Blurry Goals

While practicing I've come to realize that at times, the goals that the patient has in mind can be very different than what the goals the clinician has in mind. From a clinicians point of view it is about control of symptoms, medication side effects, and doctor patient alliance. All three I believe are essential aspects of treating patients with respect and being competent. In my experience it can be extremely frustrating when the patient is unwilling to work with you on the set goals.

Many times patients have a difficult time accepting their diagnosis and in this case treatment can become more focused on treating a specific symptom of the disease such as an inability to sleep rather than treating the mood disturbance. And while this may be what the patient wants the doctor knows that the regimen may not be working and in some cases maybe even harming the patient. Education is vital when dealing with these patients and while in certain cases it does not seem to be making a difference, it still should be done.

I've also realized that in certain cases setting firm limits and letting the patient know that this is how you believe the treatment should be and what it should focus on is important.