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Those hateful patients

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Presentation on theme: "Those hateful patients"— Presentation transcript:

1 Those hateful patients
Swansea Tuesday 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/overdose Combination therapy but possible interaction..potentiate or negate Frequency & Timing Suitable form ..package Tolerance & Resistance Allergy Anaphylaxis Placebo Storage Side effects Dependency

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 clinger The entitled demander The manipulative help rejecter The 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.

10 The end

11 Describe a patient who Made 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 widely Perceived seriousness Perceived costs and benefits Cues to action

13 The doctor as a witness

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