The competence of consultants: A doctor wears many hats. He is at various times, a counselor, teacher, trainer, manager, leader, besides his allotted role of healer. Recognizing this, Britain has just restructured curriculums of training programs in medical specialties and subspecialties. The lists of competencies essential before a doctor can work as an independent consultant are laid out. The knowledge, attitude and skills for each competency are defined and they are systematic assessed on the job. All our emphasis in medical training so far has been on acquiring knowledge. But it is becoming apparent that besides basic knowledge of medicine, your communication skills and management skills also help to decide your effectiveness as a doctor. For e.g. areas of competencies of a general physician laid out include "ability to establish effective relationships with patients, leadership and personal management skills, organization, planning, and service management skills; education and monitoring abilities; quality standards, effectiveness, research, and development skills". Is the term "doctor" too dowdy and should it give way to something more hip and contemporary like health consultant? (eBMJ 14 December 2002)

All blood donors who test positive for HIV will now be informed of their status and counseled. This is a distinct change in policy from yester years. Why were donors not informed earlier? The reason was lack of adequate record keeping and facilities for counseling. Now there are 445 counseling centers established round the country. The unanswered questions include - should Hepatitis B or C positive patients also be informed? Will patients come back for confirmation and counseling? But with 4 million HIV infected patients in India and with no signs of respite of the epidemic, all tactics to counter it are welcome ( eBMJ 14 December 2002).

Now people are even doing research into what words used by doctors make the patient most nervous. The top scorer for inducing nervousness according to patients is "let us see what happens". This study was done from the department of general practice at Guy's, King's, and St Thomas's School of Medicine in Britain. Other confidence eroding statements included " I need to find out more, I don't know". All this is becoming important in the new age when transparency and openness is being encouraged. All said and done this study is sure to make the doctors more nervous (Patient Education and Counseling 2002: 48:171-176).

Gouri Rao Passi,
Consultant, Department of Pediatrics,
Choithram Hospital & Research Center,
Indore - 452 001, India
Email: [email protected]