Source: livingstingy.blogspot.com
The gap between medical facts and public perception is nothing short of amazing. For instance when I tell some patients, “Careful with your diet, your cholesterol levels will soon be off the charts.”
The best reply would be, “Alright, alright. Start me on the pills already. Give me something with “extra strength”. I want to continue on my seafood and mutton diet.”
Or at the end of the spectrum you’ll have patients rejecting every recommended treatment, and me having to convince them otherwise.
My patience, temper, and tolerance depends on how many similar patients I have that day. But generally, our society has a lackadaisical attitude towards medications. Some hypertensives adjust their medications to their “symptoms”. They’ll take two tablets instead of one if they have headaches, attributing the headaches to high blood pressures. I suppose it doesn’t cross their mind that the headaches could be a simple stress headache, or the fact that the medications have a dosing limit that could be detrimental effect on health.
“Eh doc, I felt “different” last night so I upped the dose lah,” is the usual explanation.
Diabetics are even better. I have patients who do not take their meds because they didn’t take ‘sugar’.
“What do you mean you didn’t take sugar?”
“I didn’t take sugar la. You know, the one you put in food and drinks. But don’t worry doc, I always take them when I have teh tarik with my friends.”
She looked so proud of herself that I almost stood up and give her a standing ovation. Perhaps the medications shouldn’t look so innocent, colourful, and small, eh?
I’ve also had patients referred to me for prolonged fever asking for “extra strong” antibiotics, only to throw tantrums when I politely, diplomatically declined their “requests”. Luckily no damage that can’t be undone by a cup and a bowl of desserts later.
Good news is, these were stories of how I met these patients, the very first time. They were “patient zero”. I wouldn’t have survived if they came back with similar attitudes. They got better, much better after I spent time with them.
What many people don’t realise is that most medications are not custom made for each disease. For instance a pill to treat hypertension can also be used to treat anxiety disorders, palpitations and migraines. Pills that treat allergies are also used to treat autoimmune disorders like SLEs, Rheumatoid arthritis.
Many blood pressure medications not only reduces blood pressures, but have been proven to halt damages high blood pressure and diabetes have to our kidneys and hearts. Not surprising therefore when diabetics and even those with heart conditions being prescribed medications for hypertension to utilize that benefit.
Unfortunately for us in the medical profession, the public doesn’t know that. Imagine the nightmare doctors have when patients start picking which medications to take and which not, simply because they don’t ‘think’ they need it.
“I don’t have high blood pressure. Only diabetes, so why should I take the pressure pill?”
Doctors must spend more time with patients. Every extra minute you spend with them plays an important role in determining compliance to treatment, and whether the pills end up in patient’s stomach or the bin. Nothing guarantees a non – compliance better than a doctor who doesn’t explain, coupled with a society that generally think they know everything about medicine.
As someone who is in Public Health, I believe in educating the public. It is the single, most important tool and asset any doctor can impart their patients. A good doctor must also be a good teacher, period. Our profession is not just about knowing the right treatment combinations and regimes, but more importantly is the ability to convince our patients that their health and well being receives our attention and priority.
It would be a good idea for doctors and healthcare professional to attend a class on communication. The public on the other hand should get more information from their doctors, before making decisions on their own. They should take the “information” they read online with a pinch of salt, and verify them with the healthcare providers.
Doctors are after all here to help, even if they don’t know how to say so.
Dr. Kamal Amzan is currently practicing Public Health in Sabah, and is also a Columnist for The Malay Mail Online.
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]