Knowledge Flashcards
Barriers to doctor/patient communication
Afraid of being judged
Examination room scares them
Afraid of the diagnosis
The patient may believe the doctor hasn’t really listened to them
May not trust the doctor
May be embarrassed
In what way is there uncertainty in medicine
When patients are dishonest or withhold vital info
Pre existing treatment which may affect treatment
Patients may not adhere to treatment
During surgery, may come across new complications
You can never know how people will react to bad brews
What is a diagnosis
The integration of information from various sources
- patients signs and symptoms
- a full history
- a detailed examination
- ordering appropriate tests and investigations
You analyse all of this combined and then lead to a diagnosis
What does ‘inequalities in medicine’ mean
Trusts can make their decisions on how to spend their budgets
Treatment in one trust isn’t available in another one trust
Postcode lottery means that people may have access to treatment in one postcode, but not another
When would an doctor lie to a patient
Patient may specifically ask the doctor to not tell them the truth - ie tell my family instead
Telling the truth would result in possible harm to the patient eg telling bad info to a depressed patient - could make the, suicidal
Recent advancements in medicine
Discovery of HIV medicine
Genetic testing for babies
Key hole surgery
Insulin helps to regulate diabetics
HAART
Stem cell therapy
Antibiotics
Radiography
How does medicine compare with medicine 100 years ago
Tech = MRI fMRI ultrasound, CT
Internet has enabled doctors to share info and knowledge and has helped medical research
Internet has had patients looking up their own conditions
Before 1948 (when NHS formed) people had to pay for their own treatment
DNA double helix discovery
Elderly people living longer
Media coverage
Does medicine treatment occur in hospital or in the community
A lot of ill people will go to the pharmacy to buy painkillers
Patient must go to GP to be referred
Many GPS carry out minor surgeries
Lots of chronic diseases can be monitored by GP
GP involved in preventative medicine = immunisation
Senior nurses and doctors are doing the role of the junior doctor.
How does this affect junior doctors
Reduces training opportunities, as nurses carry out the work
Affect the learning and progression of junior doctors as they have less clinical experience
The distribution of roles may help give junior doctors more time to relax and focus on their academics
Could help them succeed in exams
What are the factors that affect an individuals health or the health of the population
Smoking leads to asthma
Lots of drinking —> liver cancer
Environmental pollution leads to COPD
Occupation - could work in unsanitary conditions —> illnesses such as malaria
Obesity leads to diabetes, cardiovascular disease, stroke etc
How does politics influence healthcare decisions?
Politics set healthcare budgets and determine the amount of money available to spend on treatment
Some people are extricated to what drugs and treatment they receive
Demand always exceeds the supply
European Working Time Directive: reduced the number of hours a doctor can work to 48 hours. Increased the need for more doctors
By funding major campaigns for issues of importance and helping the NHS to pass on messages to their patients eg stop smoking
Politics is involved when deciding what to invest in when it comes to scientific research
Arguments for private healthcare
Autonomy - if a patient can afford private healthcare, they should have the right to private healthcare
Without private healthcare the NHS waiting list would increase dramatically
Some private hospitals send their patients to NHS hospitals for scans and pay the NHS
Some doctors do private as well as NHS. If they couldn’t do so, they may choose to work abroad
Private patients pay National Insurance alongside their private medical healthcare. This money can be used towards NHS patient care
Arguments against private healthcare
When private hospitals send their patients to the NHS for a scan, they are jumping the queue
In private hospitals, doctors may be carrying out unnecessary tests for extra money
Only those who can afford private healthcare can access it
In an emergency NHS staff have to look after private patients as well, so they can’t work on public
How can doctors promote good health, other than treating patients
Discussing with patients about their lifestyle, advise them on healthy eating, give up smoking, safe sex
Provide info and recommend support and organisations such as Alcoholics Anonymous
Raise awareness of mental illness and reduce stigma associated with it
Raise awareness of the ever growing obesity epidemic
Display posters in GP surgery
Can be involved in public healthcare initiatives such as government campaigns , podcasts etc
Educating patients about their condition
Increase accessibility to healthcare advice for lower socio economic groups
Structure of the NHS
Department of Health controls the NHS
NHS divided into primary and secondary care
GPS are primary care who act as independent contractors who supply the NHS
Secondary Care is care by hospitals and A&E departments
Tertiary care consists of specialist departments in Teaching Hospitals and specialist hospitals
