Category: Medicine 3rd July 2017
During the practice in secondary care clinics, I have visited Dermatology, Gastro, and Renal departments. The practice was valuable as I have learned a lot about the medical consultation, including differences in taking a history, making the clinical interview, and doing the examination in different departments. However, the acquaintance with a Vitiligo patient in the Dermatology department made the greatest impression upon me.
The patient had white patches all over the body which not only influenced his physical condition but also affected the patient emotionally and socially. He was often stigmatized for the condition, which was hurting his self-esteem and dignity. Insulting comments and bulling caused depression and mood disorders. Ultimately, the patient was on the verge of quitting the job of a taxi driver, because it demanded constant contact with people.
What I have learned from this encounter was that a disease has influence not only on the physical health but on the emotional and social well-being of a person as well. Therefore, doctors should treat the patients rather than the disease. They should establish patient-centred and person-centred approach in providing medical care.
The educational benefits of the encounter with the Vitiligo patient go far beyond applying theoretical knowledge and skills in reality. This experience has also motivated me towards further learning and self-improvement through showing the importance of the environment, empathy and understanding of patient’s experience of an illness. In addition, it has fostered the development of professional skills including critical reasoning and doctor-patient communication. I believe that such patient experience will help me to become a better student and a professional doctor in the future.
Primarily, practice in the dermatology department was critical for my education. It showed me what it is really like to work as a doctor. It has also helped me to develop professional skills. Thus, experience in a dermatology speciality helped me to gain competence in history taking and conducting a physical examination, establish professional attitudes, learn clinical reasoning, and acquire decision-making skills (1). In such a way, I have applied in practice the material and skills learned in theory. In addition, clinical experience has shown some gaps in my memory concerning the effects and treatment of Vitiligo which indicates a need for a revision of the scholarly material (2). Thus, the patient contact has also emphasized the relevance of learning and encouraged further studying and development (3).
In addition, the experience has facilitated the establishment of patient-centred and person-centred care approach which is associated with the quality of care (1, 4, 5). It made me recognize the importance of treating people instead of a disease (6).
Although Vitiligo does not produce serious direct physical impairment, the burden of the disease should not be underestimated. It can considerably influence the psychological and social well-being. For instance, patients with Vitiligo are reported to suffer from low self-esteem, poor body image, and a poor quality of life (7). Radtke et al. argue that appropriate education and treatment are likely to improve the quality of life of patients with Vitiligo and may support patients’ compliance and empowerment (8). Therefore, focus on the patient’s perception of health and illness, his beliefs, ideas, concerns, and expectations are critical when treating patients with Vitiligo.
My clinical experience was crucial for developing professional doctor-patient communication skills. Peter Tate states that good communication based on listening, synthesizing what is heard “through the medical sieve”, and understanding the patient is a critical skill for healthcare professionals (9). In addition, effective doctor-patient communication can help a doctor to understand a patient’s experience. Accordingly, conversation with the patient, listening to his story, and sharing his experiences teaches empathy (3).
Communication has facilitated both me and my patient. Thus, I have practiced active listening and speaking skills for exploration of the patient’s problems. In addition, I have shared as much knowledge as I had on the problem which, I believe, will empower the patient to exercise informed choices about the treatment and help him raise confidence and self-esteem (4).
Patient experience will have practical applications for me as a medicine student and a future doctor. Primarily, it will enlarge the number of illness scripts. Human memory stores contextual information about the patient, setting, and particular manifestations of an illness along with the clinical information. Therefore, an encounter with the patient who has a unique set of symptoms and environmental conditions might facilitate efficient retrieval in the future (3). The enriched “library” of illness scripts will help to establish a problem-solving strategy for me as a first-year medicine student. I know that this patient experience will help when next faced with a patient with a similar problem (2).
In addition, this clinical experience will contribute greatly to my self-development by fostering learning habits. I have learned how little I know in reality. Therefore, I have developed a foundation for solid on-going education so as to gain experience not only during studying but throughout my whole professional career.
Additionally, this patient experience will promote establishing patient-centred approach which is the key to high quality consultation. I have gained knowledge about the effect of ill health and a deeper understanding of patients’ experience. This knowledge will encourage showing respect and understanding for patients’ ill health condition through interactive approach to medical interview.
Finally, the practice of communication with the Vitiligo patient will facilitate the development of professional doctor-patient communication skills. It will help to target patients better, gain insight on the true reasons for medical consultation, and maximize the positive outcomes for a person. In the long run, effective communication skills will improve patients’ experience and my reputation as a future doctor. The lessons learned from the encounter with the Vitiligo patient will help me to become a better student and an exceptionally competent doctor.