Presentation is loading. Please wait.

Presentation is loading. Please wait.

COMMUNICATION IN MEDICINE Dr Sanjay De Bakshi MS; FRCS.

Similar presentations


Presentation on theme: "COMMUNICATION IN MEDICINE Dr Sanjay De Bakshi MS; FRCS."— Presentation transcript:

1 COMMUNICATION IN MEDICINE Dr Sanjay De Bakshi MS; FRCS

2 Plato: Wise men talk because they have something to say; fools, because they have to say something.

3 All the world's a stage, And all the men and women merely players; They have their exits and their entrances; And one man in his time plays many parts, His acts being seven ages.

4 COMMUNICATION IN MEDICINE Communication is extremely important in ALL stages of a doctors life.

5 Sense of Proportion 1225 medical seats (1105 MBBS BDS) Estimated number of candidates this year More than 1 lakh Dis-

6 Proportional factors 1225 medical seats (1105 MBBS BDS) engineering seats. Estimated number of candidates this year More than 1 lakh 1.225% 13%

7 MIS-COMMUNICATING EVEN BEFORE MEDICAL SCHOOL

8

9 JOINING THE STREAM The VAST majority will however study till they are ready to DROP!! JEE-IIT

10

11 DOCTOR-TO-BE The first throes of joining clinical medicine – making sure people see the stethoscope!! Myself Harsh Medical student

12 1 st SEMESTER ANATOMY PHYSIOLOGY BIOCHEMISTRY DEAD BODY BODILY FUNCTION BODY CHEMISTRY Some things don't change much

13 2 nd SEMESTER TOPICS PATHOLOGY PSM FORENSIC STUDY BODILY DYSFUNCTIONS ENVIRONMENT UNNATURAL DEATH

14 3 rd SEMESTER TOPICS MEDICINE SURGERY GYNAE & OBS. NOT ONLY STUDY BUT COMMUNICATE!!!! MEDICINE PATIENTS & PARTY SURGICAL SCIENCE PATIENTS & PARTY G & O PATIENTS (2) & PARTY

15 SYLLABUS 1 st SEMESTER---- Classes on Anatomy; Physiology and Biochemistry. 2 nd SEMESTER---- Classes on Pathology; PSM and FSM. 3 rd SEMESTER---- Classes on Medicine; Surgery and Gynaecology. WORKING LIFE--- 60% to 80% will work in Medicine; Surgery and Gynaecology. One thing will be common to ALL DISCIPLINES

16 And the number of Formal Classes on Communication during the ENTIRE THREE SEMESTERS % FOR A PROFESSION THAT IS SO COMPLETELY DEPENDENT ON COMMUNICATION & TRUST – IT IS A MAJOR OMISSION!!!

17

18 Poor communication is the catalyst for most complaints; The recognition (especially by medical indemnity organisations) that communication skills can be taught; and The increasing emphasis now being placed on communication skills in medical training.

19 MRCS EXAMINATION COMMUNICATIONS SKILL COMMUNICATION GIVING COMMUNICATION GATHERING CLINICAL SKILLS TRUNK ABDOMEN HEAD & NECK VASCULAR ORTHOPAEDICS

20 COMMUNICATION GIVING SCENARIO IN MRCS EXAMS. Allan an overweight 13year old was sent home after an emergency appendicectomy after 4 post-operative days. His mother, Mrs Green, discovers 3 days after the discharge, that he is draining dark brown fluid from the wound. She is very frightened and has brought him back to the hospital. She is very worried and angry. She has the following questions for the young doctor, who is an Senior House Officer to Mr Chorley, the Consultant.

21 COMMUNICATION GIVING SCENARIO IN MRCS EXAMS. Why did this happen to Allan? Why have I never seen Mr Chorley after the first two days? Is Allans life at risk? CANDIDATE 1 Well Mrs Green, we all loved Allan, he is such a bright young chap, but as his studies do not leave him enough time for outdoor games he is slightly healthy…… Fat heals very poorly. Mr Chorley is a very caring man. He is also very busy and I am sure that he must have been caught up in some emergency, else he would have seen Allan. I will ensure that you both get to see him asap. It appears from your history that Allan has some collection in the wound that sometimes unfortunately happens. You have the best person in Mr Chorley to treat this condition. I would trust Mr Chorleys treatment and care implicitly.

22 COMMUNICATION GIVING SCENARIO IN MRCS EXAMS. Why did this happen to Allan? Why have I never seen Mr Chorley after the first two days? Is Allans life at risk? CANDIDATE 2 Allan is very very fat. Sometimes these things happen to fat and unhealthy people. Mr Chorley is a very busy surgeon. We do not like to bother him with little things like ward rounds. He will of course see Allan when it is convenient for him. Mrs Green we all have to die some day, so dont worry!!

23 COMMUNICATING WITH COLLEAGUES! There was an audit carried out in the British NHS that hospitals with a lounge for doctors worked more efficiently - -- simply because of better inter- departmental communication.

24 COMMUNICATING WITH COLLEAGUES! "Are you sure he's anesthetized?" TO ENSURE BEST TREATMENT FOR THE PATIENT AND TO ELIMINATE CONFUSION !!

25 (MIS) COMMUNICATING WITH COLLEAGUES! PATIENT IN ICU AT St. ELSEWHERE FOLLOWING DIFFICULT SURGERY. Admitted under a Gastroenterologist –designated the Primary Care Physician. Patient turned bad at middle of night and DIED at 4.00A.M. SURGEON –(Who did the operation) gets the first phone call at 9.00A.M Sir, what should be the cause of death in the D.C.??

26 Writing a paper!

27 Suggestions Have something worthwhile to say. Learn to be brief. Write grammatically correct english. Get your spellings WRITE AVOID ABBREVIATIONS.

28 ART OF ABBREVATIONS Doublespeak supplanted English as the national language at about the time POTUS, FLOTUS and SCOTUS replaced the President, First Lady, and Supreme Court of the United States. Paul Greenberg

29 Be Prepared to Sometimes Re-do your Paper Again and Again and Again!!! Get your facts right. Get your References right and IN THE PROPER FORMAT! Read through the Journal you are Targeting and Learn the required Format. TRY AND TRY AGAIN

30 READING A PAPER!! PLENTY of papers!!! Learning to separate the wheat from the chaff!!!! Level I, II or III.(RCTs)!! A Personal Series of Treating Bilateral Varicose Veins Dr A Gressive; World J of N Surgery; 2009 Feb ; 215(1): Treating Bilateral Varicose Veins with Bilateral Thigh Amputations – 0% recurrence.

31 COMMUNICATING AT MEETINGS The brain is a wonderful organ. It begins to work the day we are born and keeps on working- Till the time that you get up to speak in public!!! IT EITHER DRIES UP OR GOES INTO THE THROES OF VERBAL DIARRHOEA!!

32 According to most studies, people's number one fear is public speaking. Number two is death. Death is number two. Does that sound right? This means to the average person, if you go to a funeral, you're better off in the casket than doing the eulogy. - Jerry Seinfeld COMMUNICATING AT MEETINGS

33 LEARN to handle your CUE CARD smoothly. Write big, bold letters. Never read basics i.e. name of V.I.P/Organisation/Occasion etc. from a CUE CARD. SPEECH should be not too long nor too short. If you wish to cut down on the spot : delete one Complete point/paragraph. It is always a good policy to prepare more but speak less. NEVER try to recall what you had written & rehearsed. Speak as it comes to you naturally. It will be far superior than the write up.

34 COMMUNICATING AT MEETINGS FOCUS on all the people who are listening to (not on those who are not). Do not get distracted by disturbances if any, If it is minor ignore the disturbance & go ahead. If it is major, wait till things settle down, tell a fitting joke, make a sportive comment and go ahead. If a V.I.P has come, announce his presence, and go ahead. Never take it personally. In any case never loose your charm & calm. IGNORE if you have erred and no one noticed. ADMIT & correct if it is pointed out. ACCEPT if anyone gives additional Data thank the person.

35 COMMUNICATING AT MEETINGS QUESTIONS from audience is a welcome sign. It shows they have listened to you. Answer if you can, otherwise ask all present to answer. Do not bluff, do not feel hurt. Answer with wit, tact and humour. Answer short and sweet. Be at your best : cool & charm. NEVER begin with apology. NEVER carry written speech NEVER memorize any speech

36 THE ART AND CRAFT OF TECHNOLOGY USING THE POWERPOINT PRESENTATION

37 BASIC RULES Keep the slide simple and restrict a slide to about seven lines.

38 No body has the patience to go through the slide!! Ann Surg Jan;215(1): Gallbladder sludge and stone formation in relation to contractile function after gastrectomy. A prospective study. Inoue K, Fuchigami A, Higashide S, Sumi S, Kogire M, Suzuki T, Tobe T. First Department of Surgery, Faculty of Medicine, Kyoto University, Japan. In a prospective trial to determine whether gastric surgery induces gallbladder sludge and stone formation, 48 patients with gastric cancer were ultrasonographically examined with simultaneous observation on changes in gallbladder contractile function before and serially for 5 years after gastrectomy. Gallbladder sludge formation was induced with a high frequency of 42% 1 month after gastrectomy, with corresponding significant lowering of gallbladder contractile function. Most of gallbladder sludges, however, disappeared within 12 months in relation to the gradual recovery of gallbladder contractile function. Conversely, gallstone developed in nine patients (18.8%), mostly more than 6 months after gastrectomy. Interestingly, gallstone formation was induced in seven patients who were sludge negative. An evolvement of gallbladder sludge into stone was observed in only two patients, who were, however, treated with intravenous hyperalimentation. This study first provides evidence for the relationship between gastrectomy and a considerably high frequency of incidence of gallbladder sludge and stone in relation to changes in gallbladder kinetics after gastrectomy.

39 BASIC RULES Learn to avoid being too computer clever

40 GALL STONES AFTER GASTRECTOMY Surg Gynecol Obstet Nov;165(5): Sludge and microlithiasis of the biliary tract after total gastrectomy and postoperative total parenteral nutrition. Gafa M, Sarli L, Miselli A, Pietra N, Carreras F, Peracchia A. Istituto di Clinica Chirurgica II, Parma University, Italy. We have evaluated the incidence and evolution of sludge, microlithiasis and lithiasis formation of the biliary tract in 12 patients who underwent total gastrectomy and postoperative total parenteral nutrition (TPN) beginning immediately after operation. To this end, serial ultrasonographic studies are carried out every 72 hours during TPN and every seven days after oral refeeding and then once a month for three months. Sludge of the gallbladder was demonstrated in five of the 12 patients after a minimum period of nine days after the operation, and in four of these, microlithiasis of the biliary tract was subsequently revealed. In two of these four patients, the stones dissolved spontaneously, while in the remaining two patients, no change occurred in dimension after intervals of six and seven months, respectively. In all instances, sludge and microcalculi were completely "silent." This study was done to underline the high incidence of biliary tract sludge and microlithiasis in the patients examined and to indicate the necessity for preventive measures against

41 BASIC RULES Use LIGHT LETTERING on a DARK BACKGROUND-----

42 IT IS EASIER ON THE EYES OF THE AUDIENCE PARTICULARLY IF YOUR LETTERING IS SMALL !!!

43

44 BASIC RULES Above all know your topic. And practice, practice and practice. I LOVE SPEAKING EXTEMPORE, I PRACTICE DOING SO EVER SO OFTEN!!! George Bernard Shaw

45 REMEMBERING THE SPONSORS!! "We thank Joe's Greasy Spoon Diner for providing the patient for this stomach operation."

46 COMMUNICATING WITH PATIENTS MODELS OF PATIENT-DOCTOR RELATIONSHIP WEBERIAN MODEL VEATCH MODEL OZARS MODEL MAYS MODEL

47 COMMUNICATING WITH PATIENTS Weberian Models The paternalistic model, The informative model, The interpretive model, The deliberative model.

48 PATERNALISTIC MODEL Parental or priestly model, of the provider-patient relationship is the parent-child approach. The provider takes on the role of guardian. In this model, decision-making is taken away from the patient, thus threatening patient autonomy.

49 THE INFORMATIVE MODEL Scientific or engineering model, the physician provides all relevant information, the patient selects the intervention, and the physician executes the interventions. This model lacks physician values, patient values, and judgment. "Well my records are factually CORRECT...but where's the PASSION, the MYSTERY, THE REAL ME!..."

50 THE INTERPRETIVE MODEL The physician acts as a counselor or advisor. Conception of patient autonomy is self- understanding pertaining to medical care.

51 THE DELIBERATIVE MODEL The physician's role is one of friend or teacher. The provider helping patients choose the best interventions for their medical care. ONE NEED NOT SYMPATHISE – BUT SURELY ONE NEEDS TO EMPATHISE!

52 TO BEFRIEND OR NOT TO BEFRIEND!!

53 THINK! A busy lady executive took some quality time to take her 4 year son to a famous fair for a complete day. She was thrilled but very soon the son began whining and wanted to go home. Irate she bent down to talk to him and said- My God! What was going on?

54 OBSTACLES TO GOOD COMMUNICATION OBSTACLES PHYSICAL ENVIRONMENT DOCTOR- RELATED OBSTACLES PATIENT- RELATED OBSTACLES CULTURAL AND SOCIAL DIVERSITY

55 PHYSICAL ENVIRONMENT The physical environment may: discourage good communication; or fail to provide sufficient privacy.

56 DOCTOR-RELATED OBSTACLES The doctor may be: inadequately trained in communication skills; lacking in sensitivity or empathy; unwilling to recognise patient autonomy;

57 DOCTOR-RELATED OBSTACLES The doctor may be: inadequately trained in communication skills; lacking in sensitivity or empathy; unwilling to recognise patient autonomy; face an irritatingly aggressive relative.

58 DOCTOR-RELATED OBSTACLES The doctor may be: affected by time pressures; or distracted by external or personal factors. EMERGENCY DOCTOR YOU ARE WANTED ON THE 3 RD, 4 TH 5 TH FLOOR AND ALSO IN TRAUMA

59 ONE EXPERIENCE---- "Thanks for coming over, doctor, but a bit of antacids fixed me up fine." The doctor may be: influenced by past experiences

60 OFTEN LEADS TO ANOTHER Stick to your mother-in-law's remedy and call me in the morning if you survive." The doctor may be: influenced by past experiences

61 PATIENT RELATED OBSTACLES How much is JUST right? How much to divulge to the patient and how much to the relatives? EVERY SINGLE PATIENT WILL REACT DIFFERENTLY.

62 PATIENT RELATED OBSTACLES A 66 year old man presents with disseminated cancer of the stomach. On being informed about his condition, he wanted it to be kept a secret from his family members. His reason- being intelligent he realized that chemotherapy would at best grant him 6 months of life but would wreck his plans for his daughters impending marriage. After his death his family are very irate and want to litigate for suppression of facts.

63 PATIENT RELATED OBSTACLES An 80 year lady presents with disseminated cancer of the colon. On being informed about the disease, she stops eating, becomes severely depressed and wastes away. The family is irate that the patient was told about the news.

64 PATIENT RELATED OBSTACLES A 40 year old executive has a massive myocardial infarction and is left with an aneurysmal dilatation of the left ventricle and an ejection fraction of 20%. His family insists on his NOT being told about his prognosis as they would like to protect him from bad news. What do you do?

65 PATIENT RELATED OBSTACLES How much is JUST right? How much to divulge to the patient and how much to the relatives? EVERY SINGLE PATIENT WILL REACT DIFFERENTLY.

66 REACTION 1 TO THE NEWS ABOUT CANCER!!

67 EVERY SINGLE PATIENT WILL REACT DIFFERENTLY. REACTION 2 TO THE NEWS ABOUT CANCER!!

68 DONT BLEAT AROUND THE BUSH!!! COMMUNICATING WITH PATIENTS

69 BUREAUCRATIC WAY OF SAYING NO!!!

70 COMMUNICATING WITH THE PRESS ABOUT A PATIENT The Medical Council of India stipulates that a registered medical practitioner shall not disclose the secrets of a patient that have been learnt in the exercise of his profession except in a court of law under orders of the presiding judge. The police had summoned three doctors of INDRAPRASTHA APOLLO Prasad Rao, who headed the team that treated Rahul, Medical director Anupam Sibal and Senior doctor Mukund Pandey - for questioning.

71 WHOS RIGHT TO INFORMATION? RTI Act, meant for 'promoting transparency and accountability in the working of public authority' is most commonly used in our hospital for obtaining case sheets, wound certificates and post-mortem reports by advocates to expedite settlement of their cases. A Hospital Manager from Chennai

72 THEREFORE---- Ensure that the Bed Head Ticket is filled up diligently. While ensuring that it documents all that has happened diligently do not allow yourself the liberty of documenting your personal thoughts and angst!! Tried to contact Dr and could not!!!

73 Make sure that all informed consent is signed AN APPROPIATE TIME BEFORE the actual Procedure!! YOU MUST GET A CONSENT FROM AN ADULT PATIENT DIRECTLY– It is not medico-legally justified to get a CONSENT from a relative of an adult patient who is mentally sound. THEREFORE----

74 CORRECT THE DISCHARGE and get the CORRECTED DISCHARGE RE-TYPED!! Dont send out a Discharge with Corrections and Deletions done by Hand. THEREFORE----

75 Your adult balanced patient has the PRIMARY RIGHT to his own information according to the Supreme Court not the relatives. One must learn however, how to break a bad news gently. THEREFORE----

76 1.Humanity out from doctors? 2.How would you mark the candidates on a score of 1 to 4? 3.Would you befriend your patient? 4.Why did the lady executive say My God! as she bent down to talk to her son? 5.What would YOU tell the young executive with a very bad heart?

77 ALSO- YOU LIVE AND SLEEP AND DREAM THIS PROFESSION A PART OF YOU BLEEDS WHEN YOUR PATIENTS DO BADLY! BUT, LIKE ANY OTHER PROFESSION YOU DO HAVE YOUR LIGHT MOMENTS---

78 YOU LIVE AND SLEEP AND DREAM THIS PROFESSION

79 FIRST LESSON-- WE DOCTORS LIVE IN INCREDIBLY CLEAR GLASS HOUSES--- SO DONT THROW STONES

80 SO WHAT IS THE ANSWER-

81 SO WHILE IT IS VERY IMPORTANT TO DOCUMENT ALL ONES DEALINGS TO SAVE YOURSELF---- SPREAD A BIT OF RESPECT ALL AROUND!!!

82 IN RESPECTING YOUR PATIENT, YOU RESPECT YOURSELF, AND, YOU RESPECT THE NOBLE PROFESSION THAT WE HAVE ALL CHOSEN TO PRACTICE!!

83 Getting the attention of the Class Pretending to be on Telly. SOME TEACHERS ARE VERY GOOD!!!1

84 But some classes seem to go on and on and on!!!! THE CLASSES GO ON AND ON AND ON!!! SOME TEACHERS NOT AS GOOD!!

85 Sometimes the quality of the class is directly proportional to the quality of student response!! SO NOW THE CLASSES BEGIN!!! A HUMAN BEING HAS TWO KIDNEYS. WE TOOK OUT ONE- HOW MANY DOES HE HAVE NOW/- ANYONE??

86 TRUTHS! You remember 5% of what you hear, 10% of what you write, 20% of what you see, 50% of what you see and write, 70% of what you do, 90% of what you understand. do and teach!!

87 The MOST important fact is that- Doctors exist because of patients!!

88 COMMUNICATING WITH PATIENTS Good communication: builds trust between patient and doctor; may help the patient disclose information; enhances patient satisfaction; involves the patient more fully in health decision making; helps the patient make better health decisions; leads to more realistic patient expectations; produces more effective practice; and reduces the risk of errors and mishaps. These benefits in turn strengthen communication between patient and doctor and can contribute to better health outcomes for the patient.

89 COMMUNICATING WITH PATIENTS Poor communication: decreases confidence and trust in medical care; deters the patient from revealing important information; causes significant patient distress; leads to the patient not seeking further care; leads to misunderstandings; leads to the misinterpretation of medical advice; underlies most patient complaints; and predicts negligence claims. These difficulties may lead to poor or sub-optimal outcomes for the patient.

90 LEARNING A NEW SUBJECT!! ALL NEW TEXT BOOKS FOR DOCTORS!! WE HAVE ENOUGH ON OUR PLATE WITHOUT HAVING TO ADD ONE MORE!!!!!!!

91 PATIENT-RELATED OBSTACLES The patient may be: affected by the condition, illness or medication; anxious, embarrassed or in denial about the medical condition; inexperienced in identifying and describing symptoms; intimidated by health care settings; overawed by the doctors perceived status; disadvantaged by differences in language and culture; confused by the use of medical jargon; reluctant to ask questions; or concerned about time pressures.

92 COMMUNICATING AFTER A PROCEDURE!! "...and we call it 'exploratory surgery,' not 'poking around.'"

93 THE BIG DOCTOR THE OLYMPIAN HEIGHTS

94 GIVING BAD NEWS!

95 CULTURAL AND SOCIAL DIVERSITY Doctors see patients from a range of ethnic, cultural and socio-economic backgrounds. Social and cultural factors may determine such matters as why patients attend, and may influence the patient-doctor interaction and compliance. Doctors should strive to ensure good communication regardless of the social or cultural background of patients. Communication is facilitated when the doctor is aware of and sensitive to the background or cultural needs of the particular patient.

96 ALLOW FOR CULTURAL DIVERSITY

97 SUGGESTIONS PRIOR TO THE CONSULTATION The reception staff should be able to recognize the severity of the medical disability.

98 SUGGESTIONS INITIATING THE CONSULTATION Establishing rapport and active listening. Personal introductions Acknowledging issues such as appointment time delays

99 SUGGESTIONS DURING THE CONSULTATION ACTIVE LISTENING ASSISTING THE PATIENT HELPING UNDERSTANDING COMMUNICATING TO FACILITATE INFORMED DECISION MAKING

100 SUGGESTIONS DURING THE CONSULTATION PROVIDING INFORMATION ABOUT DIAGNOSIS PROVIDING INFORMATION ABOUT INTERVENTIONS COMMUNICATING BAD NEWS WITHHOLDING INFORMATION

101 WITHOLDING INFORMATION

102 HOW TO ADMIT A COMPLICATION "I'm afraid I have some bad news, Mr. Carstairs... but first I have a banana."

103 SUGGESTIONS DURING THE CONSULTATION USE OF PATIENT ADVOCATES AND CARERS ADVISING PATIENTS ABOUT ADDITIONAL SOURCES OF INFORMATION OFFERING AN OPTION OF A SECOND OPINION WHEN OPTED FOR CLOSING THE CONSULTATION

104 OFFERING A SECOND OPINION "His mother's here in case you want a second opinion."

105 RECORD KEEPING Adequate, accurate and comprehensible medical records are an important part of good communication. The medical record is an essential part of the communication process because continuity of care involves continuity of communication.

106 THE PATIENT'S RIGHTS 1. You have a right to be told all the facts about your illness; to have your medical records explained to you; and to be made aware of risks and side effects, if any, of the treatment prescribed for you do not hesitate to question your doctor about any of these aspects. 2.When you are being given a physical examination, you have a right to be handled with consideration and due regard for your modesty. 3.You have a right to know your doctor's qualifications. If you cannot evaluate them yourself, do not hesitate to ask someone who can. 4.You have a right to complete confidentiality regarding your illness.

107 THE PATIENT'S RIGHTS 5. If you are doubtful about the treatment prescribed and especially an operation suggested, you have a right to get a second opinion from any specialist. 6. You have a right to be told in advance what an operation is for and the possible risks invoved. If this is not possible because of your being unconscious or for some other reasons, your nearest relatives must be told before they consent to the operation. 7. If you are to be discharged or moved to another hospital, you have a right to be informed in advance and to make your own choice of hospital of nursing home, in consultation with the doctor. 8. You have a right to get your case papers upon request.

108 WHAT IS MEDICAL NEGLIGENCE? Medical negligence is defined as a failure to exercise reasonable skill and care in diagnosis and treatment as per the prevalent standards as that particular point of time.

109 REFUSAL TO TREAT There are situations where adequate communication is not possible. It is important to recognise that doctors have the right to refuse to consult and/or treat patients. This might apply when patients are violent or abusive, or when they fail to provide necessary information. In these circumstances, doctors should communicate this refusal to the patient as courteously as circumstances permit, along with the reasons for the refusal, and ensure that alternative care is offered or made available.

110 NEW PROBLEM FOR THE NEWEST GENERATION INVASION OF EVERY SECOND OF OUR EXISTENCE WITH THIS MODERN MARVEL – CALLED CELL PHONES

111 THE ULTIMATE EFFECT

112 COMMUNICATING WITH THE REST OF THE TEAM!!! "Are you sure he's anesthetized?"

113 THE ABILITY TO WRITE CLEARLY ON A PRESCRIPTION If you're stumped, why not write an illegible prescription and hope the pharmacist comes up with something?"

114 COMMUNICATING WITH PATIENTS

115 LEARNING THE ROPES

116 THE ABILITY TO SPLIT THYSELF!! EMERGENCY DOCTOR …. YOU ARE WANTED ON THE 3 RD, 4 TH 5 TH FLOOR AND ALSO IN TRAUMA

117 THE ART OF MIS- COMMUNICATION I DONT GET TO DO THAT 7 TH FLOOR GALL BLADDER

118

119 COMMUNICATING WITH YOURSELF

120 EVERY HOSPITAL CHANGES!!

121 "He was kicked out of medical school. He flunked anatomy."

122 COMMUNICATING WITH PATIENTS Pay no attention to the moaning sounds. They're coming from the cashier's office."

123 REMEMBERING MEDICAL INSURANCE!!! "Tell me more about your hospitalization policy."

124 COMMUNICATING ABOUT DELAYS!!! "There'll be a short wait for a table."

125 COMMUNICATING WITH THE REST OF THE TEAM!!! "Are you sure he's anesthetized?"

126 COMMUNICATING WITH THE REST OF THE TEAM!!! "Are you sure he's anesthetized?"

127 DOCTOR-TO-BE The dissection of human cadavers was controversial from ancient times. The first public demonstration of human anatomy came in 1315; Mondino de Luzzi, an Italian surgeon, published Anatomia, the first manual on dissection. The Renaissance saw a resurgence in interest in anatomy, in part urged by the studies of such artists as Leonardo da Vinci(1510). Medical Students, Boston, ca

128

129 A HUMAN BEING HAS TWO KIDNEYS. WE TOOK OUT ONE- HOW MANY DOES HE HAVE NOW/- ANYONE??

130

131

132

133

134

135

136

137


Download ppt "COMMUNICATION IN MEDICINE Dr Sanjay De Bakshi MS; FRCS."

Similar presentations


Ads by Google