Last modified: Monday, April 16, 2007
What makes a good patient?
Doctors treat whoever comes through their door, but some patients are much easier than others, regardless of their illness or injury. What makes a good patient?
"The most important thing patients can do is to be respectful," said Hugh Jessop, executive director of the Health Center at Indiana University Bloomington.
"For example, patients who grew up with the Internet do a lot of self-diagnosis, using information that they find on their computers. And they are often wrong," Jessop explained. That can make it difficult to convince an ill patient of what he or she must do to get well.
"It may seem helpful for the patient to have done some homework, but the clinician is able to examine the person and use objective information in the diagnosis," Jessop said. Additionally, the visit may have to be extended when the patient disagrees with the clinician's findings because they are different from the patient's self-assessment.
Another problem is the attitude of many patients toward antibiotics. When students come to the Health Center feeling ill, often they expect to be given a prescription for an antibiotic because that's how they are typically treated by their family doctor, Jessop said.
A typical situation is that a student shows up at the Health Center on Wednesday with a viral infection, which won't be helped by an antibiotic. The student is advised what to do -- increase fluids, get enough sleep and take specific over-the-counter medications for the symptoms. When the student goes home for the weekend and still doesn't feel well, a parent takes the student to the family doctor, who prescribes an antibiotic. By the following week, the student is back on campus and feeling better.
"The student's virus is self-limiting, and the student would have improved without seeing the family doctor or taking the prescribed antibiotic," Jessop said. "But the student assumes that the Health Center clinician was wrong and that the antibiotic they began taking is the reason for feeling better."
The more frequently antibiotics are used by a patient, the less effective they may be later in that person's life when they may really need them to fight a bacterial infection, Jessop pointed out.
Factors such as lack of sleep, stress, poor nutrition and lack of aerobic exercise reduce the effectiveness of the immune system and make students vulnerable to infection by viruses or bacteria. In addition, being in close quarters with other students in classes and dorms makes it easy for an infectious microorganism to pass from one student to another. But there is a basic difference between viruses and bacteria: viruses are self-limiting, whereas a bacterial infection warrants intervention with an antibiotic. Unfortunately patients often press the health care provider for antibiotics to treat viral conditions. "We use antibiotics when clinically indicated, but not simply when the patient demands them," Jessop said.
When dealing with patients the IU Health Center philosophy is to "be nice." Patients are treated with respect, and they are expected to act accordingly. Jessop emphasized that all persons working at the Health Center are treated as equals, from the support staff to the housekeepers to the doctors. This promotes a positive working environment and is reflected in the way staff members treat each other and their patients.