Dr Kasturi Lal
We are aware that at present there is no accountability about treatment of cancer as specialists in each field treat each case as per his or her wishes without being subjected to scrutiny. Public hospitals treating cancer patients do not have required resource persons to meet each cancer patients care , while in one Institution the services of one speciality may be available there may be no back up facility for the other specialities. There is no one to question the authority of the treating surgeon or physician. For want of records transparency about the outcome of treatment cannot be determined. Audit about the outcome of treatment, especially reports on morbidity and mortality post-surgery, radiation or chemotherapy for each cancer and cancer specific survival are not available. We are not working in an environment for offering care to cancer patient which is evidence based.
All functionaries are in practice and like rural practice manage traditional surgical cases and are expected to provide cancer care. They donot experience professional isolation. The other non-surgical models of therapy are also using rural solution to urban problems. The existing rural resources available to deal with care of cancer are providing the same type of services as our forefathers use to give. We have not been able to cut short the referral system to outside of the state leading to agony to the patient. Qualified surgeons are required to provide urban type of care.
Training and improvement of surgical and non-surgical skills
What should bind all health professionals together should be common goal of making a difference in the cancer care services provided to our people. Complimenting each other’s areas of interest one specialist should perform the surgical model of his choice while the other specialists focus on his speciality. Crossover must occur with respect to procedures where both are required to assist each other .The non-surgical specialities should play complimentary role or they should use their therapy as primary treatment of choice.
Teach the Teacher Programme
To keep pace with rapidly evolving science, technology, knowledge and techniques over the course of a long carrier, oncologist need a trusted partner to teach them what they need to know in the way they prefer to learn. There should be principle source of knowledge and skills.There should be agencies which have the requisite experience with testing and validating what works in oncology education and have access to top faculty and latest technology.
Teach the Teacher Programmes consisting of workshops, live demonstration of operative procedure, video sessions, special lectures and interactive sessions will involve national faculty of Oncologists working in the leading institutions of the country and local health professionals working in the field of oncology.They should debate whether the existing education paradigm is , and will continue to be sufficient to train knowledgeable and confident oncologists in future, or if the system needs to be dramatically changed to fit the demand of current oncology environments. Local faculty and their mentor should give a presentation spelling out the strategy for further management of cancer patients.
In this arrangement, we will renew our existing skills and improve our ability to practising new things, driven by a commitment for lifelong learning trying to create a future which is driven by innovation and indigenous research. Technology will help us create a better future, help us become more humane. Let nothing hold us back from providing composite cancer care through
Skill development
Indigenous researches
Clinics for underserved patients and
Public participation and awareness
The promise of a profession lies within us
We have challenges that we must address. In some cases challenges can be met on individual basis while other challenges can only be addressed collectively. We can overcome impediments by ceaselessly striving to exude high character in all what we do. Primarily we should examine the quality of our own character, secondly the behaviour we exhibit with our colleagues, thirdly the health care teams which we lead, fourth the trainees we mentor and lastly and the most important the patient to whom we provide care. We must do so because the promise of our profession ultimately lies within each of us.
Exhibited examples of poor leadership
Allusive and degrading comments
Disrespectful interaction
Refusal to cooperate
Arrogant behaviour
A report revealed that adverse clinical outcome is because of lapse in character. We all intuitively know that lapses in behaviour can and will negatively affect patient care.
Research partnership to improve cancer care
Highlights
Lack of resources
Partnership between national and local faculty
Evaluation of project
How we can apply to improve surgical as well as non-surgical care in low resource cities.
It is possible for surgeons and non-surgical specialities to undertake a broad range of projects and improved delivery of cancer care. This will undoubtedly foster a future of excellence in oncocare. It would improve contacts among professionals for reliable advice. It will provide unparalleled access to opportunities for professional development and exposure to clinical expertise, enabling the local specialists to be best provider of oncocare.
Inflicted individuals are our living gods. The agencies organising such interactive sessions should be religious in our approach to serve them and eliminate cancer from our region. They should never regret their decision to conduct exercises of teach the teacher programmes. They should appreciate the support of faculty from leading cancer institutes to mentor the local specialist and look forward to build a future for oncocare in our region.
The agencies sponsoring these programmes should be aware that money, name, fame and learning do not pay, it is commitment to particular strategy that pays, and such agencies should know that great sacrifices are required to achieve goals. It is a matter of conviction.
Doctors from Jammu are very much in demand, but only outside of Jammu, small wonder that Jammu provides the look of being one medical technology savvy place. The initiative to undertake these adventures to educate the resource persons to deal with the problem of cancer care would receive appreciation. The organisers of such programmesshould be aware that mere rhetoric will never be a substitute for one to one interaction based on common understanding.
(The author is Director Lajwant Hospital for Women, Jammu)
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