INTEGRATING THE PATIENT AND DOCTOR AGENDAS

Presenter: Saurav Mishra

Moderator: Dr. Ashok Yadav

AGENDA

List of the subjects to be dealt with or talked about in a meeting

PATIENT’S AGENDA

Feelings or experience Fears or concerns Expectation of the doctors

DOCTOR’S AGENDA

Diagnosis Management Preventive Procedure eg age ,sex and risk

factors

PATIENT CENTRED APPROACH

Why?More effective doctoringMore accurate diagnosisBetter compliance with treatmentBetter patient satisfactionMore doctor satisfactionLess law suits / angry patient parties

WHAT IS THE DOCTOR’S TASK?

1. to understand the patient 2. to understand the disease

IMPORTANCE OF UNDERSTANDING PATIENT Understanding the problem and making a

diagnosis Successful management depends on patient

motivation and cooperation Management must be appropriate (cost,

availability, fit life style, side effects) Prevention and education must be

understood by the patient

listens briefly to main complaints cuts off the patient’s story and asks direct

questions about each symptom

Often misses important cues and clues regarding the disease process and thereby missing an opportunity to gain full insight into patient’s illness

Doctor centred process

DOCTOR CENTRED PROCESS

Doctor pursues own agenda Does not try to understand the patient’s

agenda Aim is to efficiently and quickly reach the

diagnosis, write the prescription and send the patient

CONT. …

Doctor obtains relevant information Processes it by direct questioning Fits the symptoms to the criteria for a

disease eg MI Success is measured by reaching a precise

diagnosis and Making sure that the record is acceptable to

medical colleagues

PATIENT CENTRED PROCESS

Includes both patient’s and doctor’s agenda Aims is to understand the patient’s

complaints from his/ her point of view ie to understand the illness experience

Uses the way the patient is thinking to help him understand their disease and its treatment

PATIENT CENTRED PROCESS

Allows patient to express Expectations of the visit to doctor Feelings and fears about the illness

Requires Empathy, non judgemental acceptance,

congruence and honesty Consulting skills

INTEGRATION OF TWO AGENDAS

Reaching an integration so that both patient and doctor are satisfied with

what happened Patient understands more about their disease

and accepts and participates in its management

REFERENCES

MURTAGH’S GENERAL PRATICE Preventive & Social Medicine: K.Park

“It is more important to know what patient has a disease, than to know what disease the patient has.”

- Sir William Osler

Thank you