One common duty of all health personnel is to educate people so that they would be able to look after their own health. Among health personnel, doctors/physicians are in the most advantageous position to influence them since they are held in high esteem. This influence may not only be for health related matters but may encompass many aspects of their lives, especially when they are acting as family physicians and sometimes as ‘family confidantes’, giving advice on many things. Even among doctors, General Practitioners (GP) especially in districts are in a highly favorable position to influence families and people on health matters.
People seek care in private and public health clinics, usually in pain with an ailment or with some health difficulty, requesting treatment or advice. Any treatment and advice given by the doctor is received with full attention and usually followed closely because they want to get better. This is in sharp contrast to public health workers trying to promote health by giving health education (HE) to people who are in good health. It is very challenging to talk to an apparently healthy person saying that his health can be improved. The doctor, may be a GP in their clinics, should take advantage of the situation and give advice to alleviate the presenting condition, and can influence the knowledge and attitude of the patient as well as family members.
The World Health Organization (WHO) has defined Health education as “any combination of learning experiences designed to help individuals and communities improve their health, by increasing their knowledge or influencing their attitudes” (1). Health education forms an integral part of all healthcare activities: promotive, preventive, curative and rehabilitative. Looking at the spectrum of healthcare, one can see that promotive and preventive aspects are concerned mainly with apparently healthy persons, and rehabilitation is concerned with persons who are recuperating from an ailment. As such, their acceptance and practice of advice given may not receive as much attention and acceptance that shown by persons undergoing medical treatment. At hospitals or health clinics, patients follow doctors’ instructions carefully because they are suffering. The instructions should cover not only to relieve or cure the presenting disease but to prevent future relapses and promote health. The relatives should also learn from these instructions.
The practicing doctor, whether specialists or general practitioners, should consider the following activities in their practices. This is not to say that it is not being done presently. However, based on the feedback the author received from patients, the following activities are recommended to address the concerns of patients and people.
(1) Talk with your patients
Always find time to talk to your patients. In many successful practices, the doctor with many patients to see, can provide only two or three minutes per patient. Often, patients came away feeling that they missed something, let down or dissatisfied. They complain that they did not even have a chance to ask the doctor about their illness. The doctor should encourage them to ask questions and listen carefully to what they have to say and then explain what is happening and why. Just talking to the doctor can allay some of their fears and concerns. Allow the dialogue to be two-way between doctor and patient/relatives to promote better interpersonal communication, better understanding and satisfaction for the patients and relatives. This would also show the patient that the doctor cares and empathizes with them.
(2) Use of language and terms
For lay persons to easily understand, please use simple language with a conciliatory tone. Using medical and scientific terms comes easily and naturally to physicians, but patients and their attendants do not understand what is being said. Patients may not have the knowledge nor prior experience with treatments and instructions given to them. The author had an incident with prescribing “Grape Salt”, an effervescent purgative. The instruction included an explanation that the salt needed to be taken with water in the morning after deworming and the patient stated that he understood the instruction. However, the next morning, his wife became alarmed with her husband was foaming at the mouth. He had taken the powder in his mouth with water and foam was created. In this case, miscommunication of a simple instruction caused an alarming experience for the patient and his wife.
(3)Write legible prescriptions and instructionsDoctors do have a knack for writing their prescriptions in an unreadable scrawl. However, their helpers and assistants seem to know what is being written and dispense drugs and give instructions quite at the medicine counter. An interesting study would be to compare what was prescribed by the doctors and what was dispensed by the assistants. I certainly hope there are no differences.
(3) Be honestIf one is not sure or do not know something, one should admit it readily. A physician is only human and may not know everything. Some educated patients may ask you about the treatment and side effects of drugs. In this electronic age, information on nearly all topics, including diseases and their treatment, information on drugs, regimens, etc., is readily accessible on the internet and available on cell phones. Patients can look up information about prescribed drugs and if the attending doctor is not well -informed, the trust in the doctor may suffer, especially if the patient is right. Catastrophic situations can occur if a drug side effect is sudden cardiac arrest and the uninformed doctor prescribes the medicine. In such situations, the doctor should withhold the drug and proceed with treatment accordingly.
(4)Be aware of ethical principlesA practicing doctor in a clinical setting always needs to consider ethical principles since this affects how the doctor treats the patient and imparts knowledge. The main principles in patient education include: Autonomy (right of the patient to be informed, provided with relevant information to enable informed decision); Beneficence (the available medical alternatives that may provide the best result); and Justice (rights of patient vs. family, choice made by patient affecting the burden on the family, etc.). The doctor will have to consider what he does and says will not be harm the patient and others (Non-maleficence). In short, every practicing physician has to be aware of ethical principles in treating and educating the patients.
These are actions that doctors can take to increase patient satisfaction, better compliance to instructions and increase patient health knowledge for better attitudes towards health care.
References:1. World Health Organization (2018), as presented on the internet www.who.int/topics/health_education/en/
