Problem Patient 1
Posted by webmaster on June 20 2007 01:59:15

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I had attended a lecture taken by a medical student from United States who spoke
about how doctors, specifically emergency physicians can improve their behaviour
towards patients. She spoke about introducing yourself first, about telling them goodbye
etc, very agreeable.
Now what she said was that patients have a right to ask all questions they want and
that if she was a patient she would be a horrible patient and give so much trouble to
the doctor asking about all the things happening to her, every hour.

Now what would I do if I faced a patient like her? I would simply get somebody else to
see her. I will in no way let her get onto my nerves which would affect the care of lot of
other patients. And she will be dealt with by another doctor.

The question is why would patients want to behave in such a manner.
The biggest thing I hate is a patient who doesn't trust his/her doctor, questioning
every move or intervention involving treatment. I don't say that patients shouldn't be
informed of their treatment plan. But what irritates is that "advice given by an uncle
in US or an article read in some website or magazine" which interferes with patient
care.

I had a patient who had a massive MI and LVF. While I was resuscitating him, his relative
paid no attention to my words and hands me his cellphone. At the other end was his
surgeon who was telling me what to do without even knowing the patients vitals.
I had to tell the relative that if anybody was going to save the patient now, it was me.
It was not his surgeon. Ultimately the guy managed to shut up, let me stabilize the
patient and get a cardiologist to see him. This is just one example.

If a patient comes to a doctor, he should have some amount of trust in him/her.
A patient should not come to a doctor and order him to give a certain treatment or
medication which was prescribed by someone else.

Such incidents are extremely common in large corporate hospitals. This is partly due to
the class of people visiting here who are mostly from the upper section of the society.
These people demand that only the consultant of a specialty they choose, see and
touch the patient first(even if the choice is wrong!). And partly due to the ignorance of
the patients to the presence of a specialty called Emergency Medicine.

I think this kind of problem will always exist. How it is dealt with is upto the skill
and experience of the doctor. And this is more difficult for the emergency physician
due to the extremely short time period available for patient/attender interaction.


Dr. Imron Subhan
Senior Resident
Dept. of Emergency Medicine
Apollo Hospitals, Hyderabad, India.