“Competition or Collaboration” in OBGY practice
“Competition or Collaboration” in OBGY practice
Competition and Collaboration are two very strong words. Let us try and fit them into the world of gynaecology!
Beginning with some basics, collaboration is individuals or groups working towards a common goal where as competition is individuals or groups working against each other to achieve their own goals.
Fundamentally, the culture of medical practice has always been one of cooperation. This does not discount the fact that competition doesn’t exist. However, the primary focus is always one overarching goal, which is optimal patient care.
All of us associate a gynaecologist with someone sitting alone in a nursing home and multitasking all roles in one go.
Conceptually, I agree that in solo practice, one is “in control” of everything.
As a solo practioner, you are the accountant, technician, administration, in charge, marketing specialist and somewhere you are also a clinician! The question to be answered is “Are we compromising efficiency at the cost of multitasking?”
There has been a paradigm shift in the medical practice even in the past 20 years and it is time for us to change!
OBGY which was once considered to be a terminal specialty branch has today branched out into so many super specialities. Each super specialty is one of its kind, namely, high risk obstetrics, minimal invasive surgery, IVF, fetal medicine, gynae oncology, cosmetic gynaecology. It is merely impossible for one person to justify being good at all of these at the same time! The age old saying” Jack of all trades, master of none” holds true in this aspect.
It is an established fact that our practice today is governed to quite an extent by the internet. Google reviews and social media is part of the game and none of us can shy away from it.
Patient profile and patient’s expectations have drastically changed over the past 10-15 years. There is so much more awareness and information available to them at the click of a button so it is unfair to blame them!
We need to adapt to these changes and find the best medical practices to suit the needs.
One of the prime expectations today is a friendly, approachable and non-judgemental gynaecologist who will give enough time and answer their queries patiently. It is quite common for the first consultation of an infertile couple going on for nearly 30 minutes. Each one of us are here to satisfy our patients. How can one person single handedly cater to the needs of “today’s patient in trying to multi task all other roles as well?
Let us not waste time, my dear friends. Let’s put the “we go” before the “ego”. Ego is inversely proportional to knowledge. Let’s form a team and move forward. The team can consist of just two members or several more.
Clinically, we have so many advantages of team work. It provides comprehensive care to patients, ability to handle high risk patients better, better surgical outcome in advanced surgeries and peer consultation enhances decision making.
All obstetric emergencies, PPH, eclampsia, maternal collapse, amniotic fluid embolism, cord prolapse etc have one common point in the algorithm guidelines which is “Call for Help”. It is much more practical to have all the help already present with you in your workplace while working a steam than to panic in an emergency.
There is a very fine line between confidence and over confidence.
It is almost impossible to do advanced gynaecological laparoscopic surgeries without a team, irrespective of the calibre of the surgeon. Having a qualified gynaecologist with you while performing high risk surgeries is like the icing on the cake. It definitely smoothens the surgery, reduces surgical time and gives better patient outcome.
Communication with colleagues and sharing clinical experience enables us to handle patients better. Sometimes, just a clinical discussion regarding a patient in OPD provides a different perspective and help tremendously in taking apt decisions.
In health care, “Everything under one roof” has become the norm of the day.
Nowadays, to provide infrastructure even in a solo setup up to the patient’s expectations is quite a daunting task. It involves huge investments and bank loans. Sharing overhead costs and splitting expenses will definitely give long term benefits.
OBGY practioners face one of the highest litigations amongst all branches. 85% of gynaecologists face at least one litigation by the age of 65! Medicolegal cases are on the rise in India, just like Western countries. Risk sharing with partners reduces the burden to a large extent.
Combing strengths and weaknesses of partners in a team has benefits too. One of the partners could be more interested in the handling the clinical work while the other partner could be more interested in the administrative aspect and this works very well for both.
A solo gynaeoclogist is on call 24 x7 hours, 365 days a week. A group practioner on the other hand, can work for limited efficiently dividing the duty hours with colleagues, in turn increasing work efficiency.
Work- Life Balance is always questionable for most doctors.
Burnout at younger age due to excessive working hours and stress affecting the health of doctors is not uncommon news nowadays. We cannot fall prey to this. We need to take control and make changes to have enough “me time” to remain fit and healthy.
We need to start developing trust in our colleagues. Who said colleagues can’t be friends? Back up your colleagues so they back you up too! All of us work hard and we deserve vacations and breaks without having any stress of whether the patients are being taken care of well. The systems need to set from the beginning to make things work well in the long run!
NHS, UK has 4 main domains for good medical practice, one of which is communication, partnership and teamwork. There are a lot of research publications reiterating the fact that inter professional collaboration improves work efficiency.
We have learnt right from our medical school days “There is competition everywhere”. It is true, but always compete with yourself to become a better version of yourself!
I strongly believe that we cannot compare medical practice today even those who started 20 years back. For our generation of doctors, collaboration is probably to only way to sustain!
I genuinely believe that group practice is the future !
Hats off to all hardworking doctors!