In her book, every patient tells a story Lisa Sanders presents a patient that sought medical help due to a medical or a surgical illness, she then described the steps taken to diagnose to patient and subsequently treat them. She goes into details about what both the doctor and the patient were thinking and their reactions to the diagnosis. She also records her different encounters with the other doctors and their opinions over the ever fading physical examinations and the new high technology testing that is often prioritized. But mainly, great emphasis was placed on the declining use of traditional physical examination in favor of high tech medical testing and newer procedures. Lisa Sanders provides several case examples of what can be overlooked when the physician does not spend adequate time listening to the patient and performing a careful physical examination. Lisa Sanders substantiates her stories by citing quite a bit of research in order to support her contention but she also keeps an open mind and she clearly does not dismiss the value of more modern medical testing procedures but rather she highlights the synergy formed by conjoining those with physical exams to provide a comprehensive analysis.
I was able to gather the wealth of knowledge that Lisa Sanders communicates in “Every patient tells a story”. This knowledge I speak about is beyond just “book knowledge” it is wisdom expressed in the words and through the eyes of the medical professionals and their patients. Even though this book had many lessons to offer, the key recurring theme/lesson/concept that is constantly communicated is the importance of a properly executed diagnosis. In the vivid description of the pain and suffering experienced by the patient, Cryst...
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... often know their patients well enough to know details of their health status. Sadly however providers are becoming more and more specialized in order to increase efficiency and handle larger volumes of people. This is further fueled by the recent changes in healthcare reform; it’s inevitable that learning and telling a patient’s story has become an insignificant piece of the puzzle. Doctors simply can not scale to keep up with the ever growing number of health epidemics and so the story of a patient is slipping through the cracks and often has to be told and retold over and over. My view of this problem is a basic one and I believe is the root cause of why quality healthcare has become a rare commodity ties back to the lack of quality primary care where the doctor and the patient constantly communicate and the doctor has a good view of the patients health history.
As the story begins, the unnamed doctor is introduced as one who appears to be strictly professional. “Aas often, in such cases, they weren’t telling me more than they had to, it was up to me to tell them; that’s why they were spending three dollars on me.” (par. 3) The doctor leaves the first impression that he is one that keeps his attention about the job and nothing out of the ordinary besides stating his impressions on the mother, father and the patient, Mathilda. Though he does manage to note that Mathilda has a fever. The doctor takes what he considers a “trial shot” and “point of departure” by inquiring what he suspects is a sore throat (par. 6). This point in the story, nothing remains out of the ordinary or questionable about the doctor’s methods, until the story further develops.
Sophie's Heart, by Lori Wick, is the story of Sophie, an educated young woman who moves from her homeland, Czechoslovakia, to America where she becomes a housekeeper for a loneyly young widower and his three children. This book takes place mainly in Wisconsin in the 1990's. Sophie moved from Czechoslovakia to American and became employed as a housekeeper for Alec Riley. She grew to love his three children and gradually her love extended to Alec himself, who returned her love with his own. Near the end of this novel, Sophie and Alec get married.
In the vignette, the relationship between the physician and patient was authoritarian, and there was no patient-physician relationship to truly understand the concerns and the impact of his illness on the patient’s life. It almost seems that the physician did not take the patient’s concerns seriously. In addition, as his symptoms were worsening, although he consulted other physicians and he received contradictory answers, thus confusing the patient and decreasing the trust in the physician’s abilities. A patient centered relationship allows patient to build trust in the provider. I think that if the physician were more empathetic to the patient, the patient would not have had to look for answers to his questions in medical texts and other physicians. In fact, if there were open communication, maybe the doctors would have been able to find the injury and provide the necessary treatments, before it was too late.
Everything revolves around the patient: the patient’s safety, the patient’s health, the patient’s comfort, and the patient’s happiness. Therefore, having a narrative solely from a patient’s perspective of how he is dealing with life before, during, and after treatment is important. “Flowers for Algernon” is a great narrative for nurses to look back on for an insight to what a patient may be feeling and also as a reminder to not only focus on how the treatment is affecting the patient physically, but also to notice how the treatment is affecting a person
Over the span of half a century, the medical profession has witnessed a catastrophic shift in the patient-physician relationship. As the manufacturing of new pharmaceuticals and the number of patients under a physician’s care continue to rise, doctor’s are finding it difficult to employ the time-honored principles listed within the Hippocratic Oath. This oath, written in 430 BC by the Greek Physician, Hippocrates, was the first document to state the responsibilities of a physician to his patient (vadscorner, pg 2). Hippocrates believed that it was the physician’s duty, as a healer, to treat the patient infected with the disease to the best of his ability, and not to treat the disease (Hippocrates, pg 1 ). He believed that the patient was, above all, the most important aspect involved in the healing process. With the rise in the number of patients under a physician’s care and the stringent rules by which each doctor must abide, many doctor’s are finding that they are unable to devote ample time to become acquainted with their patients (spiralnotebook, pg 1). Furthermore, as newly acquired information regarding illnesses becomes available on the internet, patients are seeking the advice of multiple physicians (Changing, pg 3). These differences between patients and their physicians, as well as numerous others, have caused rifts in the patient-doctor relationship.
The ability of a medical practitioner to elicit a sound and thorough chief complaint and history is essential in treating patients. During the first encounter with the patient, medical practitioners should be able to treat based on the information the patient provides. On December 13, 2013, the Physician Associate class of 2015 had the opportunity to interview standardized patients. This encounter was videotaped for self-analysis. I was able to reflect and improve on interviewing skills from watching my own patient interview. My critiques and thoughts are delineated in this essay from which I hope to improve upon.
Any patient harmed by the provision of a healthcare service is informed of the fact and an appropriate remedy offered, regardless of whether a complaint has been made or question asked about it. This is how the term “candour” is defined by Robert Francis in his report (1). GMC defines the professional duty of candour as openness and honesty when things go wrong (2). This is applicable not only to patients but also to colleagues, employers and regulators. In a profession as stressful as medicine where doctors and other healthcare professionals are entrusted with the provision of care to people, it is vital for the care givers to be completely honest with their patients, especially when things wrong. It is not an easy task and doctors hesitate to do so due to a number of reasons such as the fact that doctors see themselves as solely benevolent and do not appreciate that they may be sources
Improvising Medicine is a must-read ethnography for students interested in bridging the gap between culture, history, and global health and medicine. Julie Livingston weaves real, grueling medical stories of advanced-stage cancer patients from the lone cancer ward in the entire southern African country of Botswana – in Gaborone’s Princess Marina Hospital. In a country where the primary, and more heavily funded, health focus has been HIV/AIDS, increased cancer awareness and the rise of “AIDS-related cancers” have led to a cancer epidemic. She argues that Africans are “living in a carcinogenic time and place,” rooted in a combination of infectious disease, environmental pollutants, and the tobacco industry (Livingston 51).
physician and then transcribed by medical transcriptionists. This report is an important form that uncovers the chief complaint of the patient, history of the present illness, and personal, family, and social history. This contains subjective data collected from the patient to begin the process of diagnosis by the physician. The physical examination includes a system-by-system physical examination by the provider to collect objective data on the patient’s condition.
patient to understand at least a general background on the doctor’s diagnosis so that they can also
Although, consistent, effective and careful communication by the physician can be a strong deterrent towards low patient health literacy, physicians often fail to utilize this skillset, where they often overestimate the literacy levels of their patients (Weatherspoon, Horowitz, Kleinmen & Wang, 2015). Therefore, physicians should focus on the close interactions with each patient without assuming that the individual’s health literacy capacity isn’t greater than their perceived notion. Studies suggest that immediately after leaving the physician, many patients are able to recall only 50% or less of the medical information communicated to them by their physicians (Williams, Davis, Parker & Weiss, 2002). Therefore, the communication between the patient and the physician is a core skill, and should exist within a patient-friendly capacity, emphasizing basic communication techniques that promote a calm and friendly healthcare environment for the individual. Furthermore, a physician should place an emphasis on using effective comprehensive techniques such as implementing a style of care that integrates simple language, speaking in a slower manner, delivering only a few concepts at a time, inquiring about the patients habits towards their follow-up once home, as well as practicing the “teach-back” method or word recognition tests, where patients repeat the information communicated to them by their physicians (Weatherspoon, Horowitz, Kleinmen & Wang,
Most physicians still relate to their patients using a peculiar communication style where they act as the clinicians knows best, does the most talking and makes almost all decisions for the patient. Patients are encouraged to be passive and compliant rather than being engaged.
Health and illness narratives have long been part of the healthcare setting, however in more recent times, the biomedical model of healthcare with its facts and finding methodology has been the more common structure of healthcare. A byproduct of healthcare systems structured in such a way is it fails to focus itself on patient centered care and as such the treatment of a patient fails to establish and treat the cause of the issue.
The TED Talk featuring Dr. Abraham Verghese was very accurate in its depiction of how some of today’s medical professionals do not get the full picture of the patient. The TED Talk was is from 2011, so some changes have been made to this, but not all. During this time and era, most doctors were working under strenuous conditions such as working long hours, seeing numerous patients in a day, and being stretched by having to do many duties due to their title and limited filled positions in their desired career. But, this does not give them the “ok” to deny each and every patient the correct singularity that they deserve. The beginning story he tells of refers to a woman who has advanced stages of breast cancer that has spread to other regions in her body. She had been to numerous doctors before
My father was a physician who treated each of his patients with genuine concern and empathy. I loved listening to his stories. He taught me the importance of treating patients not merely as a set of symptoms but as real people with real emotions. In the words of William Osler “The good physician treats the disease; the great physician treats the patient who has the disease.” These are words I live by.