We are going to tell you about a new one.
look at the doctor-patient relationship
current
this is a subject that I already come to me
dedicating through a chapter of
book of seminars in the
have placed this and this
you will understand why he
is important and why I did this
title in the sense that we analyze the
current model of medical care
see nothing better to talk about
Anything you bring is this.
to the real world and the defendant world would
in this case a 45-year-old patient is
seek medical attention with complaint
chest pain
feeling faint or sweating
to say that an excess of sweat is
sensation of vertigo this came in
outbreaks and in six months as you can
see he sought a gastroenterologist
an otolaryngologist two
ophthalmologists two neurologists five
general practitioners and 14
emergency and he would tell me
in these emergency calls he
usually looked for a different hospital
of the one who had been served because
this because he thought he had
something and in fact it is what
I told him that he did not have
nothing so famous diagnosis you do not
Is there anything that patient is tired of being
attended in our city and decided to leave
to another center and where unfortunately
was submitted to cardiac catheterization
who again showed that he did not
had nothing and the doctor told him that
no point in looking for anything else
because he had no disease and is
Imagine how this patient got a
patient with all that range of
symptoms symptoms said that made
quality of life it extremely
committed both with regard to the
labor part and the part is
socialization
and that image of the manche cry
represents as well as those patients who
suffer and have this diagnosis you
there is nothing
this reaches a point where there is a
between the doctor and the
patient at the moment he says not me
I have you, you do not know what I
I have to suffer that patient
had in fact this patient was
panic disorder that is
something extremely frequent and appears
very often in emergencies
because this is because the
panic disorder he has
very frequent symptoms in the sphere
cardiovascular
of course there are other symptoms but
especially in the cardiovascular sphere by
that he does not
specialist in mental illness, but the
cardiologist because another
suffering is physical these diseases
both depression and depression
panic they are your husband
soul to see that depression today is the
second cause of work failure is a
extremely crippling disease and
unfortunately very poorly diagnosed and
very ill-treated people imagine that
depression if not sadness
systemic and rich disease.
in physical symptoms and causes the
least 40% of those looking for
general practitioners they have
depression is unfortunately estimated to
only 25 the center are diagnosed
Why is this because it is actually a
somatization that would be the
when I can not reveal my pain
psychic speaking my body cries or
whether we live in a society
which some call perpetual euphoria
I know that if I talk about my suffering
emotional and if you will not be taken very
into consideration between my body
cries and cries in various ways
symptoms appear in all games by
this they start looking for
specialists
according to the symptoms that appear and
This patient has a great suffering.
because the very own family
society still has a very
great in relation to diseases
then somatization does nothing
more is than you bring your
suffering body and it is in
attempt to have you heard me
I think these two screens show
clearly this I see in this first screen
which is also of the joystick it shows a
picture of the beloved seju being
abandoned by the beloved and see where he
put the hand he puts his hand on the
heart was all the separation and I see
on the other screen a patient with angina or
be that pain due to lack of oxygen
in the heart and see where you put your hand
then in visual language anguish
angina confuse even because they have the
same Greek root
it then shows why these
patients are looking for distressed seek
the cardiologist to his 90 percent of them
They think they have physical illness and how
patients are cared for
by the traditional model model
traditional model that is
linked in the disease the traditional model
in which I was formed is the one who sees
the disease and not the patient is the
sees the exams there is an overvaluation
complementary techniques and a
tendency to use an excess of
medication and above all this model
neglects the subjective part and
subjectivity of each person is what
makes him the only one to be sick
may be the same but there is the impact of
disease in each patient is unique
that the same patient of the patients
with the same disease he virgin of fear
different conduct because the
diseases are the same but humans are
are different there is a
overvaluation of the use of
complementary exams
some exams such as the one that
the patient leaves the cardiac catheterization
are not completely exams is
example of risk then if you use
these exams in excess
on the contrary he knows besides not
helping them can disrupt bringing
a series of
side effects also another
aspect of this model is exactly the
super medication is what we call it
today to see you diagnosed and over
medicalization of the medication
symptoms
the greatest proof that we have today
called quaternary prevention, which
would be prevention with the plenary
It would be exactly you work on
sense of treating side effects
produced by drugs throughout the
pharmaceutical industry is interested
in drug use
the patient himself is influenced by
that in fact this technology
this would bring this true and sincere
deification of technology is not only
the doctor the patient also ended
being convinced that the tests will be
solve everything then there is a reversal
of values
the doctor who is really essential
he became an accessory and the pass and
the supplementary examination which is ancillary
It became essential and this patient
all those pilgrim symptoms of
medical and a medium time comes that
he asks for help and I brought this book
So you can see when you were in the
Congress in Spain that book says
exactly this
when is the diagnosis would be the system
There is nothing or the same doctor
Spanish, he found that this patient
They suffer a lot because it’s not
diagnosed because there is no
tomography of the soul does not exist
resonance of the soul
Actually, this is the diagnosis.
given by listening to the patient and with
he goes out looking for explanations that
can be several and one of the most common
is google it go doctor google
in order to clarify if that is what it is
who really has illness since he
is convinced that he has sickness
the doctor who can not diagnose
nothing says doctor google but that’s it
in this particular aspect
as the symptoms are very specific
he can not get clarification either
so in that period I thought what
There are so many patients
suffering
without diagnosis inappropriate treatment o
problem is the average model
This model that I told you
previously it is a model that the
relationship is between the doctor and the
and when I have a doctor’s relationship
and disease, I assume that the
diseases are the same as those diseases can
be the same but each patient is unique
now how can I respect the
I want to treat illness
as if it were the same as in
any human being
so the patient is really unique and
unrepeatable and basically to a
compelling and soul that gives
to the singularity of this patient or
What are we proposing we will leave
medicine for Disease Medicine
person in addition I see a human being
entails a paradoxical truth.
at the same time that we are here
similar
we are extremely different and it is
exactly in the perception of this
difference that I’m going to act for that
sick
even though they have the same disease
differently because in each patient it is
disease has its own impact on
that person I can not handle the
people by an algorithm by
example medicine sometimes i feel
that it aspires to be an exact science
it will never be an exact science she
was born of philosophy and is a science
which is much closer to the
human science medicine in person
It is nothing more than seen in humans
its totality that is a ransom of the
medicine and by tatiana that she could see
human being within its totality and the
relationship between doctor and patient and
not in which doctor the disease or much
less then medical and the examination would be the
the advantages of a person’s medicine would be
basically first it does not ignore
the scientific part is actually
it does not treat the disease , let alone the
exam
she sees the patient as unique and above all
it brings the possibility of
it is emotional gratification that is not
only for the doctor is per patient is the
which I call in the case of the doctor
spiritual salary
this one would be an example is a sick
is that we have operated
he had a bypass surgery
but this patient could not live
properly after surgery because
develop a depression that people
flame pressure back home 30 40%
of patients who undergo
heart by the symbolism of the heart
there is no organ in man
has greater symbolism of the heart
often an ego infarction is very
greater than the fact of the heart and
When I dealt with depression there is
No other consultation asked him.
How old was he? He said to me.
that I have, I have in fact only five
years because I just started living there
five years when I was treated
depression
so it shows that when you do
measurement of the person I actually do not
I just take away what I
I want to give life back and there really was
this patient was a great
spiritual salary for me in the
that the milk came back to live I see
what would be the great challenge of
person’s medicine would be the first
unfortunately in the world
whole formation is still called
naturalistic formation in which
relationship is very fragmented in
relation to each organ as if each
regardless of the
first aspect would be one aspect
fundamental beyond medical training
It would be the participation of all of you
if you do not participate as an attitude
citizen in the sense of saying this is not
Medicine is what I want, I’m not
satisfied with this medicine at a
Recent work published in bidding
that he says the following they wanted
knowledge among the Americans see no
was among Americans not all among
Blacks and Hispanics were mainly
descending level of Irish
fathers and not only 18% of the
Americans are satisfied with this
kind of service is a service
extremely technological in green
there is a patient medical encounter in the
most of the time said a mismatch
doctor patient
so see what I wanted to leave for
you as a message every time you
look for a doctor ask him
adopted yours can you hear me and I hope
that always this answer is yes
because if this answer is yes
means that you will have a
and this therapeutic link
only this meeting will have felt it already
brings an anxiolytic effect you do not
can enter the middle and comes out worse than
who entered
it is then having the anti
generic
then it is fundamental that people
understand that medicine is based
basically in science in art in the
technology and humanism
What happened was that we had a
technological obesity would accompany
a human malnutrition then
technical competence without competence
is extremely dangerous
especially when we are dealing
with vulnerable human beings all
we regressed from the disease and when we
we seek the doctor we want besides
of the technician I say that the students in the
that we have an inflation
of technicians in a deflation of
ie doctors are finding that
doctor who looks at you understands that
there is a human like him
after you and I are accounts were
made from the same neighborhood
I’m as a doctor here but
surely another moment I’m
with a patient then if I do not have
this vision I did not return to compassion
in relation to the patient if I have a
posture of god ph as some have ne
God’s wizard this relationship does not
why does this individual think
that he is superior to the customer is already
an asymmetrical relationship on one side and
I have health and a supposed knowledge of the
Other side I have a disease or not
know if you can not make this
more symmetrical relationship is evident
patient relationship
will be fractured
so I ask you to
help
the silent revolution because it is a
difficult revolution is few
doctors really is not bothered
with this model, we are aa
including the ability to
conspirators in the sense that we
we do not think a heart enters the
my office does not enter a liver
between a person with a unique biography
and that requires of us a relation
singular
each patient medical encounter is unique
and it’s exactly for being the one he goes
depend on you and put yourself in the
his that is his coach is what
We call it empathy. I be.
I put on the pain
the size of the pain only knows the owner of the pain
then these diseases of the soul they
remain extremely frequent
and extremely misdiagnosed
so do not forget when you look
the doctor ask that question what on
truth is your right you
Can you hear me, doctor? Because when you
another patient delivers the diagnosis
and this brings both the patient and
for the doctor a bonus
emotional neckel already translate as
spiritual salary
Thank you, I’m counting on you.
for this silent revolution
[Applause]
”
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