June 4, 2012

Food for thought

Throughout my classes in med school, no matter what organ system we are covering, we are always given statistics and risk factors for diseases.  Included in those lists are invariably obesity, diabetes, and smoking.  A few professors even explicitly say that the top two things people could do to present illness and disease is to quit smoking and lose weight.  Given that, do you think it’s ok for doctors to refuse non-emergency treatment for patients who don’t stop smoking or lose weight?  Well, according to this article, 54% of doctors in the UK apparently do.

Personally, I have to say I agree with them.  Maybe it’s my Asian upbringing, which teaches holistic lifestyle practices, but I do believe that a doctor should not be expected to be a miracle worker.  If a patient refuses to cooperate with their own health, a doctor should not be obligated to treat that person when it may do them no/much less benefit, and also uses up resources that someone else might have benefitted a lot more from.

It’s like the issue of compliance – whether patients follow what doctors tell them or not (things like taking medications on time, getting refills on time, coming to scheduled appointments and follow-ups, etc).  Doctors often decide on treatment regimes based not only on the medical condition, but on patient compliance.    Which makes sense.  You don’t want to send someone home with medications if you know they might forget to take it at the right times, for example, especially if it’s critical that they take it to prevent something bad from happening.  Instead, you might want to keep them in the hospital for a few days and have them on an IV drip to ensure the medication will be given at the right times and dosage.

So  why isn’t the same true for patients who don’t agree to take initiative in their own health and well-being?  Of course, it can be argued that people of lower education may not grasp the severity of the situation, which may be true, although it can also be argued that part of a physician’s job is to be an educator in healthcare.

Along those lines, perhaps part of what doctors need to learn is how to communicate effectively and connect with patients so that they will listen to their medical advice.  This article gave a few good tips on how to get people to listen to you better, which I thought could be useful both in and out of the clinic.

I guess that’s enough rambling for now.  Thoughts?

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