“A good physician treats the disease; The great physician treats the patient who has the disease.” Sir William Osler, 1849- 1919
As Sir Osler beautifully puts the idea of patient-healthcare-professional it becomes evident that the most important person with in the entire healthcare system is the “patient” and how I interact with my patients behind those closed blinds in my treatment sessions is what will determine whether I become a good physiotherapist or ‘just another guy you gives patients a quick rub’
As my university career is coming towards it completion I am more aware that I will have to grapple with complex ethical dilemmas within the profession, the art of physiotherapy will become less about the science of the profession and more about ethical issues we face on daily bases. The unfortunate part about how I have been trained is that I was thought the science of the profession and not enough about the ethical issues we will face as physiotherapist on daily basis. We are not told how to deal with racist patients who won`t be treated by black physiotherapist, there are no lectures teaching us how to ask a rape victim to remove her bra so you can auscultate the mid lobes of the lungs.
I do not know what to say to my patient when she says she wants to die, these are very emotionally draining situations that I do not have answers for, the worst part of all it that my patients sometimes think we have all the answers. The truth is healthcare is made of many layers and dynamics of human interactions. When we recognize these dynamics of human interactions, it becomes apparent that the patient-healthcare worker relationship is in essence the foundation of healthcare.
The patients who come into our clinics, they come in search of help and a ‘good’ physiotherapist who will serve the patient with sincerity and professionalism. I recently learnt that a good sincere and professional physiotherapist is not the one who knows all the science but he who can interact with patients on an honest human manner, the one who is able to say I do not know the answer to that question, I do not know the cause of the sharp shooting pain you are feeling radiating down your leg, but I will be happy to find out for you.
Now does this relationship we have with our patient only confined within the bounders of hospital corridor, or does it extend into patients’ lives, do I even have to greet my patients when I see them at the mall? Are healthcare professionals obligated to play multiple-roles roles of advocates, social worker, psychologist and advisory to the patient?
To answer these questions one must know his defined roles within the healthcare system however you take into account the context and resources available at your disposal at any given event, the best question to ask is “what is the worst that could happen if I do this and what is the worst that could happen if I do not do/say this?” then you can weigh the risks and benefits of deciding on a particular route to follow.
Despite the harsh realities of conditions in public healthcare sector, healthcare-workers need to ensure that the patients get the best possible quality healthcare services, which is a basic human right. When delving deeper to this issue, it must always be remembered that to be a good healthcare practitioner requires a life long commitment to be sound professional and ethical practices and dedication to to the interests of fellow human beings and society.
References: Health Professions Council of South Africa. Guidelines for Good Health Practice in the Health Care Profession. Paragraph 2.3.8. http://www.hpcsa.co.za/conduct_generic_ethical_rules.php (accessed 16 March 2014) Constitution of the Republic of South Africa, 1996 (Act No. 109 of 1996).