I make it a point to include a statement of uncertainty when offering my assessment and plan to patients in situations where a constellation of symptoms don't immediately add up by the end of an office visit. Am I right to do this? Well, I don't know.
Physicians need to lose the paternal attitude, embrace the new doctor/patient paradigm and gain some new partners who can help us prevent disease, manage big health global concerns (heart disease, cancer, hypertension) and shape a healthier world.
Being aware of what's happening in the room -- paying attention to the process -- requires an intention, a willingness to be present, to show up and engage with our patients in a way that is mutually respectful.
Lots of people are using complementary and alternative medicine (CAM) these days -- things like vitamins, homeopathic or herbal medicine, chiropractors, acupuncture or massage therapy. But they don't always tell their doctors about it.
Many people are demanding better oversight of drug manufacturers in the wake of the recent fungal meningitis outbreak. But few people are asking an even more important question: Why were these patients getting questionable -- and mostly unnecessary -- steroid injections in the first place?
Patients like Robert make clear that the very personal meaning patients find in their illnesses can be profoundly empowering. All too often, however, health care does not allow patients to explore the personal significance of their diseases.
Has this ever happened to you? You are at an appointment with your doctor. She asks you for something, say, the dosage of your cholesterol medication or the results of your recent blood draw you had. You think to yourself, shoot, if only I brought that with me!
Seeds of knowledge and understanding for patients sometimes get integrated easily, and sometimes it seems impossible. I am reminded to never give up on a patient just starting out, some people take longer to make changes.
Helen's shortness of breath forced a trip to the emergency room. Over a seven-day course of treatment Helen was handed from one doctor to the next, accumulating a patchwork team of six doctors who worked sequentially rather than together.
Doctors have created dictionaries full of terms, in Latin no less, to talk to each other about medical issues. Why on earth can't they come up with a list of terms in English, words they trust patients can use to tell them exactly what feels wrong with us?
The doctor/patient relationship is highly personal and complex. The physician must maintain a professional rapport and the patient's dignity, respect the person's privacy, and convey an impression of competence.