- •Kursk state medical university
- •V.I. Narolina, I.F. Shamara
- •Communication in doctor’s profession Kursk – 2008
- •Государственное образовательное учреждение
- •Содержание contents
- •Предисловие
- •Методика работы с учебным пособием
- •Рекомендации студенту
- •Unit I. Discussing the medical profession
- •Раздел I. Беседуем о профессии врача методические рекомендации по работе с материалами раздела
- •Коммуникативные задания
- •Terms and Speech Patterns
- •Speech Patterns:
- •My Future Profession
- •Not only by the Drugs
- •Becoming a Doctor Pre-reading
- •What Happens at a Medical School
- •Task 2. Summary Writing
- •Task 3.
- •Task 4.
- •The pediatrician
- •Case history
- •The physician
- •Case history
- •The surgeon
- •Case history
- •The general practitioner
- •Case history
- •The doctor in the Third World
- •Case history
- •The intensive care doctor
- •Case history
- •The terminal care doctor
- •Case history
- •The doctor and the law
- •Alternative medicine
- •Case history
- •Unit II. Communication of a doctor with a patient
- •Раздел II. Общение врача с больным методические рекомендации по работе с материалами раздела
- •Коммуникативные задания
- •Terms and Speech Patterns
- •Adjectives:
- •General symptoms:
- •Doctor-Patient Interaction Asking the Patient about the Present Illness
- •Physical Examination of a Patient (Giving commands)
- •Additional / Further Examination & Treatment Laboratory and Instrumental Studies
- •Consulting Specialists
- •Suggesting Hospitalization
- •Case History (Main Points)
- •Illness: described as to the time of onset, mode of onset, duration,
- •2. Nose, throat: running nose/caryzo/nasal cold ;sore
- •Enquiring into the Case History (Speech Models)
- •Pain characteristics
- •Intensity
- •E. Personal History:
- •Texts and dialogues At the Doctor’s Consulting Room
- •At the Polyclinics
- •Summoning a Doctor
- •Talk between a Mother (m), her Son (s) and the Doctor (d)
- •Examination of the Patient
- •Taking a Case History
- •Asking about the Present Complaints
- •Аsking about Pain Characteristics
- •At the Cardiologist’s
- •Asking about the Personal History & the Present Illness
- •System Review
- •Details of the Present Condition
- •Disorders Accompanying the Main Disease
- •Examining the Patient (Giving Commands)
- •Consilium on Investigations
- •Diagnosis and Treatment (Explaining to the patient)
- •Giving Advice
- •Unit III. Discussing the work of a hospital
- •Раздел III. Обсуждаем работу больницы методические рекомендации по работе с материалами раздела
- •Коммуникативные задания
- •Terms and Speech Patterns Polyclinics/Out-patient Department
- •Speech Models:
- •Medical Personnel
- •Paramedical Personnel
- •Junior Medical Personnel
- •Hospital
- •Verbs and Verb Combinations
- •Speech Models
- •Texts and Dialogues District Polyclinic
- •Interviewing the Doctor-in- Chief about the Work of the Polyclinic
- •At the Registry
- •District Doctor’s Work
- •District Doctor’s Working Day
- •Combined City Hospital
- •Interviewing the Doctor-in-Chief about the work of the Hospital
- •Work of an In-Patient Department
- •Visiting an In-Patient
- •Unit IV. Discussing the work of a chemist’s shop
- •Раздел IV. Беседуем о работе аптеки методические рекомендации по работе с материалами раздела
- •Коммуникативные задания
- •Terms and Speech Patterns
- •Drug Classes
- •Verbs and Verb Combinations:
- •Speech Patterns
- •Texts and Dialogues At the Chemist’s
- •Medicines and Medical Commodities
- •Voltaren
- •Indications
- •At the Ready-Made Medicine Department
- •At the Prescription Department
- •At a Hospital Chemist’s
- •At the University Chemist’s
- •Unit V. Discussing national health services in russia, usa, uk
- •Раздел V. Обсуждаем организацию систем здравоохранения в россии, сша, великобритании методические рекомендации по работе с материалами раздела
- •Коммуникативные задания
- •Public health institutions list
- •Management in preventive medicine (medico-sanitary) work
- •Texts and Dialogues Medical Service in Russia
- •An Interview on Medical Service in Russia
- •The National Health Service in Great Britain
- •Practitioner Services
- •Family Doctor Service
- •Professional Training
- •National Health Services in the United Kingdom
- •Medical Service in the usa
- •Health Services in the usa Situation for intercultural communication: a Russian doctor comes to the usa for a tour and speaks to an American guide about the problems of health services in the usa
- •Unit VI. Discussing scientific aspects of medicine
- •Раздел VI. Участвуем в научном общении ученых-медиков методические рекомендации по работе с материалами раздела
- •Коммуникативные задания
- •Terms and Speech Patterns Scientific Knowledge
- •Adjectives:
- •Speech Models
- •Rendering a Scientific Paper
- •Discussing an Article Starting the Сonversation
- •Discussing the Contents
- •Making Things Clear
- •Impressions
- •Closing the Discussion
- •Opening the Discussion
- •Conducting the Conference
- •Closing the Conference
- •Presenter Giving his Paper (Report)
- •Some Words Linking Ideas
- •Interaction between the Participants and the Speaker after his Report Participants Addressing the Chairman and the Speaker
- •The Speaker’s Replies
- •Some Notes for Speakers
- •Fragments of Scientific Correspondence
- •Appendix I
- •Speech Models
- •Size, Shape, Colour, Texture Characteristics
- •Speech Models
- •The Human Body
- •Speech Models
- •Muscular-Skeletal System
- •Cardiovascular System
- •Аррendix II
- •Physiological Processes and Changes
- •Приложение II
- •Описание физиологических процессов и изменений
- •Speech Моdels
- •Appendix ііi General Symptoms and Adverse Reactions: Приложение ііi
- •Пожелание студенту
- •Список литературы
- •305041, Г. Курск, ул. К. Маркса, 3.
- •305041, Г. Курск, ул. К. Маркса, 3.
Case history
James was only forty-two when he became terminally ill. He had wife and two young children. He began to lose a lot of weight and he developed severe pains in his stomach. He lost his appetite and became very weak. His general practitioner arranged an endoscopy examination which showed that James had cancer of the stomach. The surgeons did an operation to remove the cancer but unfortunately it had already spread too far.
At first, James wanted to stay at home rather than go into a hospital because he wanted to be with his family. But soon he became too weak and dependent; his wife could not look after him any more. His general practitioner arranged for him to go into a terminal care hospice. The doctors and nurses in the hospice were honest with James, and told him that he would probably die within six months. James asked to see a solicitor to make a will while he was still well enough to read and write. He developed large ulcers on his legs, which the nurses carefully dressed every day. A counselor also visited him daily, to talk with him about his fears.
Of course, it was tragedy that James died so young. But the doctors and nurses at the terminal care hospice achieved an important aim: James died in dignity, without pain, and with his family around him.
The doctor and the law
All doctors occasionally become involved with the law. An obvious example is when a patient dies. The doctor writes a death certificate to confirm that the patient is indeed dead, and to state of which disease he died. The death certificate is a legal document. It is a criminal offence to write a death certificate without seeing the dead body. If the body is to be cremated, the doctor must also sign a certificate which says that the patient died of natural causes. (Burning the body will destroy the evidence of a suspicious death.) If the doctor suspects that the patient was poisoned by his relatives, for example, he must not sign the cremation certificate. A coroner is a doctor who is also a lawyer. He investigates any death where the cause is not obvious.
If the doctor suspects non-accidental injury, he must give medical evidence to the courts. The doctor is then called an expert witness.
Most doctors do not like appearing in court. A court hearing often takes several days or weeks, and the doctor cannot attend to his other patients during this time. It may involve an unpleasant confrontation between two people, which the doctor does not wish to see. The doctor’s legal duty to provide evidence is sometimes in conflict with his professional duty to care for the patient. But whether doctors like it or not, today’s society is increasingly “litigation-conscious”, and doctors will undoubtedly spend even more of their time in the role of expert witness in the future.
Alternative medicine
Many people do not go to a doctor when they are ill. They go to an alternative therapist. “Alternative medicine” is any form of health care that is not provided by conventional doctors and nurses—that is, those who are officially registered. In Third World countries, alternative medicine is the traditional, “old-fashioned” health care which is provided cheaply by local healers. Poor people use these healers while rich people usually travel to the towns to visit conventional doctors. In developed countries, the situation is the other way around. Conventional health care is usually free for poor people, while alternative health care (which has become very fashionable) can be expensive and is often the privilege of the rich.
There are hundreds of different alternative therapies. Some, like acupuncture, are based on ancient traditions. Others, like certain types of psychotherapy, are very new. Why are they becoming so fashionable? There are several reasons. First, patients are now questioning the usefulness of conventional medicine. A hundred years ago, physicians and surgeons had very high status. They could give any treatment they wished and the patient would not protest, even if the treatment made him worse. Today, patients are realizing that some treatments in conventional medicine do not work. Quite reasonably, they want to try other forms of treatment such as Alexander technique, manipulation, massage therapies, osteopathy, chiropracty, acupuncture, transcutaneous electrical nerve stimulation, biofeedback, meditation, relaxation therapy, homeopathy and holism.
The Chinese concept of “Qi,” which means vital energy or life force, has no equivalent in conventional medicine.
A final reason for the popularity of alternative medicine is that most alternative therapists give the patient more time than conventional doctors. In Britain, general practitioners see a new patient every ten minutes; in Germany the interval is twenty minutes. Today, when so many symptoms are due to overwork or stress, an important part of the treatment is for the patient to talk about his problems and learn to relax. Obviously, he cannot do this in ten minutes! Paradoxically, the conventional doctor’s surgery often reflects the patient’s own stressed lifestyle. Doctors themselves have very high stress levels, and a much higher suicide rate than the general population. Clearly, both doctor and patient would benefit if conventional medicine allowed more time for the consultation.
A few years ago, almost all conventional doctors thought that alternative medicine was illogical and ineffective. Most alternative therapists thought that conventional doctors were arrogant and insensitive. Most patients chose either conventional medicine or alternative medicine, but not both. In the past twenty years, doctors and alternative therapists have begun to see one another’s strengths. Today, they often work with, rather than against, one another. Many doctors now also train in homeopathy, osteopathy or acupuncture. Of course, some alternative therapies are useless, expensive and even harmful. Some alternative therapists are frauds. Perhaps this is an argument for all therapists to be registered with a central organization. Although this would cost both time and money, it would raise the general standard of alternative medicine and improve the credibility of all genuine alternatives.