Symptoms as a currency

Question 1

How do symptoms effect the patients experience?

Answer 1

Patients: Mood, social, functional capacity, resilience, stress etc

Family

Clinician: Diagnosis etc

Healthcare system: Drives system development

Question 2

What are the determinants of symptoms?

Answer 2

• Sensation
• nociceptive
• neuropathic
• Perception
• alertness/arousal
• distraction
• hallucination
• Mood
• Motivation
• Expectation

Question 3

Whats the problems with biomedicine model of care?

Answer 3

• Wasted resources
• Possible detrimental to patients
• Frustration of pts and drs
• Outcomes rely on more than correct diagnosis and treatment i.e relationships, commerce, media, logistics, dr knowledge, [Direct to consumer advertising]

Question 4

Whats the problem with the direct to consumer advertising?

Answer 4

It can make patients want a particular medicine and if they are given generic it might stop adherence or create nocebo effect or straight detrimental i.e opoid crisis

Question 5

Whats the take home messages?

Answer 5

• Don’t over-investigate! (BMJ1997;315:561-2)
• Refer, and liaise, as necessary
• Avoid overdiagnosis and overtreatment
• Accept clinical uncertainty and co-morbidity as the norm