Expectations from Physicians

Expectations from Physicians

Expectations from Physicians When in a Public Gathering

Oftentimes, we hear such statements from lay people when there is / are a doctor / doctors in a crowd or public gathering.

“Don’t worry with what you are going to do.  We have a doctor / doctors with us.”

“Don’t worry with what you are going to eat.  We have a doctor / doctors with us.”

Whether said in jest or not, these statements somehow express the expectations of the public toward doctors or physicians.  The expectations are that the doctors or physicians know everything.  They can do anything and everything that needs to be done in terms of prevention and treatment of a health condition.

In reality, doctors or physicians can only do so much when something happens to a person in the crowd or public gathering.  The doctors or physicians can do emergency medical measures such as cardiopulmonary resuscitation when the person in the crowd suffers a sudden cardiac arrest.  They can apply first aid to injuries.  They can make a diagnosis.  That’s about it on what they can do.  They usually cannot prevent a health disorder from happening.  Oftentimes, except for the emergency measures, they usually cannot do more definitive treatment.

These are clarifications that I like to make on the expectations of the public on the doctors when the latter are in a crowd or public gathering.
Expectations from Physicians Who are Formally Practicing their Profession

It is a fact that physicians do not know everything, even after they are certified as physicians with license to practice, also when they are certified as specialists, in case they pursue specialty training.

After medical school, after passing the Philippine Board of Medicine examination, they can do general medical practice. There are a lot of limitations on what they can do as general practitioners as medicine is a very vast field that no physician is expected to know everything.  They have to refer to other medical colleagues, either on the same field or in other medical specialties.

Even after a medical specialty training, there are still a lot of limitations on what the specialists can do not only in general medicine but even in their specialty field.  Specialty medicine just like medicine in general are inexact sciences that will hinder the specialist physicians from knowing everything. There will be instances in which they have to refer to other medical colleagues for assistance even when they are already specialists.

So, physicians do not know everything and will never be able to know everything in the field of health.  What is expected of them are the basic competencies that should have been acquired in medical school prior to certification as physician.  They are expected to maintain these basic competencies and enhance them as they keep on practicing medicine.

They may pursue specialty medicine training.  After which, they are expected to have the necessary competencies on the specialty of their training.  Even if they are already specialists, they are expected to practice the basic competencies of a general medical practitioner.

I think the minimum expectations of the public on all doctors or physicians, whether specialists or not, are the so-called basic competencies.

So what are these basic competencies in terms of management of actual patients?

I have made a list below in broad terms or categories.  All physicians are expected to know:

  1. How to make a rational clinical diagnosis based on data from the history (interview) and physical examination.
  2. How to decide or recommend whether paraclinical diagnostic procedures are needed; when needed, know how to select; when done, know how to interpret and to consolidate the clinical diagnosis and paraclinical diagnosis into a pretreatment diagnosis.
  3. How to decide or recommend the best treatment for the patient.
  4. How to perform elemental medical diagnostic and treatment procedures.
  5. How to perform emergency medical procedures.
  6. When and how to refer to medical colleagues.

Note: I hope to expound or amplify on these basic competencies in the future.

These are clarifications that I like to make on the expectations of the public on the doctors they are consulting.

ROJ-TPOR@16jan20

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