Why doctors prefer educated patients

DOCTORS     TREATMENT     EDUCATION

In 2009, James was told, by his doctor, he had lugezigezi (he was a wiseacre) because he insisted to be treated by a female specialist.

"I had a health condition and though I was in much pain, I did not want to be treated by a general doctor, I wanted a female specialist, the doctor on duty told me that if I wanted to get better, I should allow being treated by any doctor, I insisted that I wanted a specialist, they asked me whether I wanted to get better or see a specialist, they got bored with me and said I had lugezigezi," James says.

Though James was labelled as someone who was too much for the doctors then, these days' doctors prefer educated and informed patients who can engage them. Some doctors do not like to refer patients they lack the ability to treat, because they want to make money by continuing to treat these patients, but if a patient is informed, he or she can seek a second opinion somewhere.

According to doctors, an educated patient understands the disease and the treatment course. They consult about side effects than non-informed patients who take everything the doctor says.

This was revealed during a meeting organized by the National Drug Authority, Community Health and Information Network (CHAIN) and Uganda Alliance of Patient's Organisations (UAPO) in partnership with the Council for International Organisations of Medical Sciences (CIOMS).

Dr. Fredrick Nakwagala, chairman of Mulago research and ethics committee narrated a scenario when he recommended a drug that was not suitable for breastfeeding mother, to a breastfeeding mother.

"A mother was presented with an illness, I gave her the medicine that I thought was the best for her because it had worked with other patients but I did not know it was not fit for breastfeeding mothers, the patient who was breastfeeding got the medicine and started reading the effects of the drug, she found out that the drug had grave effects, when I got to know I listened and I learnt a lot," narrated Dr Nakwagala.

Dr. Nakwagala noted that if a patient is informed about the disease, they will take all the medicine given to them, they will challenge the doctor until they get the best.

"Just as health workers should be providing information, patients too are expected to provide relevant, complete and accurate information to a health worker for diagnostic and treatment purposes," Dr. Nakwagala said.

Other patients are bullied into taking unlabelled medicines, go in for surgical procedures they don't understand or consent to.

During the meeting, Regina Kamoga, the executive director of CHAIN Uganda, noted that in order to improve health safety, there is a need for patient representation in decision making regarding drug development and clinical research.

 "90% of the people in the country are ignorant about drugs, when they buy the drug they do not read leaflets, that is why scientists need to involve and engage the patient during their research. It is from that background, that the Council for International Organisations of Medical Sciences (CIOMS) has advocated for patient involvement in the development of drugs from the research process," noted Kamoga.

 According to Kamoga, some patients when they go to see a doctor, they believe everything the doctor says without question, even when the doctors offers them an opportunity to ask anything they do not.

"People who read about their diseases will not just allow going for surgery just because the doctor has recommended, they will ask whether they are other alternatives," said Kamoga.

A patient who is informed doesn't allow anyone to just treat them, they always ask to be treated by named medical health personnel, for safety and security.

During the meetings, health workers from all sectors developed guidelines for patient involvement in the development and safe use of medicines in resource limited settings.

"Drug Researchers need to involve social scientists if they want to get experiences of patients. They interact with patients and can share the views of patients because many patients don't report side effects of drugs," said Janepher Wabulyu.

Wabulyu noted that patients need to be empowered with information, they should be given guiding information at health facilities on what they need to know when they come to get medicines. Often, people do not challenge doctors, they just believe everything doctors say.

The health workers recommended that medical doctors should advertise their skills and experiences as a way of passing information to patients rather than leaving herbalists to misled the public.