Preface

All over the world, the medical profession faces ever growing concerns about improving the efficiency of doctors, restraining expenses and enhancing the quality of healthcare. Some believe that implementing evidence-based medical practice or pouring in more resources are the solutions. However, that might not be enough. Even resource rich and scientifically developed heath care systems are not up to scratch. there is need to change the approach of doctors to include a better understanding of behavioural issues.

Despite many years of effort, the subject of Behavioural Sciences is still very new for medical institutions in Pakistan. The extent of formal integration of the subject into medical curricula varies greatly across different medical universities. But almost all institutions recognise the need to do so. A major hurdle is a dearth of trainers and training material. Not many doctors understand the nature and scope of the subject. Not much literature is available in the local market. Large texts of psychology or sociology are indeed available but they have little direct application for medical students. Unlike some other branches of medicine, behavioural medicine is strongly influenced by psycho-social aspects of society and the socio-cultural environment of a country. Therefore, an indigenous text was required. Both authors have extensive experience of not just teaching the subject to medical students but working with multi ethnic cultures both in the east and the west.

Our challenges were many. We were conscious of the fact that the medical syllabus is already crowded and any addition to it had to be focused and highly relevant to clinical practice. What are perceived to be quite complex and sometimes unclear principles of behaviour had to be explained in simple language and presented in a reader- friendly format. We have covered nearly all areas related to behavioural medicine required to develop knowledge, attitudes and skills for a holistic approach. The book sets guidelines for trainers based on an extensively researched literature. Complete references are provided for further reading. It is an indigenous text where relevant cultural aspects from our experience and from locally published research findings have been incorporated. We also learnt that very little evidence is available in the literature and that there is a great need to encourage original research in psychosocial aspects of healthcare in Pakistan.

We are very grateful to the Higher Education Commission, Pakistan for publishing the first edition of this textbook in 2010. Our proposal was approved in 2008, the draft was peer reviewed and underwent an anti-plagiarism check before the manuscript was endorsed in 2009. Finally it has been recommended for both, undergraduate and postgraduate medical education in the country. We hope that this text will help doctors develop a humane and effective approach in their practice.