Presentation on theme: "Those hateful patients"— Presentation transcript:
1 Those hateful patients SwanseaTuesday 22nd May 2007
2 The contribution of Michael Balint The doctor his patient and the illness … 1957
3 The most effective drug a doctor prescribes is himself
4 The doctor as a drug Specific The appropriate dose.. Loading/maintenance/overdoseCombination therapy but possible interaction..potentiate or negateFrequency & TimingSuitable form ..packageTolerance & ResistanceAllergyAnaphylaxisPlaceboStorageSide effectsDependency
5 The apostolic function of doctors You get the patients you deserve!
6 Diagnosis precedes treatment The feelings the patient engenders in his doctor is an important physical sign.
7 Taking care of the hateful patient J.E.Groves N.E.J.M. 1978 The dependant clingerThe entitled demanderThe manipulative help rejecterThe health denier
8 A farewell to heart sink? Gwenda Delany BJGP April 2007 Vulnerable.. Abused … Manipulative
9 Don’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.
11 Describe a patient whoMade you feel *bad*Made you feel *good*
12 The 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