HOW TO TREAT THE PATIENT: Study notes for your doctor

The following is based on study notes, published in an academic journal, to help doctors improve their inter-personal skills with the patient. There have been a few embellishments supplied by What Doctors Don’t Tell You (without apology).

It’s probably fair to say that doctors are human. As such, you understandably view most of your patients as foolish, uncomprehending, hysterical or malingering. This is certainly the case when the patient presents with a health problem that has a mysterious cause.

Unfortunately, most illnesses have a mysterious cause, so it follows that most patients must be viewed as perhaps foolish, uncomprehending, hysterical or malingering, or perhaps a combination of all of the above.

However, you must overcome these natural, and human, feelings, and should instead endeavour to communicate with the patient (even if he probably is hysterical or uncomprehending).

Now, most patients can hold only seven thoughts in their head at one time, so we can safely add ‘stupid’ to that foregoing list. Professionals (i.e. non-patients) also use vague quantifiers, such as ‘rarely’ and ‘unlikely’, which are instantly understood by a fellow professional. This confuses the patient, however, because he is also innumerate.

Also, patients look for clear answers, but yielding to that pressure is a trap that the professional must avoid at all costs. For example, they like to label a disease, and ask questions such as ‘What’s wrong with me, doctor?’

Finally, don’t use long words. When you have nothing to say to a patient who you doubt has anything wrong with him, use simple, monosyllabic terms, which unfortunately rules out useful terms such as ‘moron’ or, indeed, any of the foregoing terms such as ‘malingerer’. However, words such as ‘not’ and ‘ill’ would work, as would ‘don’t’ and ‘know’, and ‘take’ and ‘drugs’.

(Source: British Medical Journal, 2003; 326:595-7).

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Written by What Doctors Don't Tell You

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