International Journal of Academic Medicine

EXPERT COMMENTARY
Year
: 2016  |  Volume : 2  |  Issue : 1  |  Page : 98--99

Patient as teacher-innovator: An untapped potential


Ganesh Singh Dharmshaktu 
 Department of Orthopaedics, Government Medical College, Haldwani, Uttarakhand, India

Correspondence Address:
Ganesh Singh Dharmshaktu
Department of Orthopaedics, Government Medical College, Haldwani - 263 139, Uttarakhand
India

Abstract

Patient-driven innovations are infrequent events in the healthcare system. Many times, careful assessment allows us to appreciate very creative and indigenous solutions to routine clinical problems in the form of simplified technique or devices. Proper identification and diffusion of some of these practices might prove beneficial to other patients. Besides it, these small sparks of creativity rekindle the need for a good option of turning our patients into a partner in healthcare with their out of the box thinking. The following core competencies are addressed in this article: Patient care, Interpersonal and communication skills, Communication, Improvement.



How to cite this article:
Dharmshaktu GS. Patient as teacher-innovator: An untapped potential.Int J Acad Med 2016;2:98-99


How to cite this URL:
Dharmshaktu GS. Patient as teacher-innovator: An untapped potential. Int J Acad Med [serial online] 2016 [cited 2022 Oct 5 ];2:98-99
Available from: https://www.ijam-web.org/text.asp?2016/2/1/98/183326


Full Text

 Introduction



I present a short description of a recent incident that highlights an important and neglected aspect of patient care. An elderly male was admitted for fracture neck femur and was managed by endoprosthetic replacement following which he was advised bed rest for few days before guided ambulation training by physiotherapist. I advised him to keep his legs apart while lying and not to internally rotate as standard protocol to decrease chances of dislocation of prosthesis in early postoperative period. He did so with pillows or sandbags in the 1st postoperative day. In the next round, I was impressed to see that the patient was compliant to advise, and he was wearing an indigenously designed wooden frame to serve the purpose [Figure 1]. The wooden apparatus was holding his foot in natural position while lying and an underlying board was there to check rotation movements. His simplicity and innovative take on the advice of doctor, made him think, and explain his ideas to his fellow worker (he was a wooden craftsman in a shop) to create a make-do wooden apparatus according to this idea. This small incident underlines the importance of positive impact of an active involvement of the patient in their healing. Many times a quirky perspective of the patient might turn out to be productive of a simplistic idea whose time has come.{Figure 1}

Often following the arcane practice of medicine or surgery, we treat the patient as a bundle of maladies in purely physical realm. His/her intellect and creative faculties are out of sight thus out of mind amidst an environment of chaos and indifference. Doctors have failed to communicate well with patients even if they believe they fared well as studies reveal that majority of patients feel discontent with doctor-patient dialogues.[1] The importance of same thing becomes less relevant with time as doctors become busy and lose focus on holistic care.[2]

Voices from leading healthcare agencies often stir debates regarding consideration of patients as value contributing partner and thinking assets in the healthcare machinery.[3] The concept of “e-patient” that is an “empowered, engaged, equipped, and enabled” patient or group and related movement fuelled by internet, has served many patients in enabling them vision to be assistant of doctors in healing themselves.[4] Societies or websites related to patient innovations are platforms for debates, information sharing, and its propagation.[5] Many cases of innovations have been seen with patients with rare diseases or chronic needs, and proper diffusion of their knowledge might prove beneficial to society at large.[6]

We tend to overlook the fact that the patient might be a worker with particular skill set making him a stalwart in his/her own right. The views of the patient about understanding of a disease or its treatment process may be unique and deserves keen interest to unearth nuggets of fresh wisdom out of it. These observations, at times, bring innovative solutions and quick-fixes to host of clinical problems. There is no harm in asking about patient's perspective on many aspects of his journey throughout the treatment, however, irrational it may look or sound, for a gain of newer insight. Many times, patients modify certain tools or methods with their own improvisation and may benefit the society at large for their indigenous application value. Hence, the idea of turning patient as innovation partner might be a good idea of inclusive treatment.[7]

The one concern about innovations and its wider applicability would be validity for its efficacy and safety to one and all. The blind use of technology should be avoided and judicious usage of the newer techniques is warranted to safeguard the society and maintain the dictum of “primum non nocere” (“first, do no harm”). The onus, therefore, lies more on doctors to practice ethical and responsible guidance to encourage the innovation for better healing touch.[8] Apart from it, the assistance of ancillary healthcare personnel like nurses shall be equally important to monitor any untoward incident associated with new devices or procedure.[9],[10]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Tongue JR, Epps HR, Forese LL. Communication skills for patient centered care: Research-based, easily learned techniques for medical interviews that benefit orthopaedic surgeons and their patients. J Bone Joint Surg Am 2005;87:652-8.
2DiMatteo MR. The role of the physician in the emerging health care environment. West J Med 1998;168:328-33.
3Mayo Clinic. Mayo Chiefs Name a Patient as 2015 Visiting Professor. Press Release. Available from: . [Last accessed on 2014 Oct 22].
4deBronkart D. How the e-patient community helped save my life: An essay by Dave deBronkart. BMJ 2013;346:f1990.
5Patient Innovation. Sharing Solutions, Improving Lives; 26 March, 2016. Available from: https://www.patient-innovation.com/vision. [Last accessed on 2016 Mar 26].
6Oliveira P, Zejnilovic L, Canhão H, von Hippel E. Innovation by patients with rare diseases and chronic needs. Orphanet J Rare Dis 2015;10:41.
7Barnett SJ, Katz A. Patients as partners in innovation. Semin Pediatr Surg 2015;24:141-4.
8Angelos P. Ethics and surgical innovation: Challenges to the professionalism of surgeons. Int J Surg 2013;11 Suppl 1:S2-5.
9World Health Organization. Medical Devices and Equipment. Available from: http://www.who.int/medical_devices/en/. [Last accessed on 2006 Mar 21].
10Powell-Cope G, Nelson AL, Patterson ES. Patient care technology and safety. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Ch. 50. Rockville, MD: Agency for Healthcare Research and Quality (US); 2008. Available from: .[Last accessed on 2006 Mar 21].