Question

WA 7 OR WA --Choose ONE topic from a) to f) Choose only ONE topic from either one of the Module headings, and write an essay of at least 500 words, with a heading, and page numbering in the upper right-hand corner that starts with a 2 on the second page of text. Module 7A THE DIFICULT PATIENT a) Write an essay, real or fictionalized, from the point of view of a difficult patient having a consultation with a doctor. Develop your ideas with examples from the Module texts, videos, movies and podcasts and/or from your own experiences, if you wish. b) Write an essay, real or fictionalized, from the point of view of a doctor having a consultation with a difficult patient. Develop your ideas with examples from the Module texts, videos, movies and podcasts and/or from your own experiences, if you wish. If you choose to write Topics a) or b), and you use dialogue, make sure that you know how to format it correctly using quotation marks, commas, and other marks of punctuation. Also, make sure that you use the correct formatting for paragraphing dialogue. If you don't know the formatting go to the "Grammar/Punctuation course button, and go to "Punctuation: IV.)." Module 8: Hope for the Doctor-Patient Relationship c) In the podcast called "Hope and Medicine," by Dr. Jerome Groopman, he talks about HOPE being taught to medical students as part of a necessary curriculum in medical school For this writing assignment, you are the dean of education at a medical college. Write a business proposal to the board of directors of the college to get their approval for implementing courses and practicums (hands-on learning) that teach aspiring doctors to offer HOPE to patients as part of their protocols, and also to believe in HOPE themselves Make sure that your proposal is fully developed and detailed. Use any of the ideas from texts in this module or in others, or/and from life experience to create your proposal d) In an essay, write about your take away from this module, and from other modules, about the importance of HOPE in the doctor patient relationship. How can HOPE be engendered in the doctor-patient relationship? Make sure that you write specifically and concretely about the abstract notion of HOPE and COMMUNICATION, and any other quality you may discuss. Oftentimes, when students write about abstractions, they write too generally or vaguely, they tend to write broad overviews of the need for hope, communication, and other qualities. In other words, they write too abstractly about abstractions! Don't do this. In order to discuss hope for the doctor patient relationship, you have to write specifically. "Unpack the abstraction of HOPE, like the example that Dr. Groopman gives of his despondent patient who has a curable cancer. Though Dr. Groopman offers hope for curing the kind of cancer, his patient is not reassured because hope to him is an abstraction. Therefore, Dr. Groopman Introduces him to a patient who has the same type of cancer that is almost cured. Having a CONCRETE example, having a flesh-and-blood patient to discuss his journey and cure, immediately gives the despondent patient HOPE Look at these BEFORE and AFTER paragraphs

Answer 1

a. b. Consultation of difficult patient with doctor - (Patient point of view)

I am patient. I went to doctor just for swelling over elbow and snoring problem. And doctor advised me, thyroid test. I asked him,' Doctor, may I know why thyroid test ?'.

Doctor replied,'' just do it, It is needed , so I told you.''

I again asked to doctor, '' Yes, I know, it is needed and that's why you ordered it. But I need more details. I thought, my snoring is due to breathing difficulty.And elbow swelling could be injury?"

Doctor was agitated. He said, '' Okay, I will tell you. You are 45 years old and you do not have breathing problem. May be during sleeping, there is some obstruction in the wind pipe due to enlarged thyroid , which is causing snoring. Thyroid can cause imbalance in multiple systems including metabolism and joint disorder. "

Patient - Doctor, '' But my thyroid is not enlarged, there is no swelling in my neck.''

Doctor - You are right. It is not necessary to have swelling. So we need blood tests.

Finally, I went ahead with thyroid test. But I thought, this doctor could have explained me without asking me for explanation. He simply said,'' Just do it, '' As a patient, I deserve to know the details and why is it needed. Why he got agitated? I did not get that. But finally, on probing, he explained things. But I feel, doctors should properly explain to patients.

b. Consultation of difficult patient with doctor - (Doctor point of view)

As a doctor, I came across a difficult patient who was 66 years old male patient who was chronic hypertensive with acute on chronic kidney disease who had complaints of severe back ache and some difficulty in walking in difficulty. He was required to undergo series of evaluation tests but he was reluctant. It was very difficult to convince him. Below is the conversation.

Doctor (self) - Hello, Mr. A. How are you, today?

Patient (A) - Hello Doctor, Why are you even asking this question? I am not well, that's why I came to see you. Don't ask me such questions again. Just ask me , what is my health problem? Ask to the point questions and don't waste my time on silly questions.

Doctor - Oh okay !. Sorry. You are elder and senior with rich experience. So I will definitely follow your advice. So tell me sir, what is your health problem? I know about your blood pressure, Diabetes and kidney problems. But I remember, last time you had told me about your mild back pain. How is it now?

Patient - Ah...there you go, Doctor ! Glad that you remember about backache. It is worsened now. If I walk for 10 minutes, my back pains horribly.

Doctor - I see sir. We will have evaluate. I have checked your Blood Pressure. That's okay. Sugar levels are uncontrolled , so you need to control it with strict medication and diet. for backache, I would request you to get MRI done, that's must.

Patient - No, no. I don't want MRI. Just give me pain killers. I will be fine.

Doctor - Sir, please let us evaluate. I will give you pain killer. That will be short term relief. But to provide solution permanently, we need to find out cause. So MRI is essential.

Patient - No, I said no. You find cause without MRI.

Doctor - Sir, there are several causes like disc problem,spinal stenosis, malignancy, age related degeneration etc. We can not assume. We need to evaluate. And after finding cause, treatment line will be decided based upon findings.

Patient - Assume that I have age related degeneration and treat.

Doctor - No sir, how can I assume ? What if it is something else. We can treat it but we need to know the exact diagnosis.

Patient - I don't want radiological exposure.

Doctor - Sir, MRI is safe.

Patient - No,no. I said no.

Doctor- Sir, you are my old patient. You are very experienced and talented person and I respect you. But please allow me to do this test , sir.

Patient - I am not ready, but since you are my old doctor, unwillingly, I will do it. But only once.

Doctor - Now, that's like good patient. We will do the test. Thank you for your approval.

And I closed the conversation. After almost, 45 minutes discussion, patient agreed for necessary investigation, that too unwillingly. But as a doctor, I tried putting in efforts to convince him with elaborate details. I also tried to be soft spoken considering his elderly age. Finally , he was convinced and that was good doctor's consultation with difficult patient.