Patients, Doctors and Academic Medicine

oak sahib jii

Now just read the above actual article.......I am pasting some lines from this article ...so, that you won`t have any problem in understanding my concept in regards to the above article by Tallat Abid(sorry for the typo for the name of the writer in my post # 12)................

RE:-#8
oak Sahib

Here you go again. I am talking about North and you are talking about South. We are NOT on the same page.Sorry......

First of all , I did not copy any introductory section of any of my course book. I have been doing these continuing medical courses for a long time. It is mandatory for us to refresh CMEs every two months with all these vital courses. So, my knowledge is quite fresh and quite frankly I did this Siemen`s Medical Solutions module course last week and I am going again next week.

There is no such thing as introductory course book, they just give us lectures , then we do clinical discussions, then we represent our own approach with the help of such modules based on statistical data and latest research for always changing and advanced concept in Medicine. No wonder that is why American health care is the most excellent in this regard.

You said:-a)-{{{All your buzzwords about ``individual-tailored care`` will amount to nothing until the building and staff is in place.}}}.....


Now, this statement by you is a clear proof of your confusion about my posts and concept.
If I don`t know anything, believe me I have open mind to accept that and will try to learn from each other.....But, it looks like you have totally blocked your mind and you are not ready to learn this module and it`s concept.................

Just re-read my post #2 and #3 .....
This Medical solutions module is a COMPREHENSIVE module covering,``individual tailored care`` of the patient to building and staff in place............That is the reason it is simple and flexible and can be implemented in any country according to it`s needs.This module is absolutely not for America, B/c American Health care system is the best and it is already standing on best infrastructure.........

This Medical solutions module is basically for third world poor countries where there are limited resources, so that we can cater this system according to their own circumstances with implication of advanced and simple concept......

b):-You wrote:-{{{Does he want to feel empowered or cured?}}

What this module emphasis ed is empowerment of the patient in regards to his/her CURE(solution of his/her problem of health), so that patient`s safety and well being is not endangered...............Just read this from my post # 3.....

{{{Pakistani healthcare system needs a medical culture that supports empowerment and accountability favoring Patients safety and well being.}} , now what does it mean?

It means Patient`s TREATMENT/CURE WITH THE IMPLEMENTATION of safe medical culture where there should be less and less errors...........Where patient should not feel neglected, where patient should not be ignored , where patient should have check and error , where patient feels safe to be treated by the right competent individuals.

What do you think what is it? It is CURE .Simple.

Now what is there NOT to understand? I am really surprised upon your approach towards my posts.

Honestly, your post does not make any sense to me B/c the Medical solutions module I am discussing is about making the medical process more and more simple to fit in to the needs of poor countries, to cut back all the un necessary complicated steps, so that all patients regardless of poor or rich should be treated equally(which is not true in Pakistan, where poor and rich are treated on different Modules).....................Where as in America, everyone is being treated equally............regardless of rich or poor/social class or status.........Simple.

Just read this....{{b):-Simplify work process to ultimately eliminate unnecessary steps and automate where ever possible relieving clinicians of administrative task or in other words making the task more streamlined , so care providers can spend more time at bed side and optimize the coordination of services to make the most effective use of the currently available medical resources in Pakistan}}}.....

You wrote:-#3:-{{Typical global arches approach thinking what works in America will cure all the worlds ills.}}...

Well, well....This Medical Solutions Module is not for America. This is basically for all the third world poor countries, where poor`s have NO life at all, where only rich have the right to be treated superiorly b/c of money.........this medical Solutions module will reform all the healthcare infrastructure and will give an equal opportunity to rich and poor to be treated on equal basis.........

And, yes, It is true America cures all the world`s ills........they think at least one century ahead and they exactly know what your needs are.......You don`t even realize your own needs and they come up with a plan which is most suitable for your needs...............And this Medical solutions module is a typical prototypical example of such scenario............


oak sahib jii

Now just read the above actual article.......I am pasting some lines from this article ...so, that you won`t have any problem in understanding my concept in regards to the above article by Talib.................

{{{Without lashing away at predetermined and rigid concepts and redirecting the spotlight on the revitalization of academic medicine there are very little chances of any change. }}}

{{Certainly we in Pakistan can`t afford to hang around for the results of this strategic process. We should insist on more from policy makers and academic medical centers now.}}

{{{There are many parallels for change within academic medicine. A national level policy of “thinking globally and acting locally” should be formulated where patients have a fundamental role in initiatives to increase research funding and development, improve medical and patient education, and empower patients. The patients are the ultimate voice in healthcare infrastructure.}}}

{{The World Health Organization’s (WHO) emphasizes that all stakeholders must be integrated at every juncture of the course, beginning with the formulation of a proclamation on the need for change, an incorporated vision and mission, foundation concepts, and objectives. Multidisciplinary opinion leaders should be identified to facilitate the evolution of a national dialogue among factions representing the stakeholders. All stakeholders should endorse a policy of vision, core concepts and desire for change. At the same time, funding bodies must be encouraged to tender enticement for ground-breaking ideas and new ventures. A national steering body is necessary for implementation of evidence both within and across the country to motivate stakeholder groups, guide funds for national development, and highlight significant accomplishments. }}


{{Patients must be incorporated as stakeholders in all strategic and action groups because without this revitalization of academic medicine will remain as elusive as it is now.}}}

{{{The patient’s patience should not be tested as nobody can afford to be patient for an unlimited period of time. We will win when academic medicine survives. Change is a challenge, but it the only way patients can be made participants and beneficiaries.}}

{{{{
From the patient’s viewpoint academic medicine for research leading to better healthcare services, education of medical students, and leadership in patient care, research, and education are essential elements. But times have changed both for the medical profession and curriculum in Pakistan. The mounting hindrance to contribute in scholastic medicine and challenging financial, political, consumer and technology trends are grounds for disquiet. Academic medicine has to do better to survive as a leading player in the healthcare infrastructure.}}}

oak sahib jii

Now read and re read my posts and you will see where I am coming from......This is exactly what my Medical Solutions Module is ABOUT..........

That is the reason I must say, this is an EXCELLENT article with new and better revolutionized concept in Medicine in Pakistan............

I hope you will not take any offence for this post.....I am not here to convince you or anyone, I am here to APPLAUD the writer of this article and then giving my concept based on my CONTINUING MEDICAL EDUCATION courses monthly with a clear cut concept........

My concept and this writer`s article goes hand in hand.....only if you read my posts with open heart and mind.......thank you

i have this idea of medicine for modern age, for india (and maybe pakistan). we should have 2 year diplomas for nais and village hakims for basic healthcare, where they learn basics of physiology, pharmacology and opd surgery post 12 grade. after that they buy into a franchise of webMD. so, they can give lala-dawa for minor issues, and get advice from other 10 year college-type doctors on a consulting basis, while delivering basic medicine. after all, besides giving MMR shots, the main decision a pediatrician has to do is wheather to prescribe amoxycilin or tylenol based on a guess of if its baterial or viral. this way, the nai can cut hair and run a surgery and simultaneously use his computer to keep in touch with zeena for invaluable advice.

Can you define academic medicine? My understanding was that this was primarily related to research, i.e. gov`t, foundation and pharma/biotech funding driven. If so, what is your article about?

before you elite guys discuss the `Scholistic Medicine` in Pakistan -- how about throwing some light on the curriculum to provide the `Populistic Medicine` to rural Pakistan and to its bursting at the seams crowded cities and to their sprawling shanty towns.....

Re: # 6

Zeena

No, to be honest I understood exactly what you were getting at. I am familiar with these concepts. But they have a specific use which has been completely misapplied.

Take for example your claim as to the need for ``empowerment``. I am sure that in your Sieman`s handbook this has been described as a psycho-social utopia where the - medical team - work in - conjunction - with the patient to relieve all of societies ills. But consider patient A with severe migraine, nausea and vomiting which is a common presentation in Pakistan. Does he want to feel empowered or cured? If he gets access to his antimalerials he is not in the least concerned whether he feels ``empowered`` or not? Or take village B 50 km from the nearest hospital, with no nearby physician or clinic. All your buzzwords about ``individual-tailored care`` will amount to nothing until the building and staff is in place.

You seem to have just copied out the introductory section of your course book without actually having considered the issues themselves. Typical global arches approach thinking what works in America will cure all the worlds ills.

I don`t know what`s the situation now -- in our days too much time on basic sciences -- much less on clinical medicine -- should be the opposite...more emphasis on preventive than on curative -- more specialization in tropical diseases than esoteric cardiology..

...only if the priorities are properly percieved....

more on manufacturing of sterilized speculums than on un sterilized F-16 -- more building of rural medical clinics than building missile`s silos -- more ICUs than the ICBMs...

this is what the subcontinental priorities are at present:

New Delhi/Islamabad : Indian Prime Minister Manmohan Singh/Pakistani President Musharraf on Sunday/Monday/Friday said:

`` the country would soon embark upon production of futuristic weapons systems.
Singh/Musharraf said that India/Pakistan needed cutting edge technology weapons in sensors, robotics, propulsion systems, stealth and fighting wars through use of remote technology.``

What they are getting ready for in that sinful subcontinet -- is fighting a WAR on each other`s people -- not a WAR on diseases, pestilence, epidemics, clean water, good roads......

the logic of subcontinental science is primarily to kill the subhuman subcontinentals first -- before you develop the curriculum to heal the wounded ones...

.....no money for health plenty for war....

Re:-#5

oak:-{{{The problem with using marketing buzz words to analyse such a problem is self-evident. Concrete steps need to be taken, rather than bandying around high sounding manegerial type concepts meaning nothing much.

Im sure it sounds very good to big pharma. But it doesn`t impress me.}}

oak sahib

First of all if you do not have any idea about what I am emphasising here, you should not jump back and forth with your little knowledge. You do not have a slightest idea what I am talking about. Well I do understand your naivety and backwardness in regards to simple medical strategies...........And I do not need to impress you or anyone by emphasising this new concept of medical solutions..... been there, done that....

And, you out of all interactors who is already in his own confusion.....God bless you....

Just read my post #2 and #3 carefully, they are not so hard to comprehend. Simple. And then you will realise my approach , I used Siemens medical solutions module as a role model for Pakistan...........which corrects all the follies of any defaulted medical culture anywhere in the world......Mind it Pakistani medical culture is 100% defaulted...........which needs real big reforms................

I am not wordy here, and it is not a big pharma.....it is a new practical approach to solve the medical issues by using simple strategies..............

And, if we do not have an organized management, how will we be able to organize the medical system?
Pakistan and UK are much behind medical solution module and are currently facing zillions of problems based on lack of managerial system. There is absolutely NO concept of organized medical module over there and that is the core issue that needs to be addressed first, if we want reforms.......

Re: # 3

> Pakistan needs organized mission to provide consistent comprehensive , individualized and quality care with a main ethical philosophy in believing the art and science of delivery of care to Patients by fostering a collaborative, multidisciplinary approach with compassionate , culturally sensitive, holistic care with the strength of diverse population

The problem with using marketing buzz words to analyse such a problem is self-evident. Concrete steps need to be taken, rather than bandying around high sounding manegerial type concepts meaning nothing much.

Im sure it sounds very good to big pharma. But it doesn`t impress me.

Dear Dr. Abid,

While agreeing with the basic idea that there are problems in Pakistan, I am not sure if I understand you correctly. For example, you said: ``We should insist on more from policy makers and academic medical centers now``. You can pick any sentence of you article on your own and examine to see what does it convey to the reader.

Almost all of your aticle is full of generalities. Nobody can understand what you are trying to say when you have generalized your article so much. Would you not agree with that? Would you!

Please be specific. I do have some experience with Pakisatn, its a huge problem there that scholars lack an eye for specificity. Please rewrite your article if you are interested in a meaningful discussion and feedback.

On side note:-
Pakistan needs organized mission to provide consistent comprehensive , individualized and quality care with a main ethical philosophy in believing the art and science of delivery of care to Patients by fostering a collaborative, multidisciplinary approach with compassionate , culturally sensitive, holistic care with the strength of diverse population(regardless of poor and rich).

Pakistan`s health care reforms needs striving for excellence in patient outcomes via continuous performance improvement utilizing evidenc based practice. Utilizing ethical principles to protect the health, safet and rights of the patient.(which are the poortest in current Pakistani healthcare system).

Pakistani healthcare reforms also need patient and family education to promote an optimum level of health and wellness.

Pakistani healthcare system needs a medical culture that supports empowerment and accountability favouring Patients safety and wellbeing.

Pakistani healthcare system is in dire need of CONTINUING medical education that fosters professional growth, competnce and critical thinking.

Thank you

Dear writer
A good piece !!!

Pakistan needs to update the new clinical information system which is already launched and being implemented in developed world and exclusively in America. Pakistan needs to implement with Siemens Medical solutions, which is a leader in healthcare technology , for the deployment of a new state of the art cilinical information system.

This system is very practical and flexible to suit every country`s medical needs , yet maintaining high standards in benefiting clinicians by improving workflow, coordination of care and patient safety.

Pakistan needs to be committed for implementing this new totally revolutionized medical system........

When we talk about medical system, we talk about the whole infrastructure , not just doctors.( doctors are just less than 20 % of that infrastructure).....

We need to incorportate Nursing revolutionized skills(the most important aspect) b/c all the hospitals are run by nurses with their correct documentations and in patient care with the correct aministration of medicines.
Medical labs are an integral part of health care system, test results reporting in a timely and correct fashion....

Pharmacy system for checking and errors(again the most important aspect of health care system)..

Medical records, physician orders(test instructions, medications, transfers, etc.) ,

Pakistan needs a workflow redesign committee to project health care enterprise mission to accomplish the following......

a):-Improve patient safety(which is the poorest in Pakistan).

b):-Simplify work process to ultimately eliminate unnecessary steps and automate where ever possible relieving clinicians of administrative task or in other words making the task more streamlined , so care providers can spend more time at bed side and optimize the coordination of services to make the most effective use of the currently available medical resources in Pakistan.

Pakistan needs a project enterprise in healthcare system to ensure best practice patient care by boldly taking health care reform system where no one has gone before(and this is quite possible) through technology driven process improvements in clinical areas and equipping clinicians, nurses, medical techs, pharmacists, and administration with the most suitable tools which are totally lacking in current Pakistani health care system..........

PS:- I just got training for Siemens Medical Solutions module...........

Abid Sahib

I appreciate that you are trying to generalise world trends in respect of the home country. But more specifically re: Pakistan

1 Given the mushroom growth of private medical institutions & especially of medical universities is it not the key challenge at this time in mantaining standards and correct regulation, or do you think that that has been done?

2. Would you agree with me that Pakistan`s current need is in terms of primary care. PC requires a different set of skills than hospital medicine. Any reform of the system ought to have this in mind

Let me know

Cheers