Thread by @hyderabaddoctor

Sharing a few tips that could enrich doctor-patient relationship
1. I saw my first patient in 1994. During past three decades, I have learnt a lot from my patients while interacting with them. These tips could help younger doctors who have recently started this amazing journey.

2.Listen to patients: The clues to diagnosis often lie in patient’s history. Moreover, if patients are properly heard, they feel satisfied. Occasional chronic patients may have thick files; it is still worthwhile letting them narrate the story, especially if it is the first visit

3. If patient requests for a test, accept it, even if the chance of it being abnormal is low. Patients understand their body well, and you will be surprised to find an abnormality in the test they wanted and you felt it was not needed.
#MedTwitter #doctors

4. Allow patients to do investigations at a place of their choice (unless you have a doubt about the quality of the lab concerned).
If they have previously done the investigations, better to accept them instead of repeating, unless you expect a change now. Minimizing cost helps

5. Same applies to allowing them buy medicines at a chemist of their choice.
Option of choosing any brand or a generic substitute (from Jan Aushadhi Kendra) should be given to the patient.
If you suspect the quality of medicine, convey to the patient.

6. If a #patient reports an adverse effect after starting medicines, accept it (even though that particular event is not well-reported with that drug in literature). It could be a rare or unknown side effect.
(Single dose of oral #steroid can cause muscle weakness)

7. If patient wants to try Ayurveda/homeopathy, permit them. However, don’t suggest combining allopathic with traditional medicines, as I have seen adverse effects with homeopathy/Ayurveda, and it would be difficult to decide what caused adverse effects if they are taking both.

8. Advise patients about diet, exercise and lifestyle modifications in addition to medicines. Many diseases do respond to lifestyle modifications and may reduce their pill burden. Preventive strategies should also be discussed.

9. If a patient comes for second opinion and the previous doctor has correctly diagnosed/treated, convey the same and request patient to follow up with same doctor. If in doubt, it is good to discuss with the previous doctor, as clinical findings could have changed over time.

10. Tell the #Truth.
If prognosis is not good, say so rather than giving false hopes.
It may take longer duration to break the bad news and if you have alternative appointments, it would be better to call them later rather than rush and convey bad news in a hurry.

Conclusions
Success of treatment is a shared responsibility between patients and doctors.
Complete transparency and proper communication helps cement the doctor-patient relationship.