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As Dave stressed "Let patients help", my question is how can patients help their doctors?

The relation between a doctor and his/her patient is a relation of trust. If a doctor feels that he or she is not trusted enough, they may switch into defensive decision making process. And that would surely not yield good result. I personally believe that doctors treat their patients in best faith, but their treatment method may not be best. One of the vital resources "patient" is neglected till now. So how can patient help their doctor?


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    Jul 2 2011: Sulav,

    To answer this question from the negative side, a recent study (http://www.medscape.com/viewarticle/546878) of the patient behaviors neurologists found "bothersome" were: 1. no show for appointment 2. verbally abusive with staff 3. poor compliance with medications or treatment 4. late for appointment 5. do not know the medications that they are taking. Of the 30 items, those behaviors as well as answering cell phones during office visits and unnecessary phone calls after hours were among the most highly rated as bothersome.

    IMO, even these "complaints about patients" can actually be interpreted as a shared failing at best. Understanding the reasons why a patient misses an appointment might reveal that trying to schedule an appointment when it is convenient to the doctor, not the patient, makes the likelihood of showing up on time more difficult for someone that is sick. Verbal abuse to staff members should be analyzed more thoroughly - is this a boiling over of frustration with a medical system, or just rudeness? Having worked on both sides of the desk I am amazed at the level of routine rudeness in healthcare professionals - they don't even know they're doing it.

    Being late for appointments is a pretty rich complaint coming from docs, last time I was in a hospital bed I was left there until the doc caught up on his paperwork! Items 3 and 5, related to medication understanding or medication compliance, are a failing I lay squarely at the feet of the healthcare profession. You mean the patient failed to understand he's taking a sodium channel blocker? What a numbskull! Doesn't he know how important that is to increasing the seizure threshold in his temporal cortex? No, he doesn't, because he didn't go to med school, you didn't convey the required information adequately, and you didn't make sure he was supported by information, not just medication, when he left your office.

    I would propose the best thing a patient can do is be more demanding =)
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      Jul 3 2011: Dear Paul,

      While you raise several important points, I think you fail to appreciate what pressures/demands lie on the other side of the equation. This is a little biographical, but bear with me here, it's to illustrate a point. I am a physician (a paediatric surgeon, to be specific) in Canada. I have spent 4 years in medical school, during which time I was on call in the hospital every 4th night.I wrote countless examinations. I then spent 6 years in residency where I was on 1 in 4 up to 1 in 2 nights. I worked between 80-100 hours per week. I then completed a fellowship in my field, when I worked 1 out of every 2 nights for two years, still averaging 90 hours/week. I am now 1 year in practice, and work 60-70 hours per work. I usually start at 7am and don't leave before 5pm. I am now on call 1 in 5 nights. I have graduated with a significant debt, and have sacrificed much of my youth to become a physician.

      My story is not unique. It reflects the fact that becoming a competent doctor is... hard. Do I want sympathy? No. I am extremely fortunate to have risen to a place of such extreme responsibility.It is a privilege to do what I do, and I wouldn't trade it for the world. But sometimes I feel that a little respect is deserved. A patient is never concerned with the well-being of their health-care provider - they have their own health to worry about. But when speaking in the abstract, I think it deserves remembering that physicians are human too. They are subject to the same fallibilities as everyone else.

      Perhaps the next time you are made to wait, or the victim of an unkind word, you'll try and consider the perspective of the other before jumping to conclusions that may not be deserved. It's a lesson I try and practice every day.


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