In Search of Unity in Diversity.

Sir,

I read with interest the article by Selvan C, Tejal L, Shweta C et al.[1] on Indian Physicians’ perspective on patient communication to promote diabetes adherence.

I congratulate the authors for conceptualising and completing this process-oriented research in the oft-neglected area of communication skills among the medical fraternity, wherein this very important soft skill is treated more as a gift than a structured-learning skill. The study offers a sector-wide cross-sectional view of the current consultation practice in a variety of settings but is skewed more towards the urban areas – a limitation recognised by the study team.

Notwithstanding the limitations of the cross-sectional nature of the study, this research offers valuable insights into the consultation trends in terms of the duration of each consultation and the nature of those consultations. It is interesting to note that nearly half of the consultations are around 10 minutes, which is not different from the individual consultations with general practitioners in the UK.[2] Whether 10 minutes is long enough for discussing a chronic condition like diabetes could only be determined by well-designed and outcome-oriented research.

This study also brings to light impressive innovations and structures that individual clinicians have adapted in their practice. Further work aimed at identifying best practice examples and sharing them with a wider fraternity through regional and national organisations could increase awareness among clinicians, reduce the variability of practice, and improve patient experience and satisfaction. The same opportunity could be used to learn from the best practice examples from across the world like the co-creating health from the UK which focuses on patient activation for collaborative decision-making.[3]

The authors have excluded any sub-analysis of the data in this paper. They were perhaps limited by the lack of statistical power due to the small or variable sample size, but it would have been valuable to know the differences in communication strategies between the primary and specialist group; younger and older clinicians; men and women; government and private sector. In addition, the influence of the socio-economic status, education level, and cultural background of the service users on the nature of the consultation. Unearthing common threads in clinical practice may yield pearls that could lead to innovative and cost-effective and high-quality care in India, a country that rightly prides its unity in diversity.

Finally, this study snapshots contemporary medical practice at a time when chronic stable disease management is moving towards virtual consultation models as follows: telephone; video; web-based; hybrid. In these models, it becomes a chronicle whose historical value will continue to grow with time.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.