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The way i and most other relevant people have been
trained to conduct medical consultations is referred to as
the "problem-oriented medical record", where you run
through people's medical history and look at all the
problems they have as well as the problems they present
with. You then often
go on to examine them to find out all
the things they can't do, find painful or whatever. It's a
real bundle of laughs for both involved.
Therefore, i go to thinking: why not turn it round? Why
not have a medical interview aimed at all the things which
are good about someone's health? Instead of asking them
about, say, asthma, hypertension and disfiguring skin
diseases and then proceeding to demonstrate that they
can't think straight, see properly or walk across the room,
work out what they can do, talk about what's good about
their health and send them out feeling positive about their
lives, thereby achieving a placebo effect.
Now, the thing is, this could easily piss a lot of people off
hugely because they got hospitalised the other day as a
result of not being able to breathe, their toes have just
died due to diabetes or everyone in the street looks at
them funny because they appear to have a toadstool
growing out of their cheek. The answer to this is that it's
not either/or, and in fact it would probably depend on their
problems being known and therefore a preexisting
problem-oriented medical record. Therefore, instead of
doing it instead or as a result of people consulting you
about their sarcoidosis or whatever, call people in at
pseudorandom and just interview the hell out of them
positively, and also have people book in for medical
interviews just when they feel like it. If you already had
their medical records, you would have some idea of what
areas to avoid, and this is not instead of the other kind
but additional to it.
I hope that one result would be fewer medical interviews of
the other kind with the same person. Also, note that this
has nothing to do with either orthodox or complementary
therapy, unless you spell the second bit with an "I" maybe.
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'I'm not quite dead... I FEEL HAPPYYY... OOF!' |
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I heard from a physician that it is highly unethical to knowingly prescribe a placebo. You also mention this in "Sceptical Alternative Therapy" I don't get why. |
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This isn't really a placebo, it's just giving someone a positive outlook on their health and/or distracting them from the problems. |
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The real trick is to do this all the time, for everyone you encounter, whether it is a medical interview or not. But make it subtle! |
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And to yourself, not just other people! |
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Maybe placebo is the wrong word. However, in order not to prescribe a placebo, as mentioned in that very idea you mention, you would have to talk down every remedy, and if you believe in the therapeutic value of the likes of sympathy, empathy and listening, you would also have to avoid those. That would seem quite unethical too. I don't know how you would go about disentangling the two in any case. What was the argument? |
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As it happens, i've described this as placebo and that seems a fairly accurate description - pleasing the patient. It's probably somewhat unlike the general understanding of what constitutes a placebo though. |
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I think the majority of GPs are already well aware
of the placebo effect, and know that a lot of the
results they get from drugs are due in large part to
it. |
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As to the idea, well, yes, but it assumes that (a)
doctors have a lot of time, instead of the 15 (or is
it now 9) minutes they're meant to allow for each
consultation and (b) that the patient doesn't have
anything urgently wrong with them. |
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Pointing out that blood loss through your arse will
help with weight loss, or that the lump actually
makes one of your breasts look much perkier will,
I suspect, not be necessarily to the advantage of
the patient. |
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I think the solution oriented medical interview should entail solutions that interviewer and interviewee imbibe, and should mostly concern increasingly horrible / hilarous anecdotes and tales from the front, with occasional head shaking digressions into the nature of mortality / sex and how those two may be related. |
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