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Solution-oriented medical interviews

Positive health interviews for the placebo effect
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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.

nineteenthly, Dec 12 2012


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Annotation:







       'I'm not quite dead... I FEEL HAPPYYY... OOF!'
RayfordSteele, Dec 12 2012
  

       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.
farble, Dec 12 2012
  

       This isn't really a placebo, it's just giving someone a positive outlook on their health and/or distracting them from the problems.
DIYMatt, Dec 12 2012
  

       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!
bungston, Dec 12 2012
  

       And to yourself, not just other people!
pocmloc, Dec 12 2012
  

       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?   

       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.
nineteenthly, Dec 12 2012
  

       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.   

       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.   

       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.
MaxwellBuchanan, Dec 12 2012
  

       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.
bungston, Dec 12 2012
  


 

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