By Dr Maria Alice
The Super-Witch-Doctor of nowadays is the one who can master the use of his knowledge, the use of his scientific crystal ball and the use of his ready-to-prescribe potions.
Indeed, a very hard task to achieve. It takes numerous “congenital” and “acquired” factors; a balanced mixture of science and art.
And the final key, not to be missed, to achieve the best performance? Patient-centred behaviour.
Every patient is unique
I strongly believe that there are many who graduate from medical universities who, even if they became encyclopaedic ‘owners’ of all available knowledge in books, do not know what ‘a patient’ is.
Definitely an unknown rare variety, of a complicated species with never-ending multiple possibilities that they do not recognise, and therefore do not know how to deal with, as … it is not in the books! But there is also the opposite danger. Those who only take emotions into consideration and forget about science.
Doubts, doubts, doubts
This is very slippery, dangerous ground as patients are, most of the time, overtaken by emotions. Being ill frequently wipes away rationality and installs the most irrational decision-making and conduct. Also the low-grade capacity to evaluate the doctor’s scientific capability is a non-avoidable fact.
It is very difficult to have a precise idea if the mechanic who is repairing the engine of our car is ‘a good one’, good enough for the type of job required and, most of all, someone you can trust to be honest enough to know how far his capacities go, and who else would be advisable to consult in case of doubt. It is a precious quality to have good, proper, evidence-based doubts.
Then, how is it possible not to be doubtful about what to do? It is not! Like everything in life, all decisions have to be taken having rationally taken into consideration all information available and adding feelings in enough quantity, “to taste”, in a healthy way…
The actual challenge
This is a two-way truth, for doctors to deal with patients, and vice versa. As I said to start with, the special breed of nowadays’ doctors is being confronted with a unique challenge and the consequent effort.
The increasing emphasis on the published, peer-reviewed evidence-based medicine is undoubtedly important but, running the risk of being old-fashioned, I feel it is very concerning if all the never-published experience and observation skills that are the unscientific intuitions felt by most physicians would be invalidated, as they are certainly not suitable for a classical scientific evaluation analysis.
It is more and more important to stay on the right track, keep the equilibrium and be honest. Honest towards yourself, your patient, your knowledge, your crystal ball and, more than ever, to your … potions, taking in perspective the present moment of the pharmaceutical and NHS “politics” for earning and for saving money.
The act of prescribing advised behaviours or names of potions, how much, how often, and how… is the roof of the construction that a patient and a doctor start building together from the moment they start their relationship. Like any other relationship, it has to be based on confidence, trust, and a certain “click”.
So… let’s use science, master our capacities to read our crystal ball and utilise our potions, but never ever forget to be humble before the mysteries of life and the human race represented by our patient, always unique and differently new.
Best healthy wishes,
Dr. Maria Alice
Dr Maria Alice is a consultant in General and Family Medicine. General Manager/Medical Director – Luzdoc International Medical Service. Medical Director – Grupo Hospital Particular do Algarve