Dr. M G Bhat gave a presentation covering various challenges facing doctors in India. He discussed issues like maintaining trust with patients, dealing with complications, legal issues, violence, corruption and the need for better regulation. He emphasized the importance of clear communication, obtaining informed consent, avoiding negligence and maintaining proper documentation. Dr. Bhat stressed that doctors need to focus on being skilled, knowledgeable and providing sincere, accountable care to patients.
A professor holds up a glass of water in class and asks students to guess its weight without weighing it. He then asks what would happen if he held it up for longer periods of time. While the weight of the glass did not change, holding it up caused his arm to ache and become stressed. He explains that problems are like the glass - they may seem small at first but cause pain and paralysis if dwelled on. The lesson is to "put the glass down" by not stressing over problems once the day is done.
The document discusses the issue of increasing violence against doctors in India. It notes that there have been several incidents of attacks on doctors by patients' families or politicians due to factors like medical negligence, sudden death of patients, or denial of admission. Several states have passed laws like the Prevention of Violence and Damage to Property Act to protect doctors, but attacks continue. The document argues that stronger measures may be needed to prevent violence against medical professionals from escalating further.
This document discusses several problems with the current healthcare system including high carbon emissions, unstructured medical records, poor patient compliance, and incorrect diagnoses. It then introduces SkyDoc as a digital twin platform that aims to address these issues by creating structured digital records for patients, providing diagnostic assistance via an AI named Curie, and developing other digital health tools and services. The document outlines SkyDoc's goals for patient and doctor users, traction so far, and estimates for significant impact on healthcare costs, time savings, environmental benefits, and lives saved by scaling to millions of users.
Learn Community Medicine along with me : https://t.me/drvkspm
Be my friend by connecting with me through:
Instagram : https://www.instagram.com/drvenkateshkarthikeyan/
Facebook : https://www.facebook.com/drvenkateshkarthikeyan/
Twitter : https://twitter.com/dr_venkatesh_k
Website : www.drvenkateshkarthikeyan.com
LinkedIn : https://in.linkedin.com/in/dr-venkatesh-karthikeyan-8b1234ab
Learn Community Medicine along with me : https://t.me/drvkspm
Person-centred care: slides for a presentation to health and care leaders in Manchester on 12 March 2014 on implementation of the "Better Care Fund" for more integrated care. How to keep the focus on people.
This document summarizes Samikshya Gairhe's journal club presentation on a study assessing mothers' health care seeking behavior for common childhood illnesses in Northwest Ethiopia. The presentation includes an overview of the selected article, journal information, authors, abstract, introduction, methods, results, discussion, conclusion, and references. The study found that less than half of mothers sought health care during their child's illness, with most seeking care from local health posts and centers. Factors associated with increased health care seeking included the child's age being under 24 months and the perception that early treatment is important.
Healthcare Skill development - Indian PerspectiveVaibhav Bagaria
This document discusses the healthcare industry in India. It notes that healthcare is expected to become a $280 billion industry by 2020, growing at 14% annually. However, India faces shortages of over 6 lakh doctors, 10 lakh nurses, and 2 lakh dental surgeons. There are also shortages of paramedical staff and healthcare administrators. The document outlines various healthcare jobs and professional roles that will be in demand, such as nurses, technicians, office staff, and community health workers. It emphasizes the need for skill development in the healthcare sector to address workforce shortages through education and training programs.
La relazione introduttiva di Luca Pani, Direttore Generale AIFA, per l'evento "K.O. allo spreco in sanità. Accesso alle cure e aderenza terapeutica", II Festa nazionale per la lotta agli sprechi, SPoleto, 6 giugno 2015
A professor holds up a glass of water in class and asks students to guess its weight without weighing it. He then asks what would happen if he held it up for longer periods of time. While the weight of the glass did not change, holding it up caused his arm to ache and become stressed. He explains that problems are like the glass - they may seem small at first but cause pain and paralysis if dwelled on. The lesson is to "put the glass down" by not stressing over problems once the day is done.
The document discusses the issue of increasing violence against doctors in India. It notes that there have been several incidents of attacks on doctors by patients' families or politicians due to factors like medical negligence, sudden death of patients, or denial of admission. Several states have passed laws like the Prevention of Violence and Damage to Property Act to protect doctors, but attacks continue. The document argues that stronger measures may be needed to prevent violence against medical professionals from escalating further.
This document discusses several problems with the current healthcare system including high carbon emissions, unstructured medical records, poor patient compliance, and incorrect diagnoses. It then introduces SkyDoc as a digital twin platform that aims to address these issues by creating structured digital records for patients, providing diagnostic assistance via an AI named Curie, and developing other digital health tools and services. The document outlines SkyDoc's goals for patient and doctor users, traction so far, and estimates for significant impact on healthcare costs, time savings, environmental benefits, and lives saved by scaling to millions of users.
Learn Community Medicine along with me : https://t.me/drvkspm
Be my friend by connecting with me through:
Instagram : https://www.instagram.com/drvenkateshkarthikeyan/
Facebook : https://www.facebook.com/drvenkateshkarthikeyan/
Twitter : https://twitter.com/dr_venkatesh_k
Website : www.drvenkateshkarthikeyan.com
LinkedIn : https://in.linkedin.com/in/dr-venkatesh-karthikeyan-8b1234ab
Learn Community Medicine along with me : https://t.me/drvkspm
Person-centred care: slides for a presentation to health and care leaders in Manchester on 12 March 2014 on implementation of the "Better Care Fund" for more integrated care. How to keep the focus on people.
This document summarizes Samikshya Gairhe's journal club presentation on a study assessing mothers' health care seeking behavior for common childhood illnesses in Northwest Ethiopia. The presentation includes an overview of the selected article, journal information, authors, abstract, introduction, methods, results, discussion, conclusion, and references. The study found that less than half of mothers sought health care during their child's illness, with most seeking care from local health posts and centers. Factors associated with increased health care seeking included the child's age being under 24 months and the perception that early treatment is important.
Healthcare Skill development - Indian PerspectiveVaibhav Bagaria
This document discusses the healthcare industry in India. It notes that healthcare is expected to become a $280 billion industry by 2020, growing at 14% annually. However, India faces shortages of over 6 lakh doctors, 10 lakh nurses, and 2 lakh dental surgeons. There are also shortages of paramedical staff and healthcare administrators. The document outlines various healthcare jobs and professional roles that will be in demand, such as nurses, technicians, office staff, and community health workers. It emphasizes the need for skill development in the healthcare sector to address workforce shortages through education and training programs.
La relazione introduttiva di Luca Pani, Direttore Generale AIFA, per l'evento "K.O. allo spreco in sanità. Accesso alle cure e aderenza terapeutica", II Festa nazionale per la lotta agli sprechi, SPoleto, 6 giugno 2015
The document provides an overview of medicolegal issues and handling complaints in a hospital setting. It discusses the establishment of a new Unit Etika & Medikolegal at Hospital Kuala Lumpur including its roles and organizational structure. Key topics covered include classification of complaints, statistics on complaint types and resolutions, the complaints handling process, issues related to communication and medical documentation, and principles of obtaining valid informed consent from patients.
Essentials of Community Medicine - A Practical Approach.pdfdrpalachandraa
This document provides an overview and table of contents for a book titled "Essentials of Community Medicine - A Practical Approach". The summary is:
1) The document is a table of contents for a book on community medicine that covers topics like present health status, family studies, economics, communicable diseases, non-communicable diseases, and maternity and child health.
2) The table of contents provides chapter titles, section headings, and page numbers for topics within each chapter.
3) The book appears to provide practical guidance for community medicine studies and is intended to help medical students prepare for exams.
BILD Event – 21 March 2018 : Transforming care - Sharing solutions that make ...NHS England
Stream E – Clinical leadership: using dynamic risk registers to prevent admissions and Care and Treatment Reviews to facilitate discharge
Dr Roger Banks and Dr Salim Razak discuss clinical leadership and clinical culture and the dynamic process for risk stratification before describing C(E)TRs, their outcomes so far and their role in achieving successful discharge into the community.
Big data has great potential to improve medical research and healthcare in India. The large amounts of data now available from electronic medical records, health devices, clinical trials and other sources can be used to enhance clinical decision making, personalized medicine, disease prediction and more efficient care. However, challenges remain around data quality, privacy, lack of standards and interoperability between different healthcare systems and regions. Addressing these challenges through improved data integration, terminology systems and privacy protections could help unlock the opportunities of big data to advance medicine and benefit public health.
The future of Irish Community Pharmacy Dragons Den Presentation Ultan MolloyUltan Molloy
The document discusses changes in the Irish pharmacy market and opportunities for community pharmacies. It notes that while pharmacies are still opening, 1 in 4 are trading at a loss. Customers are forming shopping habits by their 30s and moving from an appearance focus to health. They want trusted advice, relationships, additional services like clinics, and a welcoming store layout beyond just shelves. To adapt, pharmacies need to redesign their space, build loyalty through community events, offer a broader product range and services beyond prescriptions, and free up pharmacist time for patients through efficient processes. Additional services, allied healthcare providers, and a focus on value beyond price can help pharmacies differentiate in an increasingly competitive market.
The document discusses strategies for donor retention and recognition through donor relations efforts. It provides examples from Yeshiva University, which increased its donor retention rate from 48% to 72% through concentrated donor relations. Some strategies discussed include analyzing donor data to segment donors into different levels, creating a calendar of personalized touches like thank you notes and invitations, producing impact reports and videos, organizing events like a "Thank a Donor Week", and ensuring an updated donor-focused website. The goal is to better serve donors and find innovative ways to engage and retain both high-level and smaller donors through continuous communication and recognition.
Hand Therapy 2.0 - Networks are made of peopble - Carlos Castaño Ortizhandfun
Ponencia sobre la calidad de la información sobre terapia de mano encontrada en internet
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Quality of the information found on the net about hand therapy
This document discusses collaborative practice in healthcare. It defines collaborative practice as developing effective working relationships between practitioners, patients, and communities to improve health outcomes. The benefits of collaborative practice include better patient care and health outcomes, increased job satisfaction and productivity, and a more sustainable and cost-effective healthcare system. Studies show collaborative practices between physicians and other healthcare providers can decrease hospitalizations, lower health metrics like blood pressure, and improve patient symptoms. The document outlines steps to implement collaborative practice through clarifying roles, improving communication, and assessing practices using tools like the Queen's University Collaborative Practice Assessment Tool. It stresses the importance of clear roles and accountability to reduce liability risks.
Mr Grant Brand: Lessons Learned in the First Nine Years of the Glasgow ARBD TeamAlcoholForum.org
The document summarizes lessons learned from the first nine years of the Glasgow Alcohol Related Brain Damage (ARBD) Team. It discusses how the team was set up, missed opportunities at the beginning, and what they have learned over time. Key points include broadening the referral criteria, conducting thorough multidisciplinary assessments, using legislation to help with harm reduction, providing rehabilitation services, and training other services on ARBD. It emphasizes the need for a public health approach, clear strategy, and person-centered flexible services for those with ARBD.
This study aims to identify the problems faced by young doctors in hospitals in Peshawar, Pakistan. It will survey 60 young doctors through questionnaires and interviews to understand the challenges they face, how their performance is impacted, and their level of satisfaction with current administrative policies. The research findings could help administrators address the problems and better devise policies to improve doctors' working conditions and ability to serve patients effectively. However, difficulties may arise in obtaining hospital cooperation and the doctors' time needed to participate in the study.
The business of medicine is changing quickly. Government and commercial payers know that we're paying more for healthcare and we're getting worse results. Patients know it too. The role of independent practices, their reimbursement models, and how they care for patients are all changing as a result.
A Conversation on Meaningful Family Engagement, from Clinical Care to Health ...LucilePackardFoundation
Engaging with families is vital to transforming the health care system and positively impacting the life course of vulnerable populations. Families have extensive experience in partnering with professionals to improve systems of care, are organized and connected across the country, and stand ready to assist at every level of next efforts for improvement. Learn how to meaningfully involve families at every level of health care systems and engage them as critical partners in designing policies that will improve care for all children.
Presentation deck accompanying my keynote talk at the Great Lakes Health Connect HIE Fall Summit Detroit on August 23, 2016. Content covers the health information exchange landscape and untapped opportunities from the context of Jess Jacobs, a healthcare industry insider and friend who recently died. Full video of the presentation is archived here: https://www.youtube.com/watch?v=5X69nAUF9PI
HxRefactored - Geisinger - Greg Moore HxRefactored
This document provides strategies for startups to partner with healthcare systems based on Geisinger Health System's experience. It discusses knowing the healthcare system partner, including their needs, budgets, and pain points. When pitching a partnership, startups should clearly articulate their vision and ability to deliver value, such as solving a real problem. Terms of the partnership should be clear upfront, with the startup considering what value it can provide, and what it needs from the healthcare system partner, such as help with demonstrations, clinical trials, or future customers.
This document discusses increasing patient access and involvement in their own healthcare records. It provides examples of three initiatives: the Swedish National Patient Portal, OpenNotes from the US, and Patients Know Best from the UK and Netherlands. OpenNotes allows patients access to visit notes online. A study found 99% of patients wanted continued access and 85% said it would influence future provider choice. The document proposes "OurNotes" which would allow patients to contribute directly to the medical record by providing information for visits. It outlines a pilot study to evaluate the impact on workflow and whether doctors and patients want to continue such a model.
The document discusses the impact of eating disorders in the workplace. A survey found that two-thirds of respondents received no workplace support for their eating disorder, and four out of five did not feel their colleagues were informed about eating disorders. Respondents believed employers could help by providing a mental health first aider, training for managers, and implementing a policy on mental health and eating disorders. The document advocates raising awareness of eating disorders and their treatment.
Doctor-Patient relationships express the values of medical profession.
The relationship should not be fish and fisherman.
It should always be like fish and water.
Understanding Patients: The Secret to a Thriving 21st Century Medical PracticeKareo
This webinar discussed how medical practices can better engage patients in the 21st century using technology and a patient-centered approach. It covered how patients now demand more control over their healthcare due to access to information and desire for convenience. The webinar also presented different types of patient personas and how their needs and preferences vary. Technologies like patient portals, secure text messaging, social media, and chatbots were examined as ways practices can better engage and communicate with patients. Finally, the webinar described how the Kareo platform can help practices implement these engagement strategies through features like the patient portal and messaging tools.
The document outlines a 10 step marketing plan for The Medical City's Pediatrics Community Services. It begins by defining the primary target market as low-income parents in Ilugin, Pasig City. It then analyzes competitors and positions The Medical City service as the only option that offers family medicine specialists and tailors programs to each family's needs. The marketing mix is described, including promoting the free services through partnerships and flyers within Ilugin to build awareness. The estimated annual market size is 360 million pesos among 400 families in the target community.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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The document provides an overview of medicolegal issues and handling complaints in a hospital setting. It discusses the establishment of a new Unit Etika & Medikolegal at Hospital Kuala Lumpur including its roles and organizational structure. Key topics covered include classification of complaints, statistics on complaint types and resolutions, the complaints handling process, issues related to communication and medical documentation, and principles of obtaining valid informed consent from patients.
Essentials of Community Medicine - A Practical Approach.pdfdrpalachandraa
This document provides an overview and table of contents for a book titled "Essentials of Community Medicine - A Practical Approach". The summary is:
1) The document is a table of contents for a book on community medicine that covers topics like present health status, family studies, economics, communicable diseases, non-communicable diseases, and maternity and child health.
2) The table of contents provides chapter titles, section headings, and page numbers for topics within each chapter.
3) The book appears to provide practical guidance for community medicine studies and is intended to help medical students prepare for exams.
BILD Event – 21 March 2018 : Transforming care - Sharing solutions that make ...NHS England
Stream E – Clinical leadership: using dynamic risk registers to prevent admissions and Care and Treatment Reviews to facilitate discharge
Dr Roger Banks and Dr Salim Razak discuss clinical leadership and clinical culture and the dynamic process for risk stratification before describing C(E)TRs, their outcomes so far and their role in achieving successful discharge into the community.
Big data has great potential to improve medical research and healthcare in India. The large amounts of data now available from electronic medical records, health devices, clinical trials and other sources can be used to enhance clinical decision making, personalized medicine, disease prediction and more efficient care. However, challenges remain around data quality, privacy, lack of standards and interoperability between different healthcare systems and regions. Addressing these challenges through improved data integration, terminology systems and privacy protections could help unlock the opportunities of big data to advance medicine and benefit public health.
The future of Irish Community Pharmacy Dragons Den Presentation Ultan MolloyUltan Molloy
The document discusses changes in the Irish pharmacy market and opportunities for community pharmacies. It notes that while pharmacies are still opening, 1 in 4 are trading at a loss. Customers are forming shopping habits by their 30s and moving from an appearance focus to health. They want trusted advice, relationships, additional services like clinics, and a welcoming store layout beyond just shelves. To adapt, pharmacies need to redesign their space, build loyalty through community events, offer a broader product range and services beyond prescriptions, and free up pharmacist time for patients through efficient processes. Additional services, allied healthcare providers, and a focus on value beyond price can help pharmacies differentiate in an increasingly competitive market.
The document discusses strategies for donor retention and recognition through donor relations efforts. It provides examples from Yeshiva University, which increased its donor retention rate from 48% to 72% through concentrated donor relations. Some strategies discussed include analyzing donor data to segment donors into different levels, creating a calendar of personalized touches like thank you notes and invitations, producing impact reports and videos, organizing events like a "Thank a Donor Week", and ensuring an updated donor-focused website. The goal is to better serve donors and find innovative ways to engage and retain both high-level and smaller donors through continuous communication and recognition.
Hand Therapy 2.0 - Networks are made of peopble - Carlos Castaño Ortizhandfun
Ponencia sobre la calidad de la información sobre terapia de mano encontrada en internet
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Quality of the information found on the net about hand therapy
This document discusses collaborative practice in healthcare. It defines collaborative practice as developing effective working relationships between practitioners, patients, and communities to improve health outcomes. The benefits of collaborative practice include better patient care and health outcomes, increased job satisfaction and productivity, and a more sustainable and cost-effective healthcare system. Studies show collaborative practices between physicians and other healthcare providers can decrease hospitalizations, lower health metrics like blood pressure, and improve patient symptoms. The document outlines steps to implement collaborative practice through clarifying roles, improving communication, and assessing practices using tools like the Queen's University Collaborative Practice Assessment Tool. It stresses the importance of clear roles and accountability to reduce liability risks.
Mr Grant Brand: Lessons Learned in the First Nine Years of the Glasgow ARBD TeamAlcoholForum.org
The document summarizes lessons learned from the first nine years of the Glasgow Alcohol Related Brain Damage (ARBD) Team. It discusses how the team was set up, missed opportunities at the beginning, and what they have learned over time. Key points include broadening the referral criteria, conducting thorough multidisciplinary assessments, using legislation to help with harm reduction, providing rehabilitation services, and training other services on ARBD. It emphasizes the need for a public health approach, clear strategy, and person-centered flexible services for those with ARBD.
This study aims to identify the problems faced by young doctors in hospitals in Peshawar, Pakistan. It will survey 60 young doctors through questionnaires and interviews to understand the challenges they face, how their performance is impacted, and their level of satisfaction with current administrative policies. The research findings could help administrators address the problems and better devise policies to improve doctors' working conditions and ability to serve patients effectively. However, difficulties may arise in obtaining hospital cooperation and the doctors' time needed to participate in the study.
The business of medicine is changing quickly. Government and commercial payers know that we're paying more for healthcare and we're getting worse results. Patients know it too. The role of independent practices, their reimbursement models, and how they care for patients are all changing as a result.
A Conversation on Meaningful Family Engagement, from Clinical Care to Health ...LucilePackardFoundation
Engaging with families is vital to transforming the health care system and positively impacting the life course of vulnerable populations. Families have extensive experience in partnering with professionals to improve systems of care, are organized and connected across the country, and stand ready to assist at every level of next efforts for improvement. Learn how to meaningfully involve families at every level of health care systems and engage them as critical partners in designing policies that will improve care for all children.
Presentation deck accompanying my keynote talk at the Great Lakes Health Connect HIE Fall Summit Detroit on August 23, 2016. Content covers the health information exchange landscape and untapped opportunities from the context of Jess Jacobs, a healthcare industry insider and friend who recently died. Full video of the presentation is archived here: https://www.youtube.com/watch?v=5X69nAUF9PI
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This document provides strategies for startups to partner with healthcare systems based on Geisinger Health System's experience. It discusses knowing the healthcare system partner, including their needs, budgets, and pain points. When pitching a partnership, startups should clearly articulate their vision and ability to deliver value, such as solving a real problem. Terms of the partnership should be clear upfront, with the startup considering what value it can provide, and what it needs from the healthcare system partner, such as help with demonstrations, clinical trials, or future customers.
This document discusses increasing patient access and involvement in their own healthcare records. It provides examples of three initiatives: the Swedish National Patient Portal, OpenNotes from the US, and Patients Know Best from the UK and Netherlands. OpenNotes allows patients access to visit notes online. A study found 99% of patients wanted continued access and 85% said it would influence future provider choice. The document proposes "OurNotes" which would allow patients to contribute directly to the medical record by providing information for visits. It outlines a pilot study to evaluate the impact on workflow and whether doctors and patients want to continue such a model.
The document discusses the impact of eating disorders in the workplace. A survey found that two-thirds of respondents received no workplace support for their eating disorder, and four out of five did not feel their colleagues were informed about eating disorders. Respondents believed employers could help by providing a mental health first aider, training for managers, and implementing a policy on mental health and eating disorders. The document advocates raising awareness of eating disorders and their treatment.
Doctor-Patient relationships express the values of medical profession.
The relationship should not be fish and fisherman.
It should always be like fish and water.
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This webinar discussed how medical practices can better engage patients in the 21st century using technology and a patient-centered approach. It covered how patients now demand more control over their healthcare due to access to information and desire for convenience. The webinar also presented different types of patient personas and how their needs and preferences vary. Technologies like patient portals, secure text messaging, social media, and chatbots were examined as ways practices can better engage and communicate with patients. Finally, the webinar described how the Kareo platform can help practices implement these engagement strategies through features like the patient portal and messaging tools.
The document outlines a 10 step marketing plan for The Medical City's Pediatrics Community Services. It begins by defining the primary target market as low-income parents in Ilugin, Pasig City. It then analyzes competitors and positions The Medical City service as the only option that offers family medicine specialists and tailors programs to each family's needs. The marketing mix is described, including promoting the free services through partnerships and flyers within Ilugin to build awareness. The estimated annual market size is 360 million pesos among 400 families in the target community.
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
surgeon and challenges presented at IAGES Raipur 2018
1. 10 February 2018 IAGES Raipur M G Bhat
Consultant Surgeon
Manipal Hospital
Apollo Spectra Hospital, Koramangala
Bangalore, India
Greetings From…
Dr. M G Bhat
MS, FRCS(England & Edinburgh),
FICS, DMLE (Law), DMIRCSEd (Informatics)
1
3. M G Bhat 310 February 2018 IAGES Raipur
SURGEON
Future
• Regulation
• Universal Health
Violence
Legal Issues
Corruption
Media
• Very Different to elsewhere
• Public and Private
• Rich and Poor
• Customized Treatment
• Consider Affordability
• 70% in Private
4. M G Bhat 410 February 2018 IAGES Raipur
Changing with times…
Doctor….Next Only to God …(NOTG)
From NOTGto Friend ..Philosopher…and Guide
Respectable Professional
Service Provider
to Health Consumer (Business)
5. Patient and Doctor
M G Bhat 510 February 2018 IAGES Raipur
The Public is losing their TRUST in us.
They see us as money minded.
They feel we don’t listen to their concerns anymore
and don’t Bother about their needs.
6. 10 February 2018 IAGES Raipur M G Bhat 6
• Human Relationship
Patient and Doctor
Communication
• Is the key for successful Practice
• Good Relationship
• Avoids all Problems
7. Case: 1 - An Honest Truth :
M G Bhat
62/F - Underwent Hysterectomy
and Incisional Hernia Repair
Dealing with Complications
Tell the truth to patient: No hiding facts
Walls have ears!
10 February 2018 IAGES Raipur 7
Patients will understand an honest mistake
if the doctor tells the truth
8. Negligence
• Low Standard of Care Causing Harm to Patient
• Misrepresenting the skills they do not have
• Failure to act in time
• Indifferent handling of case
• Not Seeking Expert Help in time
• Poor documentation and Communication
A mistake by a medical practitioner, which a
reasonably competent doctor would not have
done is NEGLEGENCE
9. 10 February 2018 IAGES Raipur M G Bhat 9
Communication
• Clear and make patient
and other members understand
• Regular Continuity communication
to the same group
• Remember most times they have
Not understood! So, document your
discussion points
• Never get Angry!
10. M G Bhat
Case: 3:
• Cancer
• Lose Talk by Colleagues
10 February 2018 IAGES Raipur 10
• 23/F with Liver Abscess
• Haemangioma-
11. 10 February 2018 IAGES Raipur M G Bhat 11
Communication 1 c
Patient- Doctor Relationship
Poor co ordination amongst doctors
Case 2 : 87/M with Recurrent Cholangitis
12. M G Bhat10 February 2018 IAGES Raipur
1. Prove Not Negligent
2. Be involved and proactive
3. Prepare well.
4. Help the lawyers
5. Have Supporting Evidence
6. Pick a good and committed lawyer
7. Be confident and sure
Dealing with Courts and
Medical Council
12
13. 10 February 2018 IAGES Raipur M G Bhat 13
Dealing with Complications and
Colleagues
Cases: Dealing with Others Complications
14. M G Bhat 14
Facts to Remember….
• In Problem Cases Get
a Colleague involved
•Sympathize with patient and help
• Lack of Communication
reason for Litigation
10 February 2018 IAGES Raipur
15. Documentation
M G Bhat 1510 February 2018 IAGES Raipur
• Clear and Legible
• All facts
• No Later Corrections!
• Documentation - is our responsibility
• OPD Notes ?
16. Informed Consent
M G Bhat
The Value of consent is realised
only when there is legal scrutiny
Is the most important document
in Surgical Practice
10 February 2018 IAGES Raipur
16
17. M G Bhat 17
Consent ….Contents - 2
• Documented in Legible way
• Make them Understand
• Signature by patient
• Signature by Witness ( Relation)
• Signature by Doctor
• No Corrections
10 February 2018 IAGES Raipur
18. M G Bhat
Consent & Documentation
Gross Medical Negligence
&
Punishable
10 February 2018 IAGES Raipur
18
19. 10 February 2018 IAGES Raipur M G Bhat 19
• Bristol Cardiac Surgery Scandal
20. Violence
M G Bhat 2010 February 2018 IAGES Raipur
• Anxious Relations
• Aggression
• Lack of Trust
• Unhappy with the Treatment
• Financial Burden
• Mob Mentality
21. M G Bhat 2110 February 2018 IAGES Raipur
Violence
• Anticipate & Be Prepared
• Inform Admin and Police
• Calmness
• Discussion & Explain
• Be involved and Sympathetic
• Assist them
• Safety of Doctors
• Doctors are at the receiving end of this
growing menace. (usually the Junior Doctors)
22. M G Bhat 2210 February 2018 IAGES Raipur
Behavior in the wards
• Nurses and Doctors talking Loud
• Laughing and fun in ward
• Discussion in front of the patient
• Discussions outside the room and
patient able to listen
•Doctor and Doctor
•Doctor and Patients
•Doctor and Nurse
•Doctor and Admin
23. M G Bhat 2310 February 2018 IAGES Raipur
Professional Fee
• Uniformity of Fee
• Unreasonable Charges
24. Corruption
M G Bhat 2410 February 2018 IAGES Raipur
• Targets Driven Unethical Practice
• Industry & Pharmacy Benefits
• Benefits for Referrals
(Hospital, Doctors, Labs)
26. M G Bhat 2610 February 2018 IAGES Raipur
• On Starting Practice
• On Change of Type of Practice
• On Changing Address
• On Temporary Absence
• On Resumption of Practice
• On Succeeding to another Practice
• Public Declaration of Charges
Advertisements & Doctors
27. Media both Positive and Negative
M G Bhat 2710 February 2018 IAGES Raipur
• Effective use of media
• Internet, Social media etc
• Also can be harmful & Damaging
28. M G Bhat 2810 February 2018 IAGES Raipur
Publishing and Presentations
• Scientific Presentations
• Media Presentations
• Plagiarism ?
29. M G Bhat 2910 February 2018 IAGES Raipur
What is our reality?
• No Audit
• MCI - Not Effective
• Associations - No Authority
• No Governance
• No Uniformity in Care
• Health Care Regulation ? Self
• We have the Best & the Worst
30. M G Bhat 3010 February 2018 IAGES Raipur
Laws For Doctors (MCI)
• Patient-Doctor Relations –Negligence
• Sexual Misconduct
• Advertisements
• Incentives to get Patients
• Incentives from Labs and others
• Research and Benefits
• Pharma Gifts
31. M G Bhat 3110 February 2018 IAGES Raipur
Who regulates?
• Self
• MCI
• Health Authority
• Medical Universities
• Hospitals
• Associations
• Guidelines
33. 10 February
2018 IAGES
• Be a Good Doctor
• Good Human Relations
• Communicate well
• Honest and Sincere
• Accountable
• Knowledgeable
• Skilled
M G Bhat 33
Solutions
• Regulation
• Universal Healthcare
34. M G Bhat 3410 February 2018 IAGES Raipur
A Patient
• Patients are human beings with hopes and Fears
• In the Hospital, they are outside their normal place
• Their valuables and belongings are taken away
• They feel “miserable, scared, helpless
Francis W. Peabody. MD
In a 1927 lecture to Harvard Medical Students
35. M G Bhat 3510 February 2018 IAGES Raipur
Lord Moynihan of Leeds
An Operation
for surgeon is a days work
For the patient it is
a question of life or death
36. 10 February 2018 IAGES Raipur M G Bhat 36
1. Learn to Communicate
2. Patience with Patients and family
3. Spend time with ”sick” Patients
A Doctor needs some bad cases to mentally drain;
Increase the pressure on life and become Miserable
and Unhappy.
Time spent on dealing with the
Family is much more than the time spent in surgery etc.
Money Will not bring the happiness!
It is the success which brings glory and happiness
37. 10 February 2018 IAGES Raipur M G Bhat
Consultant Surgeon
Manipal Hospital & Apollo Spectra Hospital, Koramangala
Bangalore , India
Thank you…
Dr. M G Bhat
MS, FRCS(England & Edinburgh),
FICS, DMLE (Law), DMIRCSEd (Informatics)
37
drmgbhat@gmail.com
www.drmgbhat.com
www.bariatricsurgerybangalore.com
Editor's Notes
In my mind, the doctor-patient relationship is sancrosanct. There is no relationship where the bond of trust should be so strong, outside ofmatrimony. As physicians, patients rely on us to help them make life-savingdecisions. And we need patients to be honest with us so that we can give thehighest quality medical advice. Yet, there has been an erosion in thisrelationship over recent years. Doctors are no longer held in such highesteem as they were decades ago. Even our own Commander-in-Chief,President Obama, alluded to the fact that doctors have financial incentive todo more surgeries. The public is losing their trust in us. They see us asdriven for profit. They feel we don’t listen to their concerns anymore anddon’t care what they want or need..
Why has the public lost trust in doctors?
♦Third parties are often making decisions. For example, they dictatetheir own formularies, and we often have our hands tied as to whatmedications we can prescribe. I often have patients ask me for the
“strong Stuff.” They don’t realize that doctors are limited in prescribinghabits, and we are not withholding the Best medications. But, we arethe ones in direct contact with the patient.
♦Outlier doctors have been gaming the system. Most doctors truly putpatients’ care first, before profit. But, there are a few whoinappropriately use their medical degrees for profit. Just look at Dr. Oztrying to get rich promoting weight loss products with no provenbenefit. These doctors make us all look bad.
♦There are many mandates imposed on us that affect patient care.One example is meaningful use. Doctors now have to document manymetrics, inputting data into our EHR systems, in order to meetrequirements. Patients take this lack of eye-to-eye contact as a sign thatwe are more interested in their digital record than them. They feel weare no longer listening to them. They don’t realize that we don’t want tobe doing this. It has been opposed on us from on high, and we will bepenalized if we don’t.
♦HMO’s have greatly cut reimbursements to doctors. In order forpractices to stay afloat financially, we have to see more patients. Weneed to find more and more room to see these extra patients if wewant to stay afloat. Patients feel this and take it as an indication that weare pushing them through for profit and don’t care about them.
♦Media tends to portray doctors in a bad light. There are big storiesabout the pill mill doctors and those arrested for fraud or harassment.There are so many more amazing stories of heroic doctors around thanthe bad apples. But the press does not give them attention. Peoplerather see the bad than the good. This too tends to paint us all in anegative light.
Medical diseases are becoming more complex, and people are living longer.There has never been a time where patients need to trust their doctorsmore. All doctors need to remember their oath and put the patient back incenter focus. We all need to take a stand against those doctors who areabusing the system for their own gain. Patients need to learn that the vastmajority us care about our patients and have their best interests in mind.We all need to become a team again. Patients need to regain our trust, andour profession needs to re-establish its integrity.