|By: Rosaria Mastronardo
Statistically, it is proven that, during a common visit to a doctor: “Every 22 seconds the doctor interrupts the patient”; moreover: “90% of diagnoses, if the patient is not interrupted, makes it himself” and finally, doctors should learn that, “the secret is to make the patient speak”.
Do you think that this, the doctors, know? I cannot answer this question, I can only speak from personal experience as I am a woman with chronic diseases who has seen many doctors in 7 years.
From personal experience, as suffering from chronic diseases, and from my experience as a facilitator of a self-help group on Fibromailgia I can say that the difficulties that we patients with chronic diseases encounter, both before and after diagnosis, are enormous, often too expensive to bear them. We turn to different doctors of different specializations, often without having received a precise diagnosis but above all without targeted therapy. It is a wandering among specialists that inevitably leads to the frustration of not being understood, or, in the worst case, of not being believed at all.
Chronic, complex diseases, such as Fibromyalgia, Chronic Fatigue, Myalgic Encephalomyelitis (ME / CFS) and many others, all difficult to diagnose, where laboratory and / or exclusive instrumental data are lacking for these diseases that would be important both to study them better and to alleviate the suffering of patients.
In my opinion, as a chronic patient for several years and due to my experience as a facilitator of groups, I believe that the relationship of trust between doctor and patient is very important and allows you to face any therapeutic attempt with a better awareness and expectation of symptom improvement.
It is essential to communicate with the patient so that he can become aware of his condition through precise information.
Today, “medicine” must no longer be centered on disease. Illness is the crucial object of the doctor’s actions. The doctor is entrusted with two major tasks: to reach a correct diagnosis and to intervene quickly through adequate therapeutic strategies.
The doctor’s approach to the disease must gradually change, more and more space must be left to the “Patient” as a whole, and to the “Relationship” as a fundamental, essential and basic tool in the diagnosis and treatment process.
No longer the disease at the center of the doctor’s interest, but the patient, that patient, with his or her history and within that specific context and with which a relationship is established. Communication, verbal and non-verbal, as a relationship tool, must over time become the center of interest in the various training courses aimed, specifically, at healthcare personnel (doctors and paramedics) and often extended to front staff as well. office inserted in care contexts.
Communication MUST become part of the therapy, the time for communication and listening are essential for the growth of the care relationship.
These are the moments in which the relationship between doctor and patient finds its maximum expression. Without communication there is no alliance, there is no relationship of trust. If there is no listening, if there is no communication, every clinic, every nursing home, every healthcare facility becomes an assembly line, the patient a bolt, the doctor a mere executor.
Arthur W. Frank. American sociologist, said: “Listening to a story of illness is not a therapeutic act, but it is giving dignity to that voice and honoring it”.
A strong, decisive “cultural” change? Yup. Unfortunately not yet fully made in Italy, my country. Communication has been the subject of teaching and evaluation in Anglo-Saxon countries for decades, while in Italy the training experiences of medical students are practically non-existent and in any case remain marginal in the training of nurses and various other health professions.
Patients are “trained” in “self-management” (self-management), we speak of an “expert patient”, we work hard to make patients increasingly aware and protagonists of the management of their chronic disease, very well good communication, verbal and non-verbal, should be an instrument of a trusting relationship between doctor and patient?