The identity of the doctor

The doctor should always keep in mind that at the first meeting with the patient, the latter assesses his personality, as well as he studies and evaluates the psychological characteristics of the patient.

For the most effective activity, the doctor must have a broad enough knowledge and high ethical qualities to surpass the patient, both morally and professionally, or at least not inferior to him. Therefore, it is natural that the doctor must have a broad outlook and be aware of both in medicine and in other areas of human knowledge. The doctor's education should be as complete, deep and complete as possible.

Recognition of the lack of knowledge about diseases and the lack of opportunities for their treatment should not be a source of frustration and self-criticism, but be an incentive for continuous self-education, regardless of the actual level of knowledge and experience gained by the doctor. An interesting fact about the last hours of the life of the great physician Abu Ali Ibn Sina (Avicenna) has been preserved. This titan of medical knowledge, under whose multivolume guidance the whole cultural world studied medicine, dying in full consciousness, modestly summed up human activity in a short phrase: "We die and take with us only one thing: the realization that we have learned nothing."

However, the knowledge and high qualification of the doctor is only a tool, the effectiveness of which depends on the personal characteristics of the doctor. Education in itself will be insufficient if it is not constantly supported by education (self-education) of morality, on the one hand, and a constant desire for active productive useful activity - on the other. The usefulness of a doctor is determined by the special position of the medical profession, associated not only and not so much with the satisfaction of his personal interests, but with the social price of his work - the price of human health.

The personality of the doctor in itself is able to have a therapeutic effect to increase the effectiveness of treatments and methods, provided that the doctor has the patient's trust and authority and authority.

Even the first impressions when meeting with a doctor significantly affect the formation of a patient's trust in him - many factors are important, ranging from the appearance of the doctor, his behavior, communication culture and ending with professional skills. Untidy appearance or, conversely, excessive extravagance of clothing and hairstyles, a large number of jewelry can cause the patient psychological rejection and prevent the establishment of a trusting relationship.

The doctor inspires confidence in the patient if he is harmonious as a person, calm, confident and determined in making decisions, but not arrogant. An important component in the professional activity of a clinician is the presence of such a quality as empathy - the ability to empathize with the interlocutor (in this case the patient), to understand his feelings, needs, interests, motivations. During communication with the patient, the doctor has a personal resonance in the form of compassion, a desire to alleviate the suffering of the sick person.

The doctor's inability to empathize and the presence of some other unfavorable qualities of temperament and character (increased excitability, propensity to angry reactions, slowness, isolation, poor emotional reactions, etc.) may prevent the establishment of trust between the patient and the doctor. Therefore, the doctor, especially a beginner, should strive to monitor the patient's reaction to their behavior and take into account the opinion of colleagues about his behavior towards patients, their relatives, medical staff. With the help of a critical attitude to himself and some effort, the doctor must shape his personality.

Thus, the activities of the doctor aimed at treating diseases in patients should be associated with self-education, which allows you to correct your own shortcomings.

If the relationship between the patient and the doctor develops unfavorably, the latter should strive to behave correctly, not to openly show his negative attitude towards the patient, but to try to gain his trust through tolerance, tact and perseverance. In some cases, when this fails, and the relationship with the patient is tense psychological, the doctor may recommend that the patient see another doctor.

1. Groddek (1866-1934), a well-known German physician and psychotherapist who is considered one of the founders of psychosomatic medicine, wrote about this: "Where there is no understanding, it is better if the doctor tells the patient that he personally cannot help. This is not cruelty. There are enough doctors in the world for every patient to find the doctor they need. The main assessment of the doctor's work and energy is highly efficient, perfect care for the patient, as well as moral satisfaction from work, accumulation of medicine. Experience and increase the authority of the doctor.

The authority of the doctor is a prerequisite for building trust in the patient before their personal meeting. Classics of domestic medicine to the components of the authority of the doctor included: deep knowledge in their field, the ability to calmly, confidently, correctly and quickly understand the patient, his problems associated with the disease, choose medical tactics that provide optimal care and improve the patient's condition. The authority of the doctor is formed by the attitude of patients, their relatives, colleagues, medical staff.

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Information about a doctor's professionalism is passed from one person to another. One of the important components of a doctor's authority is his personal charm, which consists in friendliness, sincerity, natural modesty, high moral qualities. It is known that the same drugs can have different effectiveness when prescribed by a famous, reputable doctor or little-known, young. І.П. Pavlov, highly appreciating the clinical and mental qualities of SP Botkin,

The authority of the doctor is influenced by his appearance. The doctor himself must give the impression of a healthy person. The recommendations of a doctor with a swollen face, trembling hands, covered with sweat and shortness of breath are unlikely to be credible. The doctor, who causes sympathy and pity in patients with his appearance, makes them think and remember the biblical words: "Doctor, heal yourself."

It is important for the patient to feel a healthy optimism of the doctor, which should be reasonable, based on deep knowledge and practical experience.

The true virtues of any good doctor are always combined with modesty, they do not require self-promotion. Conversely, any manifestations of arrogance, immodesty, bravado, unreasonable self-confidence in difficult situations often serve as a mask that hides serious professional shortcomings, superficial knowledge and lack of skills.

One of the most important personal qualities of a doctor that helps in practice is truthfulness. Psychological problems associated with this quality are the need in certain cases to report as a patient, and his relatives their thoughts about the fate of the patient, including very sad. Sometimes, in cases of unfavorable prognosis, a young inexperienced doctor shows excessive optimism and inappropriate belief in success: modern medicine can do anything! It is not always easy for a doctor, and not in all cases, to tell the truth to the patient. It does not follow, however, that he is allowed to lie. It is unacceptable in any case, especially when communicating with a sick person, full of anxiety, excitement, suffering and anxious anticipation of his doctor's decision.

The question of the extent and form in which to inform the patient about his condition is one of the most controversial in medical deontology. This is especially true of diseases with an unfavorable course. There are two alternative points of view:

1- Taking into account the human right to information, to inform the patient of the exact diagnosis and possible prognosis;

2- Information should be provided in doses, taking into account the nature and stage of the disease, as well as the personal characteristics of the patient, his attitude to the disease, methods of examination and treatment.

Patients with incurable diseases need a special approach that requires a doctor to solve very difficult psychological problems. This mostly applies to neurological (with the consequences of cerebral circulatory disorders, with progressive organic diseases of the nervous system, etc.) and cancer patients. The doctor, knowing that the patient's prospects are very sad, should give him hope for recovery or at least partial improvement. The doctor faces a dilemma: to hide from the patient the bitter truth or to inform about the possible forecast. It would seem that the first option is more humane. However, in cases where the patient's condition remains unchanged or continues to deteriorate progressively, despite treatment and optimistic statements of the doctor, the patient, and more often his relatives, are exhausting and fruitless search for new doctors, new clinics, new treatments, in particular, often turn to uneducated healers. As a result, material resources are wasted, distrust of medicine arises, but there is hope for miraculous healing.

Therefore, according to many prominent doctors of the past and our contemporaries, in such cases it is better to tell patients and their relatives the truth, but it should be done in a cautious manner, explaining that miracles should not be expected, that the disease is complex, extremely difficult to treat, and wait will have a long time, being in constant struggle and overcoming possible suffering.