Winning The Confidence Of Patients
NATIONAL JOURNAL OF HOMOEOPATHY 1993 May / Jun Vol II No 3.
Dr Gunavante S M.
A young medico was telling me the other day, that patients tend to have more confidence in a physician who is elderly than one who is young. I pointed out that this is entirely wrong. It is true that some young girls in India may feel shy when telling their symptoms to a young male physician. Barring this exception, which is getting rare now-a-days, especially in cities, there is no other extraneous factor such as age, looks, stylish dress, a spacious and well kept consulting room or a sweet mannered secretary or a receptionist, which can sway patients, confidence in the doctors favor or against him.
What is it then that builds up the patients confidence in the physician? It has to be admitted that it is very essential for the doctor to enjoy his patients confidence. Without it the patient would not, in the first instance, come to him for treatment. In case he comes to the doctor, guarded by his friend or relation, he or she will not open up and reveal all facets of his personal, emotional problems. Secondly we need to enjoy the patients confidence because it sometimes takes two, three or even four interviews for us to fully and correctly understand the disease picture. Hence, our first prescription may not be found quite upto the mark, because of which unless the patient has trust and confidence in us, he may not continue the treatment. Have we not seen that when the patient trusts us fully, he continues to come regularly for treatment, inspite of the fact that meantime he has not seen any obvious relief in his complaint?
Let us not forget that patients come to us not to judge us by our looks, our consulting rooms or even our sweet and winning manners, though these are not unimportant. They come to get cured and that too as fast as possible. Every patient judges his doctor by the yardstick of how eager and earnest and knowledgeable he is and whether he really takes the trouble to cure his patients, gently and rapidly. Therefore, the secret of winning patients confidence lies in each doctor developing his professional ability and displaying it in practice. Given this ability, which the patients are not slow to judge, curative results are bound to follow. It is important for us to realise that the patients have two occasions to observe our professional competence - first, when we are taking the case in order to fully and correctly understand the disease and try to probe deeper to elicit what are the patient may consider far-fetched symptoms, but which to a homoeopath are most crucial guiding characteristics on which the prescription is based. This competence displayed while taking a detailed case history puts its stamp of professional knowledge which generates confidence in the doctor - even if by chance the prescription misfires.
Secondly, if the doctor continues to exhibit the same earnestness in understanding the case, in his search for the similimum, his efforts will be crowned with success sooner or later and the patient who has begun to trust him will give him all the chance he needs to cure him.
How to develop professional competence: Given a modicum of knowledge of the principles and philosophy of homoeopathy and of at least some fifty leading remedies of the materia medica, it is not difficult even for a person of average intelligence to develop his competence, if only he is willing to work hard on some systematic lines. Kent has stressed the importance of knowing diseases and has pointed out that our remedy provings (materia medica) are nothing but the pictures of diseases.
If one thinks that it is difficult to remember the numerous symptoms in the materia medica, there is the repertory with numberless symptoms of various ailments neatly and systematically arranged, which can be referred to at a glance. Suppose, a doctor has been getting frequent cases of diarrhoea, he has only to study the various rubrics relating to diarrhoea with the causations, conditions of aggravations and ameliorations and concomitants. If he commits all these to memory, he will be able to take a complete case when the next case of diarrhoea comes by and find the curative remedy quickly. A patient thus cured will send ten more cases, even cases living in distant places. Knowledge of the rubrics will lead the doctor to concentrate on eliciting those symptoms which are really useful and not waste his time (and of the patient) in listening to useless meaningless talk. The patient realises that the doctor asked relevant questions and was able to find the correct remedy. His confidence in the doctor is automatically reinforced. Remember: it is a sign of supreme confidence when we probe for such information about the patient and his disease, which has a counterpart in the repertory and materia medica.
It goes without saying that the first rule in taking the case is to induce the patient to tell everything about himself and his complaint in as much detail as possible, including peculiar and unusual symptoms and never to interrupt him while he collect his thoughts and speaks. It is only when he has finished and has nothing more to say, that the physician asks for more details to complete the record or to get some points which are not clear or to ask for additional information which will help in understanding the case more thoroughly. But this process of interrogation should not continue till the patient gets bored (and possibly begins to lose his esteem for the doctor and for homoeopathy as well). Therefore I would say that in taking the case, the patient should occupy 60 percent of the time, the interrogation should occupy 25 percent and the doctor should analyse within himself and draw his conclusions in the remaining 15 percent of the time, drawing on his knowledge of human nature, psychology and sensitivity of people to various situations and applying them to the case in hand.
The art of acquiring competence in treating any disease follows the same lines as described above. Take a special note book and make a detailed repertorial study - rubrics - of ten or twenty cases of a given complaint - vertigo, headache, complaints of vision or hearing, appetite, backache, etc. - and you will find that your ability to handle these cases successfully has vastly increased within a few months and you would have gained increasing trust and confidence of an increasing number of patients.