Friday, September 14, 2012

Being the patient, what to do...

Even though I don't feel sick, I do have a medical problem which I have to see a GP & specialist for, so I guess in theory that makes me a patient. Thankfully, I am rarely 'the patient'. I have been very blessed to stay healthy over the past 7 years in Sierra Leone, with only 3 sick days in that entire period and a few minor illnesses here and there.

So, I guess the question is, as a doctor what do I do when I become the patient? Do I:
a) self diagnose and treat
b) ask a colleague friend for advice
c) ask your sister (a GP) for advice
d) go and see your GP
e) leave it and risk waiting too long?

I suppose for me it depends on what's wrong and where I am at the time. If in Holland, I think I would go to my GP fairly quickly. In Sierra Leone, I'm more inclined to sort it out myself. Especially if it's something minor, like a skin infection or eye infection: I self diagnose and treat. Pharmacies are scattered throughout Freetown and medication is easy to come by, which is convenient but not always so reliable. I generally stick to the one pharmacy that I believe has good quality drugs. Having said this, when I had an abscess just above my knee I self-treated and even ended up doing some very minor 'surgery' on my leg. At that point I got a bit worried, wondering if my leg would be okay. I had reached the point of considering checking with a colleague but fortunately after 48 hours of antibiotics (doubling the dose to the maximum!), my leg looked better and I could walk normally again and there was no need for a consultation.

Likewise, if I had a fever I would probably head down to one of the few laboratories I trust (because I know the technician) and get tested for malaria. If positive, I would self-treat with the same thing I prescribe for my patients, if negative I'd wait it out. And, after two days, if I was not better (or if I got worse in the meantime) I would go and see a GP in town, possibly after checking with my colleagues or sister.

I think asking for advice from colleagues or family can be quite helpful. However, I also realize it puts them in a difficult situation. I know this because I have been in that situation a number of times. It's hard to be objective when you're treating/advising someone you know well. So, for the most part, I would ask for their opinion but generally not have them treat me.

So, how do I decide what to do? I guess part of the decision making has to do with my own experience in treating patients - if it's a condition I'm familiar with, I would self-treat. However, if it's something bizarre, I'd be more inclined to get it checked out. The same goes for treating colleagues, friends, expat children - I am happy to help/advise, but if it's more complicated and they need to be seen properly, i.e. more tests, full physical, etc, then I would refer them to a GP in town. (Remember: I don't have a clinic of my own and am not doing full-time clinical work.)

Part of the decision-making also has to do with the quality of care available in Freetown, or lack thereof. Sometimes it might be better to try to sort it out yourself or go to a colleague you trust, rather than some random clinic. There are a lot of random clinics in Freetown! You need to know where to go. With my anemia for example, I was happy to check my Hemoglobin myself. I wasn't as convinced to go to local labs, because I wasn't sure if I would even trust the results. Plus, knowing I was going to Holland, I decided to wait and get it done properly. So, on arrival here (after consulting my GP sister, I have to admit), I went to my GP and he got the ball rolling. It did come to the point where I could choose to go back to Freetown and go to a local lab/GP once a month or stay here and get things sorted out first. For reasons mentioned above, it seemed wise to sort things out in Holland. So here I am, 3 1/2 weeks later...

No comments:

~ Act Justly. Love Mercy. Walk Humbly. micah 6:8 ~