Advancements in medical technology have given go up to medicalization, a process where 'non-medical' problems have become understood and cured as 'medical' issues. 1 This potentially objectifies humans, leading to "deindividuation"2, where doctors identify patients by their disease or process. The distancing of doctor-patient interactions have been worsened by limited doctor-patient interactions. 3 Humanization of drugs is critical to ensure patients obtain adequate care because they are reliant on the doctor's competence and good will. 4 This is where the BH1002 module plays a part in my development as a good doctor. It does increase my awareness of patients' needs and the complexities of the medical system. The essence of this module is encapsulated in three learning items: a) Professionalism; b) Communication in Doctor-patient connections; and c) Patient safety.
My role as a future doctor is to mend. Professionalism exemplifies the contract between contemporary society and medication as it's the groundwork of doctor-patient trust. 5 Inside the BH1002 tutorials, I was subjected to three fundamental ideas of professionalism, particularly, the primacy of patient welfare, patient autonomy and social justice. Professionalism and reliability requires honesty with patients, empowering those to make enlightened medical decisions; it needs trust and having patients' interests at heart; it involves similar distribution of professional medical resources to all patients. 5
In my opinion, medical professionalism requires demonstrating humility and compassion. Modern medicine has established a culture defined by entitlement and conceit, and humility implies weakness or incorrect modesty. 6 Having the confidence to deal with my insecurities is paramount to my development as a doctor. However, I am aware that self-confidence can develop into overconfidence as my level of clinical knowledge and skills raises. It could cause me to overestimate my capabilities, mating incompetency and arrogance.
As another doctor, I strive to remain grounded and become accountable for my blunders. I am going to avoid finger-pointing when errors occur. Being humble makes me mindful of the boundaries of my knowledge, allowing me to recognize opportunities for improvement. I am going to consider things from my patient's point of view, prioritizing the well-being of my patients. Humility and assurance are not mutually exclusive. 7 To reach a balance, I will constantly assess myself in clinical encounters. Through introspection, I could work towards being a more gracious person. I am aware that whenever I am worn out, I might have a non permanent lapse in humility and become rude to someone. In response, I will remember to apologize sincerely, fostering better work dynamics in the medical setting up.
Compassion can be an essential requirement of medical professionalism. It entails both empathy and the desire to increase the current situation. The Population for Basic Internal Medicine details empathy as "the function of effectively acknowledging the emotional talk about of another without experiencing that point out oneself. "8 With this module, I was taught to strive for detachment with my patients to ensure that my feelings do not impede the grade of good care I provide. 8 Nonetheless, it is essential to be sufficiently susceptible to my patient's suffering. When my attention is focused on my patients, they will be able to believe that I care. In contrast, being emotionally-detached could be interpreted as being indifferent, increasing their suffering because of the insufficient understanding.
A research on the effect of forty a few moments of compassion on patient nervousness noted, "The increased compassion portion was. . . effective in reducing audiences' anxiety"9. Compassion creates trust between the doctor and patients, motivating them to remember and disclose significant details about their conditions. 8 Increased awareness of the patient's situation permits more accurate identification and effective personalization of treatments, improving the grade of attention. 8 Patient satisfaction is increased, enhancing the doctor-patient romance.
I make an effort to exhibit medical professionalism and reliability when you are compassionate. As another doctor, I am in charge of the welfare of my patients. Having compassion can make me mindful of their needs. I could understand the situation from their perspective, and think about how exactly I can alleviate their suffering. Subsequently, my patients won't have to face their difficulties by themselves.
The doctor-patient romance is a keystone of treatment. Built on trust and conformity, it exists whenever a doctor serves a patient's medical needs, providing support and treatment. 10 There were two key reasons educated on why effective communication is essential: a) provision of quality health care; and b) treatments adherence. I really believe patients benefit most when there exists common trust and esteem - doctors reserve time to hear their patients; patients provide information about their medical condition to the best of their ability and comply with prescriptions. This may only be achieved with effective communication.
In the provision of better health care, it is important to focus on the medical interview between the doctor and patient. This is the primary medium through which doctors accumulate information about the patient, make diagnoses and develop the doctor-patient romance. 3 During the tutorials, I got introduced to a famous painting, The Doctor by Fildes. The painting exemplifies the qualities of an excellent doctor. Regardless of the inadequacy of medical technology, and thus inability to save the individual, he remains by the patient's bedside, providing reassurance through his presence.
This is an enormous contrast with the present day physician, who, due to large number of patients to see every day11, is often struggling to reserve time to stay by the patient's aspect. In his publication, Being Mortal: Treatments and WHAT COUNTS in the End, Gawande laments the deterioration of attention in the medical setting. He features it to the switch in focus to treating diseases quickly using modern tools, highlighting that "fast, solution-oriented treatment accounts for around one-quarter of Medicare expenditures"11. Furthermore, the time spent on write-ups is threefold enough time spent in direct contact with the patient12. Which means that short amount of time is spent on communication with the patient. For this reason, patients feel neglected and much more unpleasant when doctors are unable to listen to their psychological needs and address their concerns.
What I wanted. . . was a health care provider. . . who understood a discussion was as important as a prescription; a doctor to whom recovery mattered just as much as state-of-the-art surgery do. What I was looking for. . . was a doctor. . . who is in a position to slow down, aware of the dividends not just for patients but also for herself and then for the system. 11
In the advantages to the course, I was taught that doctors come with an ethical responsibility to prioritize the needs of the patient. This means alleviating their fighting and minimizing patient dissatisfaction. When doctors take time to listen carefully, the quality of information obtained raises, enabling a far more accurate diagnosis to be made. 3 In learning communication skills, I can clearly explain my patient's situation, avoiding misunderstandings that might occur due to the lack of knowledge of "basic health ideas, medical conditions or medical information"13. I provides emotional reassurance to prospects involved, facilitating the procedure of recovery and improving the doctor-patient relationship.
Medicine adherence refers to whether patients follow the decided recommendations and whether they take their medication for the entire length of time. 14 Effective communication is the major determinant of compliance. 15 Doctors have a problem with communicating information effectively, as observed in a study that reported, "40-80 percent of the medical information patients obtain is overlooked immediately and practically half of the info maintained is incorrect"15.
In this component, I was taught the teach-back method to improve medication adherence, which depends heavily on interacting information to patients in a way that is easily grasped. In teach-back, patients are asked to spell it out the information taught. This involves them in prescription decisions and functions as verification that they understand what has been discussed, including the prescribed dosage of the medication. Patients can then make up to date decisions regarding their use of medicines. By engaging patients in their care and attention, they are more likely to adhere to the prescriptions, leading to a higher standard of living and higher satisfaction. 14
As a future doctor, I firmly think that patients have the right to make decisions in regard to their health. This means that if patients won't take the prescribed treatment, that choice must be the best one; if they accept the suggestion, I am in charge of facilitating the appropriate adherence to maximize the effectiveness of treatment and reduce threat of side effects. Using what I learned, as well as the "SPIKES" model detailed in WHO Multi-professional Patient Basic safety Curriculum Guide16, I will provide uninterrupted time for patients to talk about their concerns and ask questions about their conditions. This will help me understand my patients' beliefs and assure them which i am listening. And, I will supply the necessary data, in a thorough manner, using the teach-back solution to check their understanding. This will likely assist in shared-decision making, where patients can effectively words concerns about areas of the treatment they disagree with. This allows me to handle the issue of limited health literacy of patients and discuss a treatment these are agreeable with.
A large proportion of the BH1002 component was spent speaking about patient safety. I got exposed to the thought of human limits and reasons why healthcare systems fail. My biggest takeaway was being constantly reminded that doctors aren't infallible. In fact, great doctors are people who expect problems that occurs and take procedures to prevent them before these errors can occur.
Humans have limitations that can predispose them to error. Through the lectures, I learned about storage constraints, verification bias in perception and selective perspective. The recalled storage is reconstructed, changing relating to what we perceive; we tend to seek evidence to aid our decisions, even if your choice may not be right; we do not notice when something unforeseen gets into our field of perspective, especially when we are focused on another thing. These cause difficulty multi-tasking and recalling complete information quickly15, creating room for problem.
Now that I am aware of these boundaries, I will devote greater effort to reduce the impact individual boundaries have on my patients' health. I am going to use writing assists, noting important information immediately, reducing the reliance on human being ram. This also removes the doubt that I could have remembered the incorrect details. I believe this habit needs to be cultivated while I am a medical learner. Therefore, I've started with the lectures I sign up for, jotting down tips lifted by lecturers and looking at them for higher understanding of this content taught. To lessen the chance of confirmation bias, I am going to make sure you gather information from reliable sources, analyze the data carefully before achieving a conclusion, rather than drawing a finish before finding research that tally with my estimation.
In a medical practice research conducted in 2000, To Err Is Human: Building a Safer Health System, it is emphasized that to make sure patients that they are safe from accidental injury, concerted work by all pros is required to "break down traditional clinical restrictions, the culture of blame, and systematically design safe practices into operations of care". 17 There are many reasons why healthcare systems are unsuccessful. First would be the traditional intolerance for error in the medical environment. Doctors are organised personally responsible even if the mistake was systems-based and beyond their control. The medical culture of blaming encourages doctors to underreport mistakes out of fear of disciplinary measures. 18 The BH1002 module taught the value of sharing the responsibility of guilt. If a health care provider makes a mistake, writing creates opportunities for everybody to review the condition objectively. Improvements can then be made to existing systems to avoid a repeat of the same mistake.
I learnt about the "Swiss cheese style of system accidents". This model compares the various levels on which mistakes occur with pieces of cheese. Each cut represents a level of protection against potential problems. In the real world, each slice has holes in several places, each representing a loophole. A catastrophe will appear when the slots align allowing a chance for accidents, directly bringing patients in contact with hazards. 19 These lapses in protection arise from two types of mistakes. Active errors are unsafe conducts committed by people that lead right to a given mistake. Latent problems are problems that stay dormant in the system until 'brought about' by other events. These arise further from the action itself, such as imperfections in the medical care business or faults in the equipment used.
Active errors are often unpredictable whereas latent mistakes can be avoided. The persons-approach, which centers solely on dynamic errors and individual blame, is therefore of limited advantage because it handles errors only after they occur. On the other hand, the systems-approach revolves around the theory that errors should be expected and designs a resilient system to reduce the chance of incidence of error before it happens.
The systems-approach is important to my development as a good doctor. It reminds me of the necessity to adhere to standard operating steps in the medical setting up. Simple techniques such as side hygiene can reduce the risk of distributing microbe infections among patients. I am aware that patient handovers are an integral part of the medical system. There are an average of 50-100 steps between the doctor's decision to order a medication and the delivery of the medicine to the individual, causing a standard 39% chance of error. 20 I'll do my part by making my case notes comprehensible and legible to avoid miscommunication between doctors. I'll clarify objectives before commencing any responsibilities and consult my superiors should I be unsure of any issues. When confirming critical lab results, I am going to use the read-back method, noting and fixing any discrepancies to guarantee the relayed information is appropriate. This will certainly reduce the chance of harm brought to the individual.
The health care environment is a very complicated one. In the beginning, I was fearful of the rigid and complicated hierarchies that exist. The BH1002 component has equipped me with the required knowledge of what must be done to be always a good doctor, as well as how I could understand my patients better and ensure their safety. I believe being in charge of my actions is the ultimate way to exhibit professionalism and help people. I look forward to overcoming the tests I'll face as a health care provider. I hope to become doctor that can provide my patients and peers well, by providing quality attention and learning to be a pillar of support.
