publicado em 07/07/2012 às 15h00:00
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The importance of the Doctor Patient Relationship

Antonio Carlos Lopes, director of the School of Medicine of UNIFESP and president of the Brazilian Society of Internal Medicine

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Foto: Divulgação/SBCM
Antonio Carlos Lopes, President of the Brazilian Society of Internal Medicine
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Antonio Carlos Lopes, President of the Brazilian Society of Internal Medicine

When we refer to a not too distant past, remember how it used the existence of a strong relationship between doctors, patients and their families. One family physician, who accompanied all its members throughout life, no longer exists. Or very few left. And unfortunately, after the advance of technology, some have to admit that the computer and magnetic resonance imaging, for example, play more important role than the role of the physician. What need to talk to the patient when you can put it inside a machine and see it inside?

Let us not forget that MRI is not able to indicate, for example, social and cultural conditions of the patient. Not able to diagnose everything that happens to him. I cite as example cases of panic disorder: the individual usually reports a framework of established disease and profound malaise, but the tests do not indicate any abnormality. In this case, the proper diagnosis is made only by history and by the relationship between doctor and patient.

Advanced technology, despite its benefits, eventually contributing to the cooling of this important interaction. And because I believe deeply that, I have personally tried to bring up the discussion of this topic at conferences and campaigns within the associations and academia.

The search for the appreciation of the involvement between doctor and patient also brought to the surface the debate on the importance of humanism in medical practice. Above all attitude, the doctor needs to focus less on the disease on computed tomography, magnetic resonance imaging and more patient-that is the reason for their professional existence. In these times of great economic and technological advancement, nothing replaces the humane treatment and nothing is more important than the medicine at the bedside.

The doctor-patient relationship is an interaction that involves trust and responsibility. It is characterized by the commitments and obligations of both actors, permeated by the sincerity and love. Without this real interaction, no medicine. It is a human relationship, like any one of its kind, is not free of complications. Often the individual who is sick has tried many professionals in many cases, even looked in his face. It is one of the difficulties to be faced at the time of the initial approach.

Medicine is not just science. It is also art. Often the patient reaches the doctor's office and can not scale the moment is as important in your life. Running out of the office, often forgets what to say to the doctor, get nervous because you have to go back to work. This is quite common, especially in the Unified Health System Then the problem becomes even more complicated, because each query is only 15 minutes. Sometimes there's even chair for the patient sitting.

Our duty as physicians is to establish an interaction with the patient, no matter their class, color or creed. This professional must be ready to face adversity, when the patient denies. And he is exercising his right. There are also situations where the patient comes accompanied by a third person who takes the role of intermediary and therefore interferes with the doctor-patient relationship. Still another time, the patient is visibly upset, with cold hands, nervous, because he waits in the waiting room for some time. With so many difficulties, as the doctor does to create a pleasant and suitable to receive the patient and interact with it? Without this contact, it is not possible to establish a dialogue and develop a proper anamnesis. We must remember that 70% of all diagnoses are coming from the interview.

What, then, the best way to allow the flow of patient-physician relationship? In my office, one strategy is to seek rapprochement through themes of everyday life, such as football. Conversations about the profession also help to relax the patient. After about 15 minutes, he is totally relaxed, which is perceived by breathing slower and change in the countenance. This is the ideal time for the beginning of history. What is needed is to disarm the patient when he is aggressive, tired, scared or simply discredited because it has already tried several professionals who could not hear him and respect him.

It is time to reclaim our roots, to redeem the good old doctor and his main qualities, without, of course, giving up all the modernity that we are entitled. The rescue of humanization as well once inserted in that context, it should rule forever the practice of medicine, with the main goal of providing quality and dignified care to the population.

To be a doctor, you must like people. Knowing that there are no diseases but, sick. Exercise the profession is to practice love of neighbor. The patient should die holding hands with your doctor and this requires calm and ideal tool for a service in which it can offer the best of his knowledge, all his attention, and especially all about you. He needs enough time to know the patient, find out their complaints, investigate his past, his desires and anxieties, and make out in relief, with the prospect of having your problem solved. Giving and receiving quality health care and universal, rather than a desire, is a universal right.

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Doctor Patient Relationship    Antonio Carlos Lopes    Paulista School of Medicine    UNIFESP    Brazilian Society of Internal Medicine   
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