Updated: Nov 10, 2018
Medical procedures and or clinic visits and consultations can be very treacherous and associated with so much anxiety that many a patient have lots of phobia going to the hospital or engaging with health care providers in issues regarding their health. This phenomenon underlies one of the reasons for the so-called white coat hypertension, a situation where the blood pressure of a patient that is apparently healthy reads in the hypertensive range whenever they are in clinics and then is never abnormally elevated when away from the hospital.
There was also a story of a patient that had to be contacted to the hospital in order to have a discussion regarding an abnormal scan result, in order to plan further investigations and hence management. The patient entered the room calmly, but for some reason, refused to sit down on the chair, but wanted the doctor to inform his the reason for being contacted to come to the clinic earlier than was earlier planned. After being informed the reason and the fact that cancer was being suspected, the patient walked out of the clinic room and walked as fast as he could, and did not come back to the clinic on that day. Needless to say, he had an advanced cancer.
Above situations present reasons for anxieties associated with hospital visits and outcomes of investigations. In some situations, patients who should normally not have died have been given wrong medications while on admission in hospital. A recent case that has gained widespread media attention was the German Nurse that serially killed several patients by administering lethal medications to his patients, with aim to show his heroism by reversing the clinical effects of those medications. Hospitals are thus not as innocent as they mostly are. So, if there is no reason to be there, then keep away. But ensure that you are keeping away healthy rather than staying with "ignorance is bliss".
Three reasons can explain anxieties associated with medical procedures. Firstly, there is fear regarding the outcome of the investigation. Could a sinister malignant, incurable diagnosis be the reason for the symptoms? Secondly, what would happen, if I am not able to undergo the test properly, forexample; due to extreme discomfort? Lastly, questions remain regarding the competence of the clinicians and other healthcare workers. I will attempt to take on each point and suggest the best strategy to undertake, in order to help you cope with anxieties associated with each of the valid fears.
In the first scenario, the chance of making a diagnosis is real. However, this does not always happen. Forexample, there is always a chance of missing colonic polyps (skin tag lesions within the bowels) in one out of every 20 people undergoing camera examination of the bowels. This means that in most instances, if the test result finds no lesion to worry about, then it is more likely that you do not have the disease that is being investigated. Unfortunately, so many worriers out there would not give up and keep asking for explanations for their symptoms and this does not abate their anxieties. For those that do have sinister lesions picked up, there is nothing that could have been done differently in order to give you better news - for all you care, the doctor did not tattoo the illness to you. So whatever is already present in your body cannot be different that what the investigations will pick up. So keep a stoical mindset whenever you go to the hospital.
In cases of extreme discomforts and or inability to complete treatments, there are always alternative means of getting diagnoses and treatments, although the efficacy of each is not similar. The fear therefore of inability to complete your test should not prevent you from engaging with your investigation or treatment. To prepare for the best outcomes, many health facilities provide leaflets and information well in advance of your planned procedure/treatment. Go through these materials and or seek to discuss with your local doctor, if such services are available. You can also access online materials in order to have a generalised idea about your problems and also to guide conversations with your doctor. I am aware that the last scenario can set up a trail of anxieties, but in most instances, it shortens clinical decision making and gets the patient to easier participate in making informed decision regarding the management of their clinical conditions.
Lastly, Regarding procedure related complications as well as adverse effects of medications, all professionals are in continuous dvelopment and are constantly certified to ensure their knowledge and competences are appropriate for the jobs and procedures that carry out on patients. No clinical procedure is without complication and so are drugs, possessing varying effects on different people. However, within acceptable window of error, it is expected that your procedure and or treatment would possess no adverse issue to worry about. Perhaps, the only way to prepare for this last bit is to study the profile of the specialist that shall be attending to you; as well as the hospital that you shall be going to.
In summary, despite founded fears and real concerns regarding contemporary issues in medical practice, there remains a robust system in place with platforms that ensures your clinicians are competent, compassionate and caring. Your participation in the medical journey should start by access to resources and engaging with the entire process of availing yourself at all appointments, keeping diaries and asking questions when necessary.
A good preparation will prevent a poor outcome. Good luck.
N.Ladep, PhD (Imperial College London)
Director, Worthy works Ltd