Dr. Vinayak S Hiremath - A Good Doctor Must Never Assume That Patient Relatives Will Understand All the Implications of a Patient's Condition (Endocrinologist & Immunologist From India)

Patient relatives need to understand the disease the patient is suffering from from a medical perspective. A good doctor must never assume that they will understand all the implications of a patient's condition. It’s important that the doctor knows what questions to ask to make sure that the relatives know the true state of their patients’ health.

1. Tell us about your upbringing, background, and journey?

I hope you all are at the pink of your health; I shall quickly acquaint myself: 

By profession, I am a Doctor, but my passion is fitness, self-care & impacting people by healing their sufferings & pain, and this inspired me & my better half to open “R-DOC”, an NGO for the health and wellness of society. 

I live with my incredible family in Cochin, Kerala; I love making digital healthcare facilities & medical specialty services functional to remote places in India where everyone in the country can access excellent healthcare services from anywhere, anytime. 

Some facts about me:

I am the youngest Indian doctor to have received “The Pride of Nation” Award in 2019 from the honorable Defence Minister of India - Sri Rajnath Singh Ji, on Kargil Vijay Diwas for my exemplary contribution in the field of medical science and diabetes.

I cleared the prestigious MRCP ( UK) exams and became a member of the Royal College of Physicians of the United Kingdom in 2020. I also hold a fellowship in Immunology from Harvard Medical School USA & a specialty degree in Endocrinology and Diabetology from the UK.

I completed my MD in Internal Medicine and MBBS from Rajiv Gandhi University Karnataka, India 

My upbringing and primary schooling were done in Gulbarga, Karnataka, which is my home town and this is where my journey of a medical career began. 

Currently, I am working as a Chief Medical Officer & Chief Consultant Physician, Endocrinologist & Immunologist at KMK Hospital, Cochin, India.

2. Why did you choose to be a doctor and decide what you specifically want to do?

 

We all get this one question, Why medicine? Why the hard journey? Why go through it? To be honest, this is not something you can easily explain. It is a very personal dream, a very strong dream. The desire to help others is indescribable. Medical school is not a place for smart people but for those who are insane enough to dream of it, pray for it, work hard for it, and live for it. 

It is for those who are crazy enough to want the sense of purpose that fuels their veins. And if it is insanity, then let it be, for even if it means more sleepless nights, more examinations to pass, more years in the university, and more sacrifices to endure, nothing will change. 

I will still keep choosing & choosing This path over and over again, even for a hundred more days and a thousand more years. And nothing in this world can stop me from taking an adventure as worth taking as this, even for a million more lifetimes. 

Being specialized in the field of diabetes, I learned that India is facing an epidemic of diabetes, and we are heading towards being the Diabetes Capital of the world; lakhs of deaths occur due to diabetes complications, and still, I can see society’s delinquency for diabetes and lack of awareness about diabetes and poverty to buy the medicine - insulin, and inadequacy of diagnosis in the pregnancy, so I started doctoring Diabetes, organizing awareness camps,  delivering free insulin to Gestational (pregnancy) diabetes as my passion & service.

3. We salute your work during the pandemic, where did you get the inspiration to work so hard?

“Life throws you curves but you learn to swerve.” No one is ever really prepared for God’s more excellent plans, but we figure it out, taking it one day at a time as nothing in life is to be feared, it is only to be understood. Now is the time to understand more, so that we may fear less."

"A life lived in fear is a life half lived." These are the thoughts our teachers taught us at the very beginning of our medical school.

Although my experience was not as life-altering as this COVID-19 challenge is today, I remember we are constantly trained in such an environment. To quote few obstacles which made me stronger was when we had severe floods in our state, Kerala, and the whole health system was dangled, we toiled 24/7 in floodwaters to take care of our patients & then we had a post-flood epidemic of deadly Nipah virus outbreak. 

Hence, the battle was constant from the beginning. The inspiration to work hard was in the blood for me even from my Med school days, And the monstrous of all challenges for the frontline workers like us was the COVID-19 pandemic. 

This uncertainty is part of life and we WILL get through it. It will make us wiser, stronger, and more resilient. That’s the Pioneer Spirit & when everyone else is trying to avoid it, we frontline healthcare workers are risking our lives to cure it and save others. This is undoubtedly the beauty of this profession.

4. How do you expect digital health to grow over the next 5 years?

Covid 19 has already taught us the need for revitalization of healthcare & the need for Telemedicine. In the next five years, the Digitalisation of healthcare and AI will play an essential role in inpatient care. We would be able to deliver high-value and responsive health care offers by assisting with routine medical check-ups. 

Digitization of health care provides very comprehensive & high-quality care at a reasonable cost. It makes life easier by simplifying the unnecessary complexities that impact the health of our communities. From a diabetologist's perspective, we now have CGM’s(continuous glucose monitoring machines) that monitor the blood sugars of patients and the doctor can digitally on video consultation guide on the treatment which is easily functional with smartphones, and better insulin pumps to manage diabetes more digitally. 

Monitoring vital signs like blood pressure, temperature, oxygen saturation, pulse rate, respiratory rate, ECG to more advanced digital podiatry assessment equipment where the patient’s foot can be examined and managed digitally. This will reduce the patient’s burden and also the risk of visiting hospitals often. All in all, it helps clinicians to keep track of their patient’s health satisfactorily.

5. What are your concerns about Digital Health?

Digital health stepping into the Pandora of the unexplored field which will have its own flip sides.  The current COVID-19 pandemic, in particular, has led to a rapid increase in the use of digital health technologies to access health information and care providers; It is very crucial in understanding how these new forms of interaction between doctors and patients define the relationship and perceptions of what 'good care' will be. 

Sociotechnical approach, doctor-patient connection? Human Touch? Clinical Examinations? Will it be at stake? Will the self-diagnosis intensify? On the other end, where 80 percent of the population stays in rural, the use of technology will be complicated. However, it is also essential to recognize that a health platform economy that utilizes new business models and market principles for growth can be ethically controlled? 

The underlying business models and data flow remain primarily opaque and jeopardize the public values.  How do health platforms and applications protect privacy?  How do they contribute to equality in health and treatment?  How do they enable informed consent regarding the reuse of citizens' data?  These questions require the development of new governance frameworks and address the wider platform ecosystem. 

The infrastructure upon which digital health operates is largely owned by a few big technology companies that run search engines (Google), cloud spaces (Amazon), app stores (Apple), and operating systems (Microsoft).  The term digital health captures a range of diverse and complex sociotechnical practices. Digital health raises require co-designing appropriate models and pathways for future care delivery.

6. Can you let us know anyone application of Digital Health in your country which has impressed you?

As emphasized already, many Physicians are using a number of tools to treat patients without actually touching them. To name a few tools, CGM, Digital Foot Scans, SanketLife Pro Plus Wireless ECG Device. Also, the consultation apps like Practo, lybrate allows video consultation. 

Also, the toll which impressed me is Vivalink which lets patients record their body temperature through a type of stethoscope that allows the physician to listen to a patient’s heart and lungs remotely, and also includes tools to send images of their ears, throat, and skin, capture information on a user’s pulse, respiratory rate, oxygen saturation, skin temperature, and step count.

7. What is your message for aspiring doctors and the young generation? Which is the best medical college according to you?

Pursuing the practice of medicine is a pursuit of passion.  The desire to help at the most fundamental level, saving and protecting lives, and apply knowledge and compassion to make lives better is in the DNA of most doctors.  

You have to have a strong desire and passion for the work to endure the long arduous education and training process. It is a very diverse clinical practice. To operate with joy in the new profession of medicine, a new ecosystem. My mantra to be a good & successful doctor is to:

Simplify:

A good doctor must use simple terms to explain and understand their patient's condition to the respective relatives and bystanders. They should be able to decide on the management and treatment options. If possible, he must speak the dialect or use the native tongue instead of medical jargons that may confuse the patients and bystanders. A simple drawing or illustration will also help so that they can visualize what is happening to their dear ones.

Ask Questions

Patient relatives need to understand the disease the patient is suffering from from a medical perspective. A good doctor must never assume that they will understand all the implications of a patient's condition. It’s important that the doctor knows what questions to ask to make sure that the relatives know the true state of their patients’ health.

Listen Attentively

Once the right questions are asked, a good doctor must listen and echo the sentiments of the patients to make sure that he gets the correct information. To add up to the point, you should also be a good listener to your juniors or nursing staff.

Take Time

No matter how busy a doctor is, he must spend time to explain to the relatives that the patient's improvement and recovery will involve their presence and participation and also spend time sharing the experience with colleagues and staff.

Praise

A good doctor must never be short of words when it comes to recognizing the efforts of the juniors or colleagues or staff.

8. What does your typical day look like and What do you like to do besides work?

My typical day would be showing up to work for 12 hours and breathing. Since I am more into fitness, if it's taught us anything, it's that we need to be getting out of bed much, much earlier. I read some inspiring books about successful people, meditate for few minutes, plan the to-do’s to be performed for the day, and head out for jogging to get some fresh air. 

I have been located in a very scenic locality filled with nature and gorgeous views from our grand gallery. I spend sipping coffee with my wife. Head up to the hospital, catch up on meetings, handling patients, conducting the rounds asking about the well-being of the patients, conducting seminars, handling the busy OPD’s, squeezing some time to make some research-related publications, and wrapping up with the chief of staff around 7pm. 

Hearing my medical podcast driving back home. Grabbing a light dinner. I have set a non-negotiable two hours of time after dinner to give free consultation on my very own digital platform to help covid -19 patients all over India. Within a  quarter of my consultation, I was able to reach out to 4k covid positive people pan India. 

Crashing the bed early. Besides work, my love for travel helped me explore various beautiful places, understand various cultures, various diversities, food styles, etc across various states, various countries. I am also an occasional chef who loves eating and love feeding too. I am also conducting various CME’s as a speaker to highlight the various new update in the field of medicine.

Dr. Vinayak S Hiremath

Chief Medical Officer & Chief Consultant Physician, Endocrinologist & Immunologist at KMK Hospital, Cochin, India

Interviewed By: Shivansh Sharma

This interview is sponsored by Plus91 Technologies, a leading Digital Health firm.