Medicine in the 1990s


        MEDICINE IN THE 1990S
Sadly medical education is almost exclusively geared to the concept of acute disease. It is directed at treating the patient as an interesting clinical problem in both diagnosis and treatment rather than looking more perceptively at the complex socio-economic-political factors that also affect our health in the 1990s. There are many predisposing influences that create a climate for severe pain to flourish. Anything from a nagging headache, which makes you feel as though your skull is splitting open, to the fear of the night, when the pain of arthritis and spinal pain make dawn seem an eternity away. The general atmosphere of acute nervous uncertainty is destabilising, to say the least, for even the most tranquil of souls. For example, the widespread unease that rapid technological change is out of control, distrust of the competence and motives of political leaders and daily reports of gloom and doom in the news media.
All these factors may have an additional unsettling effect on people who are trying to cope with their pain, be it a migraine or worse. Pain always affects those surrounding the patient — both in the home and the community at large. Family breakdown is a not unusual consequence. Some of the most common causes of pain in Australia involve third parties such as Workcare and Workers' Compensation insurers and motor car accident insurers. Selecting the top 5 per cent of matriculating students as being eligible for a career in medicine may not be the best selection method. Unfortunately, there is no present procedure to select medical students on their ability to communicate with patients. Intellectual brilliance is not necessarily the sole measure for a secondary school student to become a good medical practitioner.
Since no easy cure can be anticipated with chronic pain patients, the communication skills of the doctor are at a premium.The doctor's attention often has to be directed at helping the patient cope with disability resulting from the pain, and the side-effects of medications, rather than identifying and treating the underlying cause.
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Pain

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