There are different type of patient. One could have a PhD, or diploma, or a medical staff, and one could never been into a school for life. Approaching a patient sometimes could be difficult to do. A lot of medical staff, and medical student are approaching the patient or a community by going to the patient level of education.
Almost all the books, or lecturer would say ‘be the same level as the patient so that they could understand’ or whatsoever and almost all medical student and medical staff take this words like a gospel . I have seen many people educating a rural community by getting into that level where they are the same as the people that are educating. For example, when talking about tetanus, so make people understand here in Sabah setting (where I am right now), they would say tetanus is like a seizure, or fits. While in my opinion, this is two different things.
This would not make so much impact in the outcome of the patient but in long term perspective this could be detrimental. This is because when other medical officer is clerking the same person, in medical history they would say that they once having a seizure making the diagnosis and management differ.
Another example would be in describing thyroid disease or goiter. In place I am doing my practical right now, people told me that ‘beguk’ means mumps. While from my experience in Queen Elizabeth hospital in Kota Kinabalu, ‘beguk’ sometimes refer to goiter. Look how much impediment is created here.
Why would not a medical staff tell a patient the true name of the disease instead of creating a new one in their own language? A year ago, when I was clerking a patient, the patient said that he once had a ‘paru-paru berair’ to me and I would write in my clerking sheet that the person had a history of pleural effusion or acute pulmonary oedema…(?), while that patient is actually having a pneumonia. So my history was wrong. Was it my fault? Or it is the fault of the previous medical officer that tell the patient a laymen term, too layman term.
My idea is to change the way a medical staff or student or any doctors whatever educating their patient. For term such as pneumonia, or mumps, or hepatitis B, and etc, should be describe as it is and never be change to other things. However, the explanation part should be detailed. As example, when telling a patient regarding their hyperuracemia, you should tell him/her the exact word, hyperuracaemia. Then you would spend 5-10 minutes telling what is hyperuracaemia. This better than telling a patient that he/she has a ‘kencing masam’ (sour urine), and with only this, a patient may not know what is really going on with him/her. Later in the future, when he/she describe ‘kencing masam’ to another medical officer, I believed no one will know what the hell is that.
Another things is not to over simplify a fact. For example, when telling a patient regarding immunization, a medical personal would only tell a community or patient something like this. “ Immunisation is done to prevent illness in future, it is not harmful and it is quite safe, your children must take it’. Easy. Simple. Less than 1 minute, and a patient would always comply to take immunization. On the other hand, the patient or community would always never know what is actually a vaccine and why it is given to them.
Another thing is not to lie to the people. For example when a disease does not have a cure, then why should lie telling that the disease can be cure. For example, if someone have acute viral conjunctivitis, there are not antiviral use to treat because it is self limiting. But many medical personal out there would tell the patient to take this, take that, this would cure you. Why don’t you tell that this problem has not definitive treatment but you can treat the symptoms and tell that it is self limiting.
Many medical personnel would never think of educating patient but only think to make patient comply. Why? Do we need to keep our community in the same level as this. Of course I am only referring to our community or my community here in Sabah. If someone did not know, here in Sabah, most of the people education of medicine is the same as other places in the world 20 years back, meaning that they were too further in the past. Not progressing into the future. Whose to be blamed here? Not the public not the farmer or fishermen who are lazy to learn, but to medical staff who are lazy to teach.
Everything is always about time. It is too time consuming to teach detail about a disease. I have no time to talk that much. There are thousand patient waiting for me out there.
This is the kind of responses you would always get. It is enough if you say honestly, I am lazy to teach.
We did not need to do a full hour of talk and full hour sitting in a clinic teaching a patient. We did not need to make a patient a doctor yet we need to make them know. It is our responsibility to make them understand about their problem.
I choose to give a talk on acute viral conjunctivitis today in district health clinic. I would not choose a talk on breastfeeding, or balanced diet because this thing is always has a time to teach. Continuously, people would start to learn regarding this. However, not so many person out there know what is acute viral conjunctivitis even though they usually get it.
I hope, later in the future, our community would be educated enough to understand. I hope that someday, nurses, assistant medical officer, medical officer or anyone else would try their best to correct the wrong side of educating a patient nowadays.
In my conclusion, in approaching to educate a patient, I would always spend more time, use the actual term then describe it so patient understand, tell the truth, be a teacher. A teacher would always teach and make student understand. Why don’t the medical staff be a teacher and not only a medical staff forever.
