The modern hypocratic oath

[CDreamer]

All of us on HU and other forums see doctors, some of who are good, some bad and some indifferent.

I have just come out of a meeting with an inspirational doctor who has reminded me, as well as our group, of the modern hypocratic oath and I quote a small part which he said inspires his work which I think may be pertinent to share with you all:-

"I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery."

Perhaps when we meet with doctors who do not offer us these qualities we might remind them of their oath?

I, and my group, found it very reassuring that 'medicine' is really about humanity and as well as science. Perhaps we need to remember this and offer humility and thanks as well as critiscism to those who do help us in our hour of need.

Perhaps we need to have a patients' oath? I wonder what that might look like?

Just a thought to ponder on............

[Finvola]

Great post, CDreamer and it is wonderful to meet such physicians who can counter the negativity of the few. One such cardiologist looking at my AliveCor traces said 'Of course you are concerned - it's your heart and you only have the one. But we can do something about this.'. That did more for me than months of treatment.

A patient's oath is an idea - but everything I can think of is negative - starting with

I will not get falling down drunk/drugged up/handcuffed to a burly cop and go to A&E where I will make a damned nuisance of myself, exercising my entitlement to the detriment of everyone else.

Just a thought for today.

[Mrspat]

Being treated by an old-school consultant with no bedside manner whatsoever, whom even the nurses called Doctor Grumpy, put my treatment back years. He destroyed my trust in the medical profession. He was and still is admired by his senior colleagues but petrifies everyone else. He missed, or chose not to explain, a significant part of my condition.

My late sister, who was very active in a renal patient charity, once gave a presentation to doctors entitled "Trust me doctor, I'm a patient". I wish I had a copy of it.

[CDreamer in reply to Mrspat]

Love it! If you find a copy I would love to see it.

I think we have all come across people like your consultant - I had a stand up argument with a cardiac consultant during ward round on the acute cardiac unit at our local hospital who terrorized his juniors in front of the patients. I got a virtual cheer from the nursing staff behind his back. He was very angry because I questioned his recommendation of taking Bisoprolol which I flatly refused to take so he was rather upset, just what you need on acute cardiac ward - not!

This is why it was SO delightful and encouraging to meet this man who came to my home to talk to my group for an hour and half and was delighted to do it and said he got a lot out of the process which he says he would like to be an ongoing consultative process, things really are changing thankfully.

Best wishes CD

[Kodaska]

This is wonderful language. I wish it included something to about listening to patients and not insisting they take medicines or treatments they have legitimate objections to and don't stand up under logical scrutiny. It would also be nice if they committed to making medical recommendations on the basis of good judgment and common sense, rather than staying within the bounds of what the pharmaceutical industry promotes.

Is this cynical? It's certainly the voice of experience. Probably both.

[CDreamer in reply to Kodaska]

No it isn't cynical just common sense and I am very encouraged that in the words of this doctor, a strategic planner as well as a consultant physician, that we will see big changes in the next 5 years. His philosophy filters through his whole team and is certainly based on listening.

By the way you do have the right to refuse treatment but not demand it, however, as was commented in the meeting that hospitals can be a 'conveyor belt' which is not easy to get off and there is little or no support for very basic needs such as nutrition, massage, chiropodist, movement/exercise and other natural support and treatments which enhance well-being rather than he use pharmaceuticals - except in his department, I am SO encouraged.

[Kodaska in reply to CDreamer]

I would have refused the drugs (primarily flecainide but also diltiazem) if I'd had any idea of the possible consequences. Silly me, I let my trust in the doc's professional judgment override my own instincts.

Do you suppose we'll ever see western medicine accept other healing arts such as acupuncture? I'm 66 and very doubtful it will happen in my lifetime. Anything that can't be patented or subjected to double-blind studies (funded by Big Pharma) just doesn't get attention or credibility.

[greengranny]

I have just been reading "Do No Harm, stories of Life, Death and Brain Surgery" by Henry Marsh, a best seller by a very eminent neurosurgeon. To quote:-

"Much of what happens in hospitals is a matter of luck, both good and bad; success and failure are often out of the doctor's control. Knowing when not to operate is just as important as knowing how to operate, and is a more difficult skill to acquire".

This is a very readable book by a doctor with a an awareness of humility! Brains not hearts I know but still worth a read.

The more we, as patients, can learn the more we can make ourselves heard, ask intelligent questions and be part of a discussion about ongoing treatment. Doctors are not gods - which used to be a common misconception!

[CDreamer in reply to greengranny]

Quite agree, 'Do no harm' is not in the Hypocratic Oath - thanks for the recommendation - I will check that out. I also found 'Being Mortal' Atuo Gwande very interesting and moving.

[CDreamer]

Might not have been the best pick from the book shelf at that time!

[carrie45]

if only they would all follow this. My father was a surgeon and everyone he treated spoke highly of him. He was compassionate and caring naturally by nature and always conscientious to do his best. I therefore had a very high benchmark and very much respected anyone in the medical field because of him. But unfortunately I have experience health care and medical specialists that seem not to have the same values and are not like him at all and it has now made me more sceptical unfortunately and less likely to just trust them automatically. Of course on the flip side I am sure there must be some very good medical professionals.