I was recently asked for my thoughts on training doctors. It’s a subject that’s been on my mind lately anyway, thanks to the #MedX chats on twitter & google plus. Here are some of the things I wanted to share.
I think one of the most important things for docs to understand is that chronic patients don’t come looking for drugs. We come looking to get relief and help. If a chronic pain patient walks into your practice and says they need higher pain meds, doctors need to think about how much courage that patient needed in order to bring it up as well as how high that person’s pain levels must be. There is this almost automatic shudder when these things are mentioned and patients, especially younger females, are treated as though many things are all in their heads. By doing that, you further ostracize a patient, which just deteriorates their mental health to a dangerous point and also makes it less likely that they will follow their medication or other treatment regimens.
Really listening, instead of hearing, makes a huge difference. I suffered from fibromyalgia pain for years before Kathy (my rheumy’s NP) really listened to my symptoms to find it. My previous rheumy thought I had it, but never told me or ran any tests. I got to suffer through that pain, which ended my graduate school career and forced me to change jobs, while someone could’ve treated it if they only listened and cared enough to discuss it with me.
Having ideas on how to deal with the day-to-day issues will help immensely.
Read up on journal articles about transitioning care for juveniles who have recently graduated to adulthood. There are often things we go through that are different than adults who fall ill. Mentally, things are darker because we may have never been well enough to participate in things. Physically, things tend to be worse for us as well due to wear & tear, and the time damage has had to occur.
Treat us as your partner in the battle against whatever diseases you work with. Patients who feel as though they can work with their doctors instead of being told what to do, often do better than the others. Be receptive to new ideas, even if you think acupuncture may just help due to placebo. If no harm could be done, encourage your patient to find things that will help them – and learn to recognize body language that suggests people are having a harder time mentally or physically. It really helps in protecting patients from their own minds when you can know there is something wrong and engage them on it.