Interplay of Mindsets of Physicians and Patients in Medical Decision Making

The decision-making on what a patient should receive in terms of medical management especially if he is awake and of sound mind is a result of integration and balancing of the mind-set of the physician and that of the patient (or the relative).

The mind-set of the physician and the patient consists of their philosophy, values, beliefs and perception on diseases, their causes and how they should be managed and treated.  They may differ and will have to be reconciled.  If the same and the patient puts his complete trust in the physician, then there is no problem in decision-making on what to do.

For example, a physician believes in mainstream medicine whereas a patient believes in faith healing or non-mainstream medicine such as folk medicine and alternative medicine. There must be reconciliation of the mindsets of both parties before a shared decision-making can be arrived at.

Another example, the patient believes his disease is caused by evil spirits but the physician believes otherwise.   Again, there must be reconciliation of these differing perceptions otherwise treatment of the patient will be difficult.

Another example, a physician may be a maximalist and a patient, a minimalist or vice versa.  A physician may be a believer of medical treatment and a patient, a doubter or vice versa.  A physician may look for the latest technology and a patient may look for natural healing or vice versa.  A physician may look for the most sophisticated technology and a patient may look for the simplest technology or vice versa.  All these different mindsets between a physician and a patient must be reconciled to come out with a shared decision-making.

The minimalists like to do the least possible for medical problems and the maximalist wants to be ahead of the curve and do anything and more.

Believers are people who believe there must be a good solution for their medical problems someplace, and they just have to find it. Doubters are very focused on side effects and on unintended consequences. They are concerned that the treatment might be worse than the problem.

http://healthland.time.com/2011/10/28/mind-reading-two-harvard-docs-talk-about-making-the-best-medical-choices

A personal approach in the practice of medicine in terms of proper physician mindset vis-a-vis patient mindset

As a physician, I have a certain mindset in the practice of my medical profession.

My mind-set can consist of the following:

As to type of medical treatment:

For faith-healing:
All patients with a remediable medical condition should do self-treatment or seek assistance from physicians or medical practitioners rather than just purely rely on prayer and an exercise of faith.  They can complement the self-treatment and treatment by physicians or medical practitioners with prayers and exercise of faith though (praying and hoping that they will be successfully healed).
For the non-faith healing medical practices:
All patients should give priority to mainstream medicine over non-mainstream medicine particularly those with data showing effectiveness for the former.  If there are data showing effectiveness for the non-mainstream medicine, go ahead.
The non-mainstream medicine may be use as a complement to mainstream medicine as long as they can be shown to produce better results when combined.

Minimalist vs Maximalist (I am more of a minimalist.)

Believer vs Doubter (I am more of a believer.)

Sophisticated vs Simple Technology (I am more for simple technology.)

Acceptance of reality that medicine is an inexact science – cannot guarantee cure – “Cure sometimes, relieve often, care always.”

I use this patient management process in problem-solving and decision-making:

steps_mgt_pt

My problem-solving and decision-making in the management of a patient is usually influenced by my mind-set.

I consider the mind-set of the patients to come out with a shared decision-making.  I respect the philosophy, values, beliefs and perceptions of patients but I can try to change them when I firmly believe it is necessary for a good medical outcome.  I will do so with cautious and respectful explanations.

ROJ@17apr28

 

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