Description of the case
Complaints during consultations is a normal occurrence in the clinical practice. Family doctors experience their fair share of these complaints as discussed in this segment. As part of the resolution of complaints during consultations, effective communication is central in addressing this pertinent issue. By communicating effectively, family doctors can employ various tactics in addressing these complaints. To begin with, asking the patient how they feel concerning an issue is the foremost way of dealing with complaints. In this regard, questions such as “can you explain what is making you upset in your own words” can surface. In our case, the GP does not address any complaint during consultation due to the emergency nature of the condition. However, taking into account these measures is invaluable. Secondly, family doctors can listen keenly to complaints and in so doing, they can understand the various issues that crop up during a consultation from the patient’s perspective. After listening effectively to the complaints, a family doctors’ next objective is prioritizing the complaints based on their level of importance. This is because certain complaints during a consultation may have no real impact on the patient condition. Complaints with a direct correlation to the condition are prioritized first. In case there is uncertainty over the clinical situation of the patient, it is the role of the doctor to offer guidance, assurance and reassurance to the patient. In our case, the GP reassured the mother after diagnosing her with panic attack.
Reflection: Personally, I believe that dealing with uncertainty on the patient’s part by reassuring them plays a vital role in improving patient outcomes since a patient’s confidence is bolstered.
Dealing with uncertainty - Uncertainty principle
The uncertainty principle holds true when it becomes hard to determine the outcome of illness episodes. It therefore becomes hard to predict potential patient outcomes. Uncertainty is particularly real in most of chronic diseases and is a major problem during the diagnosis phase of a disease. In this regard, health care providers play a significant role in lessening uncertainty on the patient’s part by either giving the patient relevant education concerning the condition. The healthcare provider can also encourage the patient so as to lessen any concerns. In our case, the GP took a blood pressure reading of the mother by mechanical sphygmomanometer that the family use in order to allay the grandmothers concerns since she had said that, “It could be that her blood pressure dropped Doctor”. Later on the GP opined that “I had to address the concern of the grandmother even though it will not add anything to my clinical assessment of the mother.” Such measures are effectual in addressing in patient centred concerns.
Impact of patient illness on family and the family doctor’s role
Sensitivity by the healthcare provider
Sensitivity towards a patient’s needs including the needs of their loved ones is invaluable in the healthcare profession. By being sensitive to various concerns raised by the patient or their dispositions such as religion, cultural affiliations, raised concerns among others, is important and part of the overall care given to patients. By being sensitive also, the patient or their loved ones feel respected and cared and without which, even the best care provided can be disregarded. It is thus imperative for healthcare providers to be sensitive to diverse patient needs. In this case, the GP had to perform a blood pressure test full aware that it was unnecessary for the patient. However, being sensitive to the needs of the patient and those of loved ones, he was obliged to perform the test upon an insinuation by the patient’s mother.
Reflection: Personally, I believe that such a gesture by the GP is commendable and should be emulated since it serves to give insights into what effective health care provision should be regarded dealings with loved ones. Through the GP’s actions, the adverse psychological impact of the patient’s situation on the loved ones is eased.
Nature of Maria’s condition
Maria presents with the symptoms of panic attack of which she is diagnosed. According to Johnson et al., (7-9), panic attack presents with intense fear which results in physical reactions such as witnessed in Maria’s case even when there is no real danger. A panic attack is different from panic disorder which is a condition of recurrent panic attacks. The social history of the patient reveals that she had not only received a disturbing phone call moments before passing out, but that she had also received an email from his son who was leaving her for Canada. Panic attacks are often sudden and without warning. These attacks vary, but the symptoms usually increase within minutes of attack. In Maria’s case, these symptoms set in 30 minutes after. The resultant feelings may be confused with other conditions if not diagnosed well as was the case in Maria’s case. The family wrongly perceived her case to be that of high blood pressure due to the similar symptoms. Panic attacks, thus manifest in the form of racing heart beats, chills, feeling of nausea, abdominal issues, headaches, dizziness, numbness, dyspnea and lightheadedness to Johnson et al., (7-9).
Using basic, clinical skills to diagnose the patient’s problems
Diagnosing panic disorder, unlike other conditions, requires the skilful use of clinical skills so as not to miss the presented condition. The GP used these skills effectively by obtaining a social history from the loved ones in order to diagnose the condition. This was after a complete physical examination yielded no results. However, carrying out a full physical examination is the foremost step in diagnosis.
Management plan
The management and care for Maria’s condition involves a range of remedies involving the use of efficacious drugs, plausible use of alternative medicine, changing lifestyles, using home remedies and suggested prevention measures. Psychotherapy is the chief most and first choice treatment option used in managing panic attacks. This can thus be used for the patient in this case to reduce the frequency and intensity of panic attacks. Through psychotherapy and its variant called cognitive behavioural therapy, the patient can be taught that panic symptoms are not necessarily dangerous. However, should the condition persist, medication such as selective serotonin reuptake inhibitors (SSRIs), Serotonin and norepinephrine reuptake inhibitors (SNRIs) and Benzodiazepines may be used. Due to the cognitive challenge that presents itself in that the patient’s ability to make sound decisions is limited, the management plan is made so as to serve the patients’ interest and also meet the doctor’s requirements for treatment. Fortunately, the condition does not warrant hospital admission and the treatment option can be pursued from home. Lifestyle and home remedies equally form part of the management plan. With the consent of the patient, she can be enrolled in a support group. Additionally, since she has experienced her first episode of panic attack, avoiding future recurrences can be achieved by being physically active, getting enough sleep, avoiding caffeine, smoking or alcohol intake which may trigger panic attack episodes. Finally, by practicing stress management techniques such as taking deep breaths and through progressive muscle relaxation, the condition can be managed effectively.
Work cited
Johnson, Kirsten A., et al. "Panic attack history and anxiety sensitivity in relation to cognitive- based smoking processes among treatment-seeking daily smokers." Nicotine & Tobacco Research 15.1 (2013): 1-10.
Toombs, S. Kay. The meaning of illness: A phenomenological account of the different perspectives of physician and patient. Vol. 42. Springer Science & Business Media, 2013.
