2023-12-23 18:06:00
A study with more than 1,000 patients and doctors showed that the reports that patients make about their symptoms are not always considered / (Illustrative Image Infobae)
“Balance is being with the patient without being the patient,” said the Spanish philosopher and writer Miguel de Unamuno. In an increasingly technological world, a study in the United Kingdom warned that the experiences of patients are being underestimated by health professionals.
It is a investigation conducted with more than 1,000 patients and doctors that revealed examples of underestimation of patient reports. She was led by a team from the University of Cambridge and Kings’ College London. It was published in the specialized journal Rheumatology.
They found that doctors considered patients’ self-assessments to be the least important in making diagnosis-related decisions. They also found that professionals reported that patients exaggerated or minimized their symptoms more frequently than patients reported doing so.
However, it is known that listening to the words of patients can also help in accurately diagnosing the problem they are experiencing.
It is known that combining diagnostic tests with listening to patients can reduce erroneous diagnoses (Illustrative Image Infobae)
One of the patients, who participated in the study, shared the frequent feeling of not being believed as “degrading and dehumanizing.”
He mentioned: “If I had continued to take into account the doctors’ experience over my own, I would be dead… When I walk into a doctor’s office and my body is treated as if I had no authority over it and what I feel is not is valid, so it is a very unsafe environment… I tell them my symptoms and they tell me that that symptom is wrong, or that I can’t feel pain there, or that way.”
The researchers focused on patients with a type of lupus, an autoimmune disease that is especially difficult to diagnose. They examined the value doctors placed on 13 different types of tests used in diagnoses. It included evidence such as brain scans, patient opinions, and observations from family and friends.
Experts in family medicine, pain medicine and bioethics consulted by Infobae that patients with other diseases may be facing similar situations due to a lack of empathy and listening on the part of health professionals.
The study in the United Kingdom was done with patients with a type of lupus and doctors (Illustrative Image Infobae)
At work in the UK, less than 4% of doctors considered patient self-assessments as one of the three most important tests.
Instead, doctors included their own assessments at the top, despite acknowledging that they often did not trust diagnoses that involved often invisible symptoms, such as headaches, hallucinations and depression.
These symptoms can reduce quality of life and are more frequently misdiagnosed, the research authors clarified. Therefore, these symptoms are not treated correctly as is the case with other visible symptoms, such as skin rashes.
Almost half (46%) of the 676 patients stated that they had never or almost never been asked about their self-assessment of the disease, although others reported very positive experiences. It was also found that women are more likely to be told that their symptoms are “psychosomatic.” And male doctors were statistically more likely to say that patients exaggerated symptoms.
They recommend being accompanied by loved ones to the medical consultation. You can write down information or remember issues that you wanted to discuss with the health professional (Getty Images)
“It is time to move from the paternalistic, and often dangerous, ‘doctor knows best’ to a more egalitarian relationship in which patients with lived experiences and doctors with learned experiences work more collaboratively,” said Sue Farrington, co-chair of the Alliance against Rare Autoimmune Rheumatic Diseases. The research was funded by The Lupus Trust and LUPUS UK.
Lead author Dr Melanie Sloan, from the Department of Public Health and Primary Care at the University of Cambridge, stressed that it is “very important that we listen to and value patients’ opinions and their own interpretations of symptoms, especially in the case of chronic diseases. But we also need to ensure that doctors have time to fully explore each patient’s symptoms, which is difficult within the limitations of current healthcare systems.”
In dialogue with Infobae from the United States, Mary Catherine Beach, professor and researcher at the Center for Health Equity at the Berman Institute of Bioethics at Johns Hopkins University, pointed out that “the study highlights a very important problem to which not enough attention is paid. attention. “It is a widespread phenomenon and is not limited to rheumatological diseases.” Patients with other disorders express their symptoms, but they are not always heard.
It is known, said Professor Beach, that “it is not possible for a person to always remember everything perfectly or be able to accurately attribute the reasons why something happens, so sometimes patients may not be right. The classic example is an upper respiratory infection: patients may think they have a bacterial infection that needs antibiotics, but that doesn’t mean it’s true.”
Having a family doctor can foster a relationship of greater trust and listening.
As sometimes – he acknowledged – patients make mistakes, “doctors can overgeneralize this point and discard comments that should not be discarded. “I think there is a general bias against believing patients that is nothing more than a cognitive bias.”
Beach also opined that “as a society we have a bias toward forms of data that are considered objective rather than subjective. We have racial, illness (for example, mental disorders) and possibly gender biases that make us believe some people more than others.”
Faced with the lack of a two-way dialogue and the search for more certain answers, there is a lot to work on both on the side of health professionals and patients.
Health professionals should be trained to have the empathy and listening skills necessary to adequately care for patients (Illustrative Image Infobae)
According to María Julia Aparicio, doctor and coordinator of the Multidisciplinary University Center for the Treatment of Chronic Pain and Palliative Care at the José de San Martín Hospital de Clínicas of the University of Buenos Aires, in Argentina, “it is a frequent complaint of patients who The doctors don’t listen to them. “It is due to the lack of prior relationship between them, and the little time available for consultation.”
Many times – Aparicio told Infobae – the patient does not feel content and consults with another specialist, who requests new studies. “So successively, the consultation is diverted to see the studies and what motivated you to see a health professional initially is left in the background,” he said.
A key is “the education of health professionals because we do not receive adequate training on empathy and active listening in undergraduate or postgraduate studies. Each professional and work teams should be trained to listen to patients and their families. In this way, the task is much easier, it brings us closer and allows our work to stand out and the patient to feel heard,” he pointed out.
Daring or trying to scare patients should not be done during medical consultations (Getty Images)
Meanwhile, Karin Kopitowski, head of the Family and Community Medicine Service at the Italian Hospital of Buenos Aires and president of the Argentine Federation of Family and General Medicine, highlighted that listening to the words expressed by patients also helps to diagnose diseases.
“Having a patient speak only once in a consultation is not the same as having a trusted, trusted professional. There are patients who talk more. Others express fears of certain diagnoses due to some symptom. It is important that professionals ask patients about their beliefs and fears and that they can be heard,” said Kopitowski.
The specialist is also not in favor of challenging the patient for not following the recommendations that are made. “Patients should not be scared or challenged. They have the right to be heard and receive explanations about illnesses and symptoms,” she commented.
According to American expert Beach, “as patients, we can often tell when a doctor takes our concerns, reports or ideas seriously. You should always look for a doctor who takes you seriously. If you’re really stuck working with that doctor, the best thing a person can do is keep putting your ideas forward and explaining her reasoning. If they continue to be rejected, you can change professionals.”
That patients speak frankly and be attentive during the consultation favors dialogue and listening by the professional (Illustrative Image Infobae)
The non-profit organization AAARP, which helps people over 50 in the United States, shared these recommendations so that patients can be heard by doctors:
1. Make a personal connection. Before discussing concerns, you should break the ice with a greeting or even a joke.
2. There is no need to be distracted. After saying hello, you have to get straight to the point about the reason for the consultation.
3. You must tell the whole truth. If you do not speak frankly, the doctor cannot be expected to listen to the ailments or to resolve them adequately.
4. You can practice in advance how you will speak, especially with uncomfortable topics, such as talking about incontinence or diarrhea.
5. The phrase “it’s just aging” should not be accepted as a professional’s response when talking about a symptom
6. Questions should not be saved for the end, because when the consultation is about to end, the professional is already thinking about the next patient. You have to bring a list of concerns and share it during the first minutes.
7. You can go accompanied to the medical consultation. A loved one or family member can write down information and remember issues that they wanted to discuss. It can also be used to remember the doctor’s instructions after the consultation.
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