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SELF TREATMENT ADVOCATED TO PATIENTS
OP Kapoor
Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.
Recently, I was shocked to read that abroad, patients of ulcerative colitis are being taught "self treatment" to change the doses of Salazopyrine (Mesacol) and oral steroids which these patients often need in large doses and for life time. The patients having this disease can land up with very bad complications including malignancy of the colon. Then I thought that if this is where the medical practice has reached in Western countries, then in our poor country why can’t we start advising "self treatment" to patients having a number of common diseases, e.g.
1.Asthma patients can be taught how to regulate the dose of inhalers and when to take "rescue" courses.
2.Patients of hypertension can be told to record their blood pressure regularly and to adjust the dose of their drugs (increase or decrease).
3.Patients of diabetes can do their blood sugar regularly and adjust the doses of their drugs.
4.Patients taking drugs for osteo-arthritis of the knees and spine can be taught in what circumstances they can take NSAID group of drugs, specially the ones which have least side effects and tell when to stop them and to depend only on physiotherapy at home.
There are many other conditions and diseases which the patient can be taught to live with.
Then comes the question how will the GP’s survive? I have been teaching for the last 40 years, that the GPs should reduce giving injections and start charging consultation fees. Now I am writing again to remind the GPs that every time the patient enters their clinic and takes even a few minutes of their valuable time, "consultation fees" should be charged. Till now our patients enter the dispensary, get themselves weighed on the weighing machine and get their blood pressure recorded by the family physicians and do "namaste" with folded hands and go away!! Such practice should be stopped. They must be made to pay the consultation fees "every time" they enter the clinic. Only then can the above kind of advice be followed by the family physicians, which, really speaking, will be useful to both the parties!
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