The ten golden rules in rescuing the (medically) troubled

ten golden rules

Situations in which medical care or advice should be provided vary considerably as regard place, time and the extent of the medical problem, i.e. patient’s state as regard consciousness, cooperation, presence of patient’s relatives, etc.

Here are 10 rules that I wish to conclude from my experience in the clinical field.

1- The sense of being attended: the health care provider should stress and make sure that the patient perceives that a good medical care is being present. This would be achieved by speaking gently and confidently with the patient and/ or with the relatives. The doctor may state clearly that he/ she would have no problem to see the patient for free when the patient’s condition money-wise is not favorable. The doctor should be cautious as much as possible to protect the patient from possible negligence by his/ her relatives.  In case of a patient with perturbed consciousness the doctor would call the patient by his/ her name (if known) and hold the patient hand warmly.

2- Resort and handing: the doctor would have preliminary assessment of the medical problem, and recalls his/ her knowledge and may need to find some source as a book or contact a colleague for consultation. The doctor may have to urge for a referral to a more experienced doctor.

3- Fulfilling continuum: the doctor may inspire that human body is one continuum with dynamically operating modes and proportionately distributed components. This should be very useful in determining the dose, rate, and intervals of the medicines to be used.

4- Hierarchical approach: the management plan should be almost clear from the beginning. The management should assume a hierarchical concept as regard the relevance of interventions/medicines to one another from one side and to the human body function from the other side. It should start from natural means to encourage the self-curing power in the patient, e.g. warming the patient, changing posture, etc., and proceeding from a less invasive to more invasive.

5- Multi-footed treatment: this means that using more than one point or target in the treatment, if allowable, would help reach a more smooth response with less likelihood of misfortune. This integrated approach would allow less and more tolerable medicine doses.

6- Proof tracking:  this means that on following certain treatment the doctor keeps an open eye checking back and forth for the consistency and appropriateness of a given step in the management for a possible need to change the treatment plan.

7- Case cliché: by the time the medical condition is being resolved the doctor should formulate a clear definition of the case (diagnosis) and inform the patient or the relative(s), orally and/ or in writing.

8- A Gift-outcome-art: this means that the outcome of the medical care is quite unforeseeable. Here, the outcome is usually expressed as percentages or probabilities and not as a definitely individualized result.

9- Non obligation: the medical care should not bear any obligation from both patient’s and doctor’s side.

10- Medical ethics: the doctor should be aware of and fulfilling the medical ethics applicable to the particular medical problem being managed.

Saluti, caro dottore!

saluti caro dottore
Under this delightful Italian salutation I wish to emphasize the importance of language for the physician. Indeed, language use and mastering is one of the big challenges to be a good physician provided that good and gentle contact with the patient constitutes in most cases the secret word towards cure and release. This fact is very striking when caring for a patient of different language and culture. The patient would be so surprised and impressed when the doctor utters his/her own language words in an agreeable manner dispensing the need for an interpreter. This should be a preliminary reason to achieve patient’s confidence and cooperation. Again, the patient’s description of the present complaint in a language that is felt and tasted should help the physician to resolve the case much more precisely. The wonders of good language communication are far away from being simply listed especially when pain to be relieved and suffer to be eased.

The rendezvous with the language does not stop at containing the many Latin and Greek words and terms but the physician maybe appointed to walk a long and interesting experience with learning and practicing many tongues to help maintain good communication with people and refine the health care provision.

Twelve common pits for doctors

common pits for doctors
The relation between the treating doctor and the patient relies basically on mutual trust, respect and dignity. Some psychological element in the response of patient to treatment may be agreed on in this context. However, despite this fundamental requirement for such saintly doctor/patient relation some pits or traps may happen from either side.

Pits from doctor’s side:
1- Patient extortion is a striking sign of corruption when a doctor extorts money or other things from a patient so that the medical service would be provided.
2- Doctor’s egoism may manifest as a doctor cannot tell a patient that he/she does not know how to manage the case or when another more conservative decision has to be made as the case progresses favorably.
3- Defaming other doctors may be immorally made as a habit by some doctors in order to persuade patients to comply with their prescriptions or decisions.
4- Effecting vague symptoms is quite dangerous because many complaints, especially those made by parents in respect to their young sick kids, are exaggerated and need to be tested very carefully.
5- Effecting unclear medical directions given by some senior staff members can expose both patient and young doctor to undesirable and even fatal consequences.
6- Trying insufficiently tested approaches that may be potentially harmful.
7- Reluctance or dispensing with asking for help of other persons, colleagues or more experienced staff members.
8- So-called recommendoma circulates sometimes among doctors, usually as a bad omen, that patients recommended from some medical staff members or personnel would progress unfavorably.
9- Patient’s psychological insult by exaggerating the severity of the case, giving unduly too much medicines or resorting unduly to invasive approaches, e.g. injections.

Pits from patient’s side:
1- Chattering patient is usually a person who is more roaming around his/her luxurious and fulfilled life more than looking for some medical advice.
2- Abusing patient is a person who is trying to trick the doctor for some physical, materialistic or psychological gains.

Pits from both doctor and patient:
1- Driven treatment fault is almost likely to happen when a patient or relative of a patient persuades a doctor to provide some medical service which the doctor accepts on grounds of curiosity and professional itch rather than on scientific and ethical grounds. This problem aggravates in absence of appropriate assistance by other medical staff members.

Suggestion:
The physician has to be keen on having the morals and attitude complying with the highly beneficent message of the medical profession through careful self-judgment and self-criticism and being well acquainted with the relevant ethical and social issues beside the up-to-date available medical knowledge.