Sunday, November 15, 2015

Learning from my patients

As medical students, we used to learn from our professors and from our medical textbooks. In clinical practice, we don't have professors to teach us anymore, which is why doctors need to learn by reading medical journals; attending conferences; and from our colleagues.

However, a very important source of learning which we often forget to take advantage of is our patients. All good doctors accept that they learn from their patients all the time. However, you do need to follow a process to maximise what you can learn from your patients.

This is what I do to learn from my patients.

I am respectful and understand that patients can be very valuable sources of knowledge , if I ask them nicely. Thus, it's possible to use patients as unpaid research assistants, and to ask them to look for information on the internet or do a PubMed search. Patients are extremely motivated. Some of them are extremely intelligent and have great business analysis skills, which they can apply to their medical problem as well . I ask them to share the information they learn by doing an internet search with me , so that together we can polish our skills . I do need to guide them in the right direction in the beginning, and provide them with feedback, so that the results of their search become progressively better.

I keep my heart and ears open. There are lots  of inadvertent experiments which occur naturally in real life in clinical medicine. For example, some patients don't follow my instructions ; or forget what I tell them, in which case they end up doing something completely different; or they combine my treatment with alternative medicines.  These are clinical trial where n = 1. When this happens, they're scared and they don't tell me that they forgot to do what I told them; or that they did something completely different, as result of which I never learn from their errors . Sometimes, the outcomes of these variations is better than I would have expected. I have learned to treasure these exceptions and learn from them.

I keep channels of communication open , and tell patients it's okay to make mistakes , provided they share them with me . This way, I can learn from these first-hand experiences of my patients, and use these to tweak the treatment protocols which I offer.

Finally, smart patients will come up with clever hacks, and useful tips and tricks they use in order to manage their IVF treatment When I see that a patient is doing a great job at taking care of herself , I ask them what they are doing - and request them to share their experiences and expertise with me so that I can teach my other patients as well !

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