Monday, November 19, 2012

Day 19: Advice for new (and not so new) doctors, nurses and caregivers from a patient's perspective

1) Don't be condescending or dismissive. Be respectful and take their concerns seriously.

I think this should be a general rule when it comes to interacting with anyone, but unfortunately I have come across a few doctors who don't appear to agree with me. (Not all doctors are like this, of course!)

2) Be aware that they may be fragile.

This one unfortunately partly follows on from number 1. Your patient may have been dealing with pain and fatigue for the better part of a decade before they get to you. (The average time between onset of symptoms and diagnosis of endometriosis is 8 years.) They may have been dismissed by previous doctors and their workmates, friends and family. They may also start doubting themselves and downplaying the symptoms they are experiencing.

which leads to...

3) Recognise the link between chronic illness and mental health

Many people who have chronic illnesses also have issues with their mental health. Whether it be anxiety, depression, or both, having to deal with the uncertainty of the future and the symptoms in the present takes its toll. It is important to take this into account when treating your patient. A referral to a psychologist or counsellor may be needed, or even medication if counselling is not effective on its own.

The good news is that if you recognise the link between chronic illness and mental health, your patient will probably feel more sane, more supported and this will lead to more effective treatments and a happier patient overall.

4) Stay positive but be realistic. Tell them everything you know.

Don't tell your patient that they are going to be completely fixed by whatever treatment you are prescribing. Let them know that it may not work, but it is worth trying, and that if it does not work, you have other options that you will explore further. This will give the patient hope without raising their expectations too high and again it will make them feel supported.

I have a friend who was told by a nurse that she will probably need assistance to fall pregnant due to her gynecological conditions. This was despite having many doctor's appointments prior to this where her regular gynecologist made no mention of any potential problems she may have with fertility. This was rather traumatic news for my friend to hear so late in the game from someone that she was not familiar with. Make sure you cover all the bases.

5) For gynecologists: if possible, have a session dedicated just to people with infertility and/or endometriosis.

Someone who is having trouble conceiving generally is not going to have fun at their appointments if they have to sit in a sea of pregnant women. It only reminds them of what they don't have. Having sessions at your practice dedicated solely to those with infertility and/or endometriosis solves this problem. (Even those with endometriosis who are not thinking of having kids in the immediate future will benefit from this as it is not a reminder of something that is uncertain.)

And finally - we know you're not perfect. No one is. So this is just a list of things that I think would help me and other patients in receiving treatment. Don't beat yourself up about it if you haven't done these things or forget to do these things - I'm just trying to show my point of view.

For my post on tips for patients on getting the most out of your doctor's appointment go here.


This month I will be taking part in National Health Blog Post Month. Check back every day to see the new topic and learn more about endometriosis. Today I'm taking a bonus round and giving advice for new doctors, nurses and caregivers.

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