor
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Patient Experience is all about
bottom line
LEAST
PROFITABLE

QUARTILE
MOST
PROFITABLE
QUARTILE
PATIENTSATISFACTION
1 2 3 4
82.2
83.5
83.7
84.3
!
In research conducted by Press Ganey, hospitals were divided into four groups
(quartile) based on their profitability.
!
The least profitable hospitals had the lowest patient satisfaction scores (out of
100 points). The most profitable had the highest patient satisfaction
!
!
Source: HFM Magazine, 2008 : Looking to improve financial results ? Start by listening to patients : By: Melvin F Hall PhD
As patient satisfaction
increased, the average
hospital profitability
increased
Without a quantifiable link to profits,
the push for patient satisfaction is
based on nothing more than the
moralistic view that “it’s nice to be nice”
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Patient Experience is a lot more
than clinical outcomes
How well staff worked together to care for me
Overall Cheerfulness of the Hospital
Response to concerns/complaints made during my stay
Amount of attention paid to my personal and specific needs
Staff sensitivity to the inconvenience of hospitalization
How well nurses kept me informed
Staff’s effort to include me in decisions about my treatment
Nurses attitude towards my requests
Skill of the nurses
Friendliness of the nurses
Press Ganey Satisfaction Report , August , 2003
0.79
0.74
0.68
0.65
0.65
0.64
0.64
0.64
0.63
0.62
When hospitals spend
most of their efforts in
clinical results &
process improvement,
their data are defined
by outcomes and thus
can be measurable
objectively.
!
!
Patient however,
judge quality by his/
her perceptions,
something that is
subjective and cannot
be verified in the same
way as outcome.
!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Patients expectations from their
doctors ?
Expertise ( be well-informed and uptodate)
!
Professionalism – look out for the patient’s best interests
!
Accountability – be answerable; say Sorry ( if there is a mistake)
!
Transparency – no unnecessary tests and referrals
!
Respect their desires and their time
!
Treat them as intelligent human beings
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Types of Patients
If you can’t measure, you can’t
manage
2 3 4 5 6 7 81 90 10
Never Absolutely
Detractor Passive Promoter
Detractors are customers with the lowest rates of
repurchase and referrals. Detractors spread
negative word-of-mouth comments about the
company
Passively Satisfied customers stay with a company
more due to inertia than true loyalty
Promoters have the highest
rates of repurchase and
referral.
THE NET PROMOTER SCORE
It’s all about word of mouth
!
!
0
100
200
300
-100
-200
AVERAGE
CUSTOMER BASE
AVERAGE
CUSTOMER BASE
RETENTION
MARGINS
ANNUAL SPEND
COST TO SERVE Economic
benefits
NEGATIVE
WORD OF MOUTH
!
COST TO SERVE
ANNUAL SPEND
!
MARGINS
!RETENTION
Economic
penalties
Patients who
spoke bad
Patients who
spoke good
POSITIVE
WORD OF MOUTH
Each one point
decrease in satisfaction is associated
with a 6% increase in complaints
Stelfox, et. al. (2005) AJM 118
What’s bad about good service
quality
A satisfied person has no story to
tell. Everything went just as
expected. It is the unexpected
event that makes a stay
memorable.
!
For every loyal customer, there is
usually a special story
!
Fred Lee , Author of award winning book
If Disney Ran Your Hospital
Touch Point
1
Touch point
2
Touch point
3
Touch point
4
Touch Point
5
Touch Point
6
Touch Point
7
TOUCH
POINTS
What made them
feel bad and at
which touch
point?
What created
tears of joy and at
which touch point
did that happen ?A good story to tell
A bad story to tell
Satisfied Person
Hyper Satisfied Person
Dissatisfied Person
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
5 Things that Matter Most to Patients
1. Doctors treat patients with courtesy and respect.
2. Doctors explain the facts in a way that patients can
understand.
3. Doctors, nurses, and other hospital staff do everything
they can to help patients with their pain.
4. The hospital room and bathroom are kept clean.
5. Patients get information in writing about symptoms or
health problems to look for after they leave the
hospital.
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Patients’ Expectations
• Experience + Needs + Communication =
Expectation
!
– If Perception exceeds expectations:
Satisfaction
!
– If Expectations are less than perception:
Dissatisfaction
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Patient Satisfaction: 

GREET Tool
GREET
– 10/5 Rule: At 10 feet acknowledge; at 5 feet greet/speak
– Call patient by name (If known)
– Make eye contact , Smile
– Let the patient(s) know they are important
RECOGNIZE
– Welcome them to Hospital
– State your name, department, & role in the patient’s care
EXPECTATIONS/EXPLAIN
– How long a procedure or test will take & why…
– How long a patient should be expected to wait before getting results & why…
EDUCATE
– Explain the role of medical staff involved in providing care
– Explain if the test or procedure will cause pain or discomfort, or if any post procedure instructions
are necessary
– Offer to answer any other questions, concerns, or resolve any complaints… you do have the time
THANK YOU
– Let your patient & family members know “Thank you for choosing me for you healthcare needs!”
– Exercise courtesy by using words “Please” and “Thank You” in conversions
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
○ Mayo Clinic conducted a research involving
192 patients and conclude that a model doctor
should be:>>
EXPECTATION OF PATIENT FROM DOCTORS
○ CONFIDENT
○ EMPATHETIC
○ HUMANE
○ PERSONAL
○ FORTRIGHT
○ RESPECTFUL
○ THOROUGH
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Factors Influencing Patient Satisfaction
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Balance

Patient experience = service quality + clinical quality
Service
Quality
Clinical
Quality
Interpersonal skills/
Communication
• Engagement
• Empathize
• Educate
• Enlist
Clinical
Knowledge/
skills
• Find It
• Fix It
Adapted from Institute for Healthcare
Communication
Process Skills
• Technology
• Process Improvement
• Care Coordination
Patient Experience

Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Be a Committed Professional
• Staying Work-
Focused. Not letting
your private life
needlessly have an
impact on your job,
and not spending
time at work
attending to personal
matters.
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Good Doctor Skills
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Be you are remembered for
Principles and Integrity
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
What do doctors expect from their
patients ?
Patients will:
!
• Treat Doctor with respect
• Will say “Thank You” when things go well
• Will have realistic expectations of treatment
• Will not unfairly blame doctor anytime
there is a problem
• Will pay their professional fees promptly
and gracefully
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Respect others and other
Respect you
• Respect For
Others. Treating
all people as if
they mattered is
part of your
approach.
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Having Positive Attitude -
Benefits
!
• Pleasing personality
!
• Energizing
!
• Inspiring
!
• Problem Solving
!
• Increase work output
!
!
- 85% Attitude
- 15 % Intelligence & knowledge of specific facts $ figures
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Elements of success
Attitude
SkillKnowledge
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Be Confident
• Be confident. Others will
sense your confidence
when they see or meet
you, and they will think
better of you. Also, if you
always wear a sly smile,
like there is a joke you get
but no one else does,
people will think you are
above them in your
knowledge
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Non-verbal communication
- SOFTEN
S- Smile
O - Open posture
F- Forward lean
T – Touch. This is a privilege – use
it !
E – Eye contact
N - Nod
Polish your bedside manner
How to perfect non verbal signal
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
How to talk to your doctor –

SAFEly !
Story: Symptoms
Assessment: Problem
Fears: Overcome Patients
fears by Discussion
Expectations: What patient want
from doctor ?
Patients don’t care how much you know – until they know
how much you care !
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
BATHE technique
B = Background. What’s going on ?
A = Affect. Feelings. What do you feel about it ?
T = Troubles. What troubles you about this ?
H = Handle. How are you handling this ?
E = Empathy. It must be hard.
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Joy of practising medicine – how to
be a happy doctor
When it comes to getting positive
feedback, no profession in the
world comes close to medicine !
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Employees !
Can be your biggest asset – as well as your
biggest problem !
Keep your employees happy, and they will
keep your patients happy
Don’t skimp on their salaries
Train them well
Key test – how well does your clinic run
when you are not there ?
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
OPD SUBUNITS:
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Many other issues
Time management
Learning to keep upto date
How to buy medical equipment
How to keep medical records
How to grow and expand
Balancing family and career
Retiring
Ethics
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Communicating prognosis, hope & risk
➢ Misunderstandings in these areas can lead to patient dissatisfaction &
litigation
!
➢ Prognostication is like weather forecasting uncertain but based on
sound scientific principles
Stage of illness at presentation of patient!
Curability of disease!
!
➢ In face of uncertainty there is nothing wrong with providing hope
!
➢ Provide evidence based risks
!
➢ Never create guilt for negligence on part of patient
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
● If too many anxious attendants, send them one or another job.
eg. Bringing medicines, arranging blood- Energy utilization
!
● Never argue with attendants
!
● Argument will trigger them, at the same time your calmness and
promptness will even calm down a triggered person.
!
● If patient is sick, attend patient periodically and talk to
attendants.
!
● Check emergency tray for drugs.
!
● Try to solve/resolve crisis immediately
Do’s
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Do’s
● Patients should be attended promptly:
- Error in Decision making is Excusable but not attending
patients timely is not.
!
● Identify a Prominent Person:
- Important person/relative and explain initial assessment of
patient immediately.
- Explain them management has started.
!
● Ask if they have any questions
!
● Call senior consultant as per requirement, talk to them
telephonically if possible delay in arrival.
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Physicians should
Behave Professionally
Physicians are capable of
acting unprofessionally, but
cannot act unethically, as
ethical standards are part of
their profession. Therefore, it
behoves all patients to
educate themselves on what
constitutes  “professional”  
and  “unprofessional”  
behaviour for those involved
in health care. -
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Don’ts
● Never argue with attendants. this
situation teaches you how to remain
calm in provocative circumstances.
No book in the world can teach this.
!
● Never overlook a call, especially if
call is by a attendant.
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dealing with mistake
● Accept responsibility for the mistake
● Discuss with trusted friend, colleague
or spouse
● Disclose & Apologize to the patients
● Error analysis
● Measures to reduce similar mistake in
future
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
!
Identify & avoid negative people
Positive
!
• Part of the answer
!
• Has Program
!
• Let me do it for you
!
• Difficult but possible
!
• I must do something
!
• See the gain
!
• See possibilities.
!
• Hard arguments, Soft
words
Negative
!
• Part of the problem
!
• Has excuse
!
• Its not my job
!
• Possible but to difficult
!
• Something must be done
• See the pain
!
• See problem.
!
• Soft arguments, Hard
words
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Be A Optimist
• No one likes a
constant pessimist.
Having an upbeat
attitude and trying
to be a problem-
solver makes a big
difference.
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Use common sense with knowledge
Knowledge Vs Wisdom
• Knowledge - Piling up facts
Wisdom - Simplifying it
!
•Knowledge - Potential power
Wisdom - Real power
!
• To attain knowledge - Add things everyday
To attain Wisdom - delete things everyday
!
!
!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
“ The education of the doctor which
goes on after he has his degree is the
most important part of his education”
John Shaw Billings
Keeping updated : Managing knowledge
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Upgrade the Knowledge or you
are Lost
Self-Upgrading.
Rather than letting
your skills or
knowledge
become outdated,
you seek out ways
of staying current.
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
TRADITIONAL CME Vs CPD
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Practice building/Marketing
● Satisfied patients
● Volunteering at community medical service.
● Organizing an event – like conference
● Attracting Media attention
● Contributing article on health to magazine
● Public lecture
● News letter
● Website
● Marketing to referral base
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Physicians: problematic spouse?
● Stage 1 -- Romance – you are perfect
● Stage 2 -- Fault finding
● Stage 3 -- Blaming
● Stage 4 -- Acceptance
● Transformation – Growing together
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Marriages
● Spend time together
● Respect each other
● Have fun together
● Treat your spouse as your most important
VIP patient
-- A loved spouse is also loving spouse
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!


Children
● A meal together everyday
● Fun together once a week
● One holiday every year together
● Make sure children meet grand
parents, relatives periodically
● Help children honour family
traditions
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Litigation
● Be a nice person
● Be honest
● Be open
● Be accessible
● Keep up to date professionally
● Insurance
How to reduce chances of litigation
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Make connections.
• Make connections. You
never know when you'll
need to call in a favour
from someone to get
the job done help in
your crisis moments,
so it pays to know the
right people.
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Retirement
● Don’t retire unless you have enough financial
security
● Studies-Retirement has Predominantly positive
impact on emotional state
● Explore you hobbies
● Explore your spirituality
● Serve other selflessly-do charity work/volunteer
work
● Physical activity/light exercise
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Take home
● Let us enjoy being a doctor/physician, let us work for
joy of working, nor for a home, car or vacation
!
● Don’t find faults in medicine, Identify happy doctor &
follow their secrets
!
● Lets love what we do, and do what we love
!
● Watching dying patients should remind us about our
own mortality enabling us to live each day well.
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Take Home
● Social capital is more important than financial capital
at end of the day.
!
● Work & practice with Medical professionalism
!
● Use common sense. Identify local socio-cultural
practices & integrate in your working style
!
● People prefer those doctors with average clinical
skills but good communication skills rather than those
with excellent clinical but poor communication skills
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Never forget Professionalism is an
important component of Medicine
Professionalism is an
important component of
medicine's contract with
society. Not only do we
need to make good
decisions for our patients
based on the evidence in
the literature, but we need
to apply those decisions
in a way that is
professional and
ultimately helps our
patient
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
SUMMARY: Increase Patient Satisfaction
1.Give patient your full attention
2. Build partnership with the patient
3. Maintain positive Attitude!
4. Respect patients privacy!
5. Handle complaints effectively
7. Practice good bedside manners
6. Listen to your patients
Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
This presentation is for  doctors and students in general.
. Graphics,Images and jpeg files are taken from Google
and yahoo  Image  to heighten the specific points in this
presentation. 
• If there is any objection/or copyright violation, please
inform drsandeep123@gmail.com for prompt deletion. 
• It is intended for use only by the doctors of orthopaedic
surgery.
. Views expressed in this presentation are personal. • .For
any confusion please contact the sole author for
clarification. 
• Every body is allowed to copy or download and use the
material best suited to him. 
There is no financial involvement.
 • For any correction or suggestion please contact
drsandeep123@gmail.com or www.agrasenortho.com

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Magical facts about patients satisfaction and pearls of medical practise::Doctor-Patient Relationship & Medical Professionalism dr.sandeep c agrawal agrasen hospital gondia india www.agrasenortho.com

  • 1. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Patient Satisfaction and Pearls of Practise Doctor-Patient Relationship & Medical Professionalism Magical Facts About Patients Satisfaction That you would die to know Dr.Sandeep Agrawal Consultant Orthopedic Surgeon MS,DNB Agrasen Hospital Gondia Maharashtra India drsandeep123@gmail.com ! www.agrasenortho.com ! 09960122234
  • 2. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 3. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 4. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Behave Professionally
  • 5. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Practise management skills Every doctor is an entrepreneur ! Needs to run a business ! These skills are never taught in medical college ! Some doctors never learn them and struggle to manage their practise
  • 6. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Patients satisfaction Satisfied patient 3 other people ! ! Dissatisfied patient 20 others ! Satisfying unhappy patients 50 others
  • 7. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Medical Professionalism : Deprofessionalism Causes ● Technology – Depersonarlise medicine & deprofessionalise a physician ! ● Corporatization of Medicine ! ● Specialization – Most patients identified by disease rather than human beings who happens to have disease ! ● Patients knowing limitation of modern medicine ! ● Greed
  • 8. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Being a doctor today is not easy ! too much work too much hassle too much competition too much despair; and too little reimbursement ?
  • 9. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Physician motivators Intrinsic Serving people Work interest Career growth Ability to support oneself & family Autonomy Empowerment Socio-cultural Respect Social rewards
  • 10. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Physician : lets take lead ● Leadership – genes, charisma, education, wealth, luck, training, experience Ethics do right ! Reality Greatness vision Have no think big & new Illusion Courage act with sustained initiation
  • 11. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Patient Autonomy Autonomy = freedom to decide ! Doctors need to : 1. present the options to the patients and 2. allow patients to choose for themselves ! Informed choice means patients need information
  • 12. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Educating patients Most doctors do not spend much time educating their patients ! Primary role of a doctor should not be merely treating an illness, but helping people remain healthy Patients are the practise ! Everything else is just paper work !
  • 13. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Benefits of patient education : Happier patients practice promoter Increase patient compliance Improve public health Overall :Helps to improve empathy Reduce risk of complications
  • 14. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Communication skills “ Patients don’t care how much you know them, until they know how much you care”
  • 15. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Communication skills in clinical practice : “Its an art to talk medicine in the language of a non medical men” ! ✓ separates successful doctors from unsuccessful ones ! ✓ include ability to engage with patients at emotional level, to listen, to convey information with clarity & sympathy
  • 16. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Patient education – key component of informed consent Don’t tell the patient what to do Present the information and the treatment options – and allow them to make up their own mind ! Empower patients with information – they will respect you for this ! Information therapy - “ Prescribing the Right Information to the Right Person at the RightTime” is the best way of bridging the doctor-patient communication gap today !
  • 17. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Start your own website ! Patients are hungry for reliable information Internet :Excellent source of information, but this can be wrong and dangerous ! Provide reliable information to your patients through your own website Very cost effective ! Think global – act local !
  • 18. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Improving Doctor-patient relationship Based on TRUST Trust needs to be earned ! ! Patients feel exploited and believe medical profession has become crass and commercialized Doctors feel unappreciated, overworked, victimised and threatened. Foundation of the relationship
  • 19. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Become a Professional – 
 Trust Equation T = C + R + I/ S, where T = Trustworthiness C= Credibility R= Reliability I = Intimacy S= Self-orientation
  • 20. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Become a Professional – 
 Trust Equation Credibility =patient trust what you say ? Reliability = he trust your actions, confident that you will act honorably ? Intimacy = is he comfortable discussing his feelings and emotions with you ? Self-orientation = can he trust your motives, knowing that you care about him, and will act in his best interests ?
  • 21. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! What do patients want - Patient dissatisfaction relate to problems of communication rather than clinical competence ! - They want ● - quality information about their problems ● - risks & benefits of treatment ● - relief of emotional distress ● - to be active participate in medical decision making
  • 22. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Educate All Informations to Patient
  • 23. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Benefits of doctor patient communication - communication with personal touch provides treatment beyond drugs ! - Patients more likely to comply ! - Overall quality of care & patient satisfaction improved
  • 24. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Answering skills ▪ weakest communication skills among Indian Medical Professionals ! ▪ In Indian context patient satisfaction is largely decided by the quality of answers & explanation given by doctors ! ▪ Understand the question clearly, answer fully, & clearly but briefly ! ▪ Avoid major technical terms
  • 25. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Barriers to communication ● Work over load on doctors ! ● Shortage of man power- less time for individual patient ! ● Lack of training in communication skills during medical education ! ● Individual attitude & personality traits ! ● Under utilization of paramedical staff
  • 26. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Communication ● 7% - Spoken words ! ● 38% - Voice quality like Tone, Tempo, intonation ! ● 55% - Body language
  • 27. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 28. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! How do we fix the problem ? Two players: Doctors Patients ! It’s hard to change anyone else – you can only change yourself !
  • 29. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Today’s Health Care System Patient Health 
 Insurance Government ! ! Information Overload Media Doctor
  • 30. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 31. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 32. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 33. Patient Experience is all about bottom line LEAST PROFITABLE
 QUARTILE MOST PROFITABLE QUARTILE PATIENTSATISFACTION 1 2 3 4 82.2 83.5 83.7 84.3 ! In research conducted by Press Ganey, hospitals were divided into four groups (quartile) based on their profitability. ! The least profitable hospitals had the lowest patient satisfaction scores (out of 100 points). The most profitable had the highest patient satisfaction ! ! Source: HFM Magazine, 2008 : Looking to improve financial results ? Start by listening to patients : By: Melvin F Hall PhD As patient satisfaction increased, the average hospital profitability increased Without a quantifiable link to profits, the push for patient satisfaction is based on nothing more than the moralistic view that “it’s nice to be nice”
  • 34. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 35. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 36. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 37. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 38. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 39. Patient Experience is a lot more than clinical outcomes How well staff worked together to care for me Overall Cheerfulness of the Hospital Response to concerns/complaints made during my stay Amount of attention paid to my personal and specific needs Staff sensitivity to the inconvenience of hospitalization How well nurses kept me informed Staff’s effort to include me in decisions about my treatment Nurses attitude towards my requests Skill of the nurses Friendliness of the nurses Press Ganey Satisfaction Report , August , 2003 0.79 0.74 0.68 0.65 0.65 0.64 0.64 0.64 0.63 0.62 When hospitals spend most of their efforts in clinical results & process improvement, their data are defined by outcomes and thus can be measurable objectively. ! ! Patient however, judge quality by his/ her perceptions, something that is subjective and cannot be verified in the same way as outcome. !
  • 40. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Patients expectations from their doctors ? Expertise ( be well-informed and uptodate) ! Professionalism – look out for the patient’s best interests ! Accountability – be answerable; say Sorry ( if there is a mistake) ! Transparency – no unnecessary tests and referrals ! Respect their desires and their time ! Treat them as intelligent human beings
  • 41. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Types of Patients
  • 42. If you can’t measure, you can’t manage 2 3 4 5 6 7 81 90 10 Never Absolutely Detractor Passive Promoter Detractors are customers with the lowest rates of repurchase and referrals. Detractors spread negative word-of-mouth comments about the company Passively Satisfied customers stay with a company more due to inertia than true loyalty Promoters have the highest rates of repurchase and referral. THE NET PROMOTER SCORE
  • 43. It’s all about word of mouth ! ! 0 100 200 300 -100 -200 AVERAGE CUSTOMER BASE AVERAGE CUSTOMER BASE RETENTION MARGINS ANNUAL SPEND COST TO SERVE Economic benefits NEGATIVE WORD OF MOUTH ! COST TO SERVE ANNUAL SPEND ! MARGINS !RETENTION Economic penalties Patients who spoke bad Patients who spoke good POSITIVE WORD OF MOUTH Each one point decrease in satisfaction is associated with a 6% increase in complaints Stelfox, et. al. (2005) AJM 118
  • 44. What’s bad about good service quality A satisfied person has no story to tell. Everything went just as expected. It is the unexpected event that makes a stay memorable. ! For every loyal customer, there is usually a special story ! Fred Lee , Author of award winning book If Disney Ran Your Hospital Touch Point 1 Touch point 2 Touch point 3 Touch point 4 Touch Point 5 Touch Point 6 Touch Point 7 TOUCH POINTS What made them feel bad and at which touch point? What created tears of joy and at which touch point did that happen ?A good story to tell A bad story to tell Satisfied Person Hyper Satisfied Person Dissatisfied Person
  • 45. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! 5 Things that Matter Most to Patients 1. Doctors treat patients with courtesy and respect. 2. Doctors explain the facts in a way that patients can understand. 3. Doctors, nurses, and other hospital staff do everything they can to help patients with their pain. 4. The hospital room and bathroom are kept clean. 5. Patients get information in writing about symptoms or health problems to look for after they leave the hospital.
  • 46. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Patients’ Expectations • Experience + Needs + Communication = Expectation ! – If Perception exceeds expectations: Satisfaction ! – If Expectations are less than perception: Dissatisfaction
  • 47. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Patient Satisfaction: 
 GREET Tool GREET – 10/5 Rule: At 10 feet acknowledge; at 5 feet greet/speak – Call patient by name (If known) – Make eye contact , Smile – Let the patient(s) know they are important RECOGNIZE – Welcome them to Hospital – State your name, department, & role in the patient’s care EXPECTATIONS/EXPLAIN – How long a procedure or test will take & why… – How long a patient should be expected to wait before getting results & why… EDUCATE – Explain the role of medical staff involved in providing care – Explain if the test or procedure will cause pain or discomfort, or if any post procedure instructions are necessary – Offer to answer any other questions, concerns, or resolve any complaints… you do have the time THANK YOU – Let your patient & family members know “Thank you for choosing me for you healthcare needs!” – Exercise courtesy by using words “Please” and “Thank You” in conversions
  • 48. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! ○ Mayo Clinic conducted a research involving 192 patients and conclude that a model doctor should be:>> EXPECTATION OF PATIENT FROM DOCTORS ○ CONFIDENT ○ EMPATHETIC ○ HUMANE ○ PERSONAL ○ FORTRIGHT ○ RESPECTFUL ○ THOROUGH
  • 49. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 50. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 51. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 52. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Factors Influencing Patient Satisfaction
  • 53. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Balance
 Patient experience = service quality + clinical quality Service Quality Clinical Quality Interpersonal skills/ Communication • Engagement • Empathize • Educate • Enlist Clinical Knowledge/ skills • Find It • Fix It Adapted from Institute for Healthcare Communication Process Skills • Technology • Process Improvement • Care Coordination Patient Experience

  • 54. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 55. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Be a Committed Professional • Staying Work- Focused. Not letting your private life needlessly have an impact on your job, and not spending time at work attending to personal matters.
  • 56. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Good Doctor Skills
  • 57. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Be you are remembered for Principles and Integrity
  • 58. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 59. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 60. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! What do doctors expect from their patients ? Patients will: ! • Treat Doctor with respect • Will say “Thank You” when things go well • Will have realistic expectations of treatment • Will not unfairly blame doctor anytime there is a problem • Will pay their professional fees promptly and gracefully
  • 61. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Respect others and other Respect you • Respect For Others. Treating all people as if they mattered is part of your approach.
  • 62. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Having Positive Attitude - Benefits ! • Pleasing personality ! • Energizing ! • Inspiring ! • Problem Solving ! • Increase work output ! ! - 85% Attitude - 15 % Intelligence & knowledge of specific facts $ figures
  • 63. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Elements of success Attitude SkillKnowledge
  • 64. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Be Confident • Be confident. Others will sense your confidence when they see or meet you, and they will think better of you. Also, if you always wear a sly smile, like there is a joke you get but no one else does, people will think you are above them in your knowledge
  • 65. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Non-verbal communication - SOFTEN S- Smile O - Open posture F- Forward lean T – Touch. This is a privilege – use it ! E – Eye contact N - Nod Polish your bedside manner How to perfect non verbal signal
  • 66. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! How to talk to your doctor –
 SAFEly ! Story: Symptoms Assessment: Problem Fears: Overcome Patients fears by Discussion Expectations: What patient want from doctor ? Patients don’t care how much you know – until they know how much you care !
  • 67. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! BATHE technique B = Background. What’s going on ? A = Affect. Feelings. What do you feel about it ? T = Troubles. What troubles you about this ? H = Handle. How are you handling this ? E = Empathy. It must be hard.
  • 68. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Joy of practising medicine – how to be a happy doctor When it comes to getting positive feedback, no profession in the world comes close to medicine !
  • 69. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Employees ! Can be your biggest asset – as well as your biggest problem ! Keep your employees happy, and they will keep your patients happy Don’t skimp on their salaries Train them well Key test – how well does your clinic run when you are not there ?
  • 70. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 71. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! OPD SUBUNITS:
  • 72. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 73. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Many other issues Time management Learning to keep upto date How to buy medical equipment How to keep medical records How to grow and expand Balancing family and career Retiring Ethics
  • 74. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Communicating prognosis, hope & risk ➢ Misunderstandings in these areas can lead to patient dissatisfaction & litigation ! ➢ Prognostication is like weather forecasting uncertain but based on sound scientific principles Stage of illness at presentation of patient! Curability of disease! ! ➢ In face of uncertainty there is nothing wrong with providing hope ! ➢ Provide evidence based risks ! ➢ Never create guilt for negligence on part of patient
  • 75. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! ● If too many anxious attendants, send them one or another job. eg. Bringing medicines, arranging blood- Energy utilization ! ● Never argue with attendants ! ● Argument will trigger them, at the same time your calmness and promptness will even calm down a triggered person. ! ● If patient is sick, attend patient periodically and talk to attendants. ! ● Check emergency tray for drugs. ! ● Try to solve/resolve crisis immediately Do’s
  • 76. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Do’s ● Patients should be attended promptly: - Error in Decision making is Excusable but not attending patients timely is not. ! ● Identify a Prominent Person: - Important person/relative and explain initial assessment of patient immediately. - Explain them management has started. ! ● Ask if they have any questions ! ● Call senior consultant as per requirement, talk to them telephonically if possible delay in arrival.
  • 77. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Physicians should Behave Professionally Physicians are capable of acting unprofessionally, but cannot act unethically, as ethical standards are part of their profession. Therefore, it behoves all patients to educate themselves on what constitutes  “professional”   and  “unprofessional”   behaviour for those involved in health care. -
  • 78. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Don’ts ● Never argue with attendants. this situation teaches you how to remain calm in provocative circumstances. No book in the world can teach this. ! ● Never overlook a call, especially if call is by a attendant.
  • 79. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Dealing with mistake ● Accept responsibility for the mistake ● Discuss with trusted friend, colleague or spouse ● Disclose & Apologize to the patients ● Error analysis ● Measures to reduce similar mistake in future
  • 80. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! ! Identify & avoid negative people Positive ! • Part of the answer ! • Has Program ! • Let me do it for you ! • Difficult but possible ! • I must do something ! • See the gain ! • See possibilities. ! • Hard arguments, Soft words Negative ! • Part of the problem ! • Has excuse ! • Its not my job ! • Possible but to difficult ! • Something must be done • See the pain ! • See problem. ! • Soft arguments, Hard words
  • 81. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Be A Optimist • No one likes a constant pessimist. Having an upbeat attitude and trying to be a problem- solver makes a big difference.
  • 82. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Use common sense with knowledge Knowledge Vs Wisdom • Knowledge - Piling up facts Wisdom - Simplifying it ! •Knowledge - Potential power Wisdom - Real power ! • To attain knowledge - Add things everyday To attain Wisdom - delete things everyday ! ! !
  • 83. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! “ The education of the doctor which goes on after he has his degree is the most important part of his education” John Shaw Billings Keeping updated : Managing knowledge
  • 84. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Upgrade the Knowledge or you are Lost Self-Upgrading. Rather than letting your skills or knowledge become outdated, you seek out ways of staying current.
  • 85. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! TRADITIONAL CME Vs CPD
  • 86. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Practice building/Marketing ● Satisfied patients ● Volunteering at community medical service. ● Organizing an event – like conference ● Attracting Media attention ● Contributing article on health to magazine ● Public lecture ● News letter ● Website ● Marketing to referral base
  • 87. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Physicians: problematic spouse? ● Stage 1 -- Romance – you are perfect ● Stage 2 -- Fault finding ● Stage 3 -- Blaming ● Stage 4 -- Acceptance ● Transformation – Growing together
  • 88. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Marriages ● Spend time together ● Respect each other ● Have fun together ● Treat your spouse as your most important VIP patient -- A loved spouse is also loving spouse
  • 89. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! 
 Children ● A meal together everyday ● Fun together once a week ● One holiday every year together ● Make sure children meet grand parents, relatives periodically ● Help children honour family traditions
  • 90. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Litigation ● Be a nice person ● Be honest ● Be open ● Be accessible ● Keep up to date professionally ● Insurance How to reduce chances of litigation
  • 91. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Make connections. • Make connections. You never know when you'll need to call in a favour from someone to get the job done help in your crisis moments, so it pays to know the right people.
  • 92. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Retirement ● Don’t retire unless you have enough financial security ● Studies-Retirement has Predominantly positive impact on emotional state ● Explore you hobbies ● Explore your spirituality ● Serve other selflessly-do charity work/volunteer work ● Physical activity/light exercise
  • 93. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Take home ● Let us enjoy being a doctor/physician, let us work for joy of working, nor for a home, car or vacation ! ● Don’t find faults in medicine, Identify happy doctor & follow their secrets ! ● Lets love what we do, and do what we love ! ● Watching dying patients should remind us about our own mortality enabling us to live each day well.
  • 94. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Take Home ● Social capital is more important than financial capital at end of the day. ! ● Work & practice with Medical professionalism ! ● Use common sense. Identify local socio-cultural practices & integrate in your working style ! ● People prefer those doctors with average clinical skills but good communication skills rather than those with excellent clinical but poor communication skills
  • 95. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 96. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 97. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 98. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! Never forget Professionalism is an important component of Medicine Professionalism is an important component of medicine's contract with society. Not only do we need to make good decisions for our patients based on the evidence in the literature, but we need to apply those decisions in a way that is professional and ultimately helps our patient
  • 99. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com!
  • 100. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! SUMMARY: Increase Patient Satisfaction 1.Give patient your full attention 2. Build partnership with the patient 3. Maintain positive Attitude! 4. Respect patients privacy! 5. Handle complaints effectively 7. Practice good bedside manners 6. Listen to your patients
  • 101. Dr.Sandeep C Agrawal Agrasen Hospital Gondia India www.agrasenortho.com! This presentation is for  doctors and students in general. . Graphics,Images and jpeg files are taken from Google and yahoo  Image  to heighten the specific points in this presentation.  • If there is any objection/or copyright violation, please inform drsandeep123@gmail.com for prompt deletion.  • It is intended for use only by the doctors of orthopaedic surgery. . Views expressed in this presentation are personal. • .For any confusion please contact the sole author for clarification.  • Every body is allowed to copy or download and use the material best suited to him.  There is no financial involvement.  • For any correction or suggestion please contact drsandeep123@gmail.com or www.agrasenortho.com