1. Those hateful patients
Swansea
Tuesday 22nd May 2007

2. The contribution of Michael Balint
The doctor his patient and the illness … 1957

3. The most effective drug a doctor prescribes is himself

4. The doctor as a drug Specific
The appropriate dose.. Loading/maintenance/overdose
Combination therapy but possible interaction..potentiate or negate
Frequency & Timing
Suitable form ..package
Tolerance & Resistance
Allergy
Anaphylaxis
Placebo
Storage
Side effects
Dependency

5. The apostolic function of doctors
You get the patients you deserve!

6. Diagnosis precedes treatment
The feelings the patient engenders in his doctor is an important physical sign.

7. Taking care of the hateful patient J.E.Groves N.E.J.M. 1978
The dependant clinger
The entitled demander
The manipulative help rejecter
The health denier

8. A farewell to heart sink? Gwenda Delany BJGP April 2007
Vulnerable.. Abused … Manipulative

9. Don’t forget to care for the doctor as well as the patient.
..or as Michael Balint might say …
..Drugs that are not stored properly lose their effectiveness and may become poisonous.

10. The end

11. Describe a patient who
Made you feel *bad*
Made you feel *good*

12. The Health Belief Model
Motivation – people’s interest in their health and degree to which they are motivated to change varies widely.
Perceived vulnerability – perception of likelihood to be affected by disease or belief in diagnosis and consequences varies widely
Perceived seriousness
Perceived costs and benefits
Cues to action

13. The doctor as a witness