Presentation on theme: "The Doctor as a Drug Emma Hardwick GPR 2008. Michael Balint He developed the concept of ‘the drug ‘doctor’ (ie the doctor herself/himself is a powerful."— Presentation transcript:
Michael Balint He developed the concept of ‘the drug ‘doctor’ (ie the doctor herself/himself is a powerful medication) Balint, M. ( 1957) The doctor, his patient and the illness. London.
Prescribing yourself as a drug You need to consider the: Indications Dose Side effects
Mechanism of action You can help by being: Supportive Informative Catalytic Cathartic
Prescribing the Doctor – When? Potential indications – to help tackle/alleviate: Multiple problems (often insoluble) Multiple attendances Multiple referrals to no avail Multiple treatments (tried & failed) Heart sinks Persisting patient uncertainty or concern
Prescribing the Doctor – How? You have to utilise/explore: Your advanced consultation skills Active listening Picking up and using cues Building rapport Empathy Triangular thinking Ideas Concerns and Expectations
Prescribing the doctor – common problems If the doctor doesn’t realise they are the drug and therefore does not understand why the patient keeps re-attending. Time constraints (long and sometimes multiple consultations). Differing agendas between patient & doctor.
Prescribing the doctor – side effects Encouraging doctor dependency Transference – negative emotions expressed by the patient being engendered in the GP. Counter transference – negative emotions expressed by the GP being transferred to the patient.
Summary The doctor as a drug is a powerful tool. Be aware of when it can be effective Utilise consultation skills to make the most of this therapy Remember that there may be pitfalls for both patient and doctor.