Posted by KrissyP on March 9, 2003, at 0:31:12
In reply to The biggest problem with psychology today, posted by Gracie2 on February 21, 2003, at 4:27:22
Hi, I am new to this board ( I post on Psych-Babble) but I hear you! Sometimes, though, we as patients have to be proactive and find this info ourselves. So what then do we pay our docs for?
I am a "non-compliant patient" and have been shunned because of it. I'm happy to say that I have gotten better because every time I go off meds-I am not ready to-suffering bad consequences. I think I have learned my lesson.
I also thin that a huge reason for noncompliance, at least in my case, was PRIDE. I didn't want to be labeled "psyho" or a "loon" because I have to take psych meds. I am learning to live with this fact as I am still suffering but not as much. I also have learned not to put up with the "crabby-ass" docs-PERIOD. FORGET EM AND MOVE ON-HARD AS IT SOUNDS. These types of docs don't deserve to help us if it is strictly "about the almighty dollar"
You say, " I know it isn't possible for a doctor, these days, to sit back and chat, to go into great detail about every patient's condition and medications during a routine appointment..."- I think this SHOULD be the case-I mean we are talking about our lives, functioning, well-being not to mention our emotional state which this example doesn't helpw ith. But you're right, I agree, "there is limited personal interaction between doctor and patient".-for many reasons.
Hang in there,
Kristen:-)----------------------------------------------------------------------------------------As I see it, the biggest problem with psychology today is lack of patient information. I have no statistics to quote, but from my own experience and from reading the postings here on PB over the years, I have a pretty strong opinion on this.
I'm sure that most psychiatrists would agree that a major cause of treatment failure is patient noncompliance. A huge reason for noncompliance is lack of patient information. I consider myself to be a well-read and fairly intelligent individual, albeit with a serious mental condition. I also have over 20 years experience in the medical profession, although not a profession much related to psychology. And still, even after the books I've read in an attempt to learn more about bipolar disease, I'm STILL being surprised about some very basic truths concerning this illness, things my doctors never bothered to mention.
For instance, on my last visit to my latest psychiatrist, who seems to be extremely competent if somewhat of a crabby-ass, he demanded again to know exactly how much coffee I drink every day. And there's no way to tell him because I drink the stuff all day long, pots of Starbucks espresso, although when he told me to cut down I started to dilute the coffee more and more as the day went on with decaff and hot milk. I thought that was a pretty clever way to wean myself but this doctor, he still isn't happy. Finally I sort of yelled at him, "What difference does it make how much coffee I drink!" So then he tells me that coffee can induce mania. NOW he tells me. I've been under psychiatric care for about 3 years now and this is a newsflash.
I assume that a person with regular thought-processes might just know this. But ever since Army basic training, when your day can often start at 4:00 am, I've been swilling this stuff like water. That makes 25 years of swilling, so coffee doesn't have any meaning for me anymore unless it's not there. You know, like oxygen. (I believe difficulty in moderation is a classic bipolar symptom.) So when this doctor told me to cut down on coffee, I figured it was because he thought it might make it difficult for me to sleep. And since I was sleeping well on Seroquel, cutting down on coffee didn't seem very important.
> In my own troubled mind, I had never connected coffee and mania. I knew it was probably a good idea, but it was also sort of like telling a preteen to never have sex before marriage, without offering any reasons for it. Education is important, really important if you want a thinking person to comply.
>
> I rarely visit Psycho-Babble anymore because my own medication issues have been resolved, and a majority of the posts there have to do with confusion, misinformation and despair over drug reactions. This is, of course, the purpose of the site, but a lot of this suffering could be avoided if the doctors prescribing these medications would make an effort to educate the patient about these drugs. I've worked in doctors'
> offices for many years and I'm familiar with their routine; I know it isn't possible for a doctor, these days, to sit back and chat, to go into great detail about every patient's condition and medications during a routine appointment. However, it is quite possible for every doctor to
> to give the patient educational material or, at the very least, a single sheet of paper listing educational sources that the patient can refer to. I believe that most doctors in every speciality underestimate the ability, the
> willingness and the need for patients to learn about their condition and treatment.
>
> Right now, general patient information is pretty much limited to the pamphlets you can pick up in the waiting room of doctors' offices. While these pamphlets are a useful introduction to a patient's condition or medication, and suitable for patients who are unable or unwilling to learn more, many people need much more information. I believe that the trend towards patient self-education is not related to a lack of faith in their doctor's expertise or even distrust in the current medical system, but a direct result of today's assembly-line patient care. When things go as they should and usually do, the average person in America has access to not only competent medical care, but groundbreaking and state-of-the-art diagnostic tests and treatment.
> With all the grousing about malpractice, insurance costs, drug companies and so forth, we tend to lose sight of the big picture, how fortunate we really are. However, due to sheer numbers, there is limited personal interaction between doctor and patient. We enter the medical machine with a problem and, if all goes well, we're spit out at the end feeling better. And we often go through the whole process scared shitless, because we don't know what's happening.
>
> As long as the system is in place, why not make it better? Even when you discount people as individuals and think in terms of strictly numbers, our entire medical system is based on the success or failure of specific treatments for a diagnosed condition.
> Often success depends on patient compliance, a willingness to follow doctor's orders. Almost any patient would be motivated to comply if he really understood the consequences of not following the doctor's directions or disregarding the labels on pill bottles.
>
> While there is no need to go into the kind of detailed information available in a PDR, I believe every patient diagnosed with a specific condition and every patient prescribed any medication should, at the very least, recieve a
> list of educational sources. Depending on the severity of a patient's condition, from an annoying rash to something as devestating as cerebral palsy, patients and their families need to know about illness and treatment. They need to know why a specific medical condition occurs, what factors did or may have contributed to their illness. They need to know what symptoms may warrant immediate medical attention and which symptoms are fairly normal for a diagnosed condition. They should understand the basic reasons for a prescribed treatment and the expected results of such treatment, including a fair estimate of how long it should or might take to see visible improvement. They should know the possible results of ignoring medical advice.
>
> Damn! You've just witnessed a pretty big relapse and it's all my fault for drinking coffee and alcohol after my doctor told me not to. It's now 4:00 am and I'm ready to clean the whole house.
> I'll be sorry later. But at least I understand why I feel this way, that I made the decision at some point, myself, to keep drinking and writing
> even when I knew this would happen. A year ago, I probably would have felt that I was just hopelessly crazy and there was no point in continuing to live. Now I know better.
>
> -Gracie
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poster:KrissyP
thread:202380
URL: http://www.dr-bob.org/babble/psycho/20030203/msgs/207292.html