Before, I received my patients, I listened to them tell their problem, I prescribed medication, I offered them avenues such as relaxation, sport then I asked them what they could change in their lives to get better, I had written in their files that they had no health insurance, I encouraged them to look for another job, I renewed their work stoppage to allow them not to return to the one that made them cry while they regained their footing and found another thing, I wondered how to send them to the specialist in GrandeVille when they have no means of transport, I sutured the foreheads of the gnomes with glue, telling them stories to avoid their mom who moves by bike from having to go to the emergency room, I was doing third-party payment for those who ask me, I was looking for a bike for my homeless patient who apparently won’t have a bike since he seems to be in prison, I was re-reading the prescriptions with c each patient by explaining the methods of taking, I made summary tables of the treatments to facilitate the taking or even I had the nurse come by to prepare the treatments, I gave them the contact details of the social worker, I made an appointment for them for imagery, I was already doing a lot.
And then I received this document from the in my mail of the day. And my whole practice has changed.
…
…
No I’m kidding.
Usually they send out flyers, about tobacco, about food, I use them, or not. For tobacco, I find them pretty damn good.
But the…
There, the Inpes wants to teach me to take into account social inequalities in general medicine. And I kinda feel like people are making fun of me.
When I read that the doctor can adopt a proactive attitude by adapting his practices to improve the effectiveness of his actionsI tell myself that a guy had to think a long time and be well paid to find such a phrase-pipe.
I think of my patients who tell me that they are in the red at the end of each month, and who eat shit, while they are diabetic and I wonder what proactive attitude I could adopt to identify obstacles to its follow-up. And the only thing that comes to mind is that they need money to buy vegetables.
And yes, I think I advise people who have a high socioeconomic level to play sports because they have their ass screwed on their chair all day, whereas the masons tell me that in the evening they are too much anyway tired to play sports. I remind them that sport is not like work, they look at me as if they pity me because I’m too stupid to understand.
As advised by Inpes, I know what my patients do as a job, and it’s written in their file. It’s nice of you to explain to me that knowing what my patients do as a job helps to situate them socially. Oh good ? But no, I don’t know if they are at risk. Often when they tumble into my office crying, it’s as much a surprise for them as it is for me to learn that their business is going to close.
The table with the translation of the questions is delightful: if I ask for an address and the patient gives me an administrative address, this indicates a precarious situation. NAN MAIS SANS DECONNER L’INPES?
I also really like the item be able to direct the patient to resources close to his home: sports grounds, associations, etc. Of course yes. But when do I have the time to do all this?
And then advise to use websites to help my precarious patients, how can I put it… Some still have Nokias that can withstand being immersed in water and that last 10 days of battery life without recharging because hey, it’s hard to load when you live in your car and your tent has been stolen. Of course it’s an extreme situation, but others don’t have internet, or a computer, and don’t even have smartphones. Because yes, people who are not connected to the Internet* still exist.
We can continue to dissect everything but hey, I have work waiting for me.
In short, I threw the document in the trash and I will continue to try to adapt to the patient, according to his financial capacities, understanding, transport, etc. I don’t think I always get there. Because despite all my efforts, I don’t really realize what they are really going through. Because I don’t have time, and I’m not a social worker. Because I don’t know the prices of all the specialists in the area. Because I simply can’t do everything. I’m already trying to do medicine, between two paperwork.
This document is not a help, it is a provocation for general practitioners because it makes them responsible for people’s difficulties, difficulties caused by economic problems to which doctors do not have THE solution. This is a new pirouette to accuse GPs of the difficulties of access to care.
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* on the internet: private joke, for those who recognize themselves.