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LETTER TO THE EDITOR
Year : 2017  |  Volume : 15  |  Issue : 1  |  Page : 1-2

Focusing on 25 primary things in patients at first visit: is anyone bothered?


Department of Pharmacology, Srinivas College of Pharmacy, Mangalore, India

Date of Submission26-Feb-2017
Date of Acceptance20-Apr-2017
Date of Web Publication23-Aug-2017

Correspondence Address:
Nagesh Kamat
Department of Pharmacology, Goa College of Pharmacy Panaji Goa 403001
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AZMJ.AZMJ_14_17

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How to cite this article:
Kamat N. Focusing on 25 primary things in patients at first visit: is anyone bothered?. Al-Azhar Assiut Med J 2017;15:1-2

How to cite this URL:
Kamat N. Focusing on 25 primary things in patients at first visit: is anyone bothered?. Al-Azhar Assiut Med J [serial online] 2017 [cited 2017 Nov 20];15:1-2. Available from: http://www.azmj.eg.net/text.asp?2017/15/1/1/213585



Medical practice is becoming tough and busier, and doctors find it difficult to spend time or have minimal time for each patient in a busy outpatient day who genuinely need advice [1]. Patients often resort to the internet for more information, which may be inappropriate [2]. The doctor–patient relationship is vital in health care practice [3]. The majority of problems, namely medication errors, nonadherence, drug interactions, adverse drug reactions, rational drug use, medication regimen complexity, etc., can be tackled by spending some time helping patients understand basic things, as well by providing insights on health-seeking behavior of the patient. Drugs do not act unless patients consume them as prescribed. Hence, a patient’s decision matters for optimal response. The following advice if given at diagnosis or at first visit shall help bring out the best from patients:
  1. Always advise patients to speak the truth regarding their disease, its cause, onset, symptoms – encourage them to speak from the heart
  2. Talk slowly and in a language the patient understands, allowing time for the patient to ask questions; this enhances patient understanding
  3. Always ask patients to carry their previous investigation reports, doctor notes, past medication history details, vaccination details
  4. Advise on proper follow-up with one doctor and prevent doctor shopping; if and only if need be they would be referred to a tertiary-care hospital for specialized care
  5. Advise them to focus on making slow, sustainable changes for long-term benefits
  6. ‘You are the expert regarding your diet, not me’. Foods to be avoided or to be consumed have to be listed
  7. Advise to refrain from browsing too much online regarding the disease diagnosed, drug prescribed, its side-effects, and alternative medicine for the condition
  8. Make the patient realize that the doctor–patient relationship makes a difference and to have trust and faith in him/her, drugs, and the diagnosis
  9. There is no magic pill, all pills are bitter but help in curing the disease
  10. Advise on ‘No pill for every ill condition’, but provide assurance
  11. Discuss the need for diagnosis and its benefit in treatment
  12. Discuss the cost of therapy, alternative generic drugs, and cost–benefit to the patient
  13. Advise on long-term follow-up for chronic diseases and the benefit of completing the therapy
  14. Make them realize what doctors will be doing
  15. Make patients realize what is covered and what is not under medical insurance
  16. Ask them to enter everything in a diary regarding the disease, its symptoms, diet, aggravating/relieving factors
  17. Counsel them on the drugs, the name, dose, dosage, route of administration, and frequency
  18. Warn them about noncompliance not only to drugs but also to visits, as they have to spend more if they get admitted, and thus it is better to adhere to the current medication
  19. Warn on consumption of alcohol, smoking, and tobacco use
  20. Advise to take notes at discharge and schedule the next follow-up visit
  21. Acknowledge patients’ emotions and advise on psychosocial issues
  22. Advise not to skip medicines, discuss the problems of dosing issues, and possible side-effects of the drug
  23. Advise to be accompanied by a sensible friend, relative, or a dear one who understands them better
  24. Double-check for anything missed, advise on keeping a medical file/history. Ask for drug allerg, documents if any
  25. Ask for a written feedback, which shall be kept confidential and will help in improvements if any


Patients when made to realize these maneuvers will help in better management of their disease state. Communication with patients plays a vital role in health care. Assurance by the treating doctor provides relief to patients with chronic illnesses. Doctors need to give a minimum time to every patient, discuss issues, solve their health problems, and in case if busy the same role has to be taken up by clinical pharmacist or other allied health care professionals. Problems in health care can be tackled easily by proper counseling, and well-being of the patient can be ensured.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Dugdale DC, Epstein R, Pantilat SZ. Time and the patient-physician relationship. J Gen Intern Med 1999; 14(Suppl 1):S34–S40.  Back to cited text no. 1
    
2.
Diaz JA, Griffith RA, James J, Reinert S, Friedmann P, Moulton AW. Patients’ use of the internet for medical information. J Gen Intern Med 2002; 17:180–185.  Back to cited text no. 2
    
3.
Jennifer FH, Longnecker N. Doctor-patient communication: a review. Ochsner J 2010; 10:38–43.  Back to cited text no. 3
    




 

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