…four things to expect from a physician you are meeting for the first time?

…can he or she be compassionate at all time?

…do you need to worry about his competence?

 

Photo credit: Seun James Taiwo

Models: Chuks Nonso, Ottaz Emasoga

 

Okay! I will start like this, if you are going to be spending the next 10minutes or so reading this post, take a seat, relax and take a stance; it’s either you’re a patient or once a patient, a doctor or once a doctor! My point is, I want you to go through this article with a subjective mind-set, shifting your bias to one side, either to the doctor’s side or the patient’s. Please Don’t Ask Me Where I Stand! *smiles* Well, my defence would become obvious soon…

In contemporary hospitals, whether in Nigeria or outside her shores, you are likely to find one of the following Doctor-patient scenarios

 

Scenario 1

Patient: Good day doctor, could you help tell if this drug is safe for use?

Doctor: Can I take a look, please?

Patient: Of course, Doc…

Doctor: I assume you got this from the drug store without a Doctor’s prescription…

Patient: Yes doc, a friend suggested I should take four at a time for my menstrual pains.

Doctor: Hmm… I see Madam, if I may ask, do you have peptic ulcer, I mean stomach ulcer?

Patient: (with a smile) stomach ulcer is my second name, Doc. I was diagnosed of it 10years ago. In fact I’m with this liquid drug I take at anytime I notice the warning burning sensation.

Doctor: I’m sorry ma’am, this analgesic is not safe for you to use, It may worsen your ulcer, ma. If you don’t mind I can prescribe for you one that will resolve your menstrual pain and not have effect on your ulcer.

Patient: I don’t mind at all. Thank you so much Doc, God bless you, sir.

 

Scenario 2

Patient: Good day doctor, could you help tell if this drug is safe for use, I’m having menstrual pains?

Doctor: Where did you get this kind of medicine?

Patient: From a drug store outside.

Doctor: Madam, you are not helping yourself by self-medicating. Self-medication can kill you, do you know that?

Patient: … (mute)

Doctor: And don’t even tell me you have peptic ulcer disease?

Patient: You mean stomach ulcer? Ha Doctor, I think I have o, I even brought with me my liquid medicine for ulcer pain.

Doctor: Sorry Madam, the drug is not safe for you.

Patient: But why, Doc? My friend told me to take four at a time that it would work.

Doctor: Is your friend a Medical doctor? (asking rhetorically) Just give me that, I will prescribe you a safer one.

Patient: OK thank you sir.

 

Scenario 3

Patient: Good day doctor, could you help tell if this drug is safe for use, I’m having menstrual pains?

Doctor: Please Madam, you can check your drug safety margin with your pharmacist. I have some emergencies at hand.

read about the Dos and Don’ts of Peptic Ulcer Disease here

 

Now my question is, which of the above doctors would you like to meet next time you are in a hospital?

Well, my educated opinion puts a big question mark on the expertise and relational skills of the physician in scenario 2! My reason would soon be glaring…

While not depriving us the right to conclude, in our minds, the differences in the personalities and attitudes of the above three doctors, we also need not to forget those basic qualities that are expected from a physician—that which are required of a doctor you are meeting for the first time…

Respect and Courtesy

When a patient is shown the minutest respect, there is this natural affection that radiates from the patient toward the attending doctor, consequently building confidence and cordialness. Sharing of pleasantries with courtesy—still within the professional atmosphere—gives patients this feeling of a ‘nice and competent doctor’. The doctor in scenario 1 exhibits this quality the most, it shows in his interaction with the patient. Respect for patients extends beyond pleasantries; an attending doctor is expected to show this respect for a patient’s physical body by always seeking his consent before undergoing a physical examination or procedure.

When a patient discovers a physician would– by oath—respect and keep his or her secrets, the physician automatically becomes the patient’s confidant.

 

By the physician’s oath, a physician pledges to respect the secrets which are confided in him by the patient, and even after the patient has died!

 

Patient’s time

When a physician spends quality time with a patient, the patient appreciates it! Psychologically the patient becomes stable.

In fact, by implication of the effect of a doctor’s time with a patient (in which process, he may reassure, counsel, refute, or encourage), time might be all the patient requires to be ‘subjectively’ stable.

However to a physician, time is a premium entity. While he spends 20minutes with you on your first visit, he may only be able to spend 10 minutes with you on the next visit, and vice-versa. If you get to ask why he has refused to spend enough time with you, you may get answers like,

1. He was overwhelmed with workloads and had more serious cases to attend to.

2. He deemed you clinically stable enough and hence had to maintain professional etiquette and limit extra-medical discussion.

3. In times of other emergencies, a physician may only be able to spend zero minute with you especially when you are deemed to be otherwise stable or in lesser danger than other patients. The doctor in scenario 3 would probably give similar reason for not giving his patient the required time and attention.

 

Non-judging

Once a patient realizes a doctor would never judge or condemn him based on information he shares with the doctor, he becomes confident with his physician.

Knowing that I can tell my doctor the number of cigarette sticks I smoke a day, the frequency of my alcoholism without a rebuke or reprobation gives me assurance that I may tell him anything, I mean just anything. I may even boldly share with him my sexual experiences, which—by God’s grace—may help to put an end to this weak erection I have been battling with for years.

In scenario 2, based on his interaction with his patient, the doctor would easily condemn and rebuke… By condemning, a doctor may lose his patient’s trust. Trust helps to gain good history that may eventually give out a patient’s diagnosis.

 

Professionalism

A friend once told me she used to think doctors are pompous and uncompassionate but after deeper considerations, she now realises that it was rather unfair to judge other physicians by her first and only interaction with one. She said, she now realises that if a doctor would always, at all time, be compassionate then he would one time mismanage his or her patient…and this would answer the question, can he or she be compassionate at all times?

In showing too much of Compassion and Empathy, there is the risk of deep emotional involvement. This in most cases develops first from patient and may hamper the physician’s sense of judgement, hence one tend to question his professional competence. He either ‘over-treats’ or ‘under-treats’ based on the sentiments that have arisen from his excessive compassion for the patient. The patient tends to request for doctor’s personal contacts including mobile numbers, then he or she finds it natural to seek for treatment options that may only please him/her and not necessarily the best option offered by the Doctor. Would such doctor still be able to maintain a solid professional jurisdiction? This then becomes a case of Professionalism gone familiar! In order to prevent such instance, many physicians try to limit their relationship or friendship with patients within the professional atmospheric level.

 

Also by the physician’s oath, a physician pledges to maintain by all means in his power, the honour and noble traditions of the medical profession

 

Do you need to worry about your Doctor’s competence?

I will say ‘NOT HELPFUL’

Perhaps other opinions may differ from mine, the reality is, if you start raising question marks on your doctor’s competence while still in his consulting room, you may not get the best from him. Also, it may not help to compare your attending physician with other ‘great’ doctors that have managed you in the past. Avoid trying to measure his level of expertise by asking unnecessary questions in ambiguous medical terminologies which you may have learnt on the internet, he would always have the best of you, if truly he had spent that much years to train as a doctor. Professional competence and skills do not always correlate with theoretical knowledge.

 

In coming part of D.P.P series, I hope to share with us on ‘The different types of patients a doctor is likely to treat and what to expect when meeting them for the first time. Now as a patient, if for some reasons you doubt your doctor’s management line or dislike his ways, you perhaps have the option of seeking another physician’s attention. Do not forget that the pharmacist you will meet at that pharmacy is trained to question any unreasonable prescription by your doctor, usually in the context of drug combination.

 

Kindly leave your questions and opinions on my D.P.P series in the comment box. Join me next time as I share with us from the patient’s stance.

 

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