7.0 ROLES AND RELATIOSHIP BETWEEN HEALTH PRACTIONERS AND THEIR CLIENTS

7.1. Health care Provider- Client Relationship/ Patient-Doctor Relationship

The relationship between the sick person often referred to as the patient and the care-giver known as the doctor or the physician can only be understood in the context within which the relationship is set. The patient and the doctor occupy certain social positions and there are roles and responsibilities attached to the positions. Patients and doctors may and often hold different conceptions of illness. The roles are complementary and if both the client and health care provider conform, a harmony situation will rise and the goal of attaining good health will be achieved.

One of the fundamental roles of the patient is to get well, as soon as possible, while the primary responsibility of the doctor to his patient is to facilitate the recovery and rehabilitation of the patient to the best of his ability. In meeting this obligation, the doctor assumes the role of an expert. This is so because of the specialized training acquired to deal with the morbid condition of the sick. The sick therefore assumes the social position of the layman in the relationship. By implication, the layman is dependent upon the expert’s specialized knowledge acquired during training in dealing with his illness.

7.2-7.3. Stakeholders in the Illness Episode and their Roles

1. Symptomatic Person is the patient (sick, ill or diseased)

• he/ she is expected to understand and accept the undesirability of his/ her condition

• should accept and comply with treatment regimen e.g. taking correct dosages

• give all necessary cooperation to the professionals in all the diagnostic procedures e.g. during history taking, should not hesitate to give correct information as may be required and should avail himself/ herself in time of examinations and tests as the case may be

• in conditions that require continuous management e.g. high blood pressure/ hypertension, the patient should adhere to rules and observe the dos and don’ts so as not to worsen his/ her condition 

2. Significant Lay are the patient’s family members and other relatives

• they paly significant role in pre, during and post treatment/ management period either at home or in the hospital

• they provide financial support in terms of drugs/ test/ examination, admission bills etc. as the case may be

• they provide psychological care and support to the patient

• they ensure that the patient comply with all his treatment regimen, takes his drugs according to the correct prescription and dosage

• they give moral and emotional support to the patient by reassuring him that he will get well soon

• Their presence around the patient is a source of courage. He/she has the feeling that I am not alone

• they relieve the patient of his social responsibilities

• under whatever circumstance , they should make sure that the patient is not stigmatized

• even in terminal cases, they should help to maintain the patient’s human dignity

• as the patient passes through the transition period to death, they do everything possible not to add to his/ her agony

3. Professional Others are health care providers

• They conduct proper diagnosis e.g. history taking tests/ examinations etc.

• They prescribe right drugs/ treatment for the patient and ensure that such prescriptions are fully observed especially during hospital admissions

• They make patients understand that their ill health is undesirable and give them confidence that they will do all things possible to get them out of it

• They offer the patients psychological treatment to allay their fears and anxiety

• They relate and discuss with the significant lay on the patient’s condition. this will help them realize other remote/ social causes that might have led to the sickness/ ailment

• They guide and give correct advice to the significant lay on how best to help the patient as he is being treated/ managed

• They offer post treatment/ management follow up

• They conduct/ offer referral services where necessary

• At tertiary level, they conduct investigation/ further research on specific cases of peculiar nature

• In life threatening or terminal cases, they professionally follow the patient through his transition to death e.g. by providing palliative care

Complaints between Client and Health care Provider

Clients

• Health practitioners are always in hurry

• They keep asking every kind of questions

• They are so concerned over their clothes

• Their bill is so much

• They do not know that  injection is best, they prefer giving white medicines that look like chalk

Health care Provider

• My clients combine traditional and orthodox medicine

• They like to decide when to stop treatment

• They do not follow instructions

• They are reluctant to follow the rules guiding the practice

• so much pressure from them

• They do not appreciate the sacrifice and efforts

• They exaggerate their illness and pretend 

• They are ignorant of our barriers

Health Practitioner/ Client Relationship

Welcoming the client very well

Respecting the dignity of the client

Confidentiality

Providing adequate management/ care

Honouring the appointment

Following the instructions given in terms of care

Trust from both sides

Inter- health Practitioners Relationship

Accept the ability of each other in health facility

Respect for the dignity of various health professions

Avoiding unnecessary conflicts

Must agree on the line of care to the client

Effects of the Poor Inter Health Professional Relationship

1. Neglect of the work of health care delivery.

2. Break in the continuity of health care process.

3. No continuation of learning.

4. Poor coordination.

5. Kills importance information for research.

6. Reduce health care delivery dynamism.

7. Demote the image of the professionals.

Causes of Poor Inter health Professional Relationship

1. Poor orientation.

2. Wrong prejudice.

3. Bad association or trade union leader.

4. Personal ego and selfishness.

5. Lack of appreciation of others contribution and sacrifice.

6. Ignorance of one’s limitation.

7. Poor legislature.

STUDENTS ACTIVITIES

QUIZ:

Identify the various stakeholders in the Illness episode and their Roles

8. GENERAL PRINCIPLES OF SOCIAL PLANNING AND ITS INFLUENCE ON HEALTH CARE

8.1 Describe the Pattern of Health Care

a. National health policy in Nigeria

The goal of the national health policy is to bring about a comprehensive health care system, based on primary health care:

Promotive

Protective

Preventive 

Restorative

Rehabilitative  

b. Alternative Health Care Delivery Services/ Complementary and Alternative Medicine 

Complementary and Alternative Medicine (CAM) is the use of treatments that are not commonly practiced by the medical profession and  generally not recognized by the medical community as standard or conventional medical approaches. Alternative health care delivery services focuses on the improvement of the quality of life for the people with chronic conditions that conventional medicine can not adequately control. 

Diversity of Alternative Medicine

1. Herbalist (native doctor)

2. Prayer houses and faith clinics

3. Witch doctor

4. Islamic healing centres

5. Aromatherapy (the use of aromatic oils for relaxation) 

6. Acupuncture (ancient Chinese technique of inserting fine needles into specific points in the body to ease pain and stimulate bodily functions) 

7. Homeopathy (use of micro doses of natural substances to boost immunity)

8. Naturopathy (based on the idea that diseases arise from blockages in a person‘s life force in the body and treatments like acupuncture and homeopathy are needed to restore the energy flow) 

9. Aryuveda (Indian technique of using oil and massage to treat sleeplessness, hypertension and indigestion)

10. Shiatsu (Japanese therapeutic massage) 

11. Crystal healing (based on the idea that healing energy can be obtained from quartz and other minerals) 

12. Biofeedback (use of machines to train people to control involuntary bodily functions)

13. Use of Dietary Supplements (Like garlic to prevent blood clot, ginger, fish oil capsules to reduce the threat of heart attack)

8.2. Explain the Federal Government Policies on:

Health education

Family planning

Housing

Water supply

Waste disposal

Primitive/ preventive/ curative health care, rehabilitation and environmental protection

8.3. Social Responses to Mental Illness in Nigeria

1. Characterised by a very negative social response

2. Mental illness seen as the fault of the sick person who is said to be suffering from a spiritual attack

3. Majority of services are provided by 8 regional psychiatric centres and department and medical schools of 12 major universities

4. Few general hospitals provide some limited services

5. The formal centres often face competition from native herbalists and faith healing centres   

STUDENTS ACTIVITIES

1. Write a short note on alternative medicine

2. Describe the societal responses to mental illness in Nigeria