Aug 18, 2009

Ms. Smith and the Doctors

So in the last post Doctor D told you about 5 different styles of doctoring, but how would these doctors care for a patient with a difficult situation?

For this I give you the hypothetical patient: Ms. Smith. Overall she is feeling well and getting all her preventive care, but Ms. Smith has one tricky problem--she smokes. It is a universally acknowledged truth that this bodes poorly for her future well-being. Even tobacco companies now admit that smoking kills. But quitting ain't easy. Ms. Smith may need a doctor to help her get there.

Which of the 5 different doctors would work best for her?
  • The Drill Sergeant: "No excuses Ms. Smith, quit now! If you don't stop smoking, I'll fire you as my patient!"
  • The Parent: "I understand how hard it is for you, but you really must stop. I will keep asking you till you do, because I care."
  • The Buddy: "Think about quitting smoking. It would be really good for you, but if you don't want to that's okay. I'll still take care of you."
  • The Consultant: "Smoking significantly increases the risk of premature death from heart disease, cancer or emphysema, as well as worsening respiratory problems and inflammatory conditions. Should you be interested in quitting I can tell you about ten different strategies for doing so."
  • The Mechanic: This doctor won't actually talk to Ms. Smith about smoking. The mechanic takes as granted that smoking is just what her body does. The mechanic will provide treatments for the damage that smoking does to her heart and lungs. If Ms. Smith isn't interested in quitting, she might appreciate that the mechanic won't bother her about it.

Which one would work best for Ms. Smith? Well she's a fictional person, but perhaps the one you thought best for her indicates which sort of doctor you should be looking for.


Anonymous said...

Thank you. This is great!
As I read the options, three sounded awful to me, one sounded iffy, and one jumped out as an excellent doctor. Guess I've figured out which style I like best :)

Doctor D said...

Just out of curiosity Warmsocks, which one sounded excellent to you?

Doctor said...

I would add a personality that approached her smoking by finding out the reasons for her smoking so that the reasons can be addressed rather than just the bad stuff related to the smoking.

Maybe if her doc finds out that she smokes to treat pain, depression, anxiety, lack of concentration, or boredom, etc. the doc can get her to what she gets from the nicotine and find away to live without nicotine.

Doctor D said...

Good thought, Doctor, but I'm not sure if investigating the patient's reasons would make a new type all together.

I suspect all doctor types would makes some attempt to understand her reasons for smoking (except perhaps the mechanic). I think the "buddy" and the "parent" would be more likely to incorporate this more personal knowledge into their advice.

Perhaps you can elaborate more on this "investigative doctor" or "psychological doctor" and send it in. I could add it to the post on doctoring styles.

Anonymous said...

Consultant, most definitely. Give me information so that I know what's going on and can make good decisions.

With the parent coming in a distant second (compassionate guidance when needed).

WarmSocks said...

Clarification: "good decisions" might not have been the best word choice. I want my doctor making the medical decisions, not me. He's the one qualified, not me. I want to know about the treatment he decides on, though.

When my PCP prescribed a new medicine, he mentioned that it's a beta blocker. That was good to know. I was able to ask, "Aren't beta blockers contraindicated for people with Raynauds?" Not to question his judgement (I do trust him). If he's considered that fact and still thinks it's the best treatment, I'll try it. But if it's possible to treat one problem without making another one worse, it would sure be nice.

If I go to an appointment hoping to cut back on my meds, and instead walk out with two additional prescriptions, I need to know why.

If I understand the consequences of going without treatment, I can make the decision to keep taking my medicine, even though I'm sick to death of all these pills. That's the type of decision-making I'm doing.

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