The challenge of young adult patients: Consumer attitudes

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Responding to young adult patients can be quite demanding for the doctor.

During the 1990’s consumer attitudes developed in society, and this included the medical sphere. As a result of a general social change, previous respect for senior members of the community such as the local bank manager, teacher, vicar, and doctor was eroded. As salaries have fallen comparatively for these groups, respect has diminished, another consumer effect.  It seems that the salary which a position commands is valued more that the expertise and demands of the job.

After seeing a doctor and collecting a prescription it appeared to become the prerogative of the younger patient to decide if or when to take the medication. The emphasis on individualism and personal autonomy encouraged self-reliance and this was manifest in some patients as a disregard for specialist knowledge. A series on Channel 4 TV explored this phenomenon. For example, some young diabetic patients would go to a party and eat and drink just like their ‘normal’ friends. When inevitably they became unwell, they would attend A&E and expect the staff to sort them out. Similarly, a group of patients consistently indulged in food and drink in disregard of dietary advice and eventually demanded a ’gastric band’ as a mechanistic solution to reverse their weight gain.

Whatever the health problem it was easier just to turn up to their convenience at A&E rather than bothering to make an appointment at the GP and remember to attend. This potential access to healthcare is less available now that waiting times in casualty departments are so long. (2023) From a doctor’s viewpoint this is an attitude that is neither healthy nor thoughtful.

It represents the view that the medical team is a ‘commodity’ or a ‘resource’ to be used when needed. This disregards the lengthy training and good will of the team doing their best to help.

This kind of patient demonstrates the consumer frame of mind which is much less reverential to the doctor and treats a doctor’s appointment more like an appointment at the hairdressers.

In contrast there has developed a view among followers of social media that their group experience trumps a doctor’s experience. Because, for example, one influencer suffered a trivial side-effect from a course of antibiotics, this implies in their mind, that all antibiotics should be refused.

Many younger patients (but of course not all) are impatient for results. However, diagnosis of a health problem is often complex and achieved by a series of eliminations.  Diagnosis is a journey.

Some patients after researching for themselves on the internet arrive at a consultation with a firm assertion about their own self-diagnosis. This approach throws the normal course of enquiry off track. It may seem easier for the doctor just to accept this and go along with it. In the busy clinic it certainly saves time. However, the end result may be a mistaken diagnosis and inappropriate treatment. Much better for the patient to present the problem and not the solution. Better to rely on the doctor’s expertise to reach a logical conclusion. In contrast to consumer attitudes taking medicine for granted, respect for science and scientists did receive a boost during the recent pandemic. Daily press conferences demonstrated the ingenuity, professionalism and sheer hard work of the scientists and doctors devoting themselves to combatting Covid.

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