June 2014 | ISSUE 12
Walking a patient's journey

Students at LKCMedicine meet patients right from the beginning of their medical degree. By the second month of their studies, they have already spent a week following patients’ journeys through hospitals and another talking to patients at polyclinics to find out what brings them there and how they feel about their health and wellbeing. During their first year, students also start out on their Long-Term Patient Project. In pairs or groups of threes, the students visit a patient at home to see what life is like for him or her.

 
LKCMedicine students Julia Ng and Stewart Retnam visited their patient, Phillip, as part of the Long-Term Patient Project

The LKCMedicine catches up with one student pair, Julia Ng and Stewart Retnam, to find out what they have learnt so far from the project. They have been getting to know Phillip (not his real name), an elderly man with multiple medical conditions and a hearing impairment, and here they reflect on what their interaction with him has taught them. They also share their own reflections on this journey – read Stewart’s here and Julia’s here.

The LKCMedicine: What have you learnt from the Long-Term Patient Project?

Julia: We learnt a lot about the role of caregivers who play a very important role in caring for the patients and can impact their prognosis. The home environment too plays a big part.

Stewart: Yes, the caregiver can make a big difference in helping to bridge the gap between the doctor and patients who might not have the same level of trust in a doctor as they do in their family members. Without the caregiver, elderly patients may also have trouble getting to the hospital, understanding what is happening to them when they are in the hospital, and navigating the entire healthcare system.

The LKCMedicine: How important is a good relationship with your patient to being a good doctor?

Stewart: When we visited the patient, a doctor came along to take some diagnostic measurements. The patient seemed okay with what the doctor was doing and I think that’s because he trusted her and had confidence in her. To get to this stage, I think you need to be confident and show that you care for the patient. The patient may not get this from verbal communication (because of language barriers or hearing impediments), but he can tell whether your heart is really there from your tone of voice and body language.

Julia: Judging from what the patient said, a good relationship that has a certain level of trust between doctor and patient is very important. When we visited our patient, I could tell that his relationship with his doctor had been affected by the fact that his doctor was not able to determine the cause of his condition immediately. But at the same time, the patient knew that he could not expect doctors to know everything.

The LKCMedicine: What will you do differently in the future?

Julia: I guess the major learning point is that the home environment and the people who take care of the patient are very important. If I could, I would visit patients at home but that may be quite impossible. So, I will try to take my time to understand what patients are like at home and see how they interact with their caregivers during consultations.

Stewart: Along with diagnosing and providing a treatment plan to the patients, what I would like to do is to find out more about what patients think and how they feel about life. Especially for elderly patients, finding out the factors that shape their outlook on life and what makes them tick – are they waiting to see their children or grandchildren graduate or get married – will help us to make medical decisions that don’t just look good on paper but are also things that patients want.

Read more about the students’ reflections: Click here to read Stewart’s and here to read Julia’s.