Unscrewing Medicine with Healthcare Social Media

Why I threw a patient’s ‘counsel’ out of my clinic

in Orthopedics/Personal by
Patients with a bantay or 'counsel' photo taken from this site (http://www.umc.org)

It’s not uncommon to see a patient or a patient’s relative bringing along some unrelated individual as “counsel” in your clinic. This counsel is unique among my Filipino patients and such counsel’s role has baffled me ever since I started my medical career. Roles, that to my knowledge broadly range from just plain ambulatory assistant or worst, to a nagging and combative counsel to the patient. I have tolerated such roles before because at times they can be very helpful in educating patients and relatives who haven’t had any time to convene a family meeting on their health issues at hand. But a recent bad experience with a ‘counsel’ pushed me to institute a policy of “no non related guardians allowed” inside my clinic.

My patient was a 10 year old girl who sustained a supracondylar fracture from falling over a park statue where she was playing with her cousins. The kid was brought to my clinic after 3 days, on a makeshift splint and after 3 sessions with a known bone setter in the area. The elbow is already grayish blue in color and is still swollen. The kid is wrenching in pain but  I can still feel the pulses and there are no signs of compartment syndrome. The mom brought with her a “counsel” after the bone setter allegedly ordered an xray. In my setting here, even if we’re already an urbanize city with a tertiary level hospital at that , bone setters are primarily the first one being sought by patients or their relatives when dealing with fractures. It’s even very common to hear bone setters manipulating fractures and ordering x-rays! Anyway, what bugged me that time was the way this ‘counsel’ is disrupting my talk with the patient’s mom.

I was explaining the diagnosis and the treatment options to the mom, baring that a surgery is already needed in her daughters case. I could employ a conservative treatment (if cost is prohibitive to the parents) but the results, which I explained carefully to the mom, would be unacceptable and costly in the end. The ‘counsel” is impolite in drawing attention of the mom, and whispering barely audibles that as I can figure out was a urging the mom not to have the surgery done and bring back the patient to the bone setter. The mother was very much bothered and was in fact becoming inattentive to me because of the constant nudging of this counsel.  As it grew frustrating to me, I looked straight to the counsel’s eye but politely asked the mom what is this counsel’s relation to the patient or the mom. She was a neighbor, the mom told me. She was also the one who brought the kid to the bone setter for manipulation twice! I asked the mom again politely of course, to ask the counsel to leave the clinic now and just wait outside. I also urged the mother to call a family meeting and talk with her husband the treatment options I laidout for the patient.

Well, that didn’t happen. The counsel refused to leave and worst, she kept on annoyingly nagging the patient’s mom.  This prompted me to talk directly at the counsel, ask her that if she doesn’t stop disrupting our conversation, she’d answer for all the complications her constant nagging has brought to the patient’s condition. And she’d be thrown off the clinic’s premises for good!

Then there was this an uneasy silence. Everyone in the clinic knew that my usual cool composure got blown by this annoying ‘counsel’. Everyone was silent for at least 3 minutes. When the counsel was escorted out of the clinic, I apologized to the patient’s mom, not for throwing out the counsel, but for the disruption in our conversation. She just smiled and from that moment on. I know I won another loyal patron.

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Dr. Remo-tito Aguilar co-founded #HealthXPh. A board certified orthopedic surgeon, he is previously Chief of Clinics at St. Louis Hospital in Tacurong City and a consultant in Orthopedics at the Southern Philippines Medical Center in Davao City. Dr. Aguilar is a healthcare social media evangelist and writes his medical musings at The Cast & Curious (www.remomd.com).

6 Comments

  1. my tolerance for pain is so minuscule and it was literally painful reading your blog until that part when you "threw" out the counsel. hahahaha! way to go, doc! dapat yan na ang maging policy mo from now on.

  2. Doc, your throwing away the counsel was what gave you the respect that you really deserve. And that counsel was bastos talaga to blabber away what she knew despite the lack of her medical experience.

  3. @Orman, Sheng, more often than not a physicians tolerance to such annoying personalities is a bit higher than the average worker.Part training, and perhaps an advantage to the line of work I have. But then even us, sometimes blow off our lid but we do so, still, in a polite manner….

    @Gigi, you know our work. As surgeons we really have to imbibed a higher tolerance level right???

  4. Good for you Remo! So, did you operate on the girl?

    As for the neighbour baka may cut sya everytime she refers to the bone setter, LOL.

  5. @Jill, sadly di pa nakabalik yung mag ina. 🙁 Baka na convince ulit not to…and yes, i'ts not uncommon to encounter 'fixers' here, and even in health care services…

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