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Treatment of the patient


Last week we looked at the diagnosis that your doctor gives to you. I said that your doctor should explain the diagnosis simply and the subsequent investigations should have some relationship with the diagnosis.{{more}} In other words, your doctor should not say you have a sprained ankle and then send you for a head scan. Likewise, some female patients have complained that they visited their doctor for a headache or a belly pain and he ended up doing a breast examination. You should feel free to question the doctors as to why certain tests and examinations are being done. You also have the right to refuse any examination or test that is done without explanation or your permission.

The last part of your interaction with your doctor is your treatment. Most patients think this means a prescription or “description” as some of the older patients call it. Indeed, it is a description! The process is done in coordination with the patient and comes at the end of the consultation. Your doctor should “describe” to you what he is going to do to make you better in light of his diagnosis. This diagnosis would have been made in light of a proper history, physical exam and appropriate investigations; so, if any of this process is flawed, then the diagnosis and hence treatment would be flawed also.

The treatment as I said, does not have to include a prescription even though most patients expect one and lots of doctors get into the habit of giving one, even when one isn’t necessary. The treatment may involve referring you to another doctor or another health professional like a physiotherapist.

When the doctor gives you a prescription, he is supposed to write your name, age, address and date on the paper. The medication should be written legibly so you can read it! It should have the dose of the medication, how often it is given (dosing interval) and the duration of the treatment. The doctor should tell you the name of the medication, explain to you how it works and describe the most common side effects and how to avoid them or what to do if they occur. So, you see the treatment really is a description, not just a prescription. It should be the longest part of the consultation.

Some patients do not understand that the treatment should be done in consultation with the patient. For example, there might be 2 different medications that can be used to treat the same condition. You should be given the choice, based on information on the price, side effects, and how effective the medication is. You, the patient, also need to know that the treatment is patient specific and is based on things like your age, sex, your other conditions, like the presence of heart, liver or kidney disease. The presence of diabetes and hypertension also affects treatment.

Ever so often I meet patients who say doc, why did you advise me to have a certain treatment for my condition when someone else with the same condition got a different treatment? The problem is the condition may be the same, but the patients are different. They may be different ages, different type or severity in the condition, different abilities to pay for a specific treatment, different availability of the treatment and different ability of their bodies to tolerate the treatment based on the presence of diabetes, hypertension, or other diseases.

For comments or question contact:
Dr. Rohan Deshong
Tel: (784) 456-2785