Sunday 2 March 2008

Flash points and Balint

Champagne moments
Or…
Even champagne has unwanted effects


Flash points

Balint described the flash technique where doctors become aware of their feelings in the consultation and sometimes interpret the feelings back in a way that can give the patient some insight into the problems that are presented.

This applies to teaching GPRs too
Teacher gets emotional feedback > encourages him to continue


Danger – GPR is very vulnerable > the apostolic function (P216 of "Doctor, patient illness")

It is almost as if every (doctor) trainer had revealed knowledge of what was right and what was wrong for (patients) registrars to expect and endure, and further, as if he had a sacred duty to convert to his faith all the ignorant and unbelieving amongst his (patients) registrars.

….if asked, he will readily quote impressive reasons for his choice, but these on closer examination reveal themselves to be secondary rationalsations.


“Practice” = “habitual action”
Vs
Showing humanity – we all make mistakes


“Trainer as drug”
Vs
Modelling


In spite of our almost pathetic lack of knowledge about the dynamisms and possible consequences or “reassurance” and “advice”, these two are perhaps the most often used forms of medical treatment (p116)

“Simple supportive treatment”, “advice”, “reassurance” in dealing with GPRs with problems > our need to make it right
Vs
Appropriate challenge, devolvement of responsibility fro problems and actions
(but what about mental health issues?)

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