Benefits of a new approach

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I would like to suggest a different relationship between doctor and patient: a partnership which is more evenly balanced than the current failing formula.

Let’s look at the way doctors and patients have related in the past.

Here is one patient’s account of a professional exchange. This story may seem very familiar.

A South African patient, Angela A., was attending a conference away from home in the UK when she developed a sore throat. This was a regular intermittent problem for her. She sought advice from the conference doctor. Angela was shown into the consulting room and took a seat. The doctor did not look up but asked her what she wanted. His gaze was fixed on the computer screen in front of him.

Angela explained her symptoms and without looking at her or in her throat the doctor said, ‘Well you’ve obviously got a throat infection. I’ll write you a prescription.’ He gave her a prescription for a mild antibiotic. From previous experience Angela knew that this was unlikely to help. The doctor ended the consultation and dismissed her. Angela left feeling annoyed and dissatisfied.

So, what had gone wrong with this encounter?

First the doctor had not greeted Angela, looked at her and made personal contact. Secondly, he had not enquired about her general health or previous episodes of sore throat and if these had been treated successfully in the past.

Thirdly he had in fact failed to register her foreign accent which could have been relevant as unusual infections acquired abroad are now quite a common problem. Without looking at her how could he possibly know that she was not entering the UK with an untreated case of Ebola?

Fourthly, a fundamental mistake, he had failed to examine the patient or take a throat swab.

And what of Angela? What else could she have done to avoid the unsatisfactory outcome?

Angela could have been much more direct and insistent. When she saw what the doctor had prescribed, she could have recounted her previous experience and the choice of antibiotic which had been most helpful in the past. It is most likely, but not certain, that the same infection was recurring. A simple throat swab would have proved it either way. As a patient, being politely insistent, with good cause, is a vital part of successful doctor patient relationships.

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