[In my previous blog, I had mentioned that I would be talking about various aspects of Doctor - Patient Relationship over the next few months. This blog is in line with the same.]
Over the last weekend, my brother – Dr. Mukesh Rathi (as mentioned in my previous blogs – Mukesh is a practicing Gynecologist) published a blog titled “What is in the Name?“. I will encourage you all to check it out. As I had mentioned in my previous blog, I had been very curious about how patients typically get treated and also about what typically goes on in Doctor’s mind while diagnosing a patient. Mukesh and I have had several conversations on the same in the last few months. He has tried to capture some portions of those conversations in this blog. He had sent me the first copy of his thoughts a week back. My contributions to his blog has been from the proof-reading side.
Mukesh’s blog talks about an interesting aspect – which IMHO – many a times sub-consciously is considered as non-important by many of us – “why is it so important to know or derive the disease name?” The reason I say it is interesting is because – how many times ‘we‘ patients have walked out of the doctor’s room without asking him/her – what is the name of the disease/illness which I am suffering from?
Based on lots of reading and research, I have come to the realization that almost all human ailments typically tend to have a name i. e. a disease name. These names either are a derived name from a primary classification of diseases or could be combination of multiple of disease names. The second realization (and I thought an important one too) for me was that any prescribed treatment in medical books/literature are always associated with a disease name. A very simple example – there is a prescribed treatment plan set for H1N1 (Swine Flu). So a patient possibly suffering from H1N1 would undergo the treatment associated with it only after it has been validated that he/she is suffering from H1N1. In other words – the treatment is linked to the disease name. So the key (from doctor’s perspective) here is to identify the disease name (note that there are millions of diseases out there) from the set of symptoms which the patient is exhibiting. Once the disease name is correctly identified – prescribing the treatment is easy as most of the treatments are very well documented in the medical literature. This is the gist of Mukesh’s blog.
So why is disease name identification so important – you may ask? Well, if the disease name is not correctly identified – logically the treatment which a patient might be undergoing may also be incorrect. Simple as that. Incorrect identification of the disease name to start with is the major cause of medical errors/misdiagnosis.
To get an essence of Mukesh’s thoughts from a doctor-patient relationship perspective – it might be worthwhile to consider what Federation of State Medical Boards of United States has mentioned in their model guidelines on when do they think a typical relationship between a doctor and a patient starts evolving -
“A typical physician-patient relationship tends to begin when an individual seeks assistance from a physician with a health-related matter for which the physician may provide assistance. However, the relationship is clearly established when the physician agrees to undertake diagnosis and treatment of the patient and the patient agrees, whether or not there has been a personal encounter between the physician (or other supervised health care practitioner) and patient.”
As the above guideline states – the function of diagnosis and treatment are at the core of a good Doctor-Patient relationship. And as I had mentioned in my previous blog (link above) – if we all were to understand the behavioral drivers behind these functions – it can only ultimately result in better doctor-patient relationship and communication. Hence I felt that Mukesh’s blog was highly relevant.
Deriving the name of the disease correctly as part of the diagnosis process can be tough many a times and can be prone to trial and error. Contrary to common perception that it is doctor’s responsibility to derive the name – patients also have to play a big role in this investigative process. I will be talking more about this in my future blogs.
I would welcome your thoughts and comments.
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