Friday, September 12, 2014

Patients, still dumb?

   Gone are the times when patients were unaware of their clinical condition and used to reply solely on doctors' advice. On the other hand, they have become proactive in clinical decision making and it's implementation.
  The good thing about it is- there is more awareness. Involving patients and relatives will improve Health care in the country. This provides a thrust to the new form of therapy- "the information therapy" where along with the conventional "therapy", the health care provider will take informed decisions from the patient concerned and it's relatives. 
   However, we still continue to treat them as dumb people. I would give you an example-
   "We were having clinics in the side room of ward 12 on 10/9/14. The case which was being presented was of GI system. The presenter began- "my patient....present with chief complaints of jaundice, abdominal distenss " and the teacher snapped in between- "you shouldn't say jaundice. Because the patient will never himself say he has jaundice. What he will notice is yellowish discolouration of the sclera(first) and skin(later). So instead of saying "jaundice" we should say "yellowish discolouration of the sclera and skin"....even though the patient clearly mentioned he had jaundice. The Essense of Histroy Taking, I believe is a record of the conversation between the doctor and patient. So the same words should be used
     There comes an argument to this proposition-
•the patient may be wrong in his diagnosis as there will be differential diagnosis to yellowish discolouration
    In that case, none of the two know what really he has. So it doesn't make a difference, does it?