‘I prefer Injection, I read on the internet’; how the patient took the wind out of the doctor’s sail

Fri, 20 Jul 2018 Source: Patrick Fynn

It's a cold morning -- a few minutes away from 8. A doctor is drowned in fatigue and looks a lot more like bulls in a China shop. His focus is on the fleeting hands on the clock that hangs above him. Like a bored stranger, he's itching to leave.

The morning team is filing in. The hospital is buzzing with constant movement and exchange.

A new aura fills the clinic. Noise levels begin to graduate. It's coming from the parking lot, the waiting area and the nurses station, where a child is vehemently rejecting a thermometer.

The situation is a preview of happenings around the world, wherever there's a clinic. People are thronging the doctor's place to keep their misery to a minimum. They are fighting all forms of ill health from Alzheimer's to Zoonosis.

So yes, it's a big day around the world. Every physician will have a tough day.

But the physicians being asked to prescribe antibiotics for a flu, bloods tests for insect bites, injections in place of tablets; will have a tougher day. These ones will return home feeling beaten and dispirited.

The average literate, elite hospital attendant has become overly imposing, unbearably demanding and is subtly directing the course of his treatment in a way that is appalling. Treatment preference and opinion imposition from patients are becoming every doctor's challenge. It's a silent coup d’état the average physician dreads. For a practice that is a science, an art and a craft, it gets embarrassingly worrying when patients dictate to the doctor.

It's a big day around the world. Every physician will have a tough day. The client walks into the consulting room and runs down a list of complaints which he crowns with his own impression, "I think I have Pneumonia. I read on the internet and my symptoms fit".

He's handed a prescription, which he glances with contempt, and drops a bombshell, "Tablets don't work for me. Won't you give me an injection?". Or he goes ahead to recommend what kind of medicines will best cure him. Guess what just happened…

Four, five, six years of medical training sentenced to slow, miserable, painful death!

The advent of the internet and the accessibility of information has only rendered the doctor incapacitated; like a chef who cannot boil water. So what we have in the health care system is a knowledgeable sick person who comes to the clinic with his own kettle and water. Very often, with bread and butter too.

Clients are getting insistent on taking laboratory confirmations of a doctor's diagnosis for diagnoses whose tests are even non-existent.

There was a time when you were sick, we just drain your blood like you're getting an oil change. People believed it was the way to go because knowledge was limited, then. Today, there's a time people hold on to knowledge so much that they disbelieve the person who has the knowledge. Today, patients have become the proverbial child who removes the feathers from a bird, and asks the elderly to identify it.

There was a time when you were sick, we just drilled holes in your head… today, sick people are boring holes in the heads of their healers and making them sicker.

Patients want to treat doctors like an ATM. They want to slot in their card of a cluster of symptoms and pull out that which meets their expectations.

Health psychology and ethics of the practice entreats the practitioner to involve the patient in the course of treatment. But the patient's sociology, status and internet make him overtake the sailor of this ship.

The shared model of medical decision-making has been proposed as the ideal means of care. However, rational use of drugs and treatmemt regimens may be more difficult to achieve if preferences are polarised.

Hold on, did you just say you read about your condition on the internet? Why then put on a raincoat if you're already wet?

Columnist: Patrick Fynn