The Doctor-Patient Relationship - Case Study Example

The Doctor-Patient Relationship The doctor in Abre Los Ojos (“Open Your Eyes” in English) has a very complicated relationship with Cesar, who is a young playboy who has been involved in a car accident at the hands of his jealous lover Nuria. Here, the elements that will be analyzed in the doctor-patient relationship include: the principles, foundation, and dynamic of the doctor-patient relationship, especially between the Dr. and Cesar in Abre Los Ojos; what it means to be a professional (whether or not the doctor follows the rules and laws of doctor-patient relations); the doctor’s use of purpose, theory, scientific base, structure, contracts, roles, and labels; the self-exploration and identity struggles the doctor faces while treating Cesar; and environments, expectations, tone of voice and trust or mistrust, the doctor’s focus of Cesar’s needs, the doctor’s verbal and/or nonverbal actions, his manner, his cues, his attitude, his validation of Cesar, and key words and phrases the doctor uses with respect to psychology. The principles, foundation, and dynamic of the doctor-patient relationship in Abre Los Ojos are very interesting. The doctor himself is a no-nonsense type of guy who encourages Cesar to try to remember what he himself did, and the movie also has a few twists at the end. Another important aspect of being a doctor—which Cesar’s doctor exemplifies—is what it means to be a professional (whether or not the doctor follows the rules and laws of doctor-patient relations). Understandably so, doctors must be continually assessing and evaluating the needs of the patient. Are the patients’ medications at the correct dosages? Do they need to be adjusted? The duty of the doctor is to continuously be monitoring a patient’s relative progress or the lack thereof. A doctor, if there is any significant change in the patient’s status (positive or negative) should make notes of this in his or her care plans and make contingency plans to provide for any changes in temperament in the patient. The doctor’s use of purpose, theory, scientific base, structure, contracts, roles, and labels is clearly defined in Abre Los Ojos. The duty of the doctor is to reassure that all the patient’s needs are coordinated. Usually a patient’s care team consists of: the doctors that are working on all of the patients; the main doctors which oversee the patient’s care setting; the social worker; the chaplain; and perhaps most obviously, the family and/or caregivers. In this case of Cesar the family and/or caregivers are basically replaced by the jail. It is the duty of the doctor on the end of the hospital or other organization taking care of the patient—not now speaking of the family and/or caregivers—that they establish a sense of trust and reliability with the patient. Since the doctor is the person who will have the most contact with the patient, it is of maximum importance that the doctor be professional, respectable, and affable. It is the duty of the other doctors to patiently listen as each individual doctor expresses his or her reflections on the progress of the patients. Similarly, it is the doctors’ duty to reflect on how the status of the patients are. The social worker is available in order to address any issues that might come up regarding the patient’s living conditions, environment, etc. The chaplain is available in order to help out with a patient’s spiritual needs. The doctor’s self-exploration and identity struggles being faced while treating Cesar are manifold. In whatever case, the doctor is very important, and of course, one cannot forget the importance of the role of the jailers, which must work with the organization’s doctor on-call. The doctor works to provide the service of helping the patient through this troubling and complex time in his or her life. Hopefully the doctor can make that patient’s journey an easier and perhaps less stressful one. Cesar’s doctor faces identity and self-exploration issues in this movie which include putting himself in his patient’s situation and imagining how he would fare. The environments, expectations, tone of voice and trust or mistrust, the doctor’s focus of Cesar’s needs, the doctor’s verbal and/or nonverbal actions, his manner, his cues, his attitude, his validation of Cesar, and key words and phrases the doctor uses with respect to psychology are all key linchpins of the movie. The demand for medical education for generalists would grow along with the nature of the care being given. Provisions hence would have to be made for the practitioners, irruptive of their fields of specializations, to have easy access to courses and short term clinical attachments. Within the general education, there has to be more emphasis on 'modular education,' especially for the nursing doctors. With the advent of the Internet and technological developments, more reliance could be placed on distance-learning which can further be accelerated by especially providing such facilities by catering to the needs of those working in jails like Cesar’s doctor. At a higher level, institutions of higher learning could augment the facilities by creating professional chairs in medical and social work. As else where pointed out in this paper, the current paucity in research could be made good if funding bodies and pharmaceutical industries recognize the relevance and need for doctor care in the incarceration setting. A vast magnitude of the population in the US is incarcerated. Patients and their families face shocks, uncertainties and need support at all stages. Though such a support was available, yet, in one survey, it was revealed that there were still considerable number of such patients who stated that they did not receive the information and support they needed and all the more showed considerable variations in the quality of care delivered across the country and one of the reasons for this was attributed to the poor interprofessional communication and coordination. Doctors must be engaging themselves in and developing standards, having realized that effective face-to-face communication between health and social care professionals is important, on the one hand. Patients and caregivers, on the other hand, is fundamental to the provision of high-quality health care, yet, in practice it was found that much of the professional support furnished to the patients who were incarcerated was delivered by non-specialist social and health care professionals in psychological aftercare, which has been an area of concern. In this regard, it is indicated that there is also a paucity of literature and in order to fulfil this gap, it is widely perceived that budgetary provisions should be enhanced. The disparities in the provisions of the incarcerated care around the world have given rise to a new genre of rhetoric in that it is seen as a human right belonging to the arms of international law. So much of rhetoric dominates the literature about the entitlement of people needing incarcerated care in the name of human rights, but, when removed from such rhetoric, the realities which remain are totally different. This is explained with reference to one sensitive topic, i.e., assisted suicide. Compassion and the right of the patient to die are two commonly-presented reasons in favor of the concept of assisted suicide. Emotions are wrought by the usage of compassion because of its universal appeal. But when divorced from emotions, it would become clear that compassion can be distorted and harmful. In this particular case, the human beings would be deprived of their dignity, and in effect it would mean their being killed. It may be a moral reason for relieving the humans from the sufferings that terminal illness brings on them, but, not a moral justification for ending a human life. In effect, while handling incarcerated patients needing incarcerated care, the leaders of governance, policy-makers and the practitioners all should remove themselves from such rhetoric and engage themselves in efforts that would make such a life as comfortable as possible without injecting further sadness into them. The environment of the jail where Cesar is kept is in a horrible condition. Neither the doctor nor Cesar is safe. The clinician’s expectations are that Cesar get well. The patient, Cesar, is hoping that the doctor might be able to help him either get free or help him realize what he actually had done and why he was in jail. The doctor tends to push Cesar to new levels, challenging him. Cesar yells a lot. The doctor is a focused attendant to Cesar’s needs, both psychological and physical. The doctor is nonverbal in expressing his anger, but verbal in declaring that Cesar needs to try to remember what happened, as his freedom depends upon it. He repeats these assertions and gives advice liberally. His main verbal and physical cues are overt and direct. It is the attitude of the physicians which largely governs the professional transactions of the doctor and his or her patient (“Changes in Attitudes of Medical Students,” 2002, pp. 1162). The doctor is not necessarily warm or caring, but to compensate for that, he is empathetic to Cesar’s plight, shows acceptance, is genuine, and is available. In an analogy, the doctor-patient relationship is very much like mirroring the teacher-student relationship (Pettit, 2008, pp. 234). The doctor validates his client and evaluates his strengths, trying to take care to stay neutral. Teachers of medical doctors acknowledge that every doctor struggles with how personally revealing he or she should be, how friendly he or she should be, and how down-to-earth he or she should be (Kagan, 2007, pp. 325). One key phrase the doctor continually uses is that Cesar must “remember.” He attempts to job is memory in a Freudian manner. Several elements have been included here about the relationship between the doctor and Cesar. It is hoped that these aspects will help develop the viewer’s understanding of the doctor, the patient, and both of their psychological underpinnings as well as the doctor’s professional demeanor. WORKS CITED ‘‘Changes in Attitudes of Medical Students toward Psychological Aspects of the Doctor-Image and the Doctor–Patient Relationship.’’ (2002). Journal of Medical Education, 40: 1162–1165. Kagan, R.A. (2007). “Terminating the doctor-patient relationship.” American Journal of Clinical Oncology, 30 (3): 325-326. Pettit, M.L. (2008). “An analysis of the doctor-patient relationship using ‘Patch Adams.’” Journal of School Health, 78 (4): 234-238. Read More