Al-Azhar Assiut Medical Journal

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?


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

Correspondence Address:
Nagesh Kamat
Department of Pharmacology, Goa College of Pharmacy Panaji Goa 403001
India




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 18 ];15:1-2
Available from: http://www.azmj.eg.net/text.asp?2017/15/1/1/213585


Full Text



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:Always advise patients to speak the truth regarding their disease, its cause, onset, symptoms – encourage them to speak from the heartTalk slowly and in a language the patient understands, allowing time for the patient to ask questions; this enhances patient understandingAlways ask patients to carry their previous investigation reports, doctor notes, past medication history details, vaccination detailsAdvise 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 careAdvise them to focus on making slow, sustainable changes for long-term benefits‘You are the expert regarding your diet, not me’. Foods to be avoided or to be consumed have to be listedAdvise to refrain from browsing too much online regarding the disease diagnosed, drug prescribed, its side-effects, and alternative medicine for the conditionMake the patient realize that the doctor–patient relationship makes a difference and to have trust and faith in him/her, drugs, and the diagnosisThere is no magic pill, all pills are bitter but help in curing the diseaseAdvise on ‘No pill for every ill condition’, but provide assuranceDiscuss the need for diagnosis and its benefit in treatmentDiscuss the cost of therapy, alternative generic drugs, and cost–benefit to the patientAdvise on long-term follow-up for chronic diseases and the benefit of completing the therapyMake them realize what doctors will be doingMake patients realize what is covered and what is not under medical insuranceAsk them to enter everything in a diary regarding the disease, its symptoms, diet, aggravating/relieving factorsCounsel them on the drugs, the name, dose, dosage, route of administration, and frequencyWarn 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 medicationWarn on consumption of alcohol, smoking, and tobacco useAdvise to take notes at discharge and schedule the next follow-up visitAcknowledge patients’ emotions and advise on psychosocial issuesAdvise not to skip medicines, discuss the problems of dosing issues, and possible side-effects of the drugAdvise to be accompanied by a sensible friend, relative, or a dear one who understands them betterDouble-check for anything missed, advise on keeping a medical file/history. Ask for drug allerg, documents if anyAsk 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

1Dugdale DC, Epstein R, Pantilat SZ. Time and the patient-physician relationship. J Gen Intern Med 1999; 14(Suppl 1):S34–S40.
2Diaz 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.
3Jennifer FH, Longnecker N. Doctor-patient communication: a review. Ochsner J 2010; 10:38–43.