I have blogged about patients before,
but I had not really researched the types of patients on the
Internet. I approached my analysis from what I read on mostly
diabetes sites and a few other web sites. Now it is time to discuss
how some in the medical profession view patients and from some other
sources. Even our doctors have different classes for us as patients.
Most are very understandable and fit many patients. Most do not
list us as compliant or noncompliant, although some may wish they
could just label us that way.
The list I have been familiar with and
that I use starts with patient, passive patient, proactive patient,
empowered patient, and e-patient. I have also listed patient advocate
to the list. I have listed the first three in this blog and the
second three in this blog.
A doctor lists the following type of
patients - passive-dependent, independent-skeptical,
intellectual-researcher, expedient-flexible, and
open-minded-exploring. I like that this list is a little more
descriptive. Rather than duplicate his work, read his descriptions
here. This is spread out over five short pages.
The next list is different. I can
understand the expansive list, but it seems a little too expanded.
The list includes pleasant, courageous, angry, manipulative,
demanding, drug-seeking, direct, all-knowing, noncompliant, anxious,
psychosomatic, depressed, suffering patients, chronic pain, dying
patients, and geriatric patients. The last type is one that needs to
be listed and often is not on any list. For the author's
explanations, read about the list here.
There are many other classifications
for patients and this depends on the field of medicine and on the
location of the patient. Fact is, I wonder if some of the patient
types are designed to confuse people. Dentist have their list of
patient types. Hospitals have several lists of patients types they
use and some are even coded to prevent others from having an idea for
the reason they are in the hospital. I am only listing one link
although there are many such lists depending on the type of hospital
and the patients each serves.
Neurology has a list of patient types.
This is the last list I will link to as it raises many valid concerns
when dealing with people that have no control of the condition they
often find themselves. Nursing homes have a set of terms they use
for their clients or residents. It seems many of the medical
professions have their preferred list for patient types.
Psychologists and the related
professions have a separate list of terms for their office patients,
and those admitted to hospitals, and patients in mental facilities.
There seems to be separate patient lists for records and another list
of types for insurance purposes. I am still researching, but as of
yet I can find no linking evidence.
In doing my reading, there seems to be
different types of patients for everything and there is little
crossover of patient types. Only once did I see both compliant and
noncompliant listed on the same list. Three times I saw noncompliant
in a list of patients. It is discouraging that patients are viewed
so differently across the medical professions. I honestly feel this
is to confuse us as patients and doctors in each specialty have their
own code to describe us. After reading over 40 sources of patient
lists, I admit I don't have a grasp on the reasons for so many
different lists of patient types.
Could these lists be standardized?
This is highly doubtful as I can see the need for some of the patient
types in very specialized medical fields. As patients, we could
generalize patient types, but it would never be accepted. We can
only agree that there is a need for many patients types.
The one discussion I had with two
doctors (a husband and wife practice) probably had the greatest
impact on me and at the same time was the most rewarding. I ask the
question of did they use the term noncompliant to describe patients.
Both answered almost no immediately and stated the term was an insult
to the doctor and to the patient. Each went on to explain that if
the doctor did not take the time to explain a course of treatment and
the reasons for the particular treatment and the patient did not
understand the importance, then the doctor would be at fault if the
patient did not find it important to follow the advice.
Both doctors felt that much of what
others label a patient as noncompliant is the fault of the doctor.
Both expressed the belief that there are some patients who will start
out willingly, but dislike the routine and stop taking a medication
or look to alternative medicine for answers. This is why they have
developed a standard set of questions to ask any patient to assess
whether the patient understands the reason for the treatment, if the
patient agrees with the plan, and if there is a high indication the
patient will not follow the treatment plan, or will seek alternative
medicine advice.
One doctor said they had such a patient
and termed this patient as an alternative medicine patient. When the
doctor pressed the patient about why he even came to them, the
patient answered that a correct diagnosis was being sought and if
alternative medicine had a treatment, that would be the treatment of
choice. If alternative medicine did not have a treatment, he would
follow their treatment. Further discussion uncovered that the
patient owned his alternative medicine/health food store and was very
knowledgeable. The patient said that both doctors had never used the
word noncompliant with him and that was the reason he would continue
to have them as his doctors.
They admitted that this was an unusual
doctor-patient relationship, but that they would make the diagnosis,
discuss the treatment and the reasons, and the patient would go on
his way. If the patient determined that the alternative treatment
would not work, he would come back for the prescription and ask any
questions needed. Only once has he come back for the prescription
and a renewal in the two years of being a patient.
