The Patient Understands That: Fill & Download for Free

Yes patients do lie and they lie for multiple reasons.They are embarrased.Patients would lie about their sexual history especially promiscuity when you suspect them of having a sexually transmitted disease.It is common for patients to lie about tobacco, alcohol and drug abuse. “Doctor I smoked only for 1 or 2 years”, this usually means the patient has been puffing for a decade. “Doctor I used to smoke or drink, I have stopped now”, this usually means it was 24 hours back.“I don't eat sweets doctor, don't know why my blood sugars are high”, usually the patient is not careful about the diet.They are scared.Cancer patients hide their duration of symptoms because they are scared of the diagnosis. “Doctor I saw the lump only a week ago”, it is obvious that the football size tumor has been present for months and could not have gone unnoticed.Patients hide their previous treatment especially if it has been complementary medicine because they don't want to be blamed for coming late.They don't like the treatment they are undergoing.Some medicines can have side effects that make a patient’s life miserable. The patient stops taking the medicine and lies to the doctor. Many times the doctor wonders why the patient is not responding to the treatment.Some medicines are costly and patients can't afford them. The patients don't buy the medicine but lie to the doctor that they are taking it.Most doctors with experience will pick out these lies. We don't bother about them much as we know it is not the patients fault. It is the circumstances that make them lie. We try to work with the patients and overcome their problems and make them understand that lying will ultimately harm them.Majority of patients open up and tell the truth if the doctor is understanding and supportive.

Just yesterday, we had a middle aged female patient come to the casualty with complains of abdominal distension, pain and breathlessness. She had been in distress for two days and was seeking 'medical' attention from a 'traditional' practitioner. The very same practitioner took a chest X ray which showed haziness in the lung fields and thinking that to be the cause of her distress started his treatment accordingly. On seeing that the condition of the patient was not improving he referred the patient to us the next day.What the said traditional practitioner missed on the x-ray was air under the diaphragm much like this-Air under the diaphragm usually means a hollow viscus perforation- a hole somewhere in the intestines or stomach. It warrants an emergency laparotomy. The patient was stable, abdomen hadn't become a box yet and we were all happy that we had caught this at a stage where we can go in and intervene before it gets ugly- a rarity.As soon as we convey the diagnosis and need for surgery, the patient attenders call up the traditional practitioner. What ensues is a full on arguement on the phone with him.Why did you say she needs surgery? She is so stable that she is sitting and talking?She won't be sitting and talking for much longer if we don't operate now.You are advising surgery just to extract more money from the patient. She complains of breathlessness, and that's what you should be treating now.. . .This guy delayed medical attention by more than 24 hours by treating a case he didn't understand and subsequently convinced the patient and her relatives that we are only trying to rob her off her hard earned money and that he could treat her breathlessness after all. The patient subsequently left against medical advice.I sincerely hope she survived.I am 26 years old, and I have already put in 10+ years into my formal medical education. And I am not even halfway through.I hate the fact formal education has no value in this country.I hate the fact that formally educated doctors are at a disadvantage. Any Tom Dick and Harry can just stand up, declare themselves as doctors and dispense medical care.I hate the fact that the government doesn't safeguard the sanctity of this profession, instead encourages fraudulent entities by ignoring their transgression, and even seeks to sanctify them by anointing them via bridge courses and bring them into the mainstream.I hate the fact that the public is radicalised against modern medicine thanks to Bollywood, media and the general government apathy.I hate the fact that unsuspecting patients seek a relief in symptoms from such people and only reach the hospital in a condition where nothing more can be done.And then the doctor gets thrashed for not saving the patient.How many cases of medical negligence has been filed against these entities? ZERO.How many of these entities have been beaten up by patient attenders? ZEROHow many of these clinics have been torn down by angry relatives? ZEROAnd I am the thief, the fraud and the murderer.Edit representative image shows air- fluid under diaphragm and not air under diaphragm. But you get the idea. Thank you User-12540534538261894081 .

Here’s the thing. The foundation of psychotherapy is reading between the lines. Therapists (if they are relatively competent and well trained) understand that people are largely driven by unconscious processes. This means that there are internal forces at work that are influencing our thoughts and feelings.When a patient is late, misses a session, is very complimentary towards the therapist, angry or disappointment in the therapist, in love with the therapist, skips a meal, doesn’t do their work, etc, it’s because of an unconscious process.In order to understand anything that is going on, the clinician must try to help uncover these processes with the patient. I am explaining all this because nothing is assumed, and everything that is brought into session is information that helps the clinician and patient understand the deeper thoughts and feelings.While it’s possible that someone misrepresenting their symptoms could lead them in a particular direction, I suspect it would eventually lead to a similar place.I suppose there could be deception involved if it was a very short-term assessment, but long-term psychotherapy tends to uncover the (relative) “truth”, whether it’s willfully hidden or buried in our own unconscious.