All entries for Friday 27 May 2016

I am training to be a doctor, right?

For many people becoming a Doctor is the fulfillment of a lifelong dream. For myself I remember as a 7 year old in school being asked to draw what I want to be when I grow up and I drew a Doctor complete with white coat and stethoscope. Staring Warwick Medical School was one of the best days of my life, however the relentless lectures and seemingly endless amounts of information soon brought me down to earth with a bump. The one thing that kept me going was the promise of all the clinical, practical medicine in 2^nd year. Now that I’m over halfway through core clinical education I’m starting to ask myself where did all the practical medicine go?

In our GP placements, in particular, I’m struck by the number of medical problems that turn out to be social issues. When taking a history from a stressed out single mother who is having panic attacks due to the pressures of looking after her children alone, one of whom is autistic, I’m left thinking: how can the GP help her? Sure we could think about medication or a referral for counselling but what she really needs is some help at home and some time to herself and unfortunately that doesn’t come in a pill. We also see a lot of cases of anaemia, most of which are caused by a lack of dietary intake of iron. In the area we are in many people have poor diets, some through a lack of education, some through a lack of equipment: one lady didn’t have a working oven as her landlord had still not fixed hers after 3 months! Some people just don’t have enough money to feed themselves properly. Are iron supplements really going to solve that problem?

You may be thinking that social issues are a big part of medicine in primary care but social issues have been causing problems in hospital for a long time. I am currently assigned to a Geriatric (Elderly care) ward at UHCW. Speaking to older patients is extremely satisfying, you get to hear wonderful stories and they often enjoy testing your knowledge by throwing in a few left field answers, especially if they have spoken to medical students before! While the Geriatric ward can be very fulfilling it can also be heartbreaking. Some of the patients are only in hospital because they haven’t been looking after themselves and sadly no one else has either. Patients come in dehydrated and malnourished and with poor levels of self-care. The paramedics who brought them into hospital might have been the first people they have spoken to in weeks. Social issues bring people into hospital but they can also prevent them from leaving. If people aren’t coping at home they need to remain in hospital while packages of care are organized, every extra day that goes by is another chance to acquire a hospital acquired infection. As a medical student I am starting to understand just how complex the healthcare system is and just how many people are involved. All the cogs have to turn together to make the machine work and sadly it is often social care issues that this all come unstuck! As medical students we need to know to navigate this minefield so we can help our patients in the future and stop social inequalities impacting on the health of our patients. I’m training to be a doctor, not a social worker, but I don’t think you can be a good doctor without all the other cogs!

Joanne

Catrin Davies : 27 May 2016 11:56 |  Tags: Joanne Mbchb Patients Social Student Wards Warwick Wms |  Comments (0) |  Close comments |  Report a problem