Recently, a patient with a history of MI saw me during a stress test visit. He completed stage III without any complication. I told him that he had made an excellent recovery nonetheless keeping in mind of life-long adherence to medications and life style modification. I extended to him that a coronary angiography might be an option if he becomes symptomatic and interventions of either surgical or percutaneous route would be needed.
I routinely explained to him regarding the small but significant risks of on-table MI, stroke and death during angiography. He backed off after my explanation. It was as expected. I reassured him that medical therapy is as good as invasive interventions in face of asymptomatic status. He accepted and left my clinic happily.
I thought I have managed to convince a patient, but then..
10 mins later, a man busted into my room. Claiming to be one of his cousins, he demanded me to explain to him again from scratch. He told me that he knew Dr Z and Dr B (2 consultants in the hospital) well, and they always went out for drinks together.
Fortunately, I didn't have any more patients left and hence patiently I re-explained everything to him, in the presence of that patient. I reinstated the need of intervention in the future if he becomes symptomatic and the risks involved. I also told him that I have already made an informed decision with the patient.
"How do you be sure that he's ok if you don't do an angiogram on him?"
"I want an angiogram to be done on him."
"You know, if anything happens to him, YOU ARE responsible you know!"
I practically felt like being threatened and/or blackmailed by him!
In my clinical experience, I find that sometimes patients or patient's relative demand 'warranty' after a course of treatment. Well, the fundamental problem is that, THERE IS ABSOLUTELY IMPOSSIBLE TO HAVE WARRANTY IN CLINICAL TREATMENT!
Really, off-hand I can't recall any clinicians that have ever given out a 'warranty' to patients before. Enlighten me if I'm wrong ;)
That cousin of him really served well in 'sabotaging' the good doctor-patient relationship that I've strived to establish. Maybe one day, he could finally understand this when he's out drinking with either Dr B or Dr Z?
On second thought, maybe not...
I routinely explained to him regarding the small but significant risks of on-table MI, stroke and death during angiography. He backed off after my explanation. It was as expected. I reassured him that medical therapy is as good as invasive interventions in face of asymptomatic status. He accepted and left my clinic happily.
I thought I have managed to convince a patient, but then..
10 mins later, a man busted into my room. Claiming to be one of his cousins, he demanded me to explain to him again from scratch. He told me that he knew Dr Z and Dr B (2 consultants in the hospital) well, and they always went out for drinks together.
Fortunately, I didn't have any more patients left and hence patiently I re-explained everything to him, in the presence of that patient. I reinstated the need of intervention in the future if he becomes symptomatic and the risks involved. I also told him that I have already made an informed decision with the patient.
"How do you be sure that he's ok if you don't do an angiogram on him?"
"I want an angiogram to be done on him."
"You know, if anything happens to him, YOU ARE responsible you know!"
I practically felt like being threatened and/or blackmailed by him!
In my clinical experience, I find that sometimes patients or patient's relative demand 'warranty' after a course of treatment. Well, the fundamental problem is that, THERE IS ABSOLUTELY IMPOSSIBLE TO HAVE WARRANTY IN CLINICAL TREATMENT!
Really, off-hand I can't recall any clinicians that have ever given out a 'warranty' to patients before. Enlighten me if I'm wrong ;)
That cousin of him really served well in 'sabotaging' the good doctor-patient relationship that I've strived to establish. Maybe one day, he could finally understand this when he's out drinking with either Dr B or Dr Z?
On second thought, maybe not...
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1 comment:
To be frank, incidents like this were very rare (although they did happen) when I was working in the UK.
In asia, in particular Malaysia, this is a more frequent occurence. This is because of the culture, ppl in Msia are downright rude and abusive... 'third world personality', lack of social evolution.
Being a nice doctor and giving your time like you have done so kindly for this chap, makes him perceive you as weak. Therefore, he is going to run over you and threaten you.
I still try to be nice to all my patients. But if I sense that a conversation is going a certain way, I will try to take control and assert my position. That failing I will refuse to discuss any further, because the result will be the same; an irate and unreasonable cretin trying to tell me how to do my job. I have no time for such individuals.
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