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 ayradyss | |
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All right, everyone: I posted a request on staircase_wit's journal not so long ago, asking for his autistic spectrum friends to tell me what I, as a doctor, should be doing to make an autistic patient feel as comfortable as possible. I believe, firmly, that communication is the absolute key to healing, and that without it my purpose as a doctor is empty. And comfort is the gateway to trust, which is key to communication. I'm going to expand it now: I'm asking you, O Best Beloved, and any of your friends who might happen to want to tag along for the ride: Imagine, for a moment, that it is four years from now and I am practising medicine with my unrestricted license. You are my patient. What should I, as a doctor, be doing to make you want to come back both when you are not feeling well and to maintain your health? You may look at this situation in several ways. I'm looking for the experiences you've had - the bad and the good - the things that doctors have done to you that you could not stand or absolutely loved. I'm looking for the things you wish doctors would do and the things you hope you will never see. I'm looking for anecdotes, stories, things that are possible in this age of HMO's and managed care and things that you don't think are possible. Spread it out - ask your friends. How else am I going to learn what people really think?And now I go to study neurology. [Edit: I don't care if you all say the same thing, I want to hear what everyone has to say :) ] now feeling::  curious
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...I am scared spitless of doctors. I had horrible experiences as a child-I was sickly, and spent a lot of time in the hospital. Even today, I balk at going to the doctor.
The only decent doctor I ever had was a woman at my family practice. She spoke softly and reassuringly to me. She let me know exactly what she was doing and why. She was aware of my fear of doctors, and did everything she could to help alleviate it.
On the flipside, her colleauge is an asshole. Older man. Aware of my fears, but just didn't care. Very rough and brusque, rude even when I would ask a question.
In the first instance, I came to the office shaking in fear and left reassured.
In the second, I came in shaking and left shaking AND in tears.
The big thing to remember is that the patient doesn't have the training that you do, so it's all very scary when, say, they have a seizure out of nowhere and have to go to the doctor. Talking to them on their level, as a human being and not as some omnipotent pill-pusher is a huge help ^_^
Good luck on your schooling ^_^
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I don't think I've had bad experiences with doctors.
I guess one of the main things is to talk to the patient calmy, and let them know what you're doing, because it might scare them and think it's something worse than it really is.
Last time I went to the hospital because my mom got sick, I didn't really like the doctor because he didn't seem to.. care much, I guess. He was only doing his job, which I know that's what he's supposed to do, but I would have liked it if he had been more sensitive, and friendly. The nurse that was helping was really nice, always trying to help and talking to us, making my mom comfortable, etc. So, being friendly and letting the patient know that you're their friend is always good.
Also, try to answer every question, even though it might seem really stupid and obvious, it might not be for the patient, since you know more about that stuff than they do.
I don't know what else. But those are the main things, I think.
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Sorry Nykki, I'm sure you'll be an excellent one, but I still hate doctors, and probably always will. I don't like to be touched. Doctors *have* to touch, usually. So I don't like doctors. Also, I do not like to be looked at very closely. Another problem. I am always horribly uncomfortable around my doctors because they are *always* looking, even when they're not just checking me over to see what's wrong. They watch me constantly when they talk to me. They probably tell you "blah blah blah EYE CONTACT" in school, but I hate it. Give me a doctor who doesn't touch me and looks at the floor while they talk to me, and I'll probably be happy...
When it comes down to it, it's impossible to please everyone. There's no one way that would work to make everyone comfortable. You'll probably be working with children unless you've changed your mind since we last talked, so I don't know if this would work, but it might be a good idea to ask patients what they are comfortable with. With kids, you might just have to hone your people sense and try to find what will make the child feel more at ease. Some kids might feel comforted by touch, others, like me, will be panicked by it. I guess it's just a matter of reading signals and if the patient is old enough to respond verbally, asking what's okay and what's not.
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I loathed doctors when I was a child. To this day, I'm still not terribly fond of them, and I can't stand audiologists or speech therapists. I find most of them rather condescending, truth be told, and I could probably write at least two or three pages on doctor problems when dealing with the hearing impaired/deaf/disabled, but ... I don't want to spam you. So yeah. ^^;
If you're working with a deaf or hard of hearing patient, make sure your face is illuminated by the light; don't stand with your back to windows/light sources. It's next to impossible to lipread under those circumstances, and many high functioning hard of hearing people need to use lipreading when talking to a person whose voice they're unfamiliar with.
Similarly, don't speak slowly, because it doesn't help your speech and it's just condescending. A little louder is fine, but don't over-emphasize your speech, because that can actually make it harder for us to understand.
I don't know if this is true for other people, but in my particular case, when I lie down, my hearing drops rather dramatically. This usually makes it next to impossible for me to hear anything during a pelvic exam, for instance, or while my stomach is being palpated (sp?), and lipreading is out of the question, since the doctor's face is shaded while they look down, so I would suggest explaining what you're going to do before the exam starts.
And. This isn't really an answer to what you said, but always, always, always test infant hearing, because no matter what nurses say about children's hearing, about half of them don't know what they're talking about when it comes to hearing loss diagnosis. My parents followed every rule in the book, and I still wasn't diagnosed until I was two and a half; it still sends chills down my spine, because I only spoke seven words at the time.
Like I said earlier, I could probably babble a lot more, but I'll be quiet now. ^^;
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the most horrific doctor i ever had was my first ob/gyn. the woman over-booked patients to get as much money from OHIP as possible (canadian system, fee-per-service. more pts = more $).
i once came in with some questions written out and refused to leave until they were answered, and she said i was disrespectful to my betters. then she got into a shouting match with me...in her waiting room.
so, that's the horror anecdote taken care of.
i think it's hard to be everything to all people. for example, take obs/gyn. most of my female friends want their doc to be sensitive, caring, talk to them, explain what s/he's doing. with most other docs i want that too, but in that particular case i want someone fast and competent, who'll do the job with a minimum of chat.
i think the best thing is to take the cue from the patient. some patients are very involved and knowledgeable, want all options explained and the decisions left up to them. some prefer the doc to make the decisions, and that is their right too.
adapting to the patients' level of need, knowledge, etc is probably the hardest and one of the more important things to do concerning communication.
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My husband and I had some horrid doctor experiences a little while ago. One month after the wedding, he fell at work and hurt his back. They told us little, and did a lot of outpatient spinal injections. They were agomizing for him. I remember almost crying in frustration at more than one appointment, because his anestesiologist (-sp?) wouldn't tell us anything. Communicate, clearly and at length if need be. There's little scarier than having your husband's spine tampered with and not knowing what is being done, or what it will do.
I wouldn't ask a doctor to form any kind of emotional bond with a patient, because I'm sure that happens enough of its own accord. I do ask that doctors don't don an apathetic attitude. It's only unnerving. I think...confidant detacted frendliness, maybe?
Also, please, be careful when drawing blood. I know it's a very standard thing, but if it gets messed up it's scary and painful. I had one nurse use the needle to dig tor a vein. ;_;. I had a bruise that extended easily six inches both ways from the puncture. Another nurse did something weird with the bandage afterwards, and it soaked through with blood. I asked him for help (or at least a fresh bandage) when he passed by, but he told me I was fine and moved on. My husband flagged down another nurse who came in and did it right. By then, though, I had blood dripping all over me. I know it's minor, but it was very scary for my husband who's afraid of blood. ^_^''
I don't know if you'll ever actually take blood, since you're going to be a doctor and not a nurse, but it can be really traumatic if it's not done right.
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...evening's glow
