This is why you should tell your doctor everything

“The physician should not (simply) treat the disease, but the patient.” This is the inscription on my consulting room wall. This statement, by Maimonides, an 1100s Arab physician, is my mantra when I start my day.

It, however, never rang true until a few weeks ago when a gentleman walked into my consulting room for a routine Hepatitis B test. Before long, the test results were ready and it turned out positive. I thoroughly explained the implications and offered all the necessary advice.

My session with him had not lasted more than 30 minutes, up till then; however, my patient stayed on a further 30 minutes, pouring out his heart about his current and previous relationships, about how stressful his work is, about his hopes and dreams, about religion, about politics, about everything and about nothing.

After his satisfying session of catharsis, he thanked me profusely for being the best doctor, he’s met and yet all the “medication” I had given him was a nod here and there, and acknowledgement as needed.

All I did was listen. In our fast-paced world where the patient has no time to spell out his problems and the doctor has no time to analyze the patient, we mostly end up treating the disease while the patient leaves with a truck load of unrelieved burden.

How many times have we not seen a 5yr old girl come to the hospital severally because of an “itchy groin”, only to hear in the end that she was brutally defiled by her step-dad. Or the woman, two years in marriage, who is treated every month for a urinary tract infection, only to find out that she has been inserting very unhealthy substances into her vagina, in a bid to get pregnant.

Or the young man who prefers to leave work and accompany her able mother to the hospital every month for a medication refill, just because the nurse is the only lady he can chat with, aside her mum. The bio-psycho-social approach to medicine is a process that considers the patient as a complete being, functioning in a complex world of socio-cultural, economic and biological influences.

The mind cannot be separated from the body, the society cannot be separated from the mind and the body cannot be separated from the society. All of these interact to define illness behavior, shape response to medical intervention and determine eventual outcome.

In simple words, it is not enough to treat the physiological effects of illness; the psychological and social concerns of the individual must also be addressed for treatment to be complete. This is what patient-centered care is all about.

In a study published in the journal of Family Practice, it was found that the practice of patient-centered communication was correlated with better recovery of patients from their discomfort and concern, better emotional health 2 months later, and fewer diagnostic tests and referrals. In the final analysis, this holistic approach to medicine does not only make the patient better, quicker, it also reduces health care expenditure because unnecessary interventions are omitted.

The other side of this coin is the patient. The typical Ghanaian patient thinks he is being a burden on the health system and wasting the doctor’s time by elaborating on issues; they are in a hurry to allow the next person in, when they have not stated their case in toto: and they leave the consulting room hoping that the quinine given them to treat that malaria will also cure their depression.

The doctor is not doing you a favor; he is doing his job. You have the right to speak. So when you think you need to see the doctor next, go in with all your burdens and the ones that we can help you with, we sure will. You deserve the best.

The bio-psycho-social approach has been in existence for more than 40 yrs. If we are able to understand its significance and harness it into our practice as medics, we will save patients time and money, we will be more satisfied with our jobs and most importantly, our patients will be happier.

Email: kojotwumnimako@gmail.com

Twitter: @KTNimako