Response from Authors to Letter to Editor 'In Search of Unity in Diversity'.

Sir,

We thank the authors for their informative response to our work.

In 2020, under the mentorship of Dr. Partha Kar, Lead, NHS Diabetes, we published the “Language Matters – Type 2 Diabetes India”[1] document which was endorsed by both Endocrine Society of India and Research Society for Study of Diabetes in India. The content of the document was partially derived from recording the experiences of several patients’ encounters with their physician. The Language Matters document emphasized the need for physicians to engage in culturally sensitive, inclusive, and empathic communication with patients.[1] However, through the process of writing this document, we came to realise that it would be incomplete to introduce the need for communication skills without narrating physicians’ accounts of the medical consultation. Our current publication,[2] in the Indian Journal of Endocrinology and Metabolism is the outcome of this endeavour.

As the authors observed in their letter, it was not possible to do sub-group analysis mainly due to skewness in some of the data (e.g., area of practice). Indeed, our study was a preliminary effort with several goals: (a) to explore whether a multidisciplinary team of physicians, social scientists, and allied healthcare professionals can work meaningfully together, (c) to document the status of communication skills in Indian physicians, and (d) to generate a dialogue about the need to improve providers’ communication skills. Consequently, our study targeted a wide range of physicians which, as it is now evident, addressed our initial goals.

We appreciate the observation made by the authors regarding the consultation time of 10 min. Although comparable to the UK,[3] it needs to be pointed out that this data was the subjective observation of our study participants. There are numerous variables which can impact the consultation time such as having access to complete medical records of the patient, clearly defined issues pre-identified by the patient, interruptions during the consultations, duration of the physician–patient relationship, the medical milieu/setting (e.g., government versus private), and whether the physician had a team of allied healthcare professionals to support patient care.[45] Future research must situate the concept of “time spent in the medical consultation” within these medical and sociocultural factors in India to gain a better understanding of communication.

From our study, we are at various stages of several projects exploring topics such as patients’ experiences and expectations of their physician’s communication, physicians’ communication strategies regarding menopause and its management, empathic communication of needs and support between young women with polycystic ovary syndrome (PCOS)-induced hirsutism and their mothers, and perspectives of healthcare providers’ and patients about discussing obesity management. Through these projects, we aim to develop a culturally informed communication skills training for Indian physicians and question-asking skills for patients and their caregivers. We believe that while it is necessary to take into account best practices from developed countries (e.g., UK, USA, Australia), it is vital that we ensure cultural appropriateness. Indeed, we hope that our findings will strengthen and inform the existing approaches to communication in these countries, owing to their multicultural population.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.