Dear Neil, your question: 'How can senior clinicians can be encouraged to be more responsive and to work together as a team...' means to me 'how can we encourage these clinicians to be evidence based medicine more oriented?
I repeat myself: by obliging (obliging, not simply encouraging) them to write down a complete report of the medical contact, inclusive of diagnosis and treatment. The same as they do for in-patients, every day of the admission period: the difference is that in case of out-patient the report is given directly to the patient. Indeed health belongs to the patient, not to the doctor: he/she must know his/her diagnose and keep it with care and secrecy.
It is a right of patient to have With him/her the description of what the doctor found (signs & symptoms) and what was the suspected diagnosis.
A right, in Africa, Asia, Europe, where there is a right there should be a duty, isnt'it?
National Clinical Guidelines(NCG)should stay permanently on the doctor's desk. He wont be allowed to write down a diagnose that is not reported in NCG: medicine is one, doctors are many. Therapy will follow the same guidelines.
No extravagant diagnosis or therapy, no absurd leaflets of paper (with the logo of the clinic or doctor) that poor mothers exhibit when their cildren are sick.
Only one document please: the personal health booklet, not to be left in
the clinic (they do so in order to keep the client coming back there) but instead to stay WITH the patient.
In Africa, Asia, Europe...
HIFA profile: Massimo Serventi is a long-standing Pediatrician working in Africa since 1982. He currently works on a volunteer basis in an excellent missionary/credited hospital in north Uganda, St. Mary's Hospital-Lacor-GULU. He has worked for several NGOs in 6 African/2 Asian countries. His interests include clinical and community pediatrics, adherence to clinical guidelines and school education as the major determinant of good health.