What are the doctors taught and the start of an individualised care plan?
So a patient comes into the doctor’s office with back or neck pain. How are doctor’s taught to deal with that person? Are they told to give the patient medications, a physiotherapy appointment for some time in the future and the advice to exercise? Or are they taught to look further into the patients life, family history of back/neck issues and the patients current coping strategies?
I would very much like to receive comments or you can contact me via the contact formon the blog confidentially to understand what our medical students are taught or what our more seasoned GP’s recommend to their patients. Maybe we can have a focused debate on this subject right here!
Individualised patient care plan! Our doctors are busy, they only have a few minutes for each patient. Whilst it would be great for them to be able to talk with the patient in depth the reality is that this is really hard to fit in the time slot available however dedicated the doctor may be. Therefore I would like to propose a checklist as a starting point for an individual care plan. This plan can then be reviewed as the patient progresses. Some examples of questions are given below. These are very much suggestions and a rigorous look at the format of a checklist would need to be done before adopting it within the NHS.
- Is this the first episode of back pain?
- If not the first, how many other times has the patient experienced back/neck pain?
- Have other family members experienced back problems? If so what problems have they had?
- What percentage of your day do you sit, stand, move around, lift objects, drive?
- What exercise do you currently do?
- What self help remedies do you attempt?
- Are you at any of these stages in your life? Changing school, moving house, exams, getting married, changing jobs, relationship problems, pregnant, just had a baby, suffered a bereavement?
- What medication have you used up to this point?
- What are you prepared to do to help your pain? Exercise, looking at your current way of life, learning a technique such as the Alexander Technique which requires a commitment to the process?
I very much believe all these factors have a role to play in how a patient recovers from back pain along with what the doctor would then go onto recommend. I also believe how a patient is first treated when a back problem is diagnosed will affect their experiences of back pain in the future. The role of chronic pain plays a part in back issues for many people and this must be addressed also as it links in strongly with point 9. above. The requirements of a patient (medication, support, access to new techniques/exercise) and their ability to react to back and neck issues also changes throughout a person’s life and this should be recognised by doctors and re looked at by reviewing the checklist when required.
(Sarah does not have a medical background so it is emphasised that her blog is the result of her experiences and listening to others only. Before doing any of the suggestions contained in her blog, check with your doctor if you have any concerns on how they may affect you)