RAMOSA’S MAR [15-07]:When a Physician’s Care becomes Personal

MEDICAL ANECDOTAL REPORT
Indexing Title: RAMOSA’S MAR [15-07]
MAR Title: When a Physician’s Care becomes Personal
Date of Medical Observation: June 2015
Tag: Empathy in patient care
Category: Professional/Ethical, Stimulus

Narration:

It was my turn to man the Out Patient Department. I was expecting one of my post- operative patients to follow-up. The patient is an 18-year-old male who underwent appendectomy. The day passed by but there was no sign of him. Since I knew his phone number, I sent him a text message asking how he was; however, there was no reply. A few days later, I finally received a response from him. “Good evening po doktora. Sorry po kung hindi po ako nakapunta diyan. Nag-away po kami ng mama ko at dahil po dun ay lumayas po ako. Pasensiya na po talaga.” (Good evening, doctor. I’m sorry I wasn’t able to go there. My mother and I had a fight and I ran away because of it. I’m really sorry.) An
image of his mother suddenly flashed in my mind; that sad and worried look on her face as I was explaining her son’s situation. I remembered how his mother accompanied and took care of him during his short stay at the hospital. She never left his side. I can’t help but feel sorry for her as I learned that his son left him.

I replied inquiring only about his well-being and asking when he could come back for follow-up. He eventually sought consult and upon seeing him personally, I couldn’t stop myself from sharing my opinion. I told him that he just needed to calm down and rethink the whole situation.  I also told him that it would be best to go back to his house and that
I’m pretty sure his mother is worried about him. He just said “Salamat po doktor, pag-iisipan ko po.” (Thank you, doctor, I’ll think about it). That was the last time I saw him and I haven’t heard from him since then.

INSIGHT:
(Physical, Psychosocial, Professional/Ethical), (Discovery,
Stimulus, Reinforcement)

Empathy means that you can express understanding of what the person is going through and comprehend how the person has told you he or she is feeling. Empathy is good for better doctor-patient communication; however, up to what extent should we be involved in our patient’s personal life? As doctors, how far can we go with regards to rendering
treatment for our patients? What is expected of us? When will we cross the line?

In this case, I was concerned for my patient’s welfare. More than his health status, I was worried that as young as he is, he might not be able to sustain for himself. He might be misguided by his emotions and eventually lose his way without his mother’s guidance. I knew that someone had to talk some sense into him. I may not be significant enough in his life to do it but at least hopefully I made him rethink his decision. I knew that he might not appreciate it or even got offended by my action but I couldn’t just stay still and do nothing about it.

We physicians would like to give the best care possible to our patients. We are taught that we should treat them in a holistic manner; not only thinking about the physical aspect of their disease but also the emotional and social aspect. However, we should keep in mind that while we want to offer empathy and understanding, it is necessary to be professional and identify the border line between empathizing and imposing ourselves. After asserting what we think is best for the patient, we should not forget that in the end, it is ultimately still the patient’s prerogative whether to follow our advice or not.

ROJoson’s Notes (17jan20):

Try to do what you have to do as a physician. However, remember you can only do so much. Do not impose.

 

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