Vijai P. Sharma, Ph.D
"What is the drug you use in your medical practice all the time?" The question posed by a psychiatrist used to baffle many doctors in London in the sixties.
"The doctor is the drug," Dr. Michael Balint would supply the answer to a puzzled doctor.
Balint should know as he was the first one who brought the mental health specialists and the general practitioners of London together to understand a patient's medical problems.
The concept that physical illnesses and their recovery had a psychological angle was revolutionary then in the sixties, and is novel and intriguing even for our times. The doctor is the major "drug" in getting a patient better.
I am sure that you have experienced one time or the other that an ache or an ailment is bothering you, you fix an appointment with your doctor, and as the day of the appointment arrives, just that day, that very day, that ache or that ailment disappears!
When it happens with me, I wish the problem would not go away like that because what will I tell the doctor then. It is embarrassing, when the doctor asks you where exactly it is hurting, and you are not even sure if it was left side or the right, let alone the exact spot where it hurts.
The explanation for this annoying fact of life is that the doctor works as the drug. I used to hear a popular saying as a child, "Half the problem goes away when you see a doctor and the remaining half goes away when you take the medicine."
A placebo, which is a non-drug, such as a sugar pill, is given to a patient by a doctor and it, in many cases, works like a real medication in improving a real physical condition.
How is that possible? It works that way because it is given by the doctor. The patient believes that the doctor is the expert who treats and cures the illness.
It is the respect, faith, hope, and all those good aspects of a relationship that a patient places in the doctor. The word "placebo" translates in English as, "I please you." The pleasing aspect of the doctor relationship works for the patient.
"The doctor-patient relationship is probably the single most important dimension of medical care," says Richard Frankel, a sociologist and an expert in human interaction. Research shows that you are likely to do better medically if you have a doctor with whom you can communicate.
A Consumer Report survey which involved more than 70,000 readers of the magazine indicates that if there is a good communication and team-work spirit between you and the doctor, then you may be diagnosed more accurately, respond better to treatment, and recover more quickly.
Satisfaction will also be at its highest in such a doctor-patient relationship. You are more likely to feel in control, tolerate symptoms better, and take more responsibility for improving your health.
A good communication and teamwork spirit between a patient and a doctor is established, when doctors, among other things, seek opinion of patients about what they think is wrong with them; explain how patients may improve their health and make beneficial lifestyle changes, explain possible side effects of their medication; encourage patients to ask questions about their diagnosis and treatment, and appear to care about patients' emotional well-being and about their families.
Patients are likely to place more trust and hope in a doctor who knows them as a person beside knowing them as a patient.
Norman Cousins, author of "Anatomy Of An Illness," a classic in the psychological aspects of medicine, conducted a survey on patients' satisfaction when he was on the faculty of the UCLA.
One aspect of the survey was about why patients switched to another physician. His finding revealed a fascinating facet: the reason why patients leave their doctor is not because they think that doctor is not competent or is not knowledgeable but, they leave because of the doctor's behavior and interaction with the patient, or because they simply didn't hit it off.
This is how important the doctor-patient relationship
is to a patient. In a chronic illness, such as back pain
or headache when medication has hit its point of
limitation, it's the satisfying relationship with the
doctor that is a more effective drug than the chemical
drug itself.
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Copyright
1996, Mind Publications
Dr. Vijai Sharma
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