doctor-patient relationship

by

Choose The Learning and The Teaching You do, and That is Done To You: Patient-Doctor relationship

I'll Give You All I Can...

Self-Care Tip – Choose the learning and the teaching you do, and not be passive to it, when in your patient-doctor relationship.

Hearing a physician tell us when we can and cannot take medications is somewhat private.  In our culture in our “advanced” and liberated age it isn’t so easy to feel handled like that.  But feeling handled verses helped is our choice.  It is all the more reason to dig in our fears and see what scares us.  If what we find there is that our fear is playing into keeping us from receiving this information, and decide actively if that is really in our best interest.  Emotion has it’s own activity, different from a muscle in our arm.  When we respond to the emotion, and especially if we respond before we do this kind of digging into the fear, we might not actually be doing protective behavior, like our fear would have us believe.

We have talked a bit in previous blog-posts about the patient-doctor relationship being a team effort.  It quickly became apparent that some of us don’t perceive that we have the luxury of working with a physician who see’s their patient as a person to learn from and influence their treatment decisions.  But it is still important to know that this exchange is critical for us and then to let that knowledge progress to a wanting in us to have this dynamic relationship with our physician.  The knowledge and the wanting will have their way in us and in our communities subsequently.  We do not know how long that will take but it will happen.

The marvelous scientist, Deb Roy, from MIT talked about his research on language development.  It was of course extremely endearing as it began with his work with his own infant baby and hooked us both by the intimacy of it and the marvelous discoveries.  Then after we were oohing and ah’ing (most appropriately because this is AWESOME stuff!) he moved us into our cities and media and showed us with his data and eloquence that in order for learning to happen, the professor and the student, the sales rep and the client, the physician and the patient, the parent and the child, both learn and teach simultaneously.  Whether it is subconscious or conscious.  The baby teaches the parent to teach him better and the parent learns this from the baby.   The physician teaches the patient and the patient teaches the physician to teach him better.

Both roles of instructor and student you see requires humility to learn and teach.  They both push into private spaces of the other.  Without consent, either conscious consent or subconscious consent must be there, it will not happen.  So this is consensual, even when we do not realize it.

Now what do you think the friendly thing is for us to do for ourselves, considering this growth in our knowledge?

Of course.  We will be more effective if we embrace this knowingly, willingly, humbly.  Move this learning process from the subconscious to the conscious level.  Make it as deliberate as possible.  For both physician and patient, this is good self-care.  Accept that when we engage in a patient-doctor relationship, we are giving that other person admittance, by our will and choice, admittance to that private space inside of us and not feel the victim when they enter.

Questions:  How has feeling like a victim sabotaged your patient-doctor relationship?  How have you worked past it in a positive way for both of you?  Please tell me your story.

Related Articles
by

Participate – Work as Part of A Team With Your Medical Providers

Katrina-14841

Image via Wikipedia

Self-Care Tip – Work as part of a team with your medical providers.

Today I had the pleasure of speaking with managing editor of the Journal of Participatory Medicine (JoPM,) Kathleen O’Malley.  Ms. O’Malley spoke to me about the effort they are making in this online journal to collaborate the work between patients and physicians.  Ultimately, their goal is to eliminate the barriers that keep us each from seeking to learn from the other’s perspective and knowledge.  She tells me that,

We are a team.

When my brother Vance’s baby was born, she was damaged and premature, so tiny and needed help to live.  Now, one year later, I am playing ball with her on the floor.  Her intelligent smile, thriving body and especially the lovely nape of her neck with that baby-curl of hair lipping up makes remembering her near death-dive into life surreal.  I don’t really want to remember it anyway.  But when I cannot help myself, what I like to think of is how my brother and sister-in-law were treated.

The physicians at UCSD were unbelievable.  Vance told me, with somewhat pressured speech from his amazement, how they, without hesitation, included him in their daily decision-making and informed him of any medical study results.  In case you don’t know, in case you have never been sick or been in a medical setting otherwise, this does not always happen.

I know I am guilty of this too.  Hovering over charts, hiding laboratory results, many of us practitioners behave as if our patients were at any moment going to throw us into court.  It is embarrassing, even though the truth is, too many of us physicians are stalked by litigious intentions, whilst the hoards of truly awful practitioners seem to sail away on unsinkable malpractice without pursuit.

Ms. O’Malley and the JoPM are working with all of us to put the bows, arrows, guns and weaponry down and take two steps back.  It is Thanksgiving-day every day there (I call Pocahontas!  I look good with brades.) and at the safe-place that this journal offers, we can learn from each other.  We can collaborate.  We can be vulnerable and not be preyed upon.   We can be sick, we can teach, we can simply observe and hope that like my niece, in time, we will find ourselves growing up in health and love more so because of it.

Please take a gander over to JoPM.  Say hi to Ms. O’Malley.  Read some of the stories from patients and physicians.  Comment if you will and participate for self-care.  It is your right.  You are free to choose.

Questions:  When you have had, or been proxy to (as I was with my niece), a spectacular patient-doctor exchange – what made it so great?  How did you “participate?”  How did participating make a difference for you v. “being mere passengers?”  Please tell me your story.

Related Articles

by

The Patient-Doctor Relationship And Self-Care

Viral pharyngitis. The oropharynx is swollen a...

Image via Wikipedia

Self-Care Tip – Explore self-care in ways where you do have choice, including healthy alliances with your connections.

PattyAnne came in knowing what she wanted.  She was sure she was struggling with ADHD because she could not focus, she had difficulty connecting with others and she was impulsive.  This was limiting her intimacy and ability to love and be loved by the people she wanted in her life.  PattyAnne had read about ADHD and was relieved thinking that taking a stimulant would improve her that much.

Getting ADHD as a diagnosis would explain to the people she would hurt why she hurt them.  It would give PattyAnne a name for the chaos that followed her or preceded her – she could not tell which.  Having a diagnosis that comes from a figure of perceived authority, say a Doctor of Medicine, offers this.  It is much like a judge who pronounces us innocent and another guilty.  This is not a bad or good motive.  It just is.  It is natural, as far as I can tell, to want to get away from implied or direct negatively perceived labels.

As a practitioner, it is not that easy to resist the lure of treatment when it would be so easy to make our patient happy.  It also takes a lot more time in patient education and building a trust relationship if we don’t agree with the patient’s self-diagnosis.  These pressures are real for any practitioner and many have wondered if the frequency of prescribing is affected by it.  For example, it is estimated that 73% of doctor visits for sore throats result in antibiotic prescriptions, but over 90% of sore throats do not respond to antibiotics.   (I know.  That is robbery!  Those poor other patients who got nothing for their copays!  Not even a prescription!)

So in comes PattyAnne, diagnosis and treatment already in place, all she thinks she needs is my signature.  It is not easy to be a patient.  Being a patient is a hard job in fact.  It requires at least some insight or the ability to receive insight, a vulnerable pose, humility, courage, self-respect and so much more.  Maybe PattyAnne was thinking, “Oh boy.  Now I got this woman who does not know that I’m ADHD!”

We have each other and begin the adventure of doctor-patient relationship, an alliance and a connection.

Questions:   What does a doctor-patient relationship mean to you?  How do you see your involvement in choice and control inside of it?  Please tell me your story.

Related Articles

 

by

Choose Differently. You Are Not A Victim.

Candid Creeper #1 By Tony3

Self-Care Tip #143 – Choose differently.  Be a friend to yourself.

Psychiatry, love of my professional life, married me into his secretive family.  Of course I wanted and want psychiatry, finding so much inner congruence to the paradigms regarding human behavior, emotion, and more.  However, I did not want all the dangers of prescribing, of sharing advice (even solicited advice) if given outside sound proof walls, formalities with documentation, and a doctor-patient relationship that guards against abuse of power.  These are important things for sure but for me, they seemed to seep into my personal life.  For example, I was coached that even a cousin or friend or colleague whom I loved and loved me might throw me into prison, a Joseph toward the land of Egypt, should something go wrong that they thought was connected to my involvement.  Their own guilt and anger would be my judgment.

We do see this.  It is not a myth.  It happens not only in the personal scenarios I have described, but even when treatment is done in the most discreet, professional and informed circumstances.  In eating disorder families, for example, the psychiatrist might become the scape-goat.  Their calorie-deprived daughter, wife, sister, son is hospitalized and despite all their physician does or does not do, the beloved starves and dies.  The survivors are so confused by their grief.  Their pain, an angry god, will consume them if nothing is done.  And that is how the psychiatrist ends up in court to carry the sins away for the lives left behind.

And so my professional relationship with psychiatry became part of the neighborhood zoning that conditioned my choice to be more personally disconnected.  There are other cultural reasons, some of which I have mentioned in the blog-post Journey.  The key though is that is was my choice.  No one forced this on me.  No one forced me to respond in the ways that I have.  I am not a victim to my culture, sex, profession or anything else.  And I can choose differently any time I want.

I choose.  Is not that marvelous?!

Question:  What trips up your choices to connect?  What has helped you choose differently when you needed to?  Please tell me your story.

Related Articles

 

by

When I Can’t Take Care Of “Me”

hairstylepictureshairstyles.net

Self-Care Tip #130 – Ask for help.  Be a friend to yourself.

The last two days we’ve talked about self-care,

1.  Bringing pleasure to be sticky

2.  Starting and ending with “Me.”

The natural progression is to now discuss,

3.  Taking care of ourself when we cannot.  When we Cannot take care of “Me.”

Still responsible for the single person that God gave us to take care of, “Me,” we lie down unable to move.  Unmotivated, maybe too scared to do what we need to do, emotions awry, other medical problems chorusing in with pain, stomach upset, even infertility – our own brain betrays us in our need.

When we cannot trust our own brain, our own selves, whom can we trust?

Some of us have found our answers to that.  Our lives starting and ending with God, we go where He is.  But the brain is ill and, sometimes, suspicious of the rest of us around without a visible halo.  When people point at me, and say, “God can heal me.  Do not you believe that?!” I say, “Yes.  God is the Great Psychiatrist.  I love that we are in the same line of work.”  And I do.

I do my best to help tell, educate, and offer opportunities that lead to healing for ill people to choose.  It is their choice.  Self-care in the context of illness, of losing the ability to care for yourself, is a place of vulnerability.  We show our jelly sides, the places without defense and we ask for help.  Taking care of our selves includes asking for help.  Scary, undefined, entrusting yourself with outside sources takes the courage that only those with mental illness could know.

Asking for help does not mean that the thread of self-care has left you.  It cannot really.  You being its source.  Do not be confused by the obvious.  Outside help does not mean you are not doing self-care.

When we cannot do our own self-care, we ask for help.  Asking for help is self-care.

thysleroux.wordpress.com

(In reality, everyone doing self-care needs to know when to ask.  Healthy or ill, we cannot be good at it all.  We are creatures who need each other.)

When we cannot trust our brain, find someone(s) else we are willing to invite to join our self-care efforts.  Ask for help.

Question:  How has asking for help been for you?  Please tell me your story.

Related Articles