A pediatrician who desires to be a champion, should be academically strong, financially stable, physically fit and mentally joyous, and must excel on all the three fronts – rational practice, community service and personal life.

Pediatric practice requires a scientific approach combined with learning the art of delivering compassionate care. Science expects us to periodically update our knowledge, sift through evidence-based medicine, develop appropriate skills, apply these principles to our patients, and guide the parents through difficulties in parenthood. The art of dealing with the caregivers has to be learnt through hard-earned experience, taking years if not decades to perfect. Medical practice has many ‘non-academic’ dimensions:

Firm- (i.e., business) that includes planning and building our health care facility, training of personnel, logistics of practice, pros and cons of different models of health delivery, legal statutes and regulations .

Finances- Generally doctors are challenged, when it comes to financial matters. It is vital to become financially literate and consider all options before any financial decision. It includes book-keeping and taxes, investment options, retirement planning and savings.

Fitness- The price we pay for long hours in our practice and unhealthy life style is compromise in fitness as we age. Fitness includes the appropriate measures that can fit in our busy lives, practicing these in a regular basis, and the realization that fitness is essential.

Factual- Knowledge is based on scientific facts, and the process of acquiring knowledge, skills and attitude depends on a methodical approach to learning Pediatrics. One could look at multiple learning options and ways in which this knowledge could be accessed in times of need.

Family-Though family is rated high in any doctor’s priorities, it is sadly neglected when it comes to real life. We need to explore various strategies to harmonize work- life balance, and improve the quality of precious family time.

Fraternity– i.e,. involvement with friends and colleagues. Success in practice depends on our association and friendship with various leaders and opinion makers in the community. Public relations, community projects, and social media are some of the main approaches.

Force- i.e., motivation. What motivates us to give our best, excel in what we do – not once but daily, year after year – should be analyzed . Motivation compels us to re-define our goals and values, and act accordingly

The parents must experience a clean, odorless and pleasing clinic right from the entrance to the exit. If we enter on time, it reflects that we value patients’ time too. If we are not punctual, the staff members too do not develop discipline, and over a period we lose moral right to ask them to reach on time. It is desirable to segregate the patients in the waiting area if the space permits. Parents dissatisfied with treatment may ‘infect’ parents sitting next to them, and some of the newcomers might leave without our knowledge! Displaying mementoes, certificates and newspaper clippings adds to our authenticity. It goes without saying that the clippings should praise us (A friend of mine had put a newspaper clipping carrying a news item about a case against him in the consumer court!). One can delight the customers by gifting a toy or offering a cup of coffee.

One must be particular while selecting the staff members. A receptionist with a good IQ is a real boon for the set-up, and must receive good PPF (Payment, Praise and Food). A well-paid receptionist won’t speak ‘ill’ about the clinic/hospital or the management. It is desirable to praise the staff in front of everyone, and reprimand only in person. Simple gestures like sanctioning holidays, financial support in times of emergency, celebrating birthdays, and displaying the photograph of ‘staff of the week’ go a long way in building the team. The team spirit is very important and the pediatrician should lead by doing – if a cotton ball is lying on the floor, one should pick it up and put it in the dustbin. The staff members should look forward to reach the clinic every day out of affection and emotional attachment, and not only for earning their daily wages.

A pediatrician must use all his five senses (smell, listen, look, speak, touch) for communicating with the parents. Listening is the first step towards empathy. If we reshuffle the alphabets of ‘LISTEN’, we get ‘SILENT.’ One has to be silent while listening to the parents. Looking into the eyes of caregivers reflects our transparency and truthfulness. We must call every child by name. Whatever we SPEAK must convey our Sincerity, Personality, Experience, Authenticity and Knowledge. We must not forget to praise the caregivers for keeping the child neat and tidy, for proper administration of medication etc. Nothing impresses parents more than a thorough clinical examination. Even the poorest of the poor patient understands whether the doctor has examined the child properly or not.

As the time passes, we acquire a new degree called DHDP (Diploma in Handling Demanding Parents)! One must not get irritated while dealing with Inquisitive and Troublesome (IT) parents. It is necessary that you put yourself into the shoes of anxious parents. One must appear serious in the cabin while giving consultation. In a lighter vein, a successful pediatrician (male) should have a bald head, a pot belly and piles! Bald head indicates experience, pot belly shows your prosperity, and piles give a sense of anxiety on the face – parents feel that the pediatrician is very much concerned about their child’s condition!

Prescription has to be written in a legible handwriting. Many doctors are careless about two HWs – Handwashing and Handwriting. Medication errors are too common, and must be avoided by writing clearly and neatly. It is necessary to make parents aware that prescribing medicines telephonically may prove dangerous for the child. The best telephonic advice for some of the common symptoms is water – for acute watery diarrhea it’s oral rehydration salt (ORS) packet prepared in a liter of water, for cough it’s lukewarm water with honey, and for fever it’s tepid sponging with water! One must avoid irrational use of antibiotics, cough and cold remedies, anti-diarrheals, micronutrients, and so called ‘appetizers’, ‘tonics’ and immunity boosters. The best vaccine that a pediatrician can offer to the parents and children is HE vaccine – Health Education. All parents should receive BIG advice (about Breastfeeding and complimentary feeding, Immunization and Growth-development). The potency of ‘HE Vaccine’ should be maintained in the COLD chain of Continuous Observation, Learning and Dissipation of information.

Commerce of practice is equally important as the art and science. Remember the mnemonic EARTHS while billing. Give an Estimateof expenditure, collect Advance, be Reasonable and Transparent, present the bill under different Headings, and inform about Seriousness of the condition. A sensitive pediatrician should have the ability to ‘feel’ the tears in the eyes of parents. My teacher taught me to be a good human being first, and then a good pediatrician. Most of the medicolegal problems in practice are either due to lack of communication or excessive billing. For achieving Pedicolegal fitness (One of the IAP Action Plans 2016), one must remember the ABCDEF of don’ts which includes Arguing, Behaving rudely, passing Casual remarks, Discussing in operation theaters, charging Exorbitantly, and False Promises!

During this year, all the IAP action plans came out with flying colours, and got distinction in child welfare! Every program now begins with an IAP song. IAP’s ‘Immunize-India’ programme is now the world’s largest and most successful vaccination reminder programme with 1.5 million children enrolled. An immunization helpline for answering the queries related to immunization is under way. We are actively involved in Mission Indradhanush, and we will ensure that the indradhanush (rainbow) is not short lasting, but becomes mission P (Persistent)-indradhanush. The IAP growth chart app has become a great asset to the existing armamentarium of a pediatrician. The module ‘Cradle-to-crayon’ has been fruitful in sensitizing pediatricians towards early childhood development. SOS (Survival of Sickest) module has helped immensely by changing the behaviour of pediatricians while Handling Office Pediatric Emergencies (HOPE). DTDC (Day To Day Challenges), Adieu to anemia, RAPID (Rational Approach to Pediatric Infectious Diseases), Fighting with Fahren ‘heights’, pediatricians as adolescent health ambassadors, and paren‘teen’ing are some other successful programs. A periodic bulletin called ZODIAC (Zinc, ORS, Diet, Immunization, Antibiotics and Cleanliness) has been a great boon for improving the prescription rates of Zinc and ORS. The outstanding faculty of the module ‘Clearing Pediatric Airways’ is delivering oxygen of outstanding scientific contents to IAP’s alveoli – the members. My role is like a surfactant, facilitating air exchange to reduce the hypoxia of ignorance. Ideal start to human life is a program to focus on the best delivery room practices. A chart of "Delivery Room Mantras", wherein a newborn is appealing to the caregivers, is being given to every pediatrician for display in the delivery room. We have started an online certification course on human lactation management, called ‘Feeding Fundamentals.’ The guidelines and policies related to immunization, vitamin D and rickettsial disease have been drafted by experts. IAP’s ‘Poshan’ project, launched last year, is the largest ever mother’s education program to prevent malnutrition, which will educate 25 million women in 3 years. The babycare diary has proved to be extremely useful for parents to record the progress of the child, and is being translated in all the major languages. We have launched IAP-TV to educate parents in pediatrician’s waiting rooms, eventually educating 33 million mothers every year. In partnership with the government and development organizations, IAP has planned to formulate a tasty protein and micronutrient supplement for mothers. This will be available at affordable rates and also subsidized for poor women.

The major causes of childhood mortality in our country are Neonatal, Immunization preventable diseases, Diarrhea, Respiratory and Anopheles-related (Malaria). A pediatrician has to strive hard to get our country out of this ‘NIDRA’ (sleep). One must remember that the remedy to India’s health is hidden in dealing with PSM (Poverty, Sanitation and Malnutrition). An IAP member should use Intelligence, Authenticity and Pyaar for children to become a social champion, and devote two hours a week for Public health, which is the third side of life’s triangle in addition to Practice and Personal life.

I appeal all IAPians to get actively involved in IAP activities. One cannot learn swimming by reading a book . You have to dive into the pool. So take a dive into the pool of IAP activities. You will not merely experience the change within; you will also unleash the power within. If science of pediatrics is complemented with three aces – art of practice, academic excellence and advocacy for issues of public health importance – pediatrics will become a lifetime enjoyable experience.

Let me conclude with a story of a king who had 17 elephants. On his death bed, he expressed his desire to his minister to distribute half of these elephants to the eldest son, one-third to the middle son and remaining to the youngest son, and breathed his last. The minister got confused about division of this uneven number of elephants. But then an idea clicked his mind. He added his own elephant to the 17 making a total of 18 elephants. He then gave half of 18 (i.e. 9) to the eldest son, one-third (i.e. 6) to the middle one and 2 to the youngest son making a total of 17, and walked away with his 18th elephant. Friends, I feel that the role of every IAP president is to bring in his 18th elephant to facilitate proper functioning of the organization, and walk away with his elephant after completing his tenure!