1. STRESS
AND
SUCCESSFUL
DOCTORS
DR
SHRINIWAS
KASHALIKAR
M.B.B.S., M.D., D.Sc. [OIUCM],
Fellow of Indian College of Gerontology [Mumbai],
Foreign Faculty Fellow of Basic Medical Sciences;
(Medical
University of South Carolina and Educational
Commission for
Foreign Medical Graduates) USA

2. No cure of the part should
be attempted without
treatment the whole
NO attempt should be
made to treat the body
without the soul
PLATO
*
All that Heals is Medicine
*

3. 1. Accept, love and respect your patients
unconditionally: it promotes healing
2. Your patients already have a healer
within: Invoke him!
3. Educational policy [Including medical
education] affects the health of millions
including you and your patients!
4. Take care of yourself!
5. Teach them win-win formula
6. Time Management: A way to greater
efficiency
7. Be profound and wise, not simple and
straightforward
8. Discuss with pharmaceuticals the
perspective of global welfare, which is a
treasure of lifetime!
9. Do not get imposed and do not impose
yourself.
10 Be a leader and not a follower!

4. 1. Accept, love and respect your patients
unconditionally: it promotes healing
Consider this experience of mine in a clinic. I had gone to
a pathologist with another friend of mine to collect the
blood reports. We were waiting in the reception. My
friend’s face was full of anxiety and his eyes reflected a
strange feeling of helplessness and suffocation. Being
close to him I was aware of the financial and other
stresses he was going through. I was also aware as to why
he was undergoing different blood tests.
After some time full of tension and pressure the
pathologist called us.
As soon as we entered he turned ferocious and started
scolding my friend, for indulging.
He was so precipitous and incessant that my friend could
nothing but only listen in shame.
After the pathologist finished his bombardment his eyes
began to emanate the contempt and pity.
The pathologist had satisfaction on his face for having
fulfilled what he considered his duty.

5. My friend was drowned in self-pity and guilt. He
appeared far sicker now than when he had entered the
lab.
It was becoming unbearable now.
Some how I changed the topic, finished the formalities of
payment, thanked the pathologist and came out.
My friend said, “I would prefer to die in dignity than
getting harassed here and everywhere. Why don’t people
understand that I am being suffocated by repeated
failures and unending deceptions. I am not able to cope
and hence trying escape from time to time though with
counterproductive effects. Really, disease is not killing
me. But I am killed every now and then this leaving
death is forcing me into disease and its sequel the final
death.” His eyes filled with tears.
He headed in the direction of a bar!
Let us consider another experience.

6. I had taken my fried to an orthopedic surgeon. My friend
was in agony, due to severe soft tissue in inflammation in
his leg muscle. After careful examination and discussion
with the patient the doctor advised the patient about care
to be taken.
I, being aware of the smoking habit of the patient asked
the surgeon if it was essential to quit smoking.
To my surprise the surgeon smiled and said, “Already he
is in pain and agony. Considering the prose and cons, I
would not like to deprive the patient of his small
pleasure”
My friend appeared solaced and in deep sense of
gratitude for the considerate gesture of the doctor.
After we came out of the clinic, having relieved by the
doctor’s permission to smoke, I was expecting him to
take out and light a cigarette.
But he did not. On the contrary he gradually quit
smoking altogether.
Now let us consider yet another experience!
I had taken my friend to a sex specialist.
Right in the beginning the sex specialist welcome us
warm greetings. Then after making us comfortable he
just made a remark indicating that sexual disorders do

7. not signify any kind of inferiority and or criminal
mentality. Thus first indirectly and then directly
suggested to us that we should accept the given situation
unconditionally (without guilt and lowliness), love it [i.e.
not to despise and resent it] and then respect it i.e. (avoid
casual approach and take deep interest involve in careful
study and conquer it).
Then he began to take detailed history and my friend
revealed his heart and all the facts with full confidence.
The sex specialist now examined the patient thoroughly
well.
After examination, the doctor discussed several issues
such as in laws, children, job, wife’s job, wife’s health
status, her perspective or vision of life, hobbies which
apparently appeared to be unrelated to sexual problem.
Then the doctor wrote in details his prescription and
suggested that the whole family visit his clinic for more
complete benefits and even more, better quality of life.
Some days later, I met my friend. This time he was with
wife and there was that beautiful broad smile on their
face. Their eyes were sparkling with happiness and
contentment.
Without me asking them any further, they ecstatically
exclaimed about the wonderful results.

8. I requested them to divulge few things if they could
without being embarrassed, so that I could use that
information for benefit of others.
They said, “The doctor gave us new life. He gave new
vision. He gave new dimension. He empowered us to
express the best within us for the society and for
ourselves. He gave us detailed knowledge about the realm
of instincts and their role in life. He later elucidated in
details the role of sexual/reproductive instinct, courtship,
pregnancy care, parental instinct, rearing the baby,
effects of our emotions and thoughts on sexual
gratification and how to minimize the damage caused by
a variety of stressors on our happiness [which heavily
depended on our sexual happiness]. He gave books on
stress management and introduced a stress management
expert. As a result apart from getting sexual fulfillment
[by properly managing the stress] we are conquering
blood pressure, diabetes and many ailments related to
stress. In fact we have started getting results in terms
regaining our youth, vigor and fulfillment in life!
Now I was beginning to understand the meaning of
“Accepting unconditionally, loving unconditionally and
respecting unconditionally”!

9. 2. Your patients already have a healer within:
Invoke him!
Let us go through this letter from my friend. She is a
doctor herself.
“Dear Dr
Thank you for your concern about my backache.
Considering your interests, I would like to elaborate a
little more on it.
It is true that the backache troubled me a lot. But since I
was having a variety of differential diagnoses in my
mind, I was afraid that I would have to undergo plethora
of investigations and possibly undergo a major surgery!
Hence I was reluctant to see a doctor.
But the discomfort went on increasing. Finally I decided
to contact a consultant friend of mine. I phoned her.
After talking few things, I conveyed to her my problem.
On phone itself she shouted, “How come you have waited
so much? It is essential to do ultrasonography urgently.
It could be prolapsed disc. It could be lumbar canal
stenosis, tuberculosis of bone, endometriosis some other
malignancy with secondaries…..”

10. I was shocked! Hearing to all this all my fear was as if
endorsed. I felt as if I already entered some terminal
sickness. I was terrified. Chills swept throughout my
spine like electric current. I began to shiver with fear and
started perspiring. Somehow I finished the phone call.
What I was trying to negate had appeared in front of me
with menacing face! Now what to do? I was trying to
negate all these possibilities because I wanted to some
how avoid hospitalization, investigations and surgery.
Apart from the thought of expenses, unpleasant
atmosphere, doubtful outcome and above all; suffering!
Moreover; I had so many preoccupations, obligations
and responsibilities to fulfill.
I repented for having made the phone call! But there was
nothing I could to then! I did not speak anything to my
husband, as I did not want to add to his stress. I thought,
he would be shaken by the content of our telephonic
conversation.
Somehow I spent that night in extreme anxiety and next
day morning I went to a friend’s place. This friend of
mine; a simple housewife, immediately reassured me and
instantly took me to her family physician.
Since she personally accompanied me, I was feeling
greatly relieved. However my anxiety reflected on my
face.

11. The doctor took me in the examination room along with
my friend and examined me clinically.
Then the doctor asked few questions about my personal,
menstrual and family and past background.
He seemed quite satisfied with my dietary and exercise
habits.
Looking at my anxious face with pleasing smile, he
affirmed, “Nothing has to be done”.
“But what about the pain? Any investigations? Any
internal medicines? Any external applications?”
His face reflected supreme confidence. He repeated with
emphasis on every word, “Nothing is required. Continue
your exercises and add some yoga techniques, which I
would teach you. You would be alright within a week!”
This was a reverse shock! Decompression! Relief!
Freedom from tons of burden! I breathed a sigh of huge
relief!
I began to thank the doctor profusely. But the doctor
seemed to be in bliss for what he done spontaneously and
most naturally; and oblivious to my thanks!
Within a week I became all right. I contacted my
housewife friend and went back to give the feed back.
The doctor received us with smile and then explained to
me that as a result of expectations of the patients and

12. their relatives, expectations of the society, quest for
glamour and glitter, desire for power and quick money,
fierce competition, various policies, rules and regulations,
demands of family, financial liabilities, pharmaceutical
propaganda such many factors and most importantly;
their own inability to manage the stress; the doctors are
under enormous stress. He said, “Doctors are really
undergoing enormous turmoil within! Conceptual chaos
and value crisis is taking toll of them! They are not able
to exercise clinical judgment. Please don’t blame them!”
Looking at my friend’s brightened face he further said,
“Your doctor friend has forgotten your clinical wisdom
because of stresses and strains in life. Hence she gave lop
sided weightage to the differential diagnoses. Hence the
fears were compounded!”
Waiting for a while the doctor added, “Stresses and
strains have not only blinded the clinical acumen of
doctors, but their ability to see the fountain of strength
within themselves and their patients as well! This has
made them weak. Weakness perpetuates weakness! I
only can be complimented for retaining my clinical
acumen and ability to see the healing power within
myself and within you. That is why I asked your friend to
humbly suggest you a traditional way to invoke and
experience the healer within oneself and the others!”!

13. Dear Dr I feel happy to share with you the joy of relief
from not merely backache but regaining my clinical
acumen and healer within myself. Now I am able to
invoke my patients’ healing abilities in their getting
healthier and happier!”
Thanking you once again,
Sincerely,
Dr. Shraddha “
Dr. Shraddha’s story is self-explanatory.
However, Dr. Shraddha has not mentioned two points
about her background. I think they will be of benefit to
all of us.
First point is: Dr. Shraddha was one of the toppers in her
school and college career. She was a not merely
intelligent but a very charming sensible girl. However in
the course of medical training, she seemed to be getting
frustrated. Her curiosity seemed to be suppressed. Her
concern for the patient seemed to be laughed at rather
than nurtured. Her quest for the happiness of the
patients appeared to be treated as in vein and utopian.
After entering into practice along with her husband she
seemed to be increasingly disillusioned with medical

14. profession. She had begun to indulge and some how cope
with. But her melancholy was on the rise. This had begun
to get reflected on her physical health. Gradually she had
started losing weight, graying, wrinkling, darkening, and
getting arthritis and many other complaints. She had
begun to lose confidence and had become phobic and
feeble. In view of these effects of stress damaging
subconsciously, her backache had been only the tip of the
iceberg!
The second point: The doctor who treated her effectively
had taken care of these points with the help of Dr.
Shraddha’s housewife friend [who is trained in Total
Stress Management and acted as a support system for
Dr. Shraddha]. As a result Dr. Dr. Shraddha is showing
beneficial effects on all the organs and organ systems and
her over all personality. She is fairer, stronger, confident,
quick and agile. She has started looking younger and
exudes happiness. From academic point of view Dr.
Shraddha has begun to imbibe perspective of holistic
health and holistic medicine. Her approach has become
eclectic. Her patients get far more options than they were
getting earlier. From professional point of view; her
practice has multiplied.
In short, her patients, her family and she herself are all
happier and healthier!

15. 3. Educational policy [Including medical
education] affects the health of millions
including you and your patients!
My friend has roaring practice as a pediatrician. Once I
asked the secret of her practice.
She said, “It is very difficult to pin point to any
particular “secret”, but probably my perspective is
working good for me and my patients.”
I asked what she meant by that.
She replied, “In the course of my practice I started
realizing that mastering Nelson’s pediatrics is not
enough! It is important to study the stress that is playing
havoc in the children’s life. I also began to realize how
stress affected my own personality. So I decided to study
the stress, its dimensions and understand the vast
number factors [not described medical text books]
affecting health. Having appreciated the importance of
these factors; I began to educate the parents and relatives
of my little patients about dimensions of stress and how
to cope with them. I think it is this understanding that
has given human touch to my interactions with my
patients and that is working well!”
“Can you give an example of how you educate your
patients’ parents and relatives?”

16. “Yes. I gist of what I teach is as follows.”
“Education is defined in various ways but it can be safely
said to have FOUR domains, which are as follows.
The first domain is called AFFECTIVE DOMAIN. This
means the state of mind. In simple words affective
domain relates to how we feel. Thus when our mind is
full of alertness, attention, enthusiasm, buoyancy,
affection, concern, joy, tolerance, self esteem, mutual
respect, mutual trust, commitment, dedication,
confidence, positive and victorious spirit, we would call it
healthy affective domain. In addition the zeal and
concentration needed in the pursuit of excellence in
intellectual field, tenacity and endurance required in
skillful activities and patience and commitment essential
for “satisfying and socially beneficial actions” constitute
affective domain. The purpose of education is to nurture
this domain by designing suitable curricula and syllabi.
The second domain of education is called
PSYCHOMOTOR DOMAIN. This implies ability to
appreciate skills and ability to perform physical and
mental skills, with speed, accuracy, elegance, ease of
performance etc. This may involve appreciation and
performance of skills such as surgery, playing a musical
instrument, playing basketball or doing carpentry! The
purpose of education is to nurture this domain through

17. designing suitable curriculums, syllabuses; but also by
providing sufficient practical and demonstration classes
with all the necessary equipment.
The third domain is called COGNITIVE DOMAIN.
Cognitive domain incorporates accurate perspective,
contemplation, correct perception understanding,
conceptualization, analysis and recall of problems, ability
to evaluate, synthesize, correlate and make decisions,
make appropriate policies, plans and expertise in the
management, administration, etc.
It is clear that all the domains have three components viz.
cognition [Perception], affect [Feelings] and conation
[Response].
And fourth domain is productive domain!
Let us consider the traditional system (in India) in a
dispassionate manner and scrutinize the merits and
demerits. It is obvious that we will not be able to consider
all the details of the system as they varied from time to
time and from place to place. But a general review of the
system would help us to rectify the education system!
This can be done only if we rise above the petty
considerations of religion, region, caste, political power
and other vested interests. This would help us rectify the
present education system.

18. Conversely, unless the existing education system is
rectified appropriately subsequent generations may not
be able to develop the four domains of education
adequately and hence won’t be able to be healthy
enough.
Many of you may argue here that this task cannot be
accomplished by common people, but can be successfully
accomplished only by the politicians, political advisors,
the decision-makers and the top administrators.
This argument is partially valid, but not completely. It
has to be appreciated that no statesman, no political
leader, no policy maker and no administrator can bring
about change in an existing system unless, there is
consensus about these changes in the vast majority of
people whose cooperation in such matters is very vital.
So let us take at least a cursory look at the traditional
system of education in India.
The traditional education system in general ensured that:
a] Careers were not selected on the basis of monetary
gains,
b] Careers were not selected arbitrarily on the basis of
idiosyncrasies and whims,
c] Some lucrative careers could not be sought after, in
preference to the others,

19. d] All careers ensured income and production from early
age,
e] All careers ensured that society was benefited,
f] All careers ensured security to all the social groups,
g] All the careers ensured intimacy and closeness
between young and old in the families.
h] All careers ensured ethical education and passage of
experience from generation to generation.
In my view these were merits.
But it is probably true but not entirely clear if
A] The traditional system was marked by deprivation of
scholastic education to many people,
B] It was also marked by apparently unjustifiable
distribution of a variety of jobs amongst different castes.
C] It did not have the infrastructure for collective
scientific and technological efforts.
D] It suppressed the talents and individual aspirations
amongst the children and parents from many castes.
E] It had an element of arbitrary imposition of hierarchy
and exploitation.
As the education shifted from homes, home industries
and farms to; nurseries, K.G. schools, schools, colleges,
universities, corporate industries, research institutions
etc.
Cognitive domain suffered because of:

20. a] Huge number of students, in a single class making
following three things almost impossible. These things
are i] individual attention ii] dialogue iii] discussions,
b] Lack of adequate salary, accountability, incentive and
economic security to the teachers taking away the
initiative of nurturing cognitive domain
c] Increase in alienation with respect to student’s
background and aptitude
d] Lack of adequate incentive to the students in the form
of creativity, production and earning, service to the
family and service to the nation [thereby thwarting
motivation required for building up cognitive domain]
e] Lack of conviction essential in the growth of cognitive
domain in the teachers and students because of outdated
practical and demonstration classes, lack of
interdisciplinary dialogue and in general the irrelevance
of education to the realities of day to day life in as much
as almost predictable consecutive unemployment at the
end! The lack of conviction could be partly due to lack of
participation by teachers in decision-making, policy
making, development of curricula, syllabi etc.
f] Emphasis on recall and hence rote learning thereby
denying free inquiry, reading, questioning etc. thereby
directly thwarting the cognitive domain

21. g]] Too many examinations with irrelevant parameters
or criteria of evaluation [besides being unfair in many
instances] leading to misguided and in most cases
counterproductive efforts thus adversely affecting the
cognitive domain
h] Competitions where the manipulative skills,
callousness, selfishness are given more respect, [thereby
destroying the enthusiasm of growing in cognitive
domain]
i] Information explosion affecting cognitive domain by
either causing enormous and unnecessary burden on
memory or inferiority complex
j] Pressure of interviews causing constant tension and
sense of inadequacy, right from the tender age,
k] Protracted hours of homework in schools denying the
students their legitimate right to enjoy their childhood
[causing hypokinetic stress, denial of parental rearing]
and make them physically, mentally and intellectually
unfit to grow in cognitive domain
l] Irrelevant and unnecessary information loading in
lectures in the form of monologue, leading to suppression
of the spontaneity, originality, interest and enthusiasm so
much required in cognitive development amongst the
students,
Affective domain suffered due to,

22. A] Isolation of the children from their parents and their
domestic environment at an early age [Making the
parents also equally sad]
B] Lack of warm bonds due to huge number,
C] Cut throat competition,
D] Inadequate facilities of sports, trekking, educational
tours, recreation and physical development etc
E] Alienation from one’s social environment and culture
Psychomotor domain suffered due to
A] Almost total lack of opportunities to actually
participate in skillful activities such as drawing, painting,
sewing, sculpturing, carpentry, knitting, weaving, music,
agriculture, horticulture, other handicrafts, various
sports, performing arts etc.
It is important to realize that promotion of psychomotor
domain is evident but in its caricature form. It has no
concrete economic realistic basis. The activities have no
economic incentive and no productive element.
The present education system basically and almost
completely prevents a huge section of society such as
teachers, students, clerks, servants, sweepers and many
others such as education inspectors, etc. from being
creative and productive. In addition it causes colossal loss
of space, electricity, construction cost and so on. In

23. addition because of the typical emphasis on rote learning
it leads to phenomenal waste of educational material
such as paper, bags, pencils, ball pens etc.
Lack of productive element in education not only causes
colossal loss to nation but it also causes economic loss to
children while suppressing and starving their
psychomotor domain! The lack of productive element
and economic incentive is a single most important cause
of
1] Reduction in the dignity of labor amongst those who
continue to learn, as well as reduction in the income of
the concerned families and the nation
2] Lack of education, lack of employment and starvation
or criminalization amongst those who are forced to drop
out because of poverty [Note that children in villages
normally contribute to the earning of the family].
3] Inhuman suffering of those dropouts, who somehow
manage to get into cheap labor for subsistence.
It has to be appreciated that billions of rupees are spent
on construction, decoration and maintenance of schools
and colleges. Billions more are spent on payment of
millions of teachers and other staff members engaged in
unproductive exercises. Billions are spent on electricity,
and so called educational material. Billions more are
spent on the exams conducted to test the “capacity and

24. merit of rote learning”. This way we weaken the national
economy, jeopardize the developmental activities and
force millions of students to drop out due to economic
reasons and get into the hell of child labor, besides
starving and suppressing the cognitive, affective and
psychomotor domains of millions who are in schools. In
short, present day education system harnesses [amongst
those who continue to learn] arrogance coupled with lack
of confidence leaving all the domains viz. cognitive,
psychomotor and affective, [including creative and
productive skills and physical health] defective, deficient
and underdeveloped. Further, when this education fails
to give a job, it tends to create vindictive attitude
transforming an individual into a criminal or develops
frustration and transforms an individual into a mental
wreck.
It must be appreciated that some institutions and
individuals are making illustrious efforts in the direction
of rectifying the education at their level.
But the mainstream education system has to ensure that
the student must have economic incentive for what he/she
is privileged to make. Besides, everybody connected with
education directly or indirectly must be involved in
production or service.
Everyday; approximately

25. 20 % of the time must be spent in production of suitable
items and service can involve community projects such
plantation, cleanliness etc.
20 % of the time must be spent in physical activities such
as sports, exercise, trekking, hiking etc.
20 % of the time must be spent in personality
development i.e. broadening of perspective through
various means such as invited guest lectures, seminars,
discussions on holistic health, educational tours and visits
to places where the student gets exposed to rapid
developments in the society such as laboratories,
airports, government offices, share market, farms etc
20 % of the time must be spent in entertainment such as
playing musical instruments, dance, painting or anything
that makes a student happy such as mimicry, singing,
story telling, drama, movie etc]
20 % of the time must be spent on cognitive domain i.e.
study of languages, history, geography, mathematics etc
with utmost emphasis on interpretation and relevance in
day to day life. Thus typical questions in the examination
of history, languages should be totally done away with.
The subject such as economics, psychology, civics,
philosophy, logic, sociology etc must include field work
and made relevant to the present society”.

26. Finally I conclude by saying, “If we are able to rectify the
education system (not only in India but all over the world
including medical education), then hypo kinetic stress,
stress resulting from rote learning, undue tension of the
examination success, cancerous growth of copying,
corruption for getting grant, and consequent stress can
be prevented. Indeed, drop outs from school, child labor,
unemployment and corrupt practices affect our health
and cannot be ignored by anyone aspiring for holistic
health i.e. global welfare!”
I am sure you saw in the above instance; how you can
make the life worthwhile and truly successful!
*****

27. 4. Take care of yourself!
There is a glaring example of a young doctor!
He is a physician. He stared practice and by virtue of his
merits started getting good work. His income started
swelling! His market demand also grew. Pharmaceutical
companies started sponsoring him for conferences. Gifts
started pouring in. His busy practice started keeping him
awake at late nights.
He started getting hardly any time for his family. The
communication amongst the family members began to
dwindle. Initially his wife and children complained. But
he did not give much importance to it. He thought it was
more important to secure them by earning more money.
Gradually his wife and children developed distance. They
seemed to stop needing his company. They seemed to; no
more require dialogue with him.
It was after some years that he sensed this change. Those
dry expressions, those lusterless eyes and those curt
words struck him.
He realized that something was going wrong somewhere.
He went to one of his old teachers. He narrated these
things and sought his advice.

28. His teacher carefully listened to his grievances. In fact
the grievances of his family members! He could see that
the strained relationships visibly disturbed the young
doctor. But; what more the teacher noticed; was
deterioration of the physical health his past student!
The teacher (himself a doctor; practicing holistic
medicine) had prepared a long questionnaire for
practicing doctors. The questions included detailed
clinical history, personal history, family history,
occupational history and so on. More importantly it
included questions regarding goals, aspirations, purpose
and ambitions in life.
This young doctor began to think about these questions!
It was not easy to come to any conclusion, as there were
no readymade answers!
After filling the whole questionnaire, the young doctor
admitted frankly that he was at a loss to give satisfactory
answers to questions such as goal in life!
Now the teacher said, “Don’t worry. The questionnaire is
not meant for filling; completely and correctly. It is
meant for making you aware of hitherto concealed
aspects of your personality. Now that you have made
attempt to fill it; let us discuss further and come to some
conclusions.

29. After having protracted discussion the young doctor
realized that every one of us has body and hence physical
needs, instincts and instinctual needs, emotions and
emotional needs, intelligence and intellectual needs and
conscience and spiritual needs!
These needs give satisfaction in ascending order, that
lasts for longer time and that can be distributed to larger
number of people!
On this background when he began to evaluate his
professional practice, he realized that he grossly
underestimated his spiritual, intellectual, emotional,
instinctual and even physical needs! He realized that
amongst these various needs he cared for physical needs
to some extent! Market forces, media hype and illusory
financial aspirations to fulfill phantom physical needs of
future were dragging him! By getting engrossed in the
practice his ego and hence emotions also were gratified to
a certain extent.
He now decided to give justice to his conscience with
utmost priority. He put the intellectual, emotional,
instinctual and physical needs in that order.
He realized that perspective of global welfare adds new
dimension and power to one’s being. He realized that
such perspective is a nurturing nectar or ambrosia of

30. life! It makes one happy and also emanates healing
happiness!
He realized that conscientious intellectual pursuit [and
not obsessive one] adds holistic perspective and hence
clinical accuracy and therapeutic efficiency. Moreover he
grasped the protective importance of intelligence in the
quest of justifying conscience and fulfilling emotional,
instinctual and physical needs!
Now he had the way to find out what could give him
maximum happiness, that would last for maximum time
and that could be distributed to maximum people.
He reorganized his practice on this basis.
He reaffirmed to himself that he would consciously get
completely committed to the total welfare of the patient.
He began to take keen interest in every patient
irrespective his personal likes and dislikes. This enabled
him to develop heart-to-heart communication with every
patient. Every patient became his friend and family
member. This prompted him for active search for
alternative modalities of treatment, which could suit a
particular individual patient. He started giving more
time to his patients [by not getting obsessed to see more
patients in less time and get more fees]. His clinic became
a source of peace and hope for the patients.

31. He stopped working at specific time of the day [by
resisting the temptation to get more money] thus
returning home in time. He began to take interest in the
rearing of the children and the interests of all the family
members. This development was welcomed by one and
all!
Everyone got reunited with the bond of love and care.
The smiles returned! He realized what he had missed and
how valuable it was!
The husband and wife once again began to share
optimum time and strengthened each other’s convictions.
Lastly, he began regular walk, exercise, yoga, and
swimming and involved his wife and children in those
activities. He paid scrupulous attention to diet, clothes,
environment and such varied factors that could satisfy
physical needs appropriately.
After few days he met his teacher again.
He asked the young doctor, “Are you satisfied with your
progress?”
The young doctor was still hesitant! He was not sure!
The teacher smiled and said, “You are on right track.
You here onwards, have to reach the top decision
makers. You have to influence them beneficially for the
welfare of millions through proper policies and decisions.

32. This would satisfy your spiritual domain and give you
fulfillment. For this; all of you need to practice and
propagate NMASMARAN”.
The young doctor prostrated in front of the wise teacher
and returned home.
Today this young doctor is not only being paid his fat fees
with great respect and gratitude but doing very well on
every front! What is more, he is beginning to get into the
position of opinion maker!

33. 5. Teach them win-win formula
Who is a successful practitioner? One who is paid more?
One who has more crowds? One who works more?
You must have seen doctors who are paid more, but
because; one has to pay them. Even as some patients can
easily afford; in most instances payment is made
reluctantly. One may agree that such doctors are usually
sought after because of their expertise, lack of other
options and practical need. But what about fondness and
love?
Some doctors are very busy. Their clinics are always
crowded. If you look into the reasons, you may find that
they are inexpensive and easily accessible. Thus here is
also compulsion, financial compulsion. Some times these
doctors are “tried” as first step.
Some doctors work more. They are dedicated. They may
get genuinely faithful patients, but; what about their
families? What about their own health? What about the
time they should be spending in academic pursuit?
I don’t want to blame any of these categories of doctors.
But consider this example!
Here is a neurosurgeon. He is in his clinic at right time.
He is fresh and enthusiastic. His staff members welcome
his arrival with joy and enjoy his presence. He is

34. confident and modest. He is dignified and respects the
dignity of his patients, especially lady patients. The
patients are brightened by his reassuring gestures.
He listens carefully and performs the clinical
examination meticulously. He makes decision that suits
the patients maximally. He is open-minded and keeps as
many options as possible.
He is methodical and always ready to do any work at any
given moment.
His staff members are always ready to help him. They
feel privileged to work with him.
Apart from these qualities, he is extremely open-minded
and ready to learn from even his juniors! He is always
helpful and ready to teach his junior colleagues.
He is never seen showing tantrums at the time of surgery.
He does not lose temper. His nurses are relaxed and alert
at the time of surgery. He has trained them very well.
Apart from all this; there is no grumbling or backbiting.
He is never heard gossiping. When he returns home he
has all the satisfaction on his face.
What is most important, everyone feels victorious with
every success of his, be it surgery, be it guest lecture, be it
winning an award, be it publication of paper!
You would agree with me, that he/she is a successful
practitioner, whom his/her patients, colleagues,

35. associates and everyone related to him/her love. In other
words, when people around you participate in your
success or failure; as if it is their own; then that is
success…. rather great success!
It is very essential therefore to learn and also to explain
the patients and their relatives, that three formulas
should be shunned!
The first formula to be discarded is win-lose formula.
In this formula if the doctor succeeds, then he would feel
triumphant. He would take all the credit. The patient’s
relatives would prostrate [or would be expected to
prostrate] as “losers”.
The doctor’s head would be bloated with pride and
arrogance and patients head would droop down in
meekness.
Now the second formula to be discarded is lose-win
formula.
Here the doctor loses. He declares his inability to handle
the patient or the doctor’s efforts fail and the patient
succumbs.
The patient’s relatives having no trust and sense of
cooperation; would develop contempt and hatred about
the doctor as he is loser and patient’s relatives would get
excited aggressive and doctor would go defensive.

36. The third formula that needs to be rejected is lose-lose
formula.
This is a strange formula where the both, doctor as well
as patient and/or patient’s relative would act cynically
and apathetically. Neither the doctor, nor the
patient/patient’s relatives would aim at getting well.
Together they accept the defeat without struggle; as if
determined to lose!
Now the fourth formula to be taught and adopted in
every day life is win-win formula.
In this win-win formula, patient’s recovery is considered
to be the success of the patient, patient’s relatives as well
as the doctor and his team and all those involved directly
and indirectly including the manufacturers of the drugs!
When the doctor, the patient and the patient’s relatives
work together to win together, they usually win! Not only
they win but also they celebrate it as their common
success!
The win-win formula is not only important for becoming
successful as a doctor, but it also assures wellness cycle,
in your life and in the life of every one around you.
Remember, all other formulas always throw us in
distress cycle. They result from as well as lead to anxiety,
violence, abusiveness, melancholy, cynicism, and lack of

37. appreciation, disinterestedness, apathy and distrust in
spouse, child, friend, relatives and destroy one another.

38. 6. Time Management:A Way to Greater
Efficiency
“Three score summers when they are gone, will appear
as one!”
“Time flies”
“We listen to people saying, “If I had some time I would
have been able accomplish this!”
It is indeed extremely important to use time in a wise
way! The wise use of time assures living to maximum
satisfaction!
Sometimes people are seen asking their more successful
friend about how does he manage so many things? How
does he get time for it?
They do not realize that everybody has twenty-four
hours of the day! No body gets extra time!
Consider these points in time management and judge for
yourself if you could extract more satisfaction and
greater success!
We should be cautious about our time but being harsh
disciplinarian usually brings more pain than happiness!
Being perfectionists also usually brings more
disappointment than satisfaction! Time management is
important but expecting others to comply with your
standards usually leads to dismay and bitterness. Time is
extremely precious. But getting obsessed by time leads us

39. nowhere. It can turn you inhuman. It can take away the
humane and warm moments in your life! It can deprive
you of the excitement in life. Another point about time
management is taking the burden about the future! The
thought of “better time management” in future obsesses
us! Avoid it!
How are you going to judge your success in time
management? Only financial yardsticks should not
evaluate time management!
When it comes to social interactions, people do expect us
to spend our time for them. It is important to assert our
priorities in such instances. We must learn to give due
value to our time and alertly protect it from being
“stolen”!
This is especially true if you are sensitive, vulnerable and
malleable!
The other side of the coin is yearning for others’
company and time! Be particular about not stealing
other’s time as that person may despise you in future.
Time management involves keeping appointments
meticulously. Always keep your appointments as that
may involve time of many individuals [e.g. meetings]
It is rather preferable to make a habit of asking, “Am I
doing at present, what I prefer most?” Let the future
take its own course! Do not worry!

40. One of the most important ways of time management is
to determine the sequence of priority.
First find out what is most important for you by using
the formula viz. what gives you maximum happiness, for
maximum time and that can be distributed to maximum
people. After you determine what is most important for
you, give it top priority. This is called prioritization.
After you prioritize it, assert yourself by actually doing
it.
After you assert it you may like to repeat and reinforce
your satisfaction or you like to revise and improve upon
your performance. According to this method, you
generally succeed in fulfilling the most important task
and never regret for having forgotten something vitally
important.
Another important point in time management is using
sense of proportion.
Many of us spend exorbitant time to save small amount
of money. In the quest of getting better bargain we go
from shop to shop. We tend to forget how valuable time
is being wasted in the process. The sense of proportion
has to be exercised while planning to buy certain
commodities. We tend to get bogged down by our
budgetary provisions and keep postponing purchasing of
certain commodities that would give us great deal of

41. comfort. It is important to realize how much time of our
life is going waste without the enjoyment of those
commodities. It is important to make a quick and
courageous decision to purchase commodities, which
would improve the quality of our lives. Another aspect of
sense of proportion is waiting. Many of us tend to wait
for a bus to save money on taxi. We must realize that we
are depriving ourselves of precious time that we could
happily spend with spouse, children or friends! This
sense of proportion also comes into play when it comes to
appointing housemaid, driver, assistant or other helpers.
We must learn to appreciate how much time we should
be saving to spend in more useful activities rather than
worrying about relatively less precious money of salaries!
The other way of time management is using technology,
human resources and other tricks.
Thus, you can use telephone, SMS, email, Internet,
printed material, compact discs, and videocassettes for
effective communication with large number of people in
small time. Similarly you can achieve education of large
number of patients in short time. This saves your time
tremendously. Talking to every patient can be wasteful
and can be tiring and irritating for you and your patients
and even their relatives!

42. Another way of time management is to delegate your
work to suitable associates. But this requires that you
train your associates properly. Training includes,
inspiring, motivating and involving them in your mission
and also training them in technical matters. If you are
able to do this then your work force, work output and
satisfaction all multiply.
Yet another trick is to do more than one thing at a time!
For example, when you take morning walk, practice
NAMASMARAN i.e. remember the name of God and
simultaneously harmonize abdominal breathing with
your steps.
When you watch news on T.V., use techniques of
reflexology or acupressure, or do head massage. Head
massage can ensure comfort to your head, improve your
sleep, improve the health your hair and also get exercise
to your hands and shoulders.
Elderly or diabetic individuals can utilize the time of T.V.
watching by doing foot massage.
You can perform foot exercises, leg exercise, knee
exercises or practice suitable yogasana also while
watching T.V. One can take food or a cup of tea as well.
One can take specific exercises of shoulders, neck
[BRAHMA MUDRA], back while watching T.V.

43. One can practice some techniques such as Bhramari,
Kapalbhati, Ashvini Mudra, Bate’s technique, Anulom
Vilom while traveling (and not driving) in bus, train,
plane or car.
Many of you may be already practicing this trick. But
what is important is now you can appreciate its
importance even more!
Having discussed this much last four steps can be simply
stated!
7. Be profound and wise, not simple and
straightforward
8. Discuss with pharmaceuticals the
perspective of global welfare, which is a
treasure of lifetime!
9. Do not get imposed and do not impose
yourself.
10 Be a leader and not a follower!
The simple way to begin all this, is
NAMASMARAN
We can try it and verify