Presentation on theme: "Those hateful patients"— Presentation transcript:
1Those hateful patients SwanseaTuesday 22nd May 2007
2The contribution of Michael Balint The doctor his patient and the illness … 1957
3The most effective drug a doctor prescribes is himself
4The doctor as a drug Specific The appropriate dose.. Loading/maintenance/overdoseCombination therapy but possible interaction..potentiate or negateFrequency & TimingSuitable form ..packageTolerance & ResistanceAllergyAnaphylaxisPlaceboStorageSide effectsDependency
5The apostolic function of doctors You get the patients you deserve!
6Diagnosis precedes treatment The feelings the patient engenders in his doctor is an important physical sign.
7Taking care of the hateful patient J.E.Groves N.E.J.M. 1978 The dependant clingerThe entitled demanderThe manipulative help rejecterThe health denier
8A farewell to heart sink? Gwenda Delany BJGP April 2007 Vulnerable.. Abused … Manipulative
9Don’t forget to care for the doctor as well as the patient. ..or as Michael Balint might say …..Drugs that are not stored properly lose their effectiveness and may become poisonous.
11Describe a patient whoMade you feel *bad*Made you feel *good*
12The Health Belief Model Motivation – people’s interest in their health and degree to which they are motivated to change varies widely.Perceived vulnerability – perception of likelihood to be affected by disease or belief in diagnosis and consequences varies widelyPerceived seriousnessPerceived costs and benefitsCues to action