Health

Afraid to ask the doctor


Holding a prescription with 6 types of medicine just prescribed by a doctor to treat stomach disease, Mr. Tu, 28 years old, did not know what they were but was afraid to ask because many patients were waiting in long lines, the doctor pressed the button to call the next person. .

Mr. Tu saw that people with stomach pain often had to abstain from a lot of food, but the doctor did not give any further advice, just instructed to go out and get medicine. Looking at the doctor a bit tired from the disease, he hesitated for a moment, asked quickly: “Do you need to abstain from any food with this disease?”. The doctor advised abstaining from alcohol, limiting sour and spicy foods and emphasizing that “these are normally not sick and should be limited”. Finally, the doctor invites the next patient to come in for examination.

Sharing this story, Mr. Tu said that many times he went to the doctor, had questions to ask the doctor, and was not explained in detail, sometimes he was angry, so he did not dare to ask for further advice. Over time, he carried the mentality of “whatever the doctor tells you to do, follow the instructions to get rid of the disease”. However, once he had an ear infection, he took all the medicine prescribed by a doctor at a cost of several million dong, and he learned that there were unnecessary tonics.

Having learned from experience, this time after the examination, he did not buy medicine right away, but sent a prescription to a familiar doctor for advice. Doctor Nguyen Huy Hoang, Vietnam – Russia Hyperbaric Oxygen Center (Hanoi), said that in this prescription, there are both supplements and functional foods that are not really necessary but are not prescribed by the doctor. clearly like the use. Doctor Hoang advised Mr. Tu to only need to take two drugs to treat stomach pain, while the other 4 drugs in this prescription are not needed. After a month of taking the drug according to the advice of Doctor Hoang, Tu’s stomach pain decreased completely.

Patient psychology is afraid to ask a doctor when going to the doctor. Doctors say that this is a story that has lasted for many years, and it is difficult to change every day, both from the patient’s side and the medical staff. In 2015, the Ministry of Health implemented the plan Innovating the service style and attitude of medical staff towards patient satisfaction, helping the medical industry to have many positive changes in recent years. However, in many hospitals with too many patients, it is difficult for doctors and nurses to do it properly.

Doctor, Doctor Nguyen Bach, Head of the Department of Internal Medicine, Nephrology, Dialysis, Thong Nhat Hospital (HCMC), said that the problem of patients being afraid to ask doctors comes from both sides, including patients who do not have the habit of asking doctors. Doctors do not know what to ask, Vietnamese people are afraid to ask questions, and secondly, doctors do not have time to explain to patients.

Like Mrs. Minh, 58 years old, she crossed more than 1,000 km from the Central region to Ho Chi Minh City to see a doctor because she often twitches in one eye and facial muscles, and she is weak and tired. After a series of tests, electromyography, she received a diagnosis sheet of “Tic disorder” with a prescription and instructions to take prescription, follow-up examination after a month from the doctor. She was stunned and did not understand what “Tic disorder” was, what the cause was, but did not dare to ask the doctor again.

“The doctor told me that I had a disease, I knew it was the disease, many times when the doctor explained it to me, I didn’t understand,” said Ms. Minh. When buying medicine, the pharmacy staff said that there was no prescription type, only “one containing equivalent active ingredients”, she “didn’t know how to contact the doctor” so she had to accept the purchase.

Dr. Hoang also said that because the level and awareness of the patients are very different, not everyone is confident to ask the doctor about problems related to prescriptions and their own health. In addition, an important issue is that in many public hospitals, doctors have to examine more than 50-70 patients in a session, and the time spent on explaining and consulting is very limited, so they can become irritable when the patient is ill. asked a lot. While the compensation at a public hospital is not commensurate with the stress of the job, doctors do not feel comfortable having to explain to patients. It is like a vicious circle, from which the patient does not want, even dare not question, argue or ask the doctor, leading to the affected rights.

Patients examine and ask medical staff for guidance at a hospital in Ho Chi Minh City. Image: Quynh Tran

From the fact that he has both worked at a public hospital, examined after hours at an international hospital and opened his own clinic, Dr. Bach recognizes the difference in doctor and patient communication between different types of patients. this medical service. At public hospitals and health insurance clinics with a very large number of patients, doctors only have a few minutes to examine each patient, so there is hardly enough time to explain much. In the atmosphere of hurry and urgency, patients mainly take prescription drugs and drink according to the instructions recorded.

In places with higher medical examination costs such as private clinics, on-demand examination areas, international hospitals…, doctors have a lot of time to spend with patients, so they can advise and answer many things. “Many private hospitals prescribe 10-15 minutes for each examination, so if the patient does not ask, the doctor also actively inquires, explains and advises,” said Dr. Bach.

There are VIP clinics that only accept up to 10 patients a session, so the time to talk with the doctor is very comfortable. Most of the patients here are usually knowledgeable, ask the doctor very carefully about the indications for tests, prescriptions, diet, activities… They often ask the doctor very detailed questions about the drugs in the prescription. What disease is prescribed, what are the side effects of taking it, can it be taken with other co-morbidities, how long to take it, how to prevent recurrence, whether family members need to be screened…

In fact, the fear of asking a doctor can make patients not fully aware of disease information, drug use, side effects, drug interactions to avoid, appropriate diet and lifestyle, thereby affecting quality of life. amount of treatment. Not to mention, the patient is passive in the medical examination and treatment process, signing a commitment to agree to treatment when he or she does not fully understand everything. violence against healthcare workers or take each other to court.

Patients are crowded at a hospital in Ho Chi Minh City, April 2021.  Photo: Thu Anh

Patients wait for examination at a hospital in Ho Chi Minh City, April 2021. Image: English Letters

The question the doctors themselves ask is how to change this situation. “This is a problem that requires raising people’s knowledge, on the part of doctors and nurses, they must change their service style and attitude, especially the health system, also have to change the quality of service,” said Dr. Bach. . From a medical perspective, Dr. Bach said that patients often do not have much medical knowledge, the doctor is responsible for explaining in the simplest way to understand, not to confuse the patient. Use anatomical models and drawings to illustrate.

Law on Medical Examination and Treatment stipulates that patients have the right to be consulted and explained about their health status, treatment methods and medical examination and treatment services suitable to the disease. Patients are treated with safe, reasonable and effective methods according to professional and technical regulations. In addition, patients must be provided with adequate information, explanations and advice about their disease status, outcomes, and possible risks to choose a method of diagnosis and treatment.

“Patients need to understand their rights, proactively ask doctors to answer questions, to protect themselves,” advised Dr. Meanwhile, Dr. Hoang suggested that colleagues when prescribing drugs for patients must clearly explain which types are tonics, which are functional foods, which drugs are political diseases, so that the patient knows and balances them. prompt to buy or not depending on economic conditions. When prescribing tests and pre-operative risk assessment, doctors must also clearly explain to the patient.

Doctors expect that when the economy develops and people’s knowledge improves, self-financed hospitals must change their service quality to attract patients, then the communication problem between medical staff and patients will be increasingly improved. In many developed countries, patients are thoroughly explained by the doctor about the disease and treatment plan, and are also given detailed instructions on how to use the drug by the clinical pharmacy department. Clinical pharmacists look at the prescriptions prescribed by the doctor, if they find it inappropriate, they can contact the doctor and ask for a clear explanation, ensuring the best interests for the patient.

On the side of the patient, Dr. Nguyen Ho Vinh Phuoc, Binh Dan Hospital (HCMC), advises when receiving new information, if you do not understand, ask again and listen to the doctor or medical staff. Afraid to ask questions and talk to doctors leads to misunderstandings in receiving medical information, which can have serious consequences. Statistics in the United States show that every year thousands of people are injured or die due to misunderstanding or underestimating the importance of medical advice.

“Before going to the doctor, the patient should write down the questions and leave room for the answers. At the clinic, it is advisable to ask and record the doctor’s answers,” advised Dr. Phuoc. If the doctor has information sheets or medical images ready for the patient, don’t be afraid to take them home for reference. The patient receives a summary of treatment information, please save it carefully and read it at home. Patients can go with relatives or friends when seeing the doctor to be more confident, understand better and have someone remind them of the doctor’s advice.

Le Phuong – Thuy Quynh

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