Wednesday, March 7, 2012

Teaching us how to teach patients


March 7
by Alison

On this rotation we have had the opportunity to consider many important aspects of medical education through ambulatory learning.  However, we have not really discussed the topic of patient education, which is often a key component of ambulatory care.  There have been many opportunities for patient education during this selective on topics such as lifestyle, medication adherence, and symptoms requiring medical attention.  These are topics for which I have been well prepared and I am quite comfortable in this aspect of patient education.  However, one area of patient education that I continue to find challenging is responding to patients’ criticisms of their previous care and educating patients about the structure and limitations of the healthcare system.

Yesterday in clinic I saw a patient who was completing treatment for an illness.  During our encounter, she mentioned that she had been misdiagnosed at a community hospital before being diagnosed at one of the teaching hospitals.  It was clear that the patient was frustrated by this and she said something critical about the care she had received at the community hospital in comparison to the care she had received at the teaching hospital. 

I understood why the patient was upset.  However, I think that sometimes patients don’t realize the difference in resources that may be available at an academic centre versus a community hospital.  This can lead to a perception that the care offered in the community is inferior to the care offered at academic centres.  Without wanting to make the patient feel that I was invalidating her concerns, I felt it was important to mention to her that we have access to a lot of excellent resources in teaching hospitals, which provides a diagnostic advantage compared to some settings.  This approach seemed to be well received by the patient.  However, I continue to find such situations to be one of the more challenging aspects of medicine, and I hope that I will receive further education on this in the future. 

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