saurav1
TRANSCRIPT
INTEGRATING THE PATIENT AND DOCTOR AGENDAS
Presenter: Saurav Mishra
Moderator: Dr. Ashok Yadav
AGENDA
List of the subjects to be dealt with or talked about in a meeting
PATIENT’S AGENDA
Feelings or experience Fears or concerns Expectation of the doctors
DOCTOR’S AGENDA
Diagnosis Management Preventive Procedure eg age ,sex and risk
factors
PATIENT CENTRED APPROACH
Why?More effective doctoringMore accurate diagnosisBetter compliance with treatmentBetter patient satisfactionMore doctor satisfactionLess law suits / angry patient parties
WHAT IS THE DOCTOR’S TASK?
1. to understand the patient 2. to understand the disease
IMPORTANCE OF UNDERSTANDING PATIENT Understanding the problem and making a
diagnosis Successful management depends on patient
motivation and cooperation Management must be appropriate (cost,
availability, fit life style, side effects) Prevention and education must be
understood by the patient
listens briefly to main complaints cuts off the patient’s story and asks direct
questions about each symptom
Often misses important cues and clues regarding the disease process and thereby missing an opportunity to gain full insight into patient’s illness
Doctor centred process
DOCTOR CENTRED PROCESS
Doctor pursues own agenda Does not try to understand the patient’s
agenda Aim is to efficiently and quickly reach the
diagnosis, write the prescription and send the patient
CONT. …
Doctor obtains relevant information Processes it by direct questioning Fits the symptoms to the criteria for a
disease eg MI Success is measured by reaching a precise
diagnosis and Making sure that the record is acceptable to
medical colleagues
PATIENT CENTRED PROCESS
Includes both patient’s and doctor’s agenda Aims is to understand the patient’s
complaints from his/ her point of view ie to understand the illness experience
Uses the way the patient is thinking to help him understand their disease and its treatment
PATIENT CENTRED PROCESS
Allows patient to express Expectations of the visit to doctor Feelings and fears about the illness
Requires Empathy, non judgemental acceptance,
congruence and honesty Consulting skills
INTEGRATION OF TWO AGENDAS
Reaching an integration so that both patient and doctor are satisfied with
what happened Patient understands more about their disease
and accepts and participates in its management
REFERENCES
MURTAGH’S GENERAL PRATICE Preventive & Social Medicine: K.Park
“It is more important to know what patient has a disease, than to know what disease the patient has.”
- Sir William Osler
Thank you