Doc-Patient interaction


Jealousy

A doctor and his wife were sitting in deck chairs on the beach when a beautiful young girl in a brief bikini jogged towards them. As she came to the doctor she waved at him and said, in a husily sexy voice: ‘Hi, there” before continuing on her way.

“Who was that?” demanded the  doctor’s wife.

“Oh, just someone I met professionally.’ replied the doctor.

“Oh, yes!’ snorted the wife.

‘Whose profession? Yours or hers?’

…………………………..

Boot on the head

A man walked into the doctor’s surgery and said:’Can you hekled me? I’ve suddenly got a funny feeling in my head-it’s all hot and I can’t see. I also walk with a limp as one leg seems shorter than the other’.

The doctor looked at him thoughtfully for a moment and then said: ‘It might help if you took your left boot off your head and put it back on your foot.’

………………………….

Long Life

Patient: “Doctor, do you think I will live until I’m a hundred?’.

Doctor: ‘Do you smoke or drink?’

Patient: ‘ No, doctor. Never’

Doctor: ‘Do you drive fast cars, gamble or play around with women?’

Patient: ‘ Certainly not!’

Doctor; ‘Then what do you want to live until a hundred for?’

Persistence


{What’s another word for perseverance. It is persistence. How terribly necessary to be persistence in everyday life. As this poem says…}

Nothing in the world
can take the place of persistence
Talent will not;
nothing is more common than
unsuccessful men with talent.
Genius will not;
unrewarded genius is almost a proverb,
Education will not;
the world is full of educated derelicts.
Persistence and determination
alone are omnipotent.
The slogan ‘Press On’ has solved
and always will solve
the problems of the human race.

(Calvin Coolidge)

Law Of Persuasion


Law of Reciprocity

When someone gives you something of perceived value, you immediately respond with the desire to give something back.

Law of Contrast

When two items are relatively different from each other, we will see them as more different if placed close together in time or space.

Law of Friends

When someone asks you to do something and you perceive that person to have your best interests in mind, and/or you would like him to have your best interest in mind, you are strongly motivated to fulfill the request.

Law of Expectancy

When someone whom you believe in or respect expects you to perform a task or produce a certain result, you will tend to fulfill his expectation whether positive or negative.

Law of Association

We tend to like products, services or ideas that are endorsed by other people we like or respect.

Law of Consistency

When an individual announces in writing or verbally that he is taking a position on any issue or point of view, he will strongly tend to defend that belief regardless of its accuracy even in the face of overwhelming evidence to the contrary.

Law of Scarcity

When a person perceives that something he might want is limited in quantity, he believes that the value of what he might want is greater than if it were available in abundance.

Law of Conformity

Most people tend to agree to proposals, products, services that will be perceived as acceptable by the majority of other people as a majority of an individual’s peer group.

Law of Power

People have power over other people to the degree that they are perceived as having greater authority, strength or expertise.

Note: If you are not a salesman, you don’t have to agree with all, the above mentioned law….he.

Polydoc


We, doctors more often than not, are familiar with polypharmacy. That is when a patient is prescribed with multiple drugs for a single diagnosis. Polydoc is when a patient consulted many different doctors for a similar complaint. Polydoc results in polypharmacy. It happens: (i) because of medical subspecialization, (ii) patient mobilization due to frequent movement in term of career and family, (iii) fragmented health care (iv) communication irregularity and (v) side-effects.

Medical subspecialization is good in providing highly specialized care. However, on the flip side, it causes more referral, manpower and resorces. Take for example a diabetic patient with complications: whether he like it or not he has to attend diabetic clinic, eye clinic, neuro clinic and nephro clinic. That may not be considered polydoc as different doctor treat different complications. It is called polydoc when he goes to see different doctor for his numbness and blurring of vision which he thinks may not be related to diabetes.

In this era of modern highways and road connections, a patient may be seeing doctor in JB today and settle down in Kangar the next day. Doctor in Kangar may not communicated with doctor in JB and this practice results in polydoc.

Fragmented health care refers not to system but existing practice in Malaysia when patients go to sinseh, tradisional message, ayurveda and even taking plain air tawar from bomoh. Those people are not doctors but when patients failed their treatment, patients will not go back to their first doctor but will find a new doctor.

Communication irregularity can be the cause and effect of polydoc. Different advices would confuse patients and finally they will find doctor who could give advice suit they own practice not in conformity with what they should do in that particular condition.

Last but not least, is the side-effect of medication. As it used to happen many times, patients who develop side-effect with medication would get advice from different doctors in the context of getting second opinion. This results in polydoc practice.

In conclusion, both doctor and patient must acknowledge this phenomena and realize how it affects the treatment. Both must be honest and find amicable solutions to overcome doctor shopping phenomena.

I Lost My Soul….


I lost my soul to-day,
For the sake of scrubbing and buttons and trash,
It was a wonder-day of beauty,
Rapturous leaves afire in the sun besought me;
Butterflies beckoned, birds entreated with song;
Implored me to drift on the miracle tide
Of gladness and renewing.
 
O Beauty, stand once more upon my threshold!
O Day of Wonder, beckon me again!
That I, the penitent, may open wide my dwelling
And pleaded with Loveliness as she has pled with me

(Angela Morgan)

Anti-psychiatry and The Present State


Comment:

This video illustrates the idea called anti-psychiatry, which was first put forward by David Cooper and popularized by RD Laing, Joseph Berke and Thomas Szasr. Cooper was originally a trained communist revolutionary and was a member of South African Communist Party and was sent to Poland, Russia and China to be trained as professional revolutionary. The proponents of anti-psychiatry movement believe psychiatry as a tool of social control resting on the subjective opinions of an uncaring medical elite.

Their claims as shown in the video was that psychiatry rests on shaky foundations and the diagnosis is based purely on symptoms and behaviours, with heavy diagnostic overlap and poor reliability. They warned on the malign influence of pharma company in distorting science, leading to the production of expensive and harmful ‘new generation’ drugs marketed via aggressive promotion and bribery.

I think the disagreement is purely ideological. The first issue to be cleared is whether psychiatric disorders are basically illness or not. Taking biopsychosocial paradigm as the basis, one has to understand that disease has to be construed not purely based on biological aetiology alone but interactions between genetic and environment which result in the disorder. Invariably, those interactions have significant impact on social and occupational functions or essentially deviation from social norm in one way or another. Further more, there are numerous clinical evidences utilizing novel radioimaging technology which show clearly that mental illnesses have definite morphological changes in the brain.

The second issue lies to the fact that there are some dominant ties between pharmaceutical companies and psychiatric doctors or researchers. Lately, big pharmaceutical companies have review their arrangement between doctors and industry in order to avoid conflict of interest in managing patients preferably using the drug that they promoted. Psychiatrists in Malaysia, as I know them personally, are always been reminded to put their patients interest as the first priority.

Bye.